Study of Ordering and Properties in Fe-Ga Alloys With 18 and 21 at. pct Ga

NASA Astrophysics Data System (ADS)

Golovin, Igor S.; Dubov, L. Yu.; Funtikov, Yu. V.; Palacheva, V. V.; Cifre, J.; Hamana, D.

2015-03-01

Dynamical mechanical and positron annihilation spectroscopies were applied to study the structure of two Fe-Ga alloys with 18 and 21 at. pct Ga after quenching and subsequent annealing. It was found that the alloy with 18 pct Ga has much better damping capacity (Ψ ≈ 30 pct) than the alloy with 21 pct Ga (Ψ ≈ 5 pct). The reason for that is the ordering of the Ga atoms in Fe-21Ga alloy. Ordering processes in both alloys are studied at heating by differential scanning calorimetry, dilatometry, and internal friction or by step-by-step annealing using positron annihilation spectroscopy and hardness tests. Experimental results are explained by sequence of ordering transitions: A2 → D03 → L12.

Analysis of Slip Activity and Deformation Modes in Tension and Tension-Creep Tests of Cast Mg-10Gd-3Y-0.5Zr (Wt Pct) at Elevated Temperatures Using In Situ SEM Experiments

NASA Astrophysics Data System (ADS)

Wang, Huan; Boehlert, Carl J.; Wang, Qudong; Yin, Dongdi; Ding, Wenjiang

2016-05-01

The tension and tension-creep deformation behavior at elevated temperatures of a cast Mg-10Gd-3Y-0.5Zr (wt pct, GW103) alloy was investigated using in situ scanning electron microscopy. The tests were performed at temperatures ranging from 473 K to 598 K (200 °C to 325 °C). The active slip systems were identified using an EBSD-based slip trace analysis methodology. The results showed that for all of the tests, basal slip was the most likely system to be activated, and non-basal slip was activated to some extent depending on the temperature. No twinning was observed. For the tension tests, non-basal slip consisted of ~35 pct of the deformation modes at low temperatures (473 K and 523 K (200 °C and 250 °C)), while non-basal slip accounted for 12 and 7 pct of the deformation modes at high temperatures (573 K and 598 K (300 °C and 325 °C)), respectively. For the tension-creep tests, non-basal slip accounted for 31 pct of the total slip systems at low temperatures, while this value decreased to 10 to 16 pct at high temperatures. For a given temperature, the relative activity for prismatic slip in the tension-creep tests was slightly greater than that for the tension tests, while the activity for pyramidal slip was lower. Slip-transfer in neighboring grains was observed for the low-temperature tests. Intergranular cracking was the main cracking mode, while some intragranular cracks were observed for the tension-creep tests at high temperature and low stress. Grain boundary ledges were prevalently observed for both the tension and tension-creep tests at high temperatures, which suggests that besides dislocation slip, grain boundary sliding also contributed to the deformation.

Early diagnostic value of plasma PCT and BG assay for CRBSI after OLT.

PubMed

Chen, J; Wang, Y; Shen, Z; Zhu, Z; Song, Y; Han, R

2011-06-01

The aim was to evaluate the role of procalcitonin (PCT) and (1-3)-β-D-glucan (BG) tests for early detection or exclusion of central venous catheter-related bloodstream infections (CRBSI) in patients after orthotopic liver transplantation (OLT). Fifty-five patients with clinically suspected CRBSI were assessed after OLT in this prospective study. On the day of clinical suspicion of CRBSI, blood samples were obtained from central venous catheters and a peripheral vein for blood cultures and from a peripheral vein for PCT and BG tests. Plasma PCT and BG values were measured by using an immunoluminometric assay and Fungitell BG assay, respectively. No prisoners or organs from prisoners were used in this study. Twenty-five patients (45%) were diagnosed with CRBIS. Among them, 13 (52%) displayed gram-positive bacteriemia, 11 (44%) gram-negative bacteriemia, and 1 (4%) fungemia. The PCT values were higher in CRBSI than in non-CRBSI patients (P = .003). CRBSI patients did not show significant increases in plasma BG values compared with non-CRBSI subjects (P = .051). PCT and BG area under receiver operating characteristic curves were 0.840 and 0.486, respectively. Sensitivity, specificity, and positive and negative predictive values of a PCT of ≥ 3.1 ng/mL for the diagnosis of CRBSI were 0.72, 0.87, 0.82, and 0.79, respectively. The figures for a BG of ≥ 83 pg/mL were 0.32, 0.90, 0.73, and 0.61, respectively. Among the 24 patients with bacteria infections, PCT was higher in patients with gram-negative than those with gram-positive bacterial infections (P = .022). We concluded that the PCT assay may be a useful rapid diagnostic adjunct for the diagnosis of suspected CRBSI in OLT patients. Copyright © 2011 Elsevier Inc. All rights reserved.

Procalcitonin: a marker of bacteraemia in SIRS.

PubMed

Bell, K; Wattie, M; Byth, K; Silvestrini, R; Clark, P; Stachowski, E; Benson, E M

2003-12-01

A number of European studies have documented the ability of procalcitonin (PCT), a novel inflammatory marker, to discriminate patients with sepsis from those with other causes of systemic inflammatory response syndrome (SIRS). The aim of this study was to assess procalcitonin's performance in an Australian intensive care unit (ICU) setting to examine whether it could discriminate between these two conditions. One hundred and twenty-three consecutive adult ICU patients fulfilling criteria for SIRS were enlisted in the study. Over a period of five days, daily serum PCT and C-reactive protein (CRP) levels were measured. At least two sets of cultures were taken of blood, sputum/broncho-alveolar lavage (BAL) and urine. Other cultures were taken as clinically indicated. Questionnaires to ascertain clinical suspicion of sepsis were prospectively answered by the ICU senior registrars. PCT values were ten times higher in patients with positive blood cultures; CRP values were also significantly higher in the bacteraemic patients. Both PCT and CRP had a good ability to discriminate bacteraemia from non-infectious SIRS, with the area under receiver operating characteristics (ROC) curves for PCT being 0.8 and for CRP being 0.82. However neither PCT or CRP was able to discriminate patients with localized sepsis from those without. Utilizing both tests resulted in a more sensitive screen than either one alone, while PCT was a more accurate diagnostic test for bacteraemia than CRP. The PCT value also differed between those who died in hospital and those who survived. Measurement of PCT alone or in combination with CRP can aid discrimination of septicaemia/bacteriemia with associated SIRS from non-infectious SIRS in an Australian ICU setting.

Characterization of the dimensional stability of advanced metallic materials using an optical test bench structure

NASA Technical Reports Server (NTRS)

Hsieh, Cheng; O'Donnell, Timothy P.

1991-01-01

The dimensional stability of low-density high specific-strength metal-matrix composites (including 30 vol pct SiC(p)/SXA 24-T6 Al, 25 vol pct SiC(p)/6061-T6 Al, 40 vol pct graphite P100 fiber/6061 Al, 50 vol pct graphite P100 fiber/6061 Al, and 40 vol pct P100 graphite fiber/AZ91D Mg composites) and an Al-Li-Mg metal alloy was evaluated using a specially designed five-strut optical test bench structure. The structure had 30 thermocouple locations, one retroreflector, one linear interferometer multilayer insulation, and various strip heaters. It was placed in a 10 exp -7 torr capability vacuum chamber with a laser head positioned at a window port, and a laser interferometer system for collecting dimensional change data. It was found that composite materials have greater 40-C temporal dimensional stability than the AL-Li-Mg alloy. Aluminum-based composites demonstrated better 40-C temporal stability than Mg-based composites.

Wear mechanisms in hybrid composites of Graphite-20 Pct SiC in A356 Aluminum Alloy (Al-7 Pct Si-0.3 Pct Mg)

NASA Astrophysics Data System (ADS)

Ames, W.; Alpas, A. T.

1995-01-01

The wear behavior of A356 aluminum alloy (Al-7 Pct Si-0.3 Pct Mg) matrix composites reinforced with 20 vol Pct SiC particles and 3 or 10 vol Pct graphite was investigated. These hybrid composites represent the merging of two philosophies in tribological material design: soft-particle lubrication by graphite and hard-particle reinforcement by carbide particles. The wear tests were performed using a block-on-ring (SAE 52100 steel) wear machine under dry sliding conditions within a load range of 1 to 441 N. The microstructural and compositional changes that took place during wear were characterized using scanning electron microscopy (SEM), Auger electron spectroscopy (AES), energy-dispersive X-ray spectroscopy (EDXA), and X-ray diffractometry (XRD). The wear resistance of 3 Pct graphite-20 Pct SiC-A356 hybrid composite was comparable to 20 Pct SiC-A356 without graphite at low and medium loads. At loads below 20 N, both hybrid and 20 Pct SiC-A356 composites without graphite demonstrated wear rates up to 10 times lower than the unreinforced A356 alloy due to the load-carrying capacity of SiC particles. The wear resistance of 3 Pct graphite 20 Pct SiC-A356 was 1 to 2 times higher than 10 Pct graphite-containing hybrid composites at high loads. However, graphite addition reduced the counterface wear. The unreinforced A356 and 20 Pct SiC-A356 showed a transition from mild to severe wear at 95 N and 225 N, respectively. Hybrid composites with 3 Pct and 10 Pct graphite did not show such a transition over the entire load range, indicating that graphite improved the seizure resistance of the composites. Tribolayers, mainly consisting of a compacted mixture of graphite, iron oxides, and aluminum, were generated on the surfaces of the hybrid composites. In the hybrid composites, the elimination of the severe wear (and hence the improvement in seizure resistance) was attributed to the reduction in friction-induced surface heating due to the presence of graphite- and iron-oxide-containing tribolayers.

Measurement of fatigue accumulation in high-strength steels by microstructural examination

NASA Astrophysics Data System (ADS)

Nakagawa, Y. G.; Yoshizawa, H.; Lapides, M. E.

1990-07-01

Fatigue test bars fabricated from an SA508 class 3 low-carbon steel plate were cyclically deformed at 300 °C (constant low-cycle fatigue, total strain range Δɛ = 0.78 pct and 0.48 pct) to crack initiation (100 pct cumulative damage, CD) and to the factors 75, 50, and 25 pct CD. The test bars were cut perpendicular to the stress axis at the center of the gage length. The X-ray diffraction line-broadening (XRD) was performed on the cross sections created by the cuts. Thin foils (˜0.1-μm thick) were prepared from each cross section and used for the transmission electron microscope (TEM) and selected area diffraction (SAD) study. The half-value line breadth change measured by the XRD increased with the CD increase up to 50 pct, beyond which a significant reduction was observed for the 75 and 100 pct CD sample regardless of the incident X-ray beam angle. By the TEM, the undamaged material (0 pct CD) was characterized by high-angle boundaries, small carbide precipitates, and dislocation cell networks in grains. These characteristics did not show any appreciable changes in all of the samples with fatigue damage of the respective levels. Micro-orientation changes of the dislocation cells studied by the SAD of the foils and a statistical data analysis clearly demonstrated that the mean orientation difference in the cells and its standard deviation increased gradually as the CD increased.

Comparison between B·R·A·H·M·S PCT direct, a new sensitive point-of-care testing device for rapid quantification of procalcitonin in emergency department patients and established reference methods - a prospective multinational trial.

PubMed

Kutz, Alexander; Hausfater, Pierre; Oppert, Michael; Alan, Murat; Grolimund, Eva; Gast, Claire; Alonso, Christine; Wissmann, Christoph; Kuehn, Christian; Bernard, Maguy; Huber, Andreas; Mueller, Beat; Schuetz, Philipp

2016-04-01

Procalcitonin (PCT) is increasingly being used for the diagnostic and prognostic work up of patients with suspected infections in the emergency department (ED). Recently, B·R·A·H·M·S PCT direct, the first high sensitive point-of-care test (POCT), has been developed for fast PCT measurement on capillary or venous blood samples. This is a prospective, international comparison study conducted in three European EDs. Consecutive patients with suspicion of bacterial infection were included. Duplicate determination of PCT was performed in capillary (fingertip) and venous whole blood (EDTA), and compared to the reference method. The diagnostic accuracy was evaluated by correlation and concordance analyses. Three hundred and three patients were included over a 6-month period (60.4% male, median age 65.2 years). The correlation between capillary or venous whole blood and the reference method was excellent: r2=0.96 and 0.97, sensitivity 88.1% and 93.0%, specificity 96.5% and 96.8%, concordance 93% and 95%, respectively at a 0.25 μg/L threshold. No significant bias was observed (-0.04 and -0.02 for capillary and venous whole blood) although there were 6.8% and 5.1% outliers, respectively. B·R·A·H·M·S PCT direct had a shorter time to result as compared to the reference method (25 vs. 144 min, difference 119 min, 95% CI 110-134 min, p<0.0001). This study found a high diagnostic accuracy and a faster time to result of B·R·A·H·M·S PCT direct in the ED setting, allowing shortening time to therapy and a more wide-spread use of PCT.

Introduction of a PCT-based algorithm to guide antibiotic prescription in COPD exacerbation.

PubMed

Picart, J; Moiton, M P; Gaüzère, B-A; Gazaille, V; Combes, X; DiBernardo, S

2016-12-01

Prescribing antibiotics for COPD exacerbations is not easy. Procalcitonin (PCT) is a useful biomarker that helps reduce the rate of antibiotic therapies. However, its proper cut-off levels are often unknown. We aimed to assess the impact of a PCT-based algorithm to guide antibiotic therapy prescription in COPD exacerbations. We conducted an observational, retrospective, and before/after study. We reviewed physician practices regarding PCT test and antibiotic therapy prescription to all patients hospitalized for COPD exacerbation. We then analyzed the rate of antibiotic prescriptions and the number of PCT tests prescribed before and after the introduction of a protocol validated by previous high-power studies. The primary endpoint was the rate of antibiotic prescriptions. A total of 124 patients before protocol and 121 patients after protocol were included. Antibiotic prescriptions decreased by 41% after protocol introduction (59% vs. 35%, P<0.001), with no increase in morbidity and mortality at Day 30. Compliance with protocol was complete in 60% of cases and partial (no PCT guidance to discontinue antibiotics) in 8% of cases. Both antibiotic duration (8.3 days vs. 8.7 days) and length of hospital stay (8.5 days vs. 8.3 days, P=0.78) did not change. Hospital physicians are already using PCT-based algorithm to guide antibiotic prescription in COPD exacerbations. Disseminating information on the appropriate PCT cut-off level to use to decide whether or not to initiate antibiotics is effective. Its proper use should be clarified to reduce antibiotic prescriptions to these overexposed patients. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Procalcitonin and C-reactive protein in urinary tract infection diagnosis.

PubMed

Xu, Rui-Ying; Liu, Hua-Wei; Liu, Ji-Ling; Dong, Jun-Hua

2014-05-30

Urinary infections are a common type of pediatric disease, and their treatment and prognosis are closely correlated with infection location. Common clinical manifestations and laboratory tests are insufficient to differentiate between acute pyelonephritis and lower urinary tract infection. This study was conducted to explore a diagnostic method for upper and lower urinary tract infection differentiation. The diagnostic values of procalcitonin (PCT) and C-reactive protein (CRP) were analyzed using the receiver operating characteristic curve method for upper and lower urinary tract infection differentiation. PCT was determined using chemiluminescent immunoassay. The PCT and CRP values in children with acute pyelonephritis were significantly higher than those in children with lower urinary tract infection (3.90 ± 3.51 ng/ml and 68.17 ± 39.42 mg/l vs. 0.48 ± 0.39 ng/ml and 21.39 ± 14.92 mg/l). The PCT values were correlated with the degree of renal involvement, whereas the CRP values failed to show such a significant correlation. PCT had a sensitivity of 90.47% and a specificity of 88% in predicting nephropathia, whereas CRP had sensitivity of 85.71% and a specificity of 48%. Both PCT and CRP can be used for upper and lower urinary tract infection differentiation, but PCT has higher sensitivity and specificity in predicting pyelonephritis than CRP. PCT showed better results than CRP. PCT values were also correlated with the degree of renal involvement.

Prognostic Value of High-Sensitivity C-Reactive Protein, Procalcitonin and Pancreatic Stone Protein in Pediatric Sepsis.

PubMed

Wu, Qiong; Nie, Jun; Wu, Fu-Xia; Zou, Xiu-Lan; Chen, Feng-Yi

2017-03-30

BACKGROUND To investigate the prognostic value of procalcitonin (PCT), high-sensitivity C-reactive protein (hs-CRP), and pancreatic stone protein (PSP) in children with sepsis. MATERIAL AND METHODS A total of 214 patients with sepsis during hospitalization were enrolled. Serum levels of PCT, hs-CRP, and PSP were measured on day 1 of hospitalization and the survival rates of children were recorded after a follow-up of 28 days. Pearson's correlation analysis was conducted to test the association of PCT, hs-CRP, and PSP with pediatric critical illness score (PCIS). Logistic regression models were used to analyze the risk factors contributing to patients' death. The AUC was used to determine the value of PCT, hs-CRP, and PSP in the prognosis of patients with sepsis. RESULTS The expression of PCT, hs-CRP, and PSP in the dying patients was higher than in the surviving patients (p<0.001). Pearson's correlation analysis showed that serum PCT, hs-CRP, and PSP levels were negatively correlated with PCIS (p<0.001). Multivariate logistic regression revealed that PCT, hs-CRP, and PSP were independent risk factors for the prognosis of patients with sepsis (p<0.001). ROC analysis showed the AUC values of PCT, hs-CRP, and PSP were 0.83 (95% CI, 0.77-0.88), 0.76 (95% CI, 0.70-0.82), and 0.73 (95% CI, 0.67-0.79), respectively. The combined AUC value of PCT, hs-CRP, and PSP, was 0.92 (95% CI, 0.87-0.95), which was significantly increased compared with PCT, hs-CRP, or PSP (p<0.001). CONCLUSIONS The combination of serum PCT, hs-CRP, and PSP represents a promising biomarker of risk, and is a useful clinical tool for risk stratification of children with sepsis.

Crack initiation and propagation in 50.9 at. pct Ni-Ti pseudoelastic shape-memory wires in bending-rotation fatigue

NASA Astrophysics Data System (ADS)

Sawaguchi, Tak Ahiro; Kausträter, Gregor; Yawny, Alejandro; Wagner, Martin; Eggeler, Gunther

2003-12-01

The structural fatigue of pseudoelastic Ni-Ti wires (50.9 at. pct Ni) was investigated using bending-rotation fatigue (BRF) tests, where a bent and otherwise unconstrained wire was forced to rotate at different rotational speeds. The number of cycles to failure ( N f ) was measured for different bending radii and wire thicknesses (1.0, 1.2, and 1.4 mm). The wires consisted of an alloy with a 50-nm grain size, no precipitates, and some TiC inclusions. In BRF tests, the surface of the wire is subjected to tension-compression cycles, and fatigue lives can be related to the maximum tension and compression strain amplitudes ( ɛ a ) in the wire surface. The resulting ɛ a - N f curves can be subdivided into three regimes. At ɛ a > 1 pct rupture occurs early (low N f ) and the fatigue-rupture characteristics were strongly dependent on ɛ a and the rotational speed (regime 1). For 0.75 pct < ɛ a < 1 pct, fatigue lives strongly increase and are characterized by a significant statistical scatter (regime 2). For ɛ a < 0.75 pct, no fatigue rupture occurs up to cycle numbers of 106 (regime 3). Using scanning electron microscopy (SEM), it was shown that surface cracks formed in regions with local stress raisers (such as inclusions and/or scratches). The growth of surface cracks during fatigue loading produced striations on the rupture surface; during final rupture, ductile voids form. The microstructural details of fatigue-damage accumulation during BRF testing are described and discussed.

Procalcitonin as a biomarker for severe Plasmodium falciparum disease: a critical appraisal of a semi-quantitative point-of-care test in a cohort of travellers with imported malaria.

PubMed

Hesselink, Dennis A; Burgerhart, Jan-Steven; Bosmans-Timmerarends, Hanna; Petit, Pieter; van Genderen, Perry J J

2009-09-01

Imported malaria occurs as a relatively rare event in developed countries. As a consequence, most clinicians have little experience in making clinical assessments of disease severity and decisions regarding the need for parenteral therapy or high-level monitoring. In this study, the diagnostic accuracy of procalcitonin (PCT) for severe Plasmodium falciparum disease was assessed in a cohort of 100 consecutive travellers with various species of imported malaria. In all patients, PCT was measured on admission with a semi-quantitative 'point-of-care' test. Patients with severe P. falciparum malaria had significantly higher median PCT levels on admission as compared with patients with uncomplicated P. falciparum disease. In addition, PCT levels in patients with non-falciparum malaria were also higher compared with patients with non-severe falciparum malaria but lower compared with severe P. falciparum malaria. At a cut-off point of 10 ng/mL, PCT had a sensitivity of 0,67 and a specificity of 0,94 for severe falciparum disease. However, at lower cut-off points the specificity and positive predictive value were rather poor although the sensitivity and negative predictive value remained high. Potential drawbacks in the interpretation of elevated PCT levels on admission may be caused by infections with non-falciparum species and by concomitant bacterial infections. Semi-quantitative determination of PCT on admission is of limited use in the initial clinical assessment of disease severity in travellers with imported malaria, especially in settings with limited experience with the treatment of malaria.

Porphyria Cutanea Tarda (PCT)

MedlinePlus

... the UROD enzyme in red blood cells (erythrocytes). Molecular genetic testing is available for familial PCT if the ... org.uk Website: http://www.porphyria.org.uk Genetic and Rare ... porphyrias. In: The Metabolic and Molecular Basis of Inherited Disease, 8th ed. Scriver CR, ...

Thermal Model of the Promoted Combustion Test

NASA Technical Reports Server (NTRS)

Jones, Peter D.

1996-01-01

Flammability of metals in high pressure, pure oxygen environments, such as rocket engine turbopumps, is commonly evaluated using the Promoted Combustion Test (PCT). The PCT emphasizes the ability of an ignited material to sustain combustion, as opposed to evaluating the sample's propensity to ignite in the first place. A common arrangement is a rod of the sample material hanging in a chamber in which a high pressure, pure oxygen environment is maintained. An igniter of some energetically combusting material is fixed to the bottom of the rod and fired. This initiates combustion, and the sample burns and melts at its bottom tip. A ball of molten material forms, and this ball detaches when it grows too large to be supported by surface tension with the rod. In materials which do not sustain combustion, the combustion then extinguishes. In materials which do sustain combustion, combustion re-initiates from molten residue left on the bottom of the rod, and the melt ball burns and grows until it detaches again. The purpose of this work is development of a PCT thermal simulation model, detailing phase change, melt detachment, and the several heat transfer modes. Combustion is modeled by a summary rate equation, whose parameters are identified by comparison to PCT results. The sensitivity of PCT results to various physical and geometrical parameters is evaluated. The identified combustion parameters may be used in design of new PCT arrangements, as might be used for flammability assessment in flow-dominated environments. The Haynes 214 nickel-based superalloy, whose PCT results are applied here, burns heterogeneously (fuel and oxidizer are of different phases; combustion takes place on the fuel surface). Heterogeneous combustion is not well understood. (In homogeneous combustion, the metal vaporizes, and combustion takes place in an analytically treatable cloud above the surface). Thermal modeling in heterogeneous combustion settings provides a means for linking test results more directly to detailed combustion mechanics, leading to improved data analysis, and improved understanding of heterogeneous combustion phenomena.

The Effects of Antimony Addition on the Microstructural, Mechanical, and Thermal Properties of Sn-3.0Ag-0.5Cu Solder Alloy

NASA Astrophysics Data System (ADS)

Sungkhaphaitoon, Phairote; Plookphol, Thawatchai

2018-02-01

In this study, we investigated the effects produced by the addition of antimony (Sb) to Sn-3.0Ag-0.5Cu-based solder alloys. Our focus was the alloys' microstructural, mechanical, and thermal properties. We evaluated the effects by means of scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDX), differential scanning calorimetry (DSC), and a universal testing machine (UTM). The results showed that a part of the Sb was dissolved in the Sn matrix phase, and the remaining one participated in the formation of intermetallic compounds (IMCs) of Ag3(Sn,Sb) and Cu6(Sn,Sb)5. In the alloy containing the highest wt pct Sb, the added component resulted in the formation of SnSb compound and small particle pinning of Ag3(Sn,Sb) along the grain boundary of the IMCs. Our tests of the Sn-3.0Ag-0.5Cu solder alloys' mechanical properties showed that the effects produced by the addition of Sb varied as a function of the wt pct Sb content. The ultimate tensile strength (UTS) increased from 29.21 to a maximum value of 40.44 MPa, but the pct elongation (pct EL) decreased from 48.0 to a minimum 25.43 pct. Principally, the alloys containing Sb had higher UTS and lower pct EL than Sb-free solder alloys due to the strengthening effects of solid solution and second-phase dispersion. Thermal analysis showed that the alloys containing Sb had a slightly higher melting point and that the addition amount ranging from 0.5 to 3.0 wt pct Sb did not significantly change the solidus and liquidus temperatures compared with the Sb-free solder alloys. Thus, the optimal concentration of Sb in the alloys was 3.0 wt pct because the microstructure and the ultimate tensile strength of the SAC305 solder alloys were improved.

Intraocular pressure change over a habitual 24-hour period after changing posture or drinking water and related factors in normal tension glaucoma.

PubMed

Sakata, Rei; Aihara, Makoto; Murata, Hiroshi; Saito, Hitomi; Iwase, Aiko; Yasuda, Noriko; Araie, Makoto

2013-08-07

We investigated the correlation between 24-hour IOP in the habitual (sitting during day and supine during night) position (H24h-IOP) and IOP after a postural-change test (PCT-IOP) and a water-drinking test (WDT-IOP). We also investigated ocular and systemic factors related with them in patients with normal tension glaucoma (NTG). Japanese NTG patients underwent H24h-IOP, PCT-IOP, and WDT-IOP measurements during a 24-hour period. Correlations among H24h-IOP, PCT-IOP, and WDT-IOP, and contributing ocular/systemic factors were investigated using regression analysis. There were 33 patients included. Peak H24h-IOP correlated positively with peak PCT-IOP and peak WDT-IOP (estimate = 0.422 and 0.419, P ≤ 0.010), and peak PCT-IOP with WDT-IOP (0.44, P = 0.002). Peak H24h-IOP correlated with refraction (0.36, P = 0.048) and negatively with the mean deviation (MD, -0.066, P = 0.031). MD and baseline IOP (the mean of H24h-IOP) correlated negatively with the H24h-IOP fluctuation (-0.058 and -0.58, P ≤ 0.050). Refraction, baseline IOP, mean blood pressure (mBP), and body mass index (BMI) correlated with peak PCT-IOP (0.23, 0.52, 0.097, and 0.32, respectively, P ≤ 0.038). PCT-IOP difference correlated with refraction and mBP (0.31 and 0.093, P ≤ 0.016) and negatively with age (-0.069, P = 0.003). Central corneal thickness, baseline IOP, age, and BMI correlated with peak WDT-IOP (0.030, 0.40, 0.088, and 0.26, P ≤ 0.050). Age and BMI correlated with WDT-IOP difference (0.086 and 0.20, P < 0.032). Positive correlation was found among the peaks of H24h-, PCT-, and WDT-IOP. A worse visual field was associated with higher peak and greater fluctuation of H24h-IOP in NTG. Several ocular/systemic factors were important in interpreting H24h-, PCT-, and WDT-IOP.

A Test of the California Wildlife-Habitat Relationship System for Breeding Birds in Valley-Foothill Riparian Habitat

Treesearch

Stephen A. Laymon

1989-01-01

The California Wildlife-Habitat Relationship (WHR) system was tested for birds breeding in the Valley-Foothill Riparian habitat along California's Sacramento and South Fork Kern rivers. The model performed poorly with 33 pct and 21 pct correct predictions respectively at the two locations. Changes to the model for 60 species on the Sacramento River and 66 species...

Procalcitonin levels in patients with positive blood culture, positive body fluid culture, sepsis, and severe sepsis: a cross-sectional study.

PubMed

Yu, Ying; Li, Xia-Xi; Jiang, Ling-Xiao; Du, Meng; Liu, Zhan-Guo; Cen, Zhong-Ran; Wang, Hua; Guo, Zhen-Hui; Chang, Ping

2016-01-01

Numerous investigations on procalcitonin (PCT) have been carried out, although few with large sample size. To deal with the complexity of sepsis, an understanding of PCT in heterogeneous clinical conditions is required. Hospitalized patients aged 10-79 years were included in this retrospective and cross-sectional study. PCT tests were assayed within 2 days of blood culture. A total of 2952 cases (from 2538 patients) were enrolled in this study, including 440 cases in the 'positive BC' group, 123 cases in the 'positive body fluid culture' group, and 2389 cases in the 'negative all culture' group. Median PCT values were 4.53 ng/ml, 2.95 ng/ml, and 0.49 ng/ml, respectively. Median PCT values in the gram-negative BC group and gram-positive BC group, respectively, were 6.99 ng/ml and 2.96 ng/ml. Median PCT values in the 'positive hydrothorax culture' group, 'positive ascites culture' group, 'positive bile culture' group, and 'positive cerebrospinal fluid culture' group, respectively, were 1.39 ng/ml, 8.32 ng/ml, 5.98 ng/ml, and 0.46 ng/ml. In all, 357 cases were classified into the 'sepsis' group, 150 of them were classified into the 'severe sepsis' group. Median PCT values were 5.63 ng/ml and 11.06 ng/ml, respectively. PCT could be used in clinical algorithms to diagnose positive infections and sepsis. Different PCT levels could be related to different kinds of microbemia, different infection sites, and differing severity of sepsis.

Dual-Quantum-Dots-Labeled Lateral Flow Strip Rapidly Quantifies Procalcitonin and C-reactive Protein

NASA Astrophysics Data System (ADS)

Qi, XiaoPing; Huang, YunYe; Lin, ZhongShi; Xu, Liang; Yu, Hao

2016-03-01

In the article, a dual-quantum-dots-labeled (dual-QDs-labeled) lateral flow strip (LFS) method was developed for the simultaneous and rapid quantitative detection of procalcitonin (PCT) and C-reactive protein (CRP) in the blood. Two QD-antibody conjugates with different fluorescence emission spectra were produced and sprayed on the LFS to capture PCT and CRP in the blood. Furthermore, a double antibody sandwich method for PCT and, meanwhile, a competitive inhibition method for CRP were employed in the LFS. For PCT and CRP in serum assayed by the dual-QDs-labeled LFS, their detection sensitivities reached 0.1 and 1 ng/mL, respectively, and their linear quantitative detection ranges were from 0.3 to 200 ng/mL and from 50 to 250 μg/mL, respectively. There was little evidence that the PCT and CRP assays would be interfered with each other. The correlations for testing CRP and PCT in clinical samples were 99.75 and 97.02 %, respectively, between the dual-QDs-labeled LFS we developed and commercial methods. The rapid quantification of PCT and CRP on dual-QDs-labeled LFS is of great clinical value to distinguish inflammation, bacterial infection, or viral infection and to provide guidance for the use of antibiotics or other medicines.

An assessment of cold work effects on strain-controlled low-cycle fatigue behavior of type 304 stainless steel

NASA Astrophysics Data System (ADS)

Rao, K. Bhanu Sankara; Valsan, M.; Sandhya, R.; Mannan, S. L.; Rodriguez, P.

1993-04-01

The influence of prior cold work (PCW) on low-cycle fatigue (LCF) behavior of type 304 stainless steel has been studied at 300, 823, 923, and 1023 K by conducting total axial strain-controlled tests in solution annealed (SA, 0 pct PCW) condition and on specimens having three levels of PCW, namely, 10, 20, and 30 pct. A triangular waveform with a constant frequency of 0.1 Hz was employed for all of the tests performed over strain amplitudes in the range of ±0.25 to ± 1.25 pct. These studies have revealed that fatigue life is strongly dependent on PCW, temperature, and strain amplitude employed in testing. The SA material generally displayed better endurance in terms of total and plastic strain amplitudes than the material in 10, 20, and 30 pct PCW conditions at all of the temperatures. However, at 300 K at very low strain amplitudes, PCW material exhibited better total strain fatigue resistance. At 823 K, LCF life decreased with increasing PCW, whereas at 923 K, 10 pct PCW displayed the lowest life. An improvement in life occurred for prior deformations exceeding 10 pct at all strain amplitudes at 923 K. Fatigue life showed a noticeable decrease with increasing temperature up to 1023 K in PCW state. On the other hand, SA material displayed a minimum in fatigue life at 923 K. The fatigue life results of SA as well as all of the PCW conditions obeyed the Basquin and Coffin-Manson relationships at 300, 823, and 923 K. The constants and exponents in these equations were found to depend on the test temperature and prior metallurgical state of the material. A study is made of cyclic stress-strain behavior in SA and PCW states and the relationship between the cyclic strain-hardening exponent and fatigue behavior at different temperatures has been explored. The influence of environment on fatigue crack initiation and propagation behavior has been examined.

Low Cycle Fatigue Behavior of 316LN Stainless Steel Alloyed with Varying Nitrogen Content. Part II: Fatigue Life and Fracture Behavior

NASA Astrophysics Data System (ADS)

Prasad Reddy, G. V.; Sandhya, R.; Sankaran, S.; Mathew, M. D.

2014-10-01

Influence of nitrogen content on low cycle fatigue life and fracture behavior of 316LN stainless steel (SS) alloyed with 0.07 to 0.22 wt pct nitrogen is presented in this paper over a range of total strain amplitudes ( ±0.25 to 1.0 pct) in the temperature range from 773 K to 873 K (500 °C to 600 °C). The combined effect of nitrogen and strain amplitude on fatigue life is observed to be complex i.e., fatigue life either decreases/increases with increase in nitrogen content or saturates/peaks at 0.14 wt pct N depending on strain amplitude and temperature. Coffin-Manson plots (CMPs) revealed both single-slope and dual-slope strain-life curves depending on the test temperature and nitrogen content. 316LN SS containing 0.07 and 0.22 wt pct N showed nearly single-slope CMP at all test temperatures, while 316LN SS with 0.11 and 0.14 wt pct N exhibited marked dual-slope behavior at 773 K (500 °C) that changes to single-slope behavior at 873 K (600 °C). The changes in slope of CMP are found to be in good correlation with deformation substructural changes.

Nonlinear relationship between the Product Consistency Test (PCT) response and the Al/B ratio in a soda-lime aluminoborosilicate glass

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

Farooqi, Rahmat Ullah; Hrma, Pavel

2016-06-01

We have investigated the effect of A1/B ratio on the Product Consistency Test (PCT) response. In an aluminoborosilicate soda-lime glass based on a modified International Simple Glass, ISG-3, the A1/B ratio varied from 0 to 0.55 (in mole fractions). In agreement with various models of the PCT response as a function of glass composition, we observed a monotonic increase of B and Na releases with decreasing A1/B mole ratio, but only when the ratio was higher than 0.05. Below this value (A1/B < 0.05), we observed a sharp decrease that we attribute to B in tetrahedral coordination.

Selective Oxidation and Reactive Wetting During Hot-Dip Galvanizing of a 1.0 pct Al-0.5 pct Si TRIP-Assisted Steel

NASA Astrophysics Data System (ADS)

Bellhouse, E. M.; McDermid, J. R.

2012-07-01

Selective oxidation and reactive wetting during continuous galvanizing were studied for a low-alloy transformation induced plasticity (TRIP)-assisted steel with 0.2 pct C, 1.5 pct Mn, 1.0 pct Al and 0.5 pct Si. Three process atmospheres were tested during annealing prior to galvanizing: 220 K (-53 °C) dew point (dp) N2-20 pct H2, 243 K (-30 °C) dp N2-5 pct H2 and 278 K (+5 °C) dp N2-5 pct H2. The process atmosphere oxygen partial pressure affected the oxide chemistry, morphology and thickness. For the 220 K (-53 °C) dp and 243 K (-30 °C) dp process atmospheres, film and nodule-type manganese, silicon and aluminum containing oxides were observed at the surface. For the 278 K (+5 °C) dp atmosphere, MnO was observed at the grain boundaries and as thicker localized surface films. Oxide morphology, thickness and chemistry affected reactive wetting, with complete wetting being observed for the 220 K (-53 °C) dp and 243 K (-30 °C) dp process atmospheres and incomplete reactive wetting being observed for the 278 K (+5 °C) dp atmosphere. Complete reactive wetting for the 220 K (-53 °C) dp and 243 K (-30 °C) dp process atmospheres was attributed to a combination of zinc bridging of oxides, aluminothermic reduction of surface oxides and wetting of the oxides. Incomplete wetting for the 278 K (+5 °C) dp atmosphere was attributed to localized thick MnO films.

The Work Softening by Deformation-Induced Disordering and Cold Rolling of 6.5 wt pct Si Steel Thin Sheets

NASA Astrophysics Data System (ADS)

Wang, Xianglong; Li, Haoze; Zhang, Weina; Liu, Zhenyu; Wang, Guodong; Luo, Zhonghan; Zhang, Fengquan

2016-09-01

As-cast strip of 6.5 wt pct Si steel was fabricated by twin-roll strip casting. After hot rolling at 1323 K (1050 °C), thin sheets with the thickness of 0.35 mm were produced by warm rolling at 373 K (100 °C) with rolling reductions of 15, 25, 35, 45, 55, and 65 pct. Influence of warm rolling reduction on ductility was investigated by room temperature bending test. The measurement of macro-hardness showed that "work softening" could begin when the warm rolling reduction exceeded 35 pct. The room temperature ductility of the thin sheets gradually increased with the increase of warm rolling reductions, and the plastic deformation during bending began to form when the warm rolling reduction was greater than 45 pct, the 65 pct rolled thin sheet exhibited the maximum plastic deformation of about 0.6 pct during bending at room temperature, with a few small dimples having been observed on the fracture surfaces. B2-ordered domains were formed in the 15, 25, 35, 45, and 55 pct rolled specimens, and their average size decreased with the increase of warm rolling reductions. By contrast, no B2-ordered domain could be found in the 65 pct rolled specimen. It had been observed that large-ordered domains could be split into several small parts by the slip of partial super-dislocations during warm rolling, which led to significant decrease of the order degree to cause the phenomenon of deformation-induced disordering. On the basis of these results, cold rolling schedule was developed to successfully fabricate 0.25-mm-thick sheets with good surface qualities and magnetic properties from warm rolled sheets.

Motion estimation using point cluster method and Kalman filter.

PubMed

Senesh, M; Wolf, A

2009-05-01

The most frequently used method in a three dimensional human gait analysis involves placing markers on the skin of the analyzed segment. This introduces a significant artifact, which strongly influences the bone position and orientation and joint kinematic estimates. In this study, we tested and evaluated the effect of adding a Kalman filter procedure to the previously reported point cluster technique (PCT) in the estimation of a rigid body motion. We demonstrated the procedures by motion analysis of a compound planar pendulum from indirect opto-electronic measurements of markers attached to an elastic appendage that is restrained to slide along the rigid body long axis. The elastic frequency is close to the pendulum frequency, as in the biomechanical problem, where the soft tissue frequency content is similar to the actual movement of the bones. Comparison of the real pendulum angle to that obtained by several estimation procedures--PCT, Kalman filter followed by PCT, and low pass filter followed by PCT--enables evaluation of the accuracy of the procedures. When comparing the maximal amplitude, no effect was noted by adding the Kalman filter; however, a closer look at the signal revealed that the estimated angle based only on the PCT method was very noisy with fluctuation, while the estimated angle based on the Kalman filter followed by the PCT was a smooth signal. It was also noted that the instantaneous frequencies obtained from the estimated angle based on the PCT method is more dispersed than those obtained from the estimated angle based on Kalman filter followed by the PCT method. Addition of a Kalman filter to the PCT method in the estimation procedure of rigid body motion results in a smoother signal that better represents the real motion, with less signal distortion than when using a digital low pass filter. Furthermore, it can be concluded that adding a Kalman filter to the PCT procedure substantially reduces the dispersion of the maximal and minimal instantaneous frequencies.

Early-Onset Neonatal Sepsis: Still Room for Improvement in Procalcitonin Diagnostic Accuracy Studies

PubMed Central

Chiesa, Claudio; Pacifico, Lucia; Osborn, John F.; Bonci, Enea; Hofer, Nora; Resch, Bernhard

2015-01-01

Abstract To perform a systematic review assessing accuracy and completeness of diagnostic studies of procalcitonin (PCT) for early-onset neonatal sepsis (EONS) using the Standards for Reporting of Diagnostic Accuracy (STARD) initiative. EONS, diagnosed during the first 3 days of life, remains a common and serious problem. Increased PCT is a potentially useful diagnostic marker of EONS, but reports in the literature are contradictory. There are several possible explanations for the divergent results including the quality of studies reporting the clinical usefulness of PCT in ruling in or ruling out EONS. We systematically reviewed PubMed, Scopus, and the Cochrane Library databases up to October 1, 2014. Studies were eligible for inclusion in our review if they provided measures of PCT accuracy for diagnosing EONS. A data extraction form based on the STARD checklist and adapted for neonates with EONS was used to appraise the quality of the reporting of included studies. We found 18 articles (1998–2014) fulfilling our eligibility criteria which were included in the final analysis. Overall, the results of our analysis showed that the quality of studies reporting diagnostic accuracy of PCT for EONS was suboptimal leaving ample room for improvement. Information on key elements of design, analysis, and interpretation of test accuracy were frequently missing. Authors should be aware of the STARD criteria before starting a study in this field. We welcome stricter adherence to this guideline. Well-reported studies with appropriate designs will provide more reliable information to guide decisions on the use and interpretations of PCT test results in the management of neonates with EONS. PMID:26222858

Kinetics of plasma procalcitonin, soluble CD14, CCL2 and IL-10 after a sublethal infusion of lipopolysaccharide in horses.

PubMed

Bonelli, Francesca; Meucci, Valentina; Divers, Thomas J; Wagner, Bettina; Intorre, Luigi; Sgorbini, Micaela

2017-02-01

Endotoxemia represents a significant clinical and economic problem for the equine industry. This study assesses the kinetics of soluble CD14 (sCD14), chemokine (CC motif) ligand 2 (CCL2), interleukin 10 (IL-10) and plasma procalcitonin (PCT) in healthy horses after the intravenous infusion of lipopolysaccharide (LPS). The aim was to contribute to the basic understanding of the equine species-specific kinetics of these molecules in response to LPS exposure, which could support further findings in clinical studies and identify valuable inflammatory biomarkers for equine practice. Eleven healthy horses were involved in this experimental in vivo study. Horses were classified as healthy before the LPS infusion. After the pre-infusion blood collection (T0), all horses received an infusion of E. coli endotoxin (30ng/kg over 30min). Data and samples were collected 1h (T1), 2 (T2), 3 (T3) and 24h (T24) after infusion. Plasma sCD14, CCL2 and IL-10 were evaluated with a fluorescent bead-based assay, while PCT was evaluated with an equine PCT ELISA assay. A one-way ANOVA test was performed between each blood-sampling time for PCT, sCD14 and IL-10, and a Friedman test was performed for CCL2. Plasma PCT, IL-10 and CCL2 concentrations increased statistically significantly at T1, T2 and T3 compared to T0. No statistically significant differences were found between plasma IL-10 and CCL2 concentrations between T0 vs T24, although plasma PCT values remained high 24h after LPS infusion. Plasma sCD14 concentration showed no statistically significant differences for any of sampling times. Our results demonstrate that LPS injection into healthy horses results in PCT, CCL2 and IL-10 increases in plasma without an increase in sCD14. The increases in PCT, CCL2 and IL-10 are related to the inflammatory response induced by circulating lipopolysaccharide. Copyright © 2016 Elsevier B.V. All rights reserved.

Role of Procalcitonin in Differentiating between Infectious and Noninfectious Fevers among Patients with Lymphoma.

PubMed

Wang, Xiao Jun; Tan, Thuan Tong; Lim, Soon Thye; Farid, Mohamad; Tao, Miriam; Quek, Richard; Chan, Alexandre; Tang, Tiffany

2017-08-01

The primary objective of this study is to prospectively evaluate the role of procalcitonin (PCT) in distinguishing infectious fever from noninfectious fever (NIF) among febrile lymphoma patients. The secondary objective is to evaluate the usefulness of PCT in distinguishing among bloodstream infections (BSI), local infections and unidentified infections (LIUI), and NIF. Patients with lymphoma and fever were prospectively recruited between August 2014 and November 2015. PCT was measured within 24 hours of fever onset (PCT1) and 24-72 hours thereafter (PCT2). The higher PCT value between PCT1 and PCT2 was also documented (PCT max ). PCT levels (PCT1, PCT2, and PCT max ) were compared for BSI, LIUI, and NIF. In addition, the difference between PCT1 and PCT2 was evaluated in patients with complete data on both PCT1 and PCT2. Of 108 eligible patients, 12 were diagnosed with BSI, 83 with LIUI, and 13 with NIF. PCT max was statistically different between the infectious fever (BSI and LIUI combined) and NIF groups (median PCT max : 0.44 ng/ml vs 0.19 ng/ml; p=0.026). PCT1 was not statistically different for patients with BSI, LIUI, and NIF (p=0.217). However, PCT2 and PCT max were significantly higher in patients with BSI compared to those with NIF (p=0.026 and 0.002, respectively). Meanwhile, patients with BSI have significantly higher PCT max values than those with LIUI (p=0.034). Among 90 cases with complete data on both PCT1 and PCT2, PCT2 was significantly higher than PCT1 in patients with BSI (median PCT: 0.98 ng/ml vs 0.47 ng/ml; p=0.045) and patients with LIUI (median PCT: 0.43 ng/ml vs 0.24 ng/ml; p=0.004), while not significant in patients with NIF (p=0.374). Two separate PCT measurements can differentiate between infectious fever and NIF and predict for BSI in lymphoma patients with fever. © 2017 Pharmacotherapy Publications, Inc.

Procalcitonin as a Serum Biomarker for Differentiation of Bacterial Meningitis From Viral Meningitis in Children: Evidence From a Meta-Analysis.

PubMed

Henry, Brandon Michael; Roy, Joyeeta; Ramakrishnan, Piravin Kumar; Vikse, Jens; Tomaszewski, Krzysztof A; Walocha, Jerzy A

2016-07-01

Several studies have explored the use of serum procalcitonin (PCT) in differentiating between bacterial and viral etiologies in children with suspected meningitis. We pooled these studies into a meta-analysis to determine the PCT diagnostic accuracy. All major databases were searched through March 2015. No date or language restrictions were applied. Eight studies (n = 616 pediatric patients) were included. Serum PCT assay was found to be very accurate for differentiating the etiology of pediatric meningitis with pooled sensitivity and specificity of 0.96 (95% CI = 0.92-0.98) and 0.89 (95% CI = 0.86-0.92), respectively. The pooled positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio (DOR), and area under the curve (AUC) for PCT were 7.5 (95% CI = 5.6-10.1), 0.08(95% CI = 0.04-0.14), 142.3 (95% CI = 59.5-340.4), and 0.97 (SE = 0.01), respectively. In 6 studies, PCT was found to be superior than CRP, whose DOR was only 16.7 (95%CI = 8.8-31.7). Our meta-analysis demonstrates that serum PCT assay is a highly accurate and powerful test for rapidly differentiating between bacterial and viral meningitis in children. © The Author(s) 2015.

Performance of third-year primary-care-track students in an integrated curriculum at Case Western Reserve University.

PubMed

Lewin, L O; Papp, K K; Hodder, S L; Workings, M G; Wolfe, L; Glover, P; Headrick, L A

1999-01-01

In 1994, Case Western Reserve University School of Medicine established a Primary Care Track (PCT) with an integrated curriculum as part of The Robert Wood Johnson Foundation's Generalist Physician Initiative. This study compared the performance of the first cohort of students to participate in the PCT third year with that of their classmates and determined student attitudes toward their experiences. The performances of 24 PCT and 81 traditional students on the Medical School Admissions Test (MCAT) and the United States Medical Licensure Examination (USMLE) Step 1 and 2 were compared using analysis of variance. Grades on the six core clerkships were compared using chi-square analysis. Performances of the PCT students and a subset of traditional students on the generalist school's objective structured clinical exam (OSCE) were compared using multivariate analysis. The students reported their perceptions on a questionnaire. The traditional students had significantly higher scores on the physical science section of the MCAT and on the USMLE Step 1, but at the end of year three, their USMLE Step 2 scores did not differ. Grade distributions in the core clerkships did not differ, except in psychiatry, where the PCT students received honors significantly more often. The PCT students had a lower mean score on the internal medicine National Board of Medicine Examiners shelf exam but performed better on the generalist OSCE exam. A majority of PCT students reported that they would choose the integrated third year again and recommend it to others.

Procalcitonin as a marker of micro-inflammation in hemodialysis.

PubMed

Conti, Giovanni; Amore, Alessandro; Chiesa, Monica; Mancuso, Domenico; Cirina, Paola; Mengozzi, Giulio; Santoro, Antonio; Coppo, Rosanna

2005-01-01

In searching for a rapid and sensitive test to detect micro-inflammation in patients on hemodialysis (HD), we measured serum procalcitonin (PCT) levels and made a comparison with other traditional markers such as C-reactive protein (CRP), serum amyloid (SAA) and homocysteine, considered related to vascular damage. We investigated 51 HD patients, without signs of infection, in basal conditions (during standard bicarbonate dialysis and unselected filters: X) and after 4 months of possibly more biocompatible treatments (on-line hemofiltration (HF) or HD with ultra-pure dialysate and biocompatible membranes: Y). Serum PCT (measured by immunoluminometric assay), CRP and SAA (nephelometric assay) and plasma homocysteine (measured by high performance liquid chromatography) concentrations were assessed at the beginning of dialysis (T0) and after 4 hr (T4). Patients on unselected dialysis displayed mean PCT values significantly increased after 4 hr of dialysis in comparison to those at the start of the sessions (XT4 1.56 +/- 3.93 vs. XT0 0.4 +/- 0.34 ng/mL; p < 0.05). The PCT levels detected after 4 hr of biocompatible treatments were significantly lower than those detected after 4 hr of unselected treatments (YT4 0.78 +/- 0.34 ng/mL; p < 0.05), even though the percentage of patients with positive PCT values (> 0.5 ng/mL) remained almost unchanged. No significant modification in mean levels or in the frequency of positive values was observed for CRP, SAA and homocysteine. After 4 months of highly biocompatible treatments, a reduction in intradialytic enhancements of all inflammation markers was detected. Our data support the conclusion that PCT is a more precise marker than other traditional tests to evaluate micro-inflammation and biocompatibility in HD.

Early Assessment of Pancreatic Infections and Overall Prognosis in Severe Acute Pancreatitis by Procalcitonin (PCT)

PubMed Central

Rau, Bettina M.; Kemppainen, Esko A.; Gumbs, Andrew A.; Büchler, Markus W.; Wegscheider, Karl; Bassi, Claudio; Puolakkainen, Pauli A.; Beger, Hans G.

2007-01-01

Background: Pancreatic infections and sepsis are major complications in severe acute pancreatitis (AP) with significant impact on management and outcome. We investigated the value of Procalcitonin (PCT) for identifying patients at risk to develop pancreatic infections in severe AP. Methods: A total of 104 patients with predicted severe AP were enrolled in five European academic surgical centers within 96 hours of symptom onset. PCT was measured prospectively by a semi-automated immunoassay in each center, C-reactive protein (CRP) was routinely assessed. Both parameters were monitored over a maximum of 21 consecutive days and in weekly intervals thereafter. Results: In contrast to CRP, PCT concentrations were significantly elevated in patients with pancreatic infections and associated multiorgan dysfunction syndrome (MODS) who all required surgery (n = 10) and in nonsurvivors (n = 8) early after onset of symptoms. PCT levels revealed only a moderate increase in patients with pancreatic infections in the absence of MODS (n = 7), all of whom were managed nonoperatively without mortality. A PCT value of ≥3.5 ng/mL on 2 consecutive days was superior to CRP ≥430 mg/L for the assessment of infected necrosis with MODS or nonsurvival as determined by ROC analysis with a sensitivity and specificity of 93% and 88% for PCT and 40% and 100% for CRP, respectively (P < 0.01). The single or combined prediction of the two major complications was already possible on the third and fourth day after onset of symptoms with a sensitivity and specificity of 79% and 93% for PCT ≥3.8 ng/mL compared with 36% and 97% for CRP ≥430 mg/L, respectively (P = 0.002). Conclusion: Monitoring of PCT allows early and reliable assessment of clinically relevant pancreatic infections and overall prognosis in AP. This single test parameter significantly contributes to an improved stratification of patients at risk to develop major complications. PMID:17457167

A procalcitonin-based algorithm to guide antibiotic therapy in secondary peritonitis following emergency surgery: a prospective study with propensity score matching analysis.

PubMed

Huang, Ting-Shuo; Huang, Shie-Shian; Shyu, Yu-Chiau; Lee, Chun-Hui; Jwo, Shyh-Chuan; Chen, Pei-Jer; Chen, Huang-Yang

2014-01-01

Procalcitonin (PCT)-based algorithms have been used to guide antibiotic therapy in several clinical settings. However, evidence supporting PCT-based algorithms for secondary peritonitis after emergency surgery is scanty. In this study, we aimed to investigate whether a PCT-based algorithm could safely reduce antibiotic exposure in this population. From April 2012 to March 2013, patients that had secondary peritonitis diagnosed at the emergency department and underwent emergency surgery were screened for eligibility. PCT levels were obtained pre-operatively, on post-operative days 1, 3, 5, and 7, and on subsequent days if needed. Antibiotics were discontinued if PCT was <1.0 ng/mL or decreased by 80% versus day 1, with resolution of clinical signs. Primary endpoints were time to discontinuation of intravenous antibiotics for the first episode and adverse events. Historical controls were retrieved for propensity score matching. After matching, 30 patients in the PCT group and 60 in the control were included for analysis. The median duration of antibiotic exposure in PCT group was 3.4 days (interquartile range [IQR] 2.2 days), while 6.1 days (IQR 3.2 days) in control (p < 0.001). The PCT algorithm significantly improves time to antibiotic discontinuation (p < 0.001, log-rank test). The rates of adverse events were comparable between 2 groups. Multivariate-adjusted extended Cox model demonstrated that the PCT-based algorithm was significantly associated with a 87% reduction in hazard of antibiotic exposure within 7 days (hazard ratio [HR] 0.13, 95% CI 0.07-0.21, p < 0.001), and a 68% reduction in hazard after 7 days (adjusted HR 0.32, 95% CI 0.11-0.99, p  =  0.047). Advanced age, coexisting pulmonary diseases, and higher severity of illness were significantly associated with longer durations of antibiotic use. The PCT-based algorithm safely reduces antibiotic exposure in this study. Further randomized trials are needed to confirm our findings and incorporate cost-effectiveness analysis. Australian New Zealand Clinical Trials Registry ACTRN12612000601831.

A Proposed Habitat Management Plan for Yellow-Billed Cuckoos in California

Treesearch

Stephen A. Laymon; Mary D. Halterman

1989-01-01

The California Wildlife-Habitat Relationship (WHR) system was tested for birds breeding in the Valley-Foothill Riparian habitat along California's Sacramento and South Fork Kern rivers. The model performed poorly with 33 pct and 21 pct correct predictions respectively at the two locations. Changes to the model for 60 species on the Sacramento River and 66 species...

Dilemma-focused intervention for unipolar depression: a treatment manual.

PubMed

Feixas, Guillem; Compañ, Victoria

2016-07-12

This article introduces a new treatment protocol for depression. Based on previous research which indicated the presence of cognitive conflicts in depression, this study created an intervention manual to address these conflicts. The therapy manual for depressive patients followed the guideline for inclusion in clinical trials (stage II), which has received high recognition. A preliminary version (stage I) of this manual was formulated based on other, more general dilemma-focused therapy publications, inspired by personal construct theory (PCT), and input from clinical experience. The resulting version was then applied during the 8-session format of a pilot study with patients diagnosed with major depressive disorder or dysthymia. Finally, feedback was requested from seasoned and highly respected therapists, some of whom were familiar with PCT. According to the mentioned guideline, the intervention manual selected the theoretical framework, in this case PCT, to include its conceptualization of depression and resolution of dilemmas (to foster clinical improvement) as a main treatment goal. The manual was then contrasted with psychoanalytic psychotherapy, cognitive-behavior therapy (CBT), motivational interviewing (MI), and other similar approaches such as cognitive-analytic therapy and coherence therapy. Following these conceptual clarifications, the specific interventions included in the manual were defined according to both categories: their unique and essential components and those conceived as common psychotherapeutic factors. Next, the general structure and content for each session were presented. The structure consisted of seven well-defined individual sessions with an additional session, which could complement any of the former sessions to address the patient's issues in greater depth, if needed. This Dilemma-Focused Intervention manual aimed to improve the treatment outcome for depression by offering an intervention that could be combined with other general approaches. At its present level of definition, it allows for inclusion in controlled trials (eg, the current RCT combining group CBT with this intervention). Thus, this manual added to the existing resources in psychotherapeutic research and practice for treatment of depression.

Performance of procalcitonin in diagnosing parapneumonic pleural effusions: A clinical study and meta-analysis.

PubMed

He, Chao; Wang, Bo; Li, Danni; Xu, Huan; Shen, Yongchun

2017-08-01

Parapneumonic pleural effusion (PPE) is a common complication of pneumonia. The accurate diagnosis of PPE remains a challenge. Recent studies suggest that procalcitonin (PCT) emerges as a potential biomarker for PPE. Our study aimed to determine the diagnostic value of PCT for PPE by a clinical study and summarize the overall diagnostic performance of PCT through a meta-analysis. Demographic and clinical data of the patients with PPE and controls were collected in our clinical study. The diagnostic performances of serum PCT (s-PCT) were analyzed via receiver operating characteristic (ROC) curve analysis, using area under the curve (AUC) as a measure of accuracy. Literature databases were systematically searched for the studies examining the accuracy of PCT for diagnosing PPE. Data on sensitivity, specificity, positive/negative likelihood ratio (PLR/NLR), and diagnostic odds ratio (DOR) were pooled. Summary ROC curves and AUC were used to evaluate overall test performance. In our clinical study, 47 patients with PPE and 101 controls were included. The s-PCT levels were significantly increased in the setting of PPE (5.44 ± 9.82 ng/mL) compared with malignant PE (0.15 ± 0.19 ng/mL), tuberculous PE (0.18 ± 0.16 ng/mL), and transudates (0.09 ± 0.03 ng/mL) (P < .001). Using a cutoff value of 0.195 ng/mL, the sensitivity and specificity of s-PCT in diagnosing PPE were 0.83 and 0.80, respectively, and AUC was 0.89. In addition, 11 studies were included in our meta-analysis. Summary performance estimates for s-PCT in diagnosing PPE were as follows: sensitivity, 0.78 (95% CI: 0.71-0.84); specificity, 0.74 (95% CI: 0.69-0.78); PLR, 3.46 (95% CI: 2.09-5.74); NLR, 0.27 (95% CI: 0.14-0.54); DOR, 12.37 (95% CI: 4.34-41.17); and AUC, 0.84. The corresponding estimates for p-PCT were as follows: sensitivity, 0.62 (95% CI: 0.57-0.67); specificity, 0.71 (95% CI: 0.68-0.75); PLR 2.31 (95% CI: 1.81-2.95); NLR, 0.47 (95% CI: 0.35-0.63); DOR, 5.48 (95% CI: 3.07-9.77); and AUC, 0.80. Both s-PCT and p-PCT might have modest performance in diagnosing PPE. However, more studies on a large scale should be performed to confirm our findings.

Observation of the TWIP + TRIP Plasticity-Enhancement Mechanism in Al-Added 6 Wt Pct Medium Mn Steel

NASA Astrophysics Data System (ADS)

Lee, Seawoong; Lee, Kyooyoung; De Cooman, Bruno C.

2015-06-01

The intercritically annealed Fe-0.15 pctC-6.0 pctMn-1.5 pctSi-3.0 pctAl and Fe-0.30 pctC-6.0 pctMn-1.5 pctSi-3.0 pctAl medium Mn steels were found to have improved mechanical properties due to the TWIP and TRIP plasticity-enhancing mechanisms being activated in succession during tensile deformation. The increase of the C content from 0.15 to 0.30 pct resulted in ultra-high strength properties and a strength-ductility balance of approximately 65,000 MPa-pct, i.e., equivalent to the strength-ductility balance of high Mn TWIP steel with a fully austenitic microstructure.

Procalcitonin (PCT) levels for ruling-out bacterial coinfection in ICU patients with influenza: A CHAID decision-tree analysis.

PubMed

Rodríguez, Alejandro H; Avilés-Jurado, Francesc X; Díaz, Emili; Schuetz, Philipp; Trefler, Sandra I; Solé-Violán, Jordi; Cordero, Lourdes; Vidaur, Loreto; Estella, Ángel; Pozo Laderas, Juan C; Socias, Lorenzo; Vergara, Juan C; Zaragoza, Rafael; Bonastre, Juan; Guerrero, José E; Suberviola, Borja; Cilloniz, Catia; Restrepo, Marcos I; Martín-Loeches, Ignacio

2016-02-01

To define which variables upon ICU admission could be related to the presence of coinfection using CHAID (Chi-squared Automatic Interaction Detection) analysis. A secondary analysis from a prospective, multicentre, observational study (2009-2014) in ICU patients with confirmed A(H1N1)pdm09 infection. We assessed the potential of biomarkers and clinical variables upon admission to the ICU for coinfection diagnosis using CHAID analysis. Performance of cut-off points obtained was determined on the basis of the binominal distributions of the true (+) and true (-) results. Of the 972 patients included, 196 (20.3%) had coinfection. Procalcitonin (PCT; ng/mL 2.4 vs. 0.5, p < 0.001), but not C-reactive protein (CRP; mg/dL 25 vs. 38.5; p = 0.62) was higher in patients with coinfection. In CHAID analyses, PCT was the most important variable for coinfection. PCT <0.29 ng/mL showed high sensitivity (Se = 88.2%), low Sp (33.2%) and high negative predictive value (NPV = 91.9%). The absence of shock improved classification capacity. Thus, for PCT <0.29 ng/mL, the Se was 84%, the Sp 43% and an NPV of 94% with a post-test probability of coinfection of only 6%. PCT has a high negative predictive value (94%) and lower PCT levels seems to be a good tool for excluding coinfection, particularly for patients without shock. Copyright © 2015 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Procalcitonin as a marker of serious bacterial infections in febrile children younger than 3 years old.

PubMed

Mahajan, Prashant; Grzybowski, Mary; Chen, Xinguang; Kannikeswaran, Nirupama; Stanley, Rachel; Singal, Bonita; Hoyle, John; Borgialli, Dominic; Duffy, Elizabeth; Kuppermann, Nathan

2014-02-01

There is no perfectly sensitive or specific test for identifying young, febrile infants and children with occult serious bacterial infections (SBIs). Studies of procalcitonin (PCT), a 116-amino-acid precursor of the hormone calcitonin, have demonstrated its potential as an acute-phase biomarker for SBI. The objective of this study was to compare performance of serum PCT with traditional screening tests for detecting SBIs in young febrile infants and children. This was a prospective, multicenter study on a convenience sample from May 2004 to December 2005. The study was conducted in four emergency departments (EDs): one pediatric ED and three EDs with pediatric units, all with academic faculty on staff. A total of 226 febrile children 36 months old or younger who presented to the four participating EDs and were evaluated for SBI by blood, urine, and/or cerebral spinal fluid (CSF) cultures were included. The test characteristics (with 95% confidence intervals [CIs]) of the white blood cell (WBC) counts including neutrophil and band counts were compared with PCT for identifying SBI. Thirty children had SBIs (13.3%, 95% CI = 8.85 to 17.70). Four (13.3%) had bacteremia (including one with meningitis), 18 (60.0%) had urinary tract infections (UTIs), and eight (26.6%) had pneumonia. Children with SBIs had higher WBC counts (18.6 × 10(9)  ± 8.6 × 10(9) cells/L vs. 11.5 × 10(9)  ± 5.3 × 10(9) cells/L, p < 0.001), higher absolute neutrophil counts (ANCs; 10.6 × 10(9)  ± 6.7 × 10(9) cells/L vs. 5.6 × 10(9)  ± 3.8 × 10(9) cells/L, p = 0.009), higher absolute band counts (0.90 × 10(9)  ± 1.1 × 10(9) cells/L vs. 0.35 × 10(9)  ± 0.6 × 10(9) cells/L, p = 0.009), and higher PCT levels (2.9 ± 5.6 ng/mL vs. 0.4 ± 0.8 ng/mL, p = 0.021) than those without SBIs. In a multivariable logistic regression analysis, the absolute band count and PCT were the two screening tests independently associated with SBI, although the area under the receiver operating characteristic (ROC) curve for PCT was the largest (0.80, 95% CI = 0.71 to 0.89). Procalcitonin is a more accurate biomarker than traditional screening tests for identifying young febrile infants and children with serious SBIs. Further study on a larger cohort of young febrile children is required to definitively determine the benefit of PCT over traditional laboratory screening tests for SBIs. © 2014 by the Society for Academic Emergency Medicine.

Corrosion testing of candidates for the alkaline fuel cell cathode

NASA Technical Reports Server (NTRS)

Singer, Joseph; Fielder, William L.

1989-01-01

It is desirable to employ a corrosion screening test for catalyst or support candidates for the fuel cell cathode before entering upon optimization of the candidate or of the catalytic electrode. To this end, corrosion test electrodes, intended for complete immersion and maximum wetting, have been made with 30 to 40 vol. pct Teflon; with perovskites this is about 10 to 15 pct. The candidates were synthesized by methods intended for single-phase product without special emphasis on high surface area, although the substances tested were no coarser than 2 m squared/g. A typical loading was 25 mg/cm sq of the pure substance, usually on gold screen, a few mm squared of which were left bare for contacting. Contact to the gold lead wire was made by welding with a micro-torch or a spot-welder. Corrosion testing consisted of obtaining current-voltage data under flowing inert gas in the potential region for reduction of O2. The electrode was immersed in 30 pct KOH. Observations were made at 20 C and 80 C, and the results compared with data from gold standards. Results with some perovskites, pyrochlores, spinels, and interstitial compounds will be discussed.

Evaluation of procalcitonin and neopterin level in serum of patients with acute bacterial infection.

PubMed

Pourakbari, Babak; Mamishi, Setareh; Zafari, Javid; Khairkhah, Hanieh; Ashtiani, Mohammad H; Abedini, Masomeh; Afsharpaiman, Shahla; Rad, Soroush Seifi

2010-01-01

Fever as a common presenting complaint in pediatric patients can be due to various causes. Differentiating bacterial infection from other causes is important because the prompt use of antibiotics is critical in bacterial infection. Traditional markers of infection such as BT and WBC count may be unspecific and culture may be late or absent. CRP and Procalcitonin (PCT) have been considered to evaluate the evolution of infections and sepsis in patients presenting with SIRS. Neopterin has also been proposed to aid in the diagnosis of bacterial infection. In this study, we compared the value of the serum PCT, neopterin level, and WBC count for predicting bacterial infection and outcome in children with fever. 158 pediatric (2-120-month-old) patients suspected to have acute bacterial infection, based on clinical judgment in which other causes of SIRS were ruled out were included in the study. WBC count with differential was determined and PCT and neopterin levels were measured. PCT level was higher in bacterial infection and patients who were complicated or expired. Rapid PCT test is superior to neopterin and WBC count for anticipating bacterial infection, especially in ED where prompt decision making is critical.

Mechanical Behavior of Three-Dimensional Braided Nickel-Based Superalloys Synthesized via Pack Cementation

NASA Astrophysics Data System (ADS)

Lippitz, Nicolas; Erdeniz, Dinc; Sharp, Keith W.; Dunand, David C.

2018-03-01

Braided tubes of Ni-based superalloys are fabricated via three-dimensional (3-D) braiding of ductile Ni-20Cr (wt pct) wires followed by post-textile gas-phase alloying with Al and Ti to create, after homogenization and aging, γ/ γ' strengthened lightweight, porous structures. Tensile tests reveal an increase in strength by 100 MPa compared to as-braided Ni-20Cr (wt pct). An interrupted tensile test, combined with X-ray tomographic scans between each step, sheds light on the failure behavior of the braided superalloy tubes.

The Role of NGAL in Peritoneal Dialysis Effluent in Early Diagnosis of Peritonitis: Case-Control Study in Peritoneal Dialysis Patients.

PubMed

Martino, Francesca; Scalzotto, Elisa; Giavarina, Davide; Rodighiero, Maria Pia; Crepaldi, Carlo; Day, Sonya; Ronco, Claudio

2015-01-01

Peritoneal dialysis (PD) is frequently complicated by high rates of peritonitis, which result in hospitalization, technique failure, transfer to hemodialysis, and increased mortality. Early diagnosis, and identification of contributing factors are essential components to increasing effectiveness of care. In previous reports, neutrophil gelatinase-associated lipocalin (NGAL), a lipocalin which is a key player in innate immunity and rapidly detectable in peritoneal dialysis effluent (PDE), has been demonstrated to be a useful tool in the early diagnosis of peritonitis. This study investigates predictive value of PDE NGAL concentration as a prognostic indicator for PD-related peritonitis. A case-control study with 182 PD patients was conducted. Plasma and PDE were analyzed for the following biomarkers: C-reactive protein (CRP), blood procalcitonin (PCT), leucocytes and NGAL in PDE. The cases consisted of patients with suspected peritonitis, while controls were the patients who came to our ambulatory clinic for routine visits without any sign of peritonitis. The episodes of peritonitis were defined in agreement with International Society for Peritoneal Dialysis guidelines. Continuous variables were presented as the median values and interquartile range (IQR). Mann-Whitney U test was used to compare continuous variables. Univariate and multivariate logistic regression were used to evaluate the association of biomarkers with peritonitis. Receiver operating characteristic (ROC) curve analysis was used to calculate area under curve (AUC) for biomarkers. Finally we evaluated sensitivity, and specificity for each biomarker. All statistical analyses were performed with SPSS version 17.0 (SPSS Inc., Chicago, IL, USA). During the 19-month study, of the 182 patients, 80 had a clinical diagnosis of peritonitis. C-reactive protein levels (p < 0.001), PCT (p < 0.001), NGAL in PDE (p < 0.001), and white blood cells (WBC) in PDE (p < 0.001) were all significantly different in patients with and without peritonitis. In univariate analysis, CRP (odds ratio [OR] 1,339; p = 0.001), PCT (OR 2,473; p < 0,001), WBC in PDE (OR 3,986; p < 0,001), and NGAL in PDE (OR 36.75 p < 0.001) were significantly associated with episodes of peritonitis. In multivariate regression analysis, only WBC (OR 24.84; p = 0,012), and peritoneal NGAL levels (OR 136.6; p = 0,01) were independent predictors of peritonitis events. Moreover, AUC for NGAL in peritoneal effluent was 0,936 (p < 0.001) while AUC for CRP, PCT, and WBC count in peritoneal effluent were 0,704 (p = 0.001), 0.762 (p = 0.039), 0,975 (p < 0.001), respectively. Finally, combined WBC and peritoneal NGAL test increased the specificity (= 96%) of the single test. These results identify NGAL in peritoneal effluent as a reliable marker of peritonitis episodes in PD patients. Collectively, our findings demonstrate that the use of peritoneal NGAL cooperatively with current clinical diagnostic tools as a prognostic indicator, presents a valuable diagnostic tool in PD-associated peritonitis. Copyright © 2015 International Society for Peritoneal Dialysis.

Diagnostic value of sTREM-1, IL-8, PCT, and CRP in febrile neutropenia after autologous stem cell transplantation.

PubMed

Michel, C S; Teschner, D; Wagner, E M; Theobald, M; Radsak, Markus P

2017-12-01

Infections and infectious complications are the major cause of morbidity and mortality in febrile neutropenic patients after autologous stem cell transplantation. Laboratory biomarkers are helpful for early identification of critically ill patients and optimal therapy management. Several studies in adult non-neutropenic patients proposed sTREM-1 as a superior biomarker for identification of septic patients as well as a predictor for survival in these patients compared with procalcitonin (PCT), C-reactive protein (CRP), or interleukin-8 (IL-8). Here, to assess the utility of PCT, CRP, IL-8, and sTREM-1 in febrile neutropenia, 44 patients presenting with febrile neutropenia after autologous stem cell transplantation were recruited in a single-center prospective pilot study. We analyzed PCT and CRP as well as IL-8 and sTREM-1 levels pre- and post-transplantation at defined time points. In 20 of 44 patients, concentration of sTREM-1 was under the detection level at appearance of febrile neutropenia. Mean levels of PCT, IL-8, and CRP were significantly increased in infections of critically ill patients who by dysfunction or failure of one or more organs/system depend on survival from advanced instruments of monitoring and therapy. However, all tested biomarkers could not distinguish between presence and absence of bloodstream infection. The combination of the biomarkers PCT and IL-8 achieved a high sensitivity of 90% and specificity of 74% for the identification of serious complications in febrile neutropenia, whereas the combination of CRP and PCT or IL-8 achieved a high sensitivity of 100%, but with the addition of a low specificity of 47or 41%. In conclusion, we found that the measurement of sTREM-1 concentration at presentation of febrile neutropenia is not useful to identify bacterial bloodstream infections and critically ill patients. PCT and IL-8 are useful biomarkers for the early identification of critically ill patients, compared to CRP and sTREM-1 in febrile neutropenia. PCT or IL-8 in combination with clinical parameters should be considered in routine measurement to identify critically ill patients as early as possible.

Modified heat treatment for lower temperature improvement of the mechanical properties of two ultrahigh strength low alloy steels

NASA Astrophysics Data System (ADS)

Tomita, Yoshiyuki; Okabayashi, Kunio

1985-01-01

In the previous papers, a new heat treatment for improving the lower temperature mechanical propertise of the ultrahigh strength low alloy steels was suggested by the authors which produces a mixed structure of 25 vol pct lower bainite and 75 vol pct martensite through isothermal transformation at 593 K for a short time followed by water quenching (after austenitization at 1133 K). In this paper, two commercial Japanese ultrahigh strength steels, 0.40 pct C-Ni-Cr-Mo (AISI 4340 type) and 0.40 pct C-Cr-Mo (AISI 4140 type), have been studied to determine the effect of the modified heat treatment, coupled above new heat treatment with γ ⇆ α' repctitive heat treatment, on the mechanical properties from ambient temperature (287 K) to 123 K. The results obtained for various test temperatures have been compared with those for the new heat treatment reported previously and the conventional 1133 K direct water quenching treatment. The incorporation of intermediate four cyclic γ ⇆ α' repctitive heat treatment steps (after the initial austenitization at 1133 K and oil quenching) into the new heat treatment reported previously, as compared with the conventional 1133 K direct water quenching treatment, significantly improved 0.2 pct proof stress as well as notch toughness of the 0.40 pct C-Ni-Cr-Mo ultrahigh strength steel at similar fracture ductility levels from 287 to 123 K. Also, this heat treatment, as compared with the conventional 1133 K direct water quenching treatment, significantly improved both 0.2 pct proof stress and notch toughness of the 0.40 pct C-Cr-Mo ultrahigh strength steel with increased fracture ductility at 203 K and above. The microstructure consists of mixed areas of ultrafine grained martensite, within which is the refined blocky, highly dislocated structure, and the second phase lower bainite (about 15 vol pct), which appears in acicular form and partitions prior austenite grains. This newly developed heat treatment makes it possible to modify the new heat treatment reported previously so as to raise 0.2 pct proof stress to a higher level and keep notch toughness at the same level. The improvement in the mechanical properties is discussed in terms of metallographic observations and the modified law of mixtures and so forth.

Hot Ductility Behavior of Boron Containing Microalloyed Steels with Varying Manganese Contents

NASA Astrophysics Data System (ADS)

Brune, Tobias; Senk, Dieter; Walpot, Raphael; Steenken, Bernhard

2015-02-01

The hot ductility is measured for six different steel grades with different microalloying elements and with varying manganese contents using the hot tensile test machine with melting/solidification unit at the Department of Ferrous Metallurgy RWTH Aachen University. To identify the influence of manganese on hot ductility, tests are performed with varying the manganese content from 0.7 to 18.2 wt pct, a high manganese steel. Additionally, the effect of different cooling and strain rates is analyzed by changing the particular rate for selected samples in the minima. To investigate and detect the cause of cracking during testing, the fracture surfaces in the ductility minima are considered with scanning electron microscope-energy dispersive X-ray spectroscopy. Thermodynamic modeling is conducted on basis of the commercial software ThermoCalc©. A sharp decrease of the hot ductility is recognizable at 1398 K (1125 °C), at only 0.7 wt pct manganese because of the low manganese to sulfur ratio. The grades with a Mn content up to 1.9 wt pct show a good ductility with minimal ductility loss. In comparison, the steel grade with 18.2 wt pct has a poor hot ductility. Because of the formation of complex precipitates, where several alloying elements are involved, the influence of boron on hot ductility is not fully clarified. By increasing the cooling rate, the reduction of area values are shifted to smaller values. For high test temperatures, these measured values are decreased for lower strain rates. Thereby, an early drop of the ductility is noticeable for the high temperatures around 1373 K (1100 °C).

Strengthening of Fe3Al Aluminides by One or Two Solute Elements

NASA Astrophysics Data System (ADS)

Kratochvíl, Petr; Daniš, Stanislav; Minárik, Peter; Pešička, Josef; Král, Robert

2017-09-01

The compressive yield stress of Fe-26Al with additives Ti (0.5 to 4 at. pct), Cr (0.5 to 8 at. pct), Mo (0.5 to 4 at. pct), and V (0.5 to 8 at. pct) at 1073 K (800 °C) has been determined. The effect of the concentration of diverse solutes on the yield stress at 1073 K (800 °C) was compared, and the additivity of the effects of solutes was tested. The effects in iron aluminides with two solutes (V and Ti, Ti and Cr, V and Cr) are compared with those of a single solute V, Ti, and Cr. It is found that the additivity of yield stress increments is valid only for lower solute concentrations. When the amount of the solute atoms increases, the yield stress increment is substantially higher than the sum of the yield stress increments of single solutes. This behavior is related to the high-temperature order in iron aluminides.

Forty years of spruce–fir stand development following herbicide application and precommercial thinning in central Maine, USA

Treesearch

Matthew G. Olson; Robert G. Wagner; John C. Brissette

2012-01-01

We examined the development of a 33-year experiment in spruce–fir stands that received nine herbicide treatments (applied aerially in 1977), with and without precommercial thinning (PCT) (applied in 1986). We tested two commonly held assumptions about the long-term effects of herbicide and PCT in mixedwood stands managed for softwoods: (i) herbicide release produces...

The role of elevated serum procalcitonin in neuroendocrine neoplasms of digestive system.

PubMed

Chen, Luohai; Zhang, Yu; Lin, Yuan; Deng, Langhui; Feng, Shiting; Chen, Minhu; Chen, Jie

2017-12-01

Elevated serum procalcitonin (PCT) was reported in patients with certain type of neuroendocrine neoplasms (NENs). The aim of this study was to assess the role of elevated serum PCT in NENs from digestive system. Serum PCT and serum CgA level were measured in 155 patients with NENs from digestive system. Elevated serum PCT was found in 63 patients (40.6%). Grade 3 disease was a significant factor associated with elevated serum PCT (OR, 9.24; 95%CI, 3.04-28.08; P<0.001). Serum PCT level was significantly decreased after treatment both in patients with stable disease (P=0.003) and patients with partial remission (P=0.001). In these patients, serum PCT level significantly increased again at the time of progression disease (P=0.001). Elevated serum PCT was a significant factor of worse survival (HR, 2.86; 95%CI, 1.36-6.03; P=0.006). Compared with patients with normal serum PCT and CgA level, patients with either PCT or CgA elevated and patients with both PCT and CgA elevated had progressively worse survival. Additionally, PCT expression in tumor cells was found in 24.0% of patients but did not correlate with other clinicopathological factors, including serum PCT. Serum PCT is elevated in part of patients with NENs of digestive system, especially in patients with grade 3 disease. Serum PCT level can help evaluate treatment response and its elevation indicates poor prognosis. Combination of serum PCT and CgA can improve outcome prediction. Copyright © 2017 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Effect of Porosity on Deformation, Damage, and Fracture of Cast Steel

NASA Astrophysics Data System (ADS)

Hardin, R. A.; Beckermann, C.

2013-12-01

A combined experimental and computational study is performed to investigate the effect of centerline shrinkage porosity on deformation, damage, and fracture of cast steel under tensile testing. Steel plates containing shrinkage porosity are cast in sand molds, machined into test coupons, and tensile tested to fracture. The average volumetric porosity in the gage section of the specimens with porosity ranges from 0.10 to 0.27 pct. Ductility in the test castings with porosity is markedly reduced with the percent elongation data ranging from 12.8 to 19.6 pct; vs 22 pct elongation for the sound material. Radiographic imaging is used to measure and reconstruct the porosity field in the test specimens. The reconstructed porosity field is then used in a finite-element stress analysis simulating the tensile testing. Local elastic properties are reduced according to the porosity fraction present. Porous metal plasticity theory is used to model the damage due to porosity and the fracture. Good agreement is obtained between the measured and predicted stress-strain curves and fracture behaviors. The reduction in ductility is predicted well by comparing the measured and the simulated elongations. The computational modeling approach used in this study allows for a detailed evaluation of the effect of porosity, including its size, shape, and location, on the fracture behavior of steel castings.

Effect of decreased hot-rolling reduction treatment on fracture toughness of low-alloy structural steels

NASA Astrophysics Data System (ADS)

Tomita, Yoshiyuki

1990-09-01

Commercial low-alloy structural steels, 0.45 pct C (AISI 1045 grade), 0.40 pct C-Cr-Mo (AISI 4140 grade), and 0.40 pct C-Ni-Cr-Mo (AISI 4340 grade), have been studied to determine the effect of the decreased hot-rolling reduction treatment (DHRRT) from 98 to 80 pct on fracture toughness of quenched and highly tempered low-alloy structural steels. The significant conclusions are as follows: (1) the sulfide inclusions were modified through the DHRRT from a stringer (mean aspect ratio: 16.5 to 17.6) to an ellipse (mean aspect ratio: 3.8 to 4.5), independent of the steels studied; (2) the DHRRT significantly improved J Ic in the long-transverse and shorttransverse orientations, independent of the steels studied; and (3) the shelf energy in the Charpy V-notch impact test is also greatly improved by the DHRRT, independent of testing orientation and steels studied; however, (4) the ductile-to-brittle transition temperature was only slightly affected by the DHRRT. The beneficial effect on the J Ic is briefly discussed in terms of a crack extension model involving the formation of voids at the inclusion sites and their growth and eventual linking up through the rupture of the intervening ligaments by local shear.

Cold-Drawn Bioabsorbable Ferrous and Ferrous Composite Wires: An Evaluation of Mechanical Strength and Fatigue Durability

NASA Astrophysics Data System (ADS)

Schaffer, Jeremy E.; Nauman, Eric A.; Stanciu, Lia A.

2012-08-01

Yield strengths exceeding 1 GPa with elastic strains exceeding 1 pct were measured in novel bioabsorbable wire materials comprising high-purity iron (Fe), manganese (Mn), magnesium (Mn), and zinc (Zn), which may enable the development of self-expandable, bioabsorbable, wire-based endovascular stents. The high strength of these materials is attributed to the fine microstructure and fiber textures achieved through cold drawing techniques. Bioabsorbable vascular stents comprising nutrient metal compositions may provide a means to overcome the limitations of polymer-based bioabsorbable stents such as excessive strut thickness and poor degradation rate control. Thin, 125- μm wires comprising combinations of ferrous alloys surrounding a relatively anodic nonferrous core were manufactured and tested using monotonic and cyclic techniques. The strength and durability properties are tested in air and in body temperature phosphate-buffered saline, and then they were compared with cold-drawn 316L stainless steel wire. The antiferromagnetic Fe35Mn-Mg composite wire exhibited more than 7 pct greater elasticity (1.12 pct vs 1.04 pct engineering strain), similar fatigue strength in air, an ultimate strength of more than 1.4 GPa, and a toughness exceeding 35 mJ/mm3 compared with 30 mJ/mm3 for 316L.

Time-Frequency Distribution of Seismocardiographic Signals: A Comparative Study

PubMed Central

Taebi, Amirtaha; Mansy, Hansen A.

2017-01-01

Accurate estimation of seismocardiographic (SCG) signal features can help successful signal characterization and classification in health and disease. This may lead to new methods for diagnosing and monitoring heart function. Time-frequency distributions (TFD) were often used to estimate the spectrotemporal signal features. In this study, the performance of different TFDs (e.g., short-time Fourier transform (STFT), polynomial chirplet transform (PCT), and continuous wavelet transform (CWT) with different mother functions) was assessed using simulated signals, and then utilized to analyze actual SCGs. The instantaneous frequency (IF) was determined from TFD and the error in estimating IF was calculated for simulated signals. Results suggested that the lowest IF error depended on the TFD and the test signal. STFT had lower error than CWT methods for most test signals. For a simulated SCG, Morlet CWT more accurately estimated IF than other CWTs, but Morlet did not provide noticeable advantages over STFT or PCT. PCT had the most consistently accurate IF estimations and appeared more suited for estimating IF of actual SCG signals. PCT analysis showed that actual SCGs from eight healthy subjects had multiple spectral peaks at 9.20 ± 0.48, 25.84 ± 0.77, 50.71 ± 1.83 Hz (mean ± SEM). These may prove useful features for SCG characterization and classification. PMID:28952511

Peripapillary Pachychoroid in Nonarteritic Anterior Ischemic Optic Neuropathy

PubMed Central

Nagia, Lina; Huisingh, Carrie; Johnstone, John; Kline, Lanning B.; Clark, Mark; Girard, Michael J. A.; Mari, Jean Martial; Girkin, Christopher A.

2016-01-01

Purpose This study examined the peripapillary choroidal thickness (PCT) in nonarteritic ischemic optic neuropathy (NAION) in comparison to contralateral eyes and normal eyes. Methods We used enhanced depth imaging spectral-domain optical coherence tomography to image the optic nerve head of 20 NAION, 10 contralateral eyes, and 102 normal eyes. Following compensation, the scans were manually delineated to identify relevant surfaces including Bruch's membrane opening (BMO), Bruch's membrane, and anterior sclera. The PCT was defined as the measurement between Bruch's membrane and the anterior sclera and was measured at increasing distance from BMO. Models adjusted for age, BMO area, and axial length were used to compare the mean PCT between NAION and normal eyes, and contralateral eyes and normal eyes. Paired t-tests were used to compare the PCT between NAION and contralateral eyes. Results The mean PCT was thicker in NAION and contralateral eyes when compared with normal eyes at all distances from BMO (P < 0.001). The PCT was not significantly thicker in contralateral eyes when compared with affected NAION eyes. Choroidal thickness was thinnest in the inferior quadrant in all eyes regardless of the group. Conclusions Increased peripapillary choroidal thickness was noted in both NAION and contralateral eyes. The thicker choroid may be an associated feature or a result of the disorder. Although further longitudinal study is required to determine causation, these findings may suggest that a thickened peripapillary choroid may be a component of the disk-at-risk clinical phenotype. PMID:27583829

Diagnosis and prediction of periodontally compromised teeth using a deep learning-based convolutional neural network algorithm.

PubMed

Lee, Jae-Hong; Kim, Do-Hyung; Jeong, Seong-Nyum; Choi, Seong-Ho

2018-04-01

The aim of the current study was to develop a computer-assisted detection system based on a deep convolutional neural network (CNN) algorithm and to evaluate the potential usefulness and accuracy of this system for the diagnosis and prediction of periodontally compromised teeth (PCT). Combining pretrained deep CNN architecture and a self-trained network, periapical radiographic images were used to determine the optimal CNN algorithm and weights. The diagnostic and predictive accuracy, sensitivity, specificity, positive predictive value, negative predictive value, receiver operating characteristic (ROC) curve, area under the ROC curve, confusion matrix, and 95% confidence intervals (CIs) were calculated using our deep CNN algorithm, based on a Keras framework in Python. The periapical radiographic dataset was split into training (n=1,044), validation (n=348), and test (n=348) datasets. With the deep learning algorithm, the diagnostic accuracy for PCT was 81.0% for premolars and 76.7% for molars. Using 64 premolars and 64 molars that were clinically diagnosed as severe PCT, the accuracy of predicting extraction was 82.8% (95% CI, 70.1%-91.2%) for premolars and 73.4% (95% CI, 59.9%-84.0%) for molars. We demonstrated that the deep CNN algorithm was useful for assessing the diagnosis and predictability of PCT. Therefore, with further optimization of the PCT dataset and improvements in the algorithm, a computer-aided detection system can be expected to become an effective and efficient method of diagnosing and predicting PCT.

The Prevalence and Clinical Significance of Low Procalcitonin Levels Among Patients With Severe Sepsis or Septic Shock in the Emergency Department.

PubMed

Choe, Eun A; Shin, Tae Gun; Jo, Ik Joon; Hwang, Sung Yeon; Lee, Tae Rim; Cha, Won Chul; Sim, Min Seob

2016-07-01

The aims of this study were to evaluate the prevalence of low procalcitonin (PCT) levels among patients with severe sepsis or septic shock, and to investigate clinical characteristics and outcomes associated with low PCT levels. We analyzed data from the sepsis registry for patients with severe sepsis or septic shock in the emergency department. Based on a specific PCT cutoff value, patients were classified into two groups: a low PCT group, PCT <0.25 ng/mL; and a high PCT group, PCT ≥0.25 ng/mL. The primary endpoint was 28-day mortality. A multivariable logistic regression model was used to evaluate independent factors associated with low PCT and 28-day mortality. A total of 1,212 patients were included. Of the eligible patients, 154 (12.7%) were assigned to the low PCT group, and 1,058 (87.3%) to the high PCT group. The 28-day mortality was 4.6% in the low PCT group and 13.5% in the high PCT group (P < 0.01). The adjusted odds ratio of the low PCT group for 28-day mortality was 0.43 (95% CI 0.19-0.98; P = 0.04). There was no trend of increasing mortality among higher PCT level patients. In a logistic regression model, factors associated with low PCT were pneumonia, lower C-reactive protein levels, lower lactate levels, the absence of bacteremia, and the absence of organ failure. Intra-abdominal infection and obesity were associated with high PCT. Initial low PCT levels were common among patients diagnosed with severe sepsis or septic shock in the emergency department, suggesting favorable outcomes. The prevalence of low PCT levels was significantly different according to obesity, the source of infection, C-reactive protein levels, lactate levels, bacteremia, and organ failure.

As-cast uranium-molybdenum based metallic fuel candidates and the effects of carbon addition

NASA Astrophysics Data System (ADS)

Blackwood, Van Stephen

The objective of this research was to develop and recommend a metallic nuclear fuel candidate that lowered the onset temperature of gamma phase formation comparable or better than the uranium-10 wt. pct. molybdenum alloy, offered a solidus temperature as high or higher than uranium-10 wt. pct. zirconium (1250°C), and stabilized the fuel phase against interaction with iron and steel at least as much as uranium-10 wt. pct. zirconium stabilized the fuel phase. Two new as-cast alloy compositions were characterized to assess thermal equilibrium boundaries of the gamma phase field and the effect of carbon addition up to 0.22 wt. pct. The first system investigated was uranium- x wt. pct. M where x ranged between 5-20 wt. pct. M was held at a constant ratio of 50 wt. pct. molybdenum, 43 wt. pct. titanium, and 7 wt. pct. zirconium. The second system investigated was the uranium-molybdenum-tungsten system in the range 90 wt. pct. uranium - 10 wt. pct. molybdenum - 0 wt. pct. tungsten to 80 wt. pct. uranium - 10 wt. pct. molybdenum - 10 wt. pct. tungsten. The results showed that the solidus temperature increased with increased addition of M up to 12.5 wt. pct. for the uranium-M system. Alloy additions of titanium and zirconium were removed from uranium-molybdenum solid solution by carbide formation and segregation. The uranium-molybdenum-tungsten system solidus temperature increased to 1218°C at 2.5 wt. pct. with no significant change in temperature up to 5 wt. pct. tungsten suggesting the solubility limit of tungsten had been reached. Carbides were observed with surrounding areas enriched in both molybdenum and tungsten. The peak solidus temperatures for the alloy systems were roughly the same at 1226°C for the uranium-M system and 1218°C for the uranium-molybdenum-tungsten system. The uranium-molybdenum-tungsten system required less alloy addition to achieve similar solidus temperatures as the uranium-M system.

[The correlation between procalcitonin, C-reactive protein and severity scores in patients with sepsis and their value in assessment of prognosis].

PubMed

Wang, Shengyun; Chen, Dechang

2015-02-01

To investigate the correlation between procalcitonin (PCT), C-reactive protein (CRP) and acute physiology and chronic health evaluation II (APACHE II) score and sequential organ failure assessment (SOFA) score, and to investigate the value in assessment of PCT and CRP in prognosis in patients with sepsis. Clinical data of patients admitted to intensive care unit (ICU) of Changzheng Hospital Affiliated to the Second Military Medical University from January 2011 to June 2014 were retrospectively analyzed. 201 sepsis patients who received PCT and CRP tests, and evaluation of APACHE II score and SOFA score were enrolled. The values of PCT, CRP, APACHE II score and SOFA score between survivals (n = 136) and non-survivals (n = 65) were compared. The values of PCT and CRP among groups with different APACHE II scores and SOFA scores were compared. The relationships between PCT, CRP and APACHE II score and SOFA score were analyzed by Spearman correlation analysis. Receiver operating characteristic (ROC) curve was plotted to assess the prognostic value of PCT and CRP for prognosis of patients with sepsis. Compared with survival group, the values of PCT [μg/L: 11.03 (19.17) vs. 1.39 (2.61), Z = -4.572, P < 0.001], APACHE II score (19.16±5.32 vs. 10.01±3.88, t = -13.807, P < 0.001) and SOFA score (9.66±4.28 vs. 4.27±3.19, t = -9.993, P < 0.001) in non-survival group were significantly increased, but the value of CRP was not significantly different between non-survival group and survival group [mg/L: 75.22 (110.94) vs. 56.93 (100.75), Z = -0.731, P = 0.665]. The values of PCT were significantly correlated with APACHE II score and SOFA score (r1 = 0.373, r2 = 0.392, both P < 0.001), but the values of CRP were not significantly correlated with APACHE II score and SOFA score (r1 = -0.073, P1 = 0.411; r2 = -0.106, P2 = 0.282). The values of PCT rose significantly as the APACHE II score and SOFA score became higher, but the value of CRP was not significantly increased. When APACHE II score was 0-10, 11-20, and > 20, the value of PCT was 1.45 (2.62), 1.96 (9.04), and 7.41 (28.9) μg/L, respectively, and the value of CRP was 57.50 (83.40), 59.00 (119.70), and 77.60 (120.00) mg/L, respectively. When SOFA score was 0-5, 6-10, and > 10, the value of PCT was respectively 1.43 (3.09), 3.41 (9.75), and 5.43 (29.60) μg/L, and the value of CRP was 49.30 (86.20), 76.00 (108.70), and 75.60 (118.10) mg/L, respectively. There was significant difference in PCT between any two groups with different APACHE II and SOFA scores (P < 0.05 or P < 0.01), but no significant differences in CRP were found. The area under the ROC curve (AUC) of PCT for prognosis was significantly greater than that of CRP [0.872 (95% confidence interval 0.811-0.943) vs. 0.512 (95% confidence interval 0.427-0.612), P < 0.001]. When the cut-off value of PCT was 3.36 μg/L, the sensitivity was 66.8%, and the specificity was 45.4%. When the cut-off value of CRP was 44.50 mg/L, the sensitivity was 82.2%, and the specificity was 80.3%. Compared with CRP, PCT was more significantly correlated with APACHE II score and SOFA score. PCT can be a better indicator for evaluation of degree of severity, and also prognosis in sepsis patients.

[Diagnostic value of serum procalcitonin in identifying the etiology of non-responding community-acquired pneumonia after initial antibiotic therapy].

PubMed

Wang, Zheng; Zhang, Xiaoju; Wu, Jizhen; Zhang, Wenping; Kuang, Hongyan; Li, Xiao; Xuan, Weixia; Wang, Kai; Ma, Lijun

2014-11-01

This study was to investigate the diagnostic value of serum procalcitonin(PCT) in identifying the etiology of non-responding community-acquired pneumonia (CAP) after initial antibiotic therapy. A retrospective analysis was performed for 232 hospitalized CAP patients admitted to the People's Hospital of Zhengzhou University during June 2013 and January 2014. Early treatment failure was defined as the presence of persistent fever (>38 °C) and/or clinical symptoms (malaise, cough, expectoration, dyspnea) or deterioration after at least 72 h of initial antimicrobial treatment, or development of respiratory failure requiring mechanical ventilation, or septic shock. Bronchoscopy or transthoracic lung biopsy was performed in case of early treatment failure when indicated. Serum level of PCT was detected by double antibody sandwich method. The differences between 2 or more groups were compared using 2-independent student t test, one-way ANOVA; Mann-Whitney U test, Kruskal-Wallis rank sum test, or χ(2) test. Risk factors and odds ratios for nonresponsiveness were analyzed by setting up a Logistic regression model. The diagnostic values of PCT were determined by receiver operating characteristic curves (ROC curves). Of the 232 CAP patients enrolled, 124 were male and 108 were female, with an average age of (46 ± 20) years. Thirty-six patients failed to respond to the initial antibiotic therapy. As shown by Logistic regression analysis, the risk factors for treatment failure included hypoalbuminemia, type 2 diabetes, previous history of splenectomy , PSI 4-5 grade, and lung infiltration ≥ 3 lobes. The most common causes of non-responsiveness were antimicrobial insufficiency (n = 23), and misdiagnosis of noninfectious mimics of pneumonia (n = 11), with 2 cases of unidentified etiology. The serum PCT level in admission was 0.19 (0.07-0.66) µg/L in the antimicrobial insufficiency subgroup, which was significantly higher than that in the misdiagnosis subgroup [0.06(0.05-0.08)µg/L; P < 0.01]. The antimicrobial insufficiency subgroup included 11 cases of bacterial infection (5 of G(+) cocci and 6 of G(-) bacilli) and 12 cases of nonbacterial infection; their PCT levels were 0.66(0.19-5.80) µg/L and 0.08(0.05-0.20) µg/L, respectively (P < 0.01). There was no statistically significant difference among PCT levels of the 4 subgroups of nonbacterial infections (4 tuberculosis, 3 fungi, 3 atypical pathogens, 2 viruses) (F = 3.025, P = 0.094). The cut-off values of PCT were >0.13 µg/L and >0.115 µg/L for differentiating non-responsiveness originated from bacterial infection or other causes, and infection vs non-infection, which yielded a sensitivity of 100% (11/11) and 65% (14/23) , specificity of 83% (19/23) and 91% (10/11) , and AUC of 0.955 and 0.802, respectively. Antibiotic failure to cover the microbial pathogens, infectious complications and misdiagnosis are the most common causes of early treatment failure in patients with CAP. Serum PCT level fails to predict non-responsiveness, but is suggestive of bacterial infections in hospitalized CAP patients with early treatment failure.

Transmission Line Modeling Applied to Hot Corrosion of Fe-40at.pctAl in Molten LiCl-KCl

NASA Astrophysics Data System (ADS)

Barraza-Fierro, Jesus Israel; Espinosa-Medina, Marco Antonio; Castaneda, Homero

2015-12-01

The effect of Cu and Li additions to the intermetallic alloy Fe-40at.pctAl on the corrosion performance in an LiCl-55wtpctKCl molten eutectic salt was studied by means of electrochemical impedance spectroscopy, transmission line modeling (TLM), and cathodic polarization. The tests were done at 723 K, 773 K, and 823 K (450 °C, 500 °C, and 550 °C), for 60 and 720 minutes. The element additions could improve the corrosion resistance of Fe-40at.pctAl in molten LiCl-KCl, while TLM could characterize and quantify the interfacial processes in hot corrosion. The polarization curves helped to establish the possible cathodic reactions in the experimental conditions.

Preliminary flight evaluation of an engine performance optimization algorithm

NASA Technical Reports Server (NTRS)

Lambert, H. H.; Gilyard, G. B.; Chisholm, J. D.; Kerr, L. J.

1991-01-01

A performance seeking control (PSC) algorithm has undergone initial flight test evaluation in subsonic operation of a PW 1128 engined F-15. This algorithm is designed to optimize the quasi-steady performance of an engine for three primary modes: (1) minimum fuel consumption; (2) minimum fan turbine inlet temperature (FTIT); and (3) maximum thrust. The flight test results have verified a thrust specific fuel consumption reduction of 1 pct., up to 100 R decreases in FTIT, and increases of as much as 12 pct. in maximum thrust. PSC technology promises to be of value in next generation tactical and transport aircraft.

Microstructure and Texture Evolutions of Biomedical Ti-13Nb-13Zr Alloy Processed by Hydrostatic Extrusion

NASA Astrophysics Data System (ADS)

Ozaltin, K.; Panigrahi, A.; Chrominski, W.; Bulutsuz, A. G.; Kulczyk, M.; Zehetbauer, M. J.; Lewandowska, M.

2017-11-01

A biomedical β-type Ti-13Nb-13Zr (TNZ) (wt pct) ternary alloy was subjected to severe plastic deformation by means of hydrostatic extrusion (HE) at room temperature without intermediate annealing. Its effect on microstructure, mechanical properties, phase transformations, and texture was investigated by light and electron microscopy, mechanical tests (Vickers microhardness and tensile tests), and XRD analysis. Microstructural investigations by light microscope and transmission electron microscope showed that, after HE, significant grain refinement took place, also reaching high dislocation densities. Increases in strength up to 50 pct occurred, although the elongation to fracture left after HE was almost 9 pct. Furthermore, Young's modulus of HE-processed samples showed slightly lower values than the initial state due to texture. Such mechanical properties combined with lower Young's modulus are favorable for medical applications. Phase transformation analyses demonstrated that both initial and extruded samples consist of α' and β phases but that the phase fraction of α' was slightly higher after two stages of HE.

Key results of the mini-dome Fresnel lens concentrator array development program under recently completed NASA and SDIO SBIR projects

NASA Technical Reports Server (NTRS)

Oneill, Mark J.; Piszczor, Michael F.; Fraas, Lewis M.

1991-01-01

Since 1986, ENTECH and the NASA Lewis Research Center have been developing a new photovoltaic concentrator system for space power applications. The unique refractive system uses small, dome shaped Fresnel lenses to focus sunlight onto high efficiency photovoltaic concentrator cells which use prismatic cell covers to further increase their performance. Highlights of the five-year development include near Air Mass Zero (AM0) Lear Jet flight testing of mini-dome lenses (90 pct. net optical efficiency achieved); tests verifying sun-pointing error tolerance with negligible power loss; simulator testing of prism-covered GaAs concentrator cells (24 pct. AM0 efficiency); testing of prism-covered Boeing GaAs/GaSb tandem cells (31 pct. AM0 efficiency); and fabrication and outdoor testing of a 36-lens/cell element panel. These test results have confirmed previous analytical predictions which indicate substantial performance improvements for this technology over current array systems. Based on program results to date, it appears than an array power density of 300 watts/sq m and a specific power of 100 watts/kg can be achieved in the near term. All components of the array appear to be readily manufacturable from space-durable materials at reasonable cost. A concise review is presented of the key results leading to the current array, and further development plans for the future are briefly discussed.

Influence of molybdenum on the creep properties of nickel-base superalloy single crystals

NASA Technical Reports Server (NTRS)

Mackay, R. A.; Nathal, M. V.; Pearson, D. D.

1990-01-01

The Mo content of an alloy series based on Ni-6 wt pct Al-6 wt pct Ta was systematically varied from 9.8 to 14.6 wt pct, in order to ascertain the influence of Mo on the creep properties of single crystals. The optimum initial gamma-gamma prime microstructure for raft development and creep strength was established in each alloy before testing. It was found that, as the Mo content increased from 9.8 to 14.0 percent, the magnitude of the lattice mismatch increased; upon reaching 14.6 percent, a degradation of mechanical properties occurred due to the precipitation of a third phase. These results suggest that small refractory metal content and initial gamma-prime variations can profoundly affect mechanical properties.

Role of fuel chemical properties on combustor radiative heat load

NASA Technical Reports Server (NTRS)

Rosfjord, T. J.

1984-01-01

In an attempt to rigorously study the fuel chemical property influence on combustor radiative heat load, United Technologies Research Center (UTRC) has conducted an experimental program using 25 test fuels. The burner was a 12.7-cm dia cylindrical device fueled by a single pressure-atomizing injector. Fuel physical properties were de-emphasized by selecting injectors which produced high-atomized, and hence rapidly-vaporizing sprays. The fuels were specified to cover the following wide ranges of chemical properties; hydrogen, 9.1 to 15- (wt) pct; total aromatics, 0 to 100 (vol) pct; and naphthalene, 0 to 30 (vol) pct. They included standard fuels, specialty products and fuel blends. Fuel naphthalene content exhibited the strongest influence on radiation of the chemical properties investigated. Smoke point was a good global indicator of radiation severity.

High-Temperature Flow Stress and Recrystallization Characteristics of Al-Bearing Microalloyed TWIP Steels

NASA Astrophysics Data System (ADS)

Somani, Mahesh Chandra; Porter, David A.; Hamada, Atef S.; Karjalainen, L. Pentti

2015-11-01

In this study, the effects of microalloying (Nb,V) and aluminum on the constitutive flow behavior and static recrystallization (SRX) characteristics of microalloyed TWIP steels (Fe-20Mn-0.6C-Al-(Nb,V)) have been investigated under hot deformation conditions. Compression tests in a Gleeble simulator, including the double-hit technique, enabled the acquisition of flow stress and recrystallization data. These were analyzed to determine the powers of strain and strain rate as well as the activation energies of deformation and recrystallization ( Q def and Q rex). Aluminum increased the flow stress and activation energy of deformation and delayed the onset of dynamic recrystallization of microalloyed TWIP steels. While microalloying with V up to 0.3 pct seems to have little or no effect on the SRX kinetics, microalloying with 0.026 pct Nb significantly slowed down the SRX rate, similarly as in the case of low C-Mn steels. Addition of high aluminum (4.9 pct) marginally retarded the SRX kinetics in comparison with the steels with low aluminum (1.5 pct), with or without microalloying with V.

75 FR 8038 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-23

... United States Patent and Trademark Office (USPTO) will submit to the Office of Management and Budget (OMB...). Title: Patent Cooperation Treaty. Form Number(s): PCT/RO/101, PCT/RO/134, PCT/IB/372, PCT/IPEA/401, PTO... information requirement for the withdrawal of an international application. This form (PCT/IB/372) is...

Suppression of Boride Formation in Transient Liquid Phase Bonding of Pairings of Parent Superalloy Materials with Different Compositions and Grain Structures and Resulting Mechanical Properties

NASA Astrophysics Data System (ADS)

Steuer, Susanne; Singer, Robert F.

2014-07-01

Two Ni-based superalloys, columnar grained Alloy 247 and single-crystal PWA1483, are joined by transient liquid phase bonding using an amorphous brazing foil containing boron as a melting point depressant. At lower brazing temperatures, two different morphologies of borides develop in both base materials: plate-like and globular ones. Their ratio to each other is temperature dependent. With very high brazing temperatures, the deleterious boride formation in Alloy 247 can be totally avoided, probably because the three-phase-field moves to higher alloying element contents. For the superalloy PWA1483, the formation of borides cannot be completely avoided at high brazing temperatures as incipient melting occurs. During subsequent solidification of these areas, Chinese-script-like borides precipitate. The mechanical properties (tensile tests at room and elevated temperatures and short-term creep rupture tests at elevated temperatures) for brazed samples without boride precipitation are very promising. Tensile strengths and creep times to 1 pct strain are comparable, respectively, higher than the ones of the weaker parent material for all tested temperatures and creep conditions (from 90 to 100 pct rsp. 175 to 250 pct).

Accurate diagnosis of acute abdomen in FMF and acute appendicitis patients: how can we use procalcitonin?

PubMed

Kisacik, Bunyamin; Kalyoncu, Umut; Erol, M Fatih; Karadag, Omer; Yildiz, Mustafa; Akdogan, Ali; Kaptanoglu, Bugra; Hayran, Mutlu; Ureten, Kemal; Ertenli, Ihsan; Kiraz, Sedat; Calguneri, Meral

2007-12-01

This study was conducted to define the value of procalcitonin (PCT) levels in the differential diagnosis of abdominal familial Mediterranean fever (FMF) attacks from acute appendicitis. From October 2006 to January 2007, 28 FMF (12 males, 16 females) patients with acute abdominal attacks and 34 patients (18 males) with acute abdomen who underwent operation with the clinical diagnosis of acute appendicitis were consecutively enrolled in this study. FMF patients with concurrent infectious diseases were excluded. PCT values were measured by an immunofluorescent method using the B.R.A.H.M.S. PCT kit (B.R.A.H.M.S. Diagnostica, Berlin, Germany). Erythrocyte sedimentation rate (ESR), C-reactive proteins (CRP) and leucocyte levels were also noted. Mean disease duration in FMF patients was 9.6 +/- 8.1 years (range 2-33 years) and all were on colchicine therapy with a mean colchicine dosage of 1.2 +/- 0.4 mg/day. Among the operated patients, 5 were excluded: 3 patients had normal findings and 2 had intestinal perforation (PCT levels were 2.69 and 4.93 ng/ml, respectively) at operative and pathologic evaluation. There were no significant differences between the two groups with respect to gender and age (p was not significant (NS) for all). Acute phase reactants and PCT levels were increased in patients with FMF compared to patients with acute appendicitis (0.529[0.12 +/- 0.96] vs 0.095 [0.01-0.80] p < 0.001, respectively). PCT levels higher than 0.5 ng/ml were found in 11% (3/28) of FMF patients compared to 62% (18/29) of acute appendicitis patients (p < 0.001). Our results suggest that PCT could be a useful test in the differentiation of abdominal FMF attacks from acute appendicitis, though it should not supplant more conventional investigations.

Effect of Extrusion Parameters on Texture and Microstructure Evolution of Extruded Mg-1 pctMn and Mg-1 pctMn-Sr Alloys

NASA Astrophysics Data System (ADS)

Borkar, Hemant; Pekguleryuz, Mihriban

2015-01-01

Three Mg alloys Mg-1 pctMn (M1), Mg-1 pctMn-1.3 pctSr, and Mg-1 pctMn-2.1 pctSr were subjected to two different extrusion temperatures and two different extrusion speeds in lab-scale extrusion. The extrusion temperatures of 573 K and 673 K (300 °C and 400 °C) and two ram speeds of 4 and 8 mm/s were used at constant extrusion ratio of 7. M1 exhibited strong basal texture after extrusion at 673 K (400 °C) at higher speed. At 573 K (300 °C), recrystallization in all alloys takes place completely or partially by continuous dynamic recrystallization mechanism, while particle stimulated nucleation (PSN) occurs in all M1-Sr alloys at both extrusion temperatures and speeds. At 673 K (400 °C), grain boundary bulging is the only recrystallization mechanism in alloy M1, while it occurs in combination with PSN in M1-Sr alloys. The effect of texture weakening by PSN is more significant in M1-Sr alloys extruded at 573 K (400 °C). The plant extrusion trials were carried out on Mg-1 pctMn, Mg-1 pctMn-0.3 pctSr, and Mg-1 pctMn-2.1 pctSr at 623 K (350 °C) with different speeds than in lab-scale extrusion. M1 alloy exhibited strong basal texture at both speeds, while Sr additions of 0.3 and 2.1 pct promoted similar amount of texture weakening.

Impact Toughness of 0.2 Pct C-1.5 Pct Si-(1.5 to 5) Pct Mn Transformation-Induced Plasticity-Aided Steels with an Annealed Martensite Matrix

NASA Astrophysics Data System (ADS)

Tanino, Hikaru; Horita, Masaomi; Sugimoto, Koh-Ichi

2016-05-01

The impact properties of 0.2 pct C-1.5 pct Si-(1.5 to 5) pct Mn transformation-induced plasticity (TRIP)-aided steels with an annealed martensite matrix which had been subjected to isothermal transformation after inter-critical annealing were investigated for potential automotive applications. The impact properties are related to the retained austenite characteristics of the steels. The products of tensile strength (TS) and Charpy impact absorbed value (CIAV) were the same for the 1.5 and 5 pct Mn steels, although the ductile-brittle transition temperature was higher for the latter. The impact properties of the 3 pct Mn steel were worse than these two steels. The high TS × CIAV value for the 5 pct Mn steel at 293 K (25 °C) was mainly caused by the TRIP effect of a larger amount of retained austenite (36 vol pct) and the hardened matrix structure; low retained austenite stability and/or a hard martensite-austenite phase reduced this value. The higher ductile-brittle transition temperature of the 5 pct Mn steel was associated with Mn segregation, a large amount of unstable retained austenite on prior austenitic grain boundaries, and decreased cleavage fracture stress owing to the high Mn content.

Microstructure-strength relations in a hardenable stainless steel with 16 pct Cr, 1.5 pct Mo, and 5 pct Ni

NASA Astrophysics Data System (ADS)

Grobner, P. J.; Blšs, V.

1984-07-01

Metallographic studies have been conducted on a 0.024 pct C-16 pct Cr-1.5 pct Mo-5 pct Ni stainless steel to study the phase reactions associated with heat treatments and investigate the strengthening mechanisms of the steel. In the normalized condition, air cooled from 1010 °C, the microstructure consists of 20 pct ferrite and 80 pct martensite. Tempering in a temperature range between 500 and 600 °C results in a gradual transformation of martensite to a fine mixture of ferrite and austenite. At higher tempering temperatures, between 600 and 800 °C, progressively larger quantities of austenite form and are converted during cooling to proportionally increasing amounts of fresh martensite. The amount of retained austenite in the microstructure is reduced to zero at 800 °C, and the microstructure contains 65 pct re-formed martensite and 35 pct total ferrite. Chromium rich M23C6 carbides precipitate in the single tempered microstructures. The principal strengthening is produced by the presence of martensite in the microstructure. Additional strengthening is provided by a second tempering treatment at 400 °C due to the precipitation of ultrafine (Cr, Mo) (C,N) particles in the ferrite.

[Procalcitonin as a predictor of trauma severity and post-traumatic sepsis in children].

PubMed

Liu, Shao-Feng; Yuan, Gao-Pin; Yang, Jian; He, Tao-Zhen; Feng, Hai-Huan; Liu, Min

2012-09-01

To determine the association of procalcitonin (PCT) with trauma severity and post traumatic sepsis in children. The blood samples of 30 children with acute trauma in a Pediatric unit were collected for four consecutive days. The levels of PCT, IL-6, CRP and WBC were measured. The pediatric trauma score (PTS), length of stay in hospital, incidence of sepsis and clinical outcomes of the children were recorded. The value of PCT for predicting prognosis of children with trauma was compared with other inflammatory markers. Plasma PCT levels increased significantly in the patients in our study. Sepsis occurred in 23.33% of the patients. The patients with sepsis had higher levels of PCT than those with and without systemic inflammatory response syndrome (SIRS) and the healthy controls (P < 0.05). The peak level of PCT emerged on day 2 after trauma. The plasma PCT levels were positively correlated with trauma severity. The level of PCT on day 2 was an independent predictor for post-trauma sepsis and SIRS. Plasma PCT levels increase markedly in post trauma children. Plasma PCT of day 2 after trauma is an independent predictor of post-traumatic sepsis and SIRS complications. There is a significant correlation between the severity of injury and plasma PCT.

-Based Slag System

NASA Astrophysics Data System (ADS)

Jiang, Binbin; Wang, Wanlin; Sohn, Il; Wei, Juan; Zhou, Lejun; Lu, Boxun

2014-06-01

The crystallization behavior of a CaO-Al2O3-based slag system with various ZrO2 content (from 1 to 5 wt pct) and CaO/Al2O3 (C/A) ratio (from 0.8 to 1.2) has been studied by using single hot thermocouple technology (SHTT) in this article. The continuous-cooling-transformation (CCT) diagrams and time-temperature-transformation (TTT) diagrams of the above slag system were constructed for the analysis of the varying crystallization behaviors. The results suggested that Al2O3 tended to enhance the slag samples crystallization when the C/A ratio ranged from 0.8 to 1.2, and the critical cooling rate and crystallization temperature increased with the decrease of C/A ratio; meanwhile, the incubation time was also getting shorter with the reduction of C/A ratio. The addition of ZrO2 would enhance the crystallization of slag samples because of the induced heterogeneous nucleation of molten slag. However, the general crystallization was determined by the balance between molten slag viscosity and heterogeneous nucleation, such that Sample 3 (C/A = 1.0, ZrO2 = 3 pct, B2O3 = 10 pct, Li2O = 3 pct [in wt pct]) would demonstrate the strongest crystallization kinetics in a high-temperature zone. The different crystals formed during the tests were also analyzed by scanning electron microscopy (SEM) and X-ray diffraction (XRD).

Development of proton computed tomography detectors for applications in hadron therapy

NASA Astrophysics Data System (ADS)

Bashkirov, Vladimir A.; Johnson, Robert P.; Sadrozinski, Hartmut F.-W.; Schulte, Reinhard W.

2016-02-01

Radiation therapy with protons and heavier ions is an attractive form of cancer treatment that could enhance local control and survival of cancers that are currently difficult to cure and lead to less side effects due to sparing of normal tissues. However, particle therapy faces a significant technical challenge because one cannot accurately predict the particle range in the patient using data provided by existing imaging technologies. Proton computed tomography (pCT) is an emerging imaging modality capable of improving the accuracy of range prediction. In this paper, we describe the successive pCT scanners designed and built by our group with the goal to support particle therapy treatment planning and image guidance by reconstructing an accurate 3D map of the stopping power relative to water in patient tissues. The pCT scanners we have built to date consist of silicon telescopes, which track the proton before and after the object to be reconstructed, and an energy or range detector, which measures the residual energy and/or range of the protons used to evaluate the water equivalent path length (WEPL) of each proton in the object. An overview of a decade-long evolution of the conceptual design of pCT scanners and their calibration is given. Results of scanner performance tests are presented, which demonstrate that the latest pCT scanner approaches readiness for clinical applications in hadron therapy.

Relationship of Serum Procalcitonin Levels to Severity and Prognosis in Pediatric Bacterial Meningitis.

PubMed

Hu, Ruimei; Gong, Yansheng; Wang, Yuzhen

2015-10-01

To investigate the relationship between serum procalcitonin (PCT) levels and prognosis in children with bacterial meningitis. Eighty-two child patients were included in this prospective study. The diagnosis of meningitis was based on clinical features and cerebrospinal fluid findings. PCT levels were measured with a specific immunoluminometric assay. (a) Patients with bacterial meningitis had significantly higher serum PCT than those with viral meningitis. (b) The PCT levels of patients with severe sepsis or septic shock were significantly higher than those who had no or mild sepsis. (c) PCT levels decreased significantly in patients who had good curative effect, whereas PCT levels did not changed in patients who had no curative effect. (d) The PCT levels were significantly higher in those who died than those who survived. Serum PCT is related to the severity of disease in children with bacterial meningitis. A fall in PCT after treatment may have favorable prognostic significance. © The Author(s) 2015.

Effect of Boron Addition on Microstructural Evolution and Room-Temperature Mechanical Properties of Novel Fe66- x CrNiB x Si ( x = 0, 0.25, 0.50 and 0.75 Wt Pct) Advanced High-Strength Steels

NASA Astrophysics Data System (ADS)

Askari-Paykani, Mohsen; Shahverdi, Hamid Reza; Miresmaeili, Reza

2016-11-01

In this study, the Vickers hardnesses and room-temperature uniaxial tensile behaviors of four Fe66- x CrNiB x Si ( x = 0 (0B), 0.25 (25B), 0.50 (50B), and 0.75 (75B) wt pct) advanced high-strength steels (AHSSs) in the as-hot-rolled and heat-treated (1373 K (1100 °C)/2 h + 973 K (700 °C)/20 min) conditions were investigated. Microstructural evolution after solidification, hot rolling, heat treatment, and uniaxial tensile tests of 0B, 25B, 50B, and 75B AHSSs was also characterized using field emission gun scanning electron microscopy and X-ray diffraction. The tensile behaviors of the 0B, 25B, 50B, and 75B AHSSs were manifested by an excellent combination of strength and ductility over 34.7 and 47.1 GPa pct, 36.9 and 42.3 GPa pct, 45.9 and 46.4 GPa pct, and 11.9 and 47.8 GPa pct, respectively, arising from microband-induced plasticity in the 0B, 50B, and 75B AHSSs and transformation-induced plasticity in the 25B specimens. All specimens in the as-hot-rolled and heat-treated states showed an austenitic matrix grain. Adding boron to the base alloy (0B) resulted in grain refinement, M2B dispersion, precipitation hardening, and solid solution strengthening, which led to an increase in strength. The results of the present work show promise for automotive applications that require excellent properties and reduced specific weight.

Procalcitonin as a diagnostic biomarker for septic shock and bloodstream infection in burn patients from the Formosa Fun Coast dust explosion.

PubMed

Wu, Rui-Xin; Chiu, Chih-Chien; Lin, Tzu-Chao; Yang, Ya-Sung; Lee, Yi; Lin, Jung-Chung; Chang, Feng-Yee

2017-12-01

Infection is the most common cause of death following burn injury. The study was conducted to compare the diagnostic value of serum procalcitonin (PCT) with the other current benchmarks as early predictors of septic shock and bloodstream infection in burn patients. We included 24 patients admitted to the Burn Unit of a medical center from June 2015 to December 2015 from the Formosa Fun Coast dust explosion. We categorized all patients at initial admission into either sepsis or septic shock groups. Laboratory tests including the worst PCT and C-reactive protein (CRP) levels, platelet (PLT), and white blood cell (WBC) count were performed at <48 h after admission. Patients were also classified in two groups with subsequent bacteremia and non-bacteremia groups during hospitalization. Significantly higher PCT levels were observed among participants with septic shock compared to those with sepsis (47.19 vs. 1.18 ng/mL, respectively; p < 0.001). Patients with bacteremia had significantly elevated PCT levels compared to patients without bacteremia (29.54 versus 1.81 ng/mL, respectively, p < 0.05). No significant differences were found in CRP levels, PLT, and WBC count between the two groups. PCT levels showed reasonable discriminative power (cut-off: 5.12 ng/mL; p = 0.01) in predicting of bloodstream infection in burn patients and the area under receiver operating curves was 0.92. PCT levels can be helpful in determining the septic shock and bloodstream infection in burn patients but CRP levels, PLT, and WBC count were of little diagnostic value. Copyright © 2017. Published by Elsevier B.V.

Development of an effusive inlet for mass spectrometric gas analysis of hypersonic boundary layer

NASA Technical Reports Server (NTRS)

Brown, Kenneth G.; Fishel, Charles E.; Brown, David R.; Lewis, Beverley W.; Wood, George M., Jr.

1987-01-01

The use of a microchannel plate (MCP) as a mass spectrometer inlet device to allow nonintrusive sampling of flight vehicle boundary layers is investigated. Two possible configurations for mounting the inlet are studied: (1) flow coaxial with the channels; and (2) flow perpendicular to the channel axis. The test gases are pure Kr; pure Ne; and a mixture of 10 pct Kr, 10 pct Ne, and 80 pct N2. The pressure ranges studied vary from 500 to 10 microns. A mass discrimination at the quadrupole mass spectrometer is observed, indicating an enrichment in the heavier gas. Possible explanations for this enrichment are discussed. It is shown that an MCP is capable of acting as a nonintrusive sampling device. Further work that will enable quantitative determination of the species at the surface is discussed.

Aviation-fuel property effects on combustion

NASA Technical Reports Server (NTRS)

Rosfjord, T. J.

1984-01-01

The fuel chemical property influence on a gas turbine combustor was studied using 25 test fuels. Fuel physical properties were de-emphasized by using fuel injectors which produce highly-atomized, and hence rapidly vaporizing sprays. A substantial fuel spray characterization effort was conducted to allow selection of nozzles which assured that such sprays were achieved for all fuels. The fuels were specified to cover the following wide ranges of chemical properties: hydrogen, 9.1 to 15 (wt) pct; total aromatics, 0 to 100 (vol) pct; and naphthalene, 0 to 30 (vol) pct. standard fuels (e.g., Jet A, JP4), speciality products (e.g., decalin, xylene tower bottoms) and special fuel blends were included. The latter group included six, 4-component blends prepared to achieve parametric variations in fuel hydrogen, total aromatics and naphthalene contents. The principle influences of fuel chemical properties on the combustor behavior were reflected by the radiation, liner temperature, and exhaust smoke number (or equivalently, soot number density) data. Test results indicated that naphthalene content strongly influenced the radiative heat load while parametric variations in total aromatics did not.

Mechanical Properties of Gradient Structure Mg Alloy

NASA Astrophysics Data System (ADS)

Chen, Hongliang; Yang, Jiang; Zhou, Hao; Moering, Jordan; Yin, Zhe; Gong, Yulan; Zhao, KunYu

2017-09-01

In this work, a surface mechanical attrition treatment (SMAT) process was applied to AZ31B magnesium alloy at room temperature. This method produced a gradient structure on the treated AZ31B, in which the grains of the topmost layer are refined to nanoscale sizes. A combination of nanocrystallites at the surface and coarse-grains in the center are the main features of this structure. This structure results in an excellent combination of both strength and ductility. The highest yield strength for the 30 minutes SMAT AZ31B samples increased to 249 ± 5 MPa and the uniform elongation decreased to 9.3 ± 0.8 pct, whereas the original yield strength was only 147 ± 4 MPa and the uniform elongation was 15.4 ± 1.1 pct. Microstructural observations, stress relaxation tests, and hardness tests were used to verify the results. Additionally, there is a specific volume fraction of gradient structure to achieve the best mechanical performance, which is shown to be in the range of 9.3 to 14 pct for the AZ31B alloy.

Serum Procalcitonin for Predicting Significant Infections and Mortality in Pediatric Oncology.

PubMed

Gunasekaran, Vinod; Radhakrishnan, Nita; Dinand, Veronique; Sachdeva, Anupam

2016-12-15

To evaluate the role of serum procalcitonin (PCT) level at admission in predicting significant infections and deaths among children on chemotherapy presenting with fever. Children with clinically significant (CSI) and microbiologically documented (MDI) infections were identified using standard definitions. Association of PCT with CSI, MDI and mortality was analyzed. We evaluated 821 febrile episodes in 316 children. CSI, MDI and deaths were seen in 40.9%, 20.1% and 2.9%, respectively. PCT levels ranged from 0.05-560ng/mL. Median PCT was higher in episodes with CSI (0.80 vs. 0.28) and MDI (0.71 vs. 0.34) (P<0.001). PCT ≥0.7ng/mL optimally predicted CSI (AUC-0.740) and MDI (AUC-0.636). Relative risk of mortality for PCT ≥5ng/mL was 7.1. PCT ≥0.7ng/mL had poor sensitivity (45-55%) but good specificity and NPV (70-90%). PCT was elevated in nearly half of documented viral and fungal infections. PCT predicts significant infections and mortality in pediatric oncology but it has poor sensitivity to guide clinical decisions.

Studies on applicability of press-coated tablets using hydroxypropylcellulose (HPC) in the outer shell for timed-release preparations.

PubMed

Fukui, E; Uemura, K; Kobayashi, M

2000-08-10

Press-coated tablets, containing diltiazem hydrochloride (DIL) in the core tablet and coated with hydroxypropylcellulose (HPC) as the outer shell, were examined for applicability as timed-release tablets with a predetermined lag time and subsequent rapid drug release phase. Various types of press-coated tablets were prepared using a rotary tabletting machine and their DIL dissolution behavior was evaluated by the JP paddle method. The results indicated that tablets with the timed-release function could be prepared, and that the lag times were prolonged as the viscosity of HPC and the amount of the outer shell were increased. The lag times could be controlled widely by the above method, however, the compression load had little effect. Two different kinds of timed-release press-coated tablets that showed lag times of 3 and 6 h in the in vitro test (denoted PCT(L3) and PCT(L6), respectively) were administered to beagle dogs. DIL was first detected in the plasma more than 3 h after administration, and both tablets showed timed-release. The lag times showed a good agreement between the in vivo and in vitro tests in PCT(L3). However, the in vivo lag times were about 4 h in PCT(L6) and were much shorter than the in vitro lag time. The dissolution test was performed at different paddle rotation speeds, and good agreement was obtained between the in vivo and in vitro lag times at 150 rpm. This suggested that the effects of gastrointestinal peristalsis and contraction should also be taken into consideration for the further development of drug delivery systems.

Using procalcitonin-guided algorithms to improve antimicrobial therapy in ICU patients with respiratory infections and sepsis.

PubMed

Schuetz, Philipp; Raad, Issam; Amin, Devendra N

2013-10-01

In patients with systemic bacterial infections hospitalized in ICUs, the inflammatory biomarker procalcitonin (PCT) has been shown to aid diagnosis, antibiotic stewardship, and risk stratification. Our aim is to summarize recent evidence about the utility of PCT in the critical care setting and discuss the potential benefits and limitations of PCT when used for clinical decision-making. A growing body of evidence supports PCT use to differentiate bacterial from viral respiratory infections (including influenza), to help risk stratify patients, and to guide decisions about optimal duration of antibiotic therapy. Different PCT protocols were evaluated for these and similar purposes in randomized controlled trials in patients with varying severities of predominantly respiratory tract infection and sepsis. These trials demonstrated effectiveness of monitoring PCT to de-escalate antibiotic treatment earlier without increasing rates of relapsing infections or other adverse outcomes. Although serial PCT measurement has shown value in risk stratification of ICU patients, PCT-guided antibiotic escalation protocols have not yet shown benefit for patients. Inclusion of PCT data in clinical algorithms improves individualized decision-making regarding antibiotic treatment in patients in critical care for respiratory infections or sepsis. Future research should focus on use of repeated PCT measurements to risk-stratify patients and guide treatment to improve their outcomes.

Strength of initially virgin martensites at - 196 °C after aging and tempering

NASA Astrophysics Data System (ADS)

Eldis, George T.; Cohen, Morris

1983-06-01

The compressive strength at -196°C of martensites in Fe-0.26 pct C-24 pct Ni, Fe-0.4 pct C-21 pct Ni, and Fe-0.4 pct C-18 pct Ni-3 pct Mo alloys, all with subzero M temperatures, has been determined in the virgin condition and after one hour at temperatures from -80 to +400 °C. The effects of ausforming (20 pct reduction in area of the austenite by swaging at room temperature prior to the martensitic transformation) were also investigated. For the unausformed martensites, aging at temperatures up to 0 °C results in relatively small increases in strength. Above 0 °C, the age hardening increment increases rapidly, reaching a maximum at 100 °C. Above 100 °C, the strength decreases continuously with increasing tempering temperature except for the molybdenum-containing alloy, which exhibits secondary hardening on tempering at 400 °C. For the ausformed martensites, the response to aging at subzero temperatures is greater than for unausformed material. Strength again passes through a maximum on aging at 100 °C. However, on tempering just above 100 °C, the ausformed materials show a slower rate of softening than the unausformed martensites. The strengthening produced by the ausforming treatment is largest for the Fe-0.4 pct C-18 pct Ni-3 pct Mo alloy, but there is no evidence of carbide precipitation in the deformed austenite to a°Count for this effect of molybdenum.

Comparison of intradermal and percutaneous testing to histamine, saline and nine allergens in healthy adult cats.

PubMed

Gentry, Christina M; Messinger, Linda

2016-10-01

Intradermal testing (IDT) in cats has potential limitations; this has led to an interest in novel testing methods. A pilot study demonstrated that healthy cats produced reliable percutaneous glycerinated (PG) histamine wheals, whereas percutaneously applied glycerosaline did not lead to wheal formation. The purpose of this study was to determine if percutaneously applied aqueous and glycerinated allergens would lead to irritant reactions in healthy cats. Percutaneous testing (PCT) with both glycerinated and aqueous allergens and IDT were compared in twelve healthy cats. The lateral thorax was clipped and histamine, saline and nine allergens were tested in rows. Objective and subjective evaluations were performed at 15, 20 and 25 min, and 4 h. Results were evaluated as positive or negative at 15, 20, 25 min and 4 h. Skin test reactions for intradermal (ID) histamine wheals were larger when compared to PG and percutaneous aqueous (PA) at the immediate reading points (P < 0.05) subjectively and objectively; however, PG was not significantly different from ID when compared as either positive (2-4) or negative (0-1). PG histamine and allergen reactions, when present, were larger than equivalent PA reactions. PG and PA allergens did not cause irritant reactions at tested concentrations. Bassia scoparia (kochia), when tested at 1000 PNU/mL with IDT, was suspected to be an irritant. Percutaneously (PCT) applied allergens did not cause irritant reactions in healthy cats. PG histamine wheals, although smaller than ID histamine wheals, were easily recognizable and PCT was simple to perform. © 2016 ESVD and ACVD.

78 FR 75336 - Notice of Intent To Grant an Exclusive License; STIC-ADHESIVE Products Co., Inc.

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-11

... Cooperation Treaty (PCT) Application No. PCT/US2012/040371: Filed June 01, 2012 entitled ``Aluminum Alloy... Case No. PAX115//PCT Application No. PCT/US2013/ 045190: Filed June 13, 2013 entitled ``Coated Aluminum...

Influence of Prior Fatigue Cycling on Creep Behavior of Reduced Activation Ferritic-Martensitic Steel

NASA Astrophysics Data System (ADS)

Sarkar, Aritra; Vijayanand, V. D.; Parameswaran, P.; Shankar, Vani; Sandhya, R.; Laha, K.; Mathew, M. D.; Jayakumar, T.; Rajendra Kumar, E.

2014-06-01

Creep tests were carried out at 823 K (550 °C) and 210 MPa on Reduced Activation Ferritic-Martensitic (RAFM) steel which was subjected to different extents of prior fatigue exposure at 823 K at a strain amplitude of ±0.6 pct to assess the effect of prior fatigue exposure on creep behavior. Extensive cyclic softening that characterized the fatigue damage was found to be immensely deleterious for creep strength of the tempered martensitic steel. Creep rupture life was reduced to 60 pct of that of the virgin steel when the steel was exposed to as low as 1 pct of fatigue life. However, creep life saturated after fatigue exposure of 40 pct. Increase in minimum creep rate and decrease in creep rupture ductility with a saturating trend were observed with prior fatigue exposures. To substantiate these findings, detailed transmission electron microscopy studies were carried out on the steel. With fatigue exposures, extensive recovery of martensitic-lath structure was distinctly observed which supported the cyclic softening behavior that was introduced due to prior fatigue. Consequently, prior fatigue exposures were considered responsible for decrease in creep ductility and associated reduction in the creep rupture strength.

Tracking performance with two breathing oxygen concentrations after high altitude rapid decompression

NASA Technical Reports Server (NTRS)

Nesthus, Thomas E.; Schiflett, Samuel G.; Oakley, Carolyn J.

1992-01-01

Current military aircraft Liquid Oxygen (LOX) systems supply 99.5 pct. gaseous Aviator's Breathing Oxygen (ABO) to aircrew. Newer Molecular Sieve Oxygen Generation Systems (MSOGS) supply breathing gas concentration of 93 to 95 pct. O2. The margin is compared of hypoxia protection afforded by ABO and MSOGS breathing gas after a 5 psi differential rapid decompression (RD) in a hypobaric research chamber. The barometric pressures equivalent to the altitudes of 46000, 52000, 56000, and 60000 ft were achieved from respective base altitudes in 1 to 1.5 s decompressions. During each exposure, subjects remained at the simulated peak altitude breathing either 100 or 94 pct. O2 with positive pressure for 60 s, followed by a rapid descent to 40000 ft. Subjects used the Tactical Life Support System (TLSS) for high altitude protection. Subcritical tracking task performance on the Performance Evaluation Device (PED) provided psychomotor test measures. Overall tracking task performance results showed no differences between the MSOGS breathing O2 concentration of 94 pct. and ABO. Significance RMS error differences were found between the ground level and base altitude trials compared to peak altitude trials. The high positive breathing pressures occurring at the peak altitudes explained the differences.

[Accesibility and use of spirometry in primary care centers in Catalonia].

PubMed

Llauger, M Antònia; Rosas, Alba; Burgos, Felip; Torrente, Elena; Tresserras, Ricard; Escarrabill, Joan

2014-01-01

Examine the accessibility and use of forced spirometry (FS) in public primary care facilities centers in Catalonia. Cross-sectional study using a survey. Three hundred sixty-six Primary Care Teams (PCT) in Catalonia. Third quarter of 2010. Survey with information on spirometers, training, interpretation and quality control, and the priority that the quality of spirometry had for the team. Indicators FS/100 inhabitants/year, FS/month/PCT; FS/month/10,000 inhabitants. Response rate: 75%. 97.5% of PCT had spirometer and made an average of 2.01 spirometries/100 inhabitants (34.68 spirometry/PCT/month). 83% have trained professionals.>50% centers perform formal training but no information is available on the quality. 70% performed some sort of calibration. Interpretation was made by the family physician in 87.3% of cases. In 68% of cases not performed any quality control of exploration. 2/3 typed data manually into the computerized medical record.>50% recognized a high priority strategies for improving the quality. Despite the accessibility of EF efforts should be made to standardize training, increasing the number of scans test and promote systematic quality control. Copyright © 2013 Elsevier España, S.L. All rights reserved.

PCT MAO’s Enhanced Performance by Specially Designed Sealers for Superior Service & Environments

DTIC Science & Technology

2014-11-01

PCT’s Process is with low silicon content. • Aluminized Steel + PCT MAO can be a cost effective alternative to Stainless Steel, Super Duplex...is applied PCT – P seal • Typical Layer thickness: 40-80 micron* • Organic sealer • Hydrophobic surface, reduces sedimentation...PCT - S seal • Typical Layer thickness: 10-40 micron* • Organo-ceramic sealer • Hydrophobic surface, reduces sedimentation. PCT Classic 1000

Removal of heavy metals from Missouri lead mill tailings by froth flotation

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

Benn, F.W.; Cornell, W.L.

Froth flotation techniques to remove heavy metals (Pb, Cu, and Zn) from southeast Missouri lead mill tailings were investigated. It has been estimated that southeast Missouri contains between 200 and 300 million st of Pb tailings stored above ground. The tailings were classified as two distinct types: (1) pre-1968 tailings from the Old Lead Belt (some more than 100 years old) and (2) post-1968 tailings from the New Lead Belt. The objectives of the investigation were to reduce the Pb remaining in the tailings to < 500 ppm (< 0.05 pct Pb) and to attempt to recover a marketable concentratemore » to offset a portion of the remediation costs. The remaining dolomite-limestone would then be used as mining backfill or agricultural limestone. Bench-scale froth flotation removed, in percent, 95 Pb, 84 Cu, and 54 Zn, leaving 94 pct of the original weight containing, in parts per million, 400 Pb, 40 Cu, and 300 Zn from the Old Lead Belt tailings. Separate flotation tests also removed, in percent, 85 Pb, 84 Cu, and 80 Zn, leaving 75 pct of the original weight containing, in parts per million, 400 Pb, 200 Cu, and 500 Zn from the New Lead Belt tailings. Concentrates recovered from the Old Lead Belt were retreated to produce a final Pb concentrate containing 72 pct Pb with a cleaner flotation recovery of 79 pct. Froth flotation proved to be a viable method to remove the heavy metals.« less

[Procalcitonin as a diagnostic marker in systemic inflammatory response syndrome (SIRS) and sepsis].

PubMed

Hryckiewicz, Katarzyna; Juszczyk, Jacek; Samet, Alfred; Arłukowicz, Elzbieta; Sledzińska, Anna; Bolewska, Beata

2006-01-01

Evaluation the value of procalcitonin as a diagnostic and prognostic marker in septic patients and patients with systemic inflammatory response syndrome (SIRS). 126 patients were included into the study. The patients were divided into four groups: 1--septic patients with positive blood cultures, 2--septic patients with negative blood cultures, 3--patients with SIRS, 4--patients without sepsis and SIRS. PCT level was measured by imunoluminometric assay (LUMItest) and immunochromatographic assay (PCT-Q). PCT level is higher in patients with sepsis than in patients with SIRS. PCT level is only slightly elevated in patients without sepsis and SIRS. The highest PCT level is found in patients with septic shock. In patients with the clinical improvement the frequency of PCT level increase is approximately twice lower than in patients who died. Measurement of PCT level on the first, second and third day of hospitalization has no prognostic value. There is no significant difference in PCT level in sepsis caused by Gram positive and Gram negative bacteria. PCT is a useful marker in diagnosis of sepsis but its role in monitoring the severity of sepsis requires more clinical studies.

Novel scintillation detector design and performance for proton radiography and computed tomography.

PubMed

Bashkirov, V A; Schulte, R W; Hurley, R F; Johnson, R P; Sadrozinski, H F-W; Zatserklyaniy, A; Plautz, T; Giacometti, V

2016-02-01

Proton computed tomography (pCT) will enable accurate prediction of proton and ion range in a patient while providing the benefit of lower radiation exposure than in x-ray CT. The accuracy of the range prediction is essential for treatment planning in proton or ion therapy and depends upon the detector used to evaluate the water-equivalent path length (WEPL) of a proton passing through the object. A novel approach is presented for an inexpensive WEPL detector for pCT and proton radiography. A novel multistage detector with an aperture of 10 × 37.5 cm was designed to optimize the accuracy of the WEPL measurements while simplifying detector construction and the performance requirements of its components. The design of the five-stage detector was optimized through simulations based on the geant4 detector simulation toolkit, and the fabricated prototype was calibrated in water-equivalent millimeters with 200 MeV protons in the research beam line of the clinical proton synchrotron at Loma Linda University Medical Center. A special polystyrene step phantom was designed and built to speed up and simplify the calibration procedure. The calibrated five-stage detector was tested in the 200 MeV proton beam as part of the pCT head scanner, using a water phantom and polystyrene slabs to verify the WEPL reconstruction accuracy. The beam-test results demonstrated excellent performance of the new detector, in good agreement with the simulation results. The WEPL measurement accuracy is about 3.0 mm per proton in the 0-260 mm WEPL range required for a pCT head scan with a 200 MeV proton beam. The new multistage design approach to WEPL measurements for proton CT and radiography has been prototyped and tested. The test results show that the design is competitive with much more expensive calorimeter and range-counter designs.

Novel scintillation detector design and performance for proton radiography and computed tomography

PubMed Central

Schulte, R. W.; Hurley, R. F.; Johnson, R. P.; Sadrozinski, H. F.-W.; Zatserklyaniy, A.; Plautz, T.; Giacometti, V.

2016-01-01

Purpose: Proton computed tomography (pCT) will enable accurate prediction of proton and ion range in a patient while providing the benefit of lower radiation exposure than in x-ray CT. The accuracy of the range prediction is essential for treatment planning in proton or ion therapy and depends upon the detector used to evaluate the water-equivalent path length (WEPL) of a proton passing through the object. A novel approach is presented for an inexpensive WEPL detector for pCT and proton radiography. Methods: A novel multistage detector with an aperture of 10 × 37.5 cm was designed to optimize the accuracy of the WEPL measurements while simplifying detector construction and the performance requirements of its components. The design of the five-stage detector was optimized through simulations based on the geant4 detector simulation toolkit, and the fabricated prototype was calibrated in water-equivalent millimeters with 200 MeV protons in the research beam line of the clinical proton synchrotron at Loma Linda University Medical Center. A special polystyrene step phantom was designed and built to speed up and simplify the calibration procedure. The calibrated five-stage detector was tested in the 200 MeV proton beam as part of the pCT head scanner, using a water phantom and polystyrene slabs to verify the WEPL reconstruction accuracy. Results: The beam-test results demonstrated excellent performance of the new detector, in good agreement with the simulation results. The WEPL measurement accuracy is about 3.0 mm per proton in the 0–260 mm WEPL range required for a pCT head scan with a 200 MeV proton beam. Conclusions: The new multistage design approach to WEPL measurements for proton CT and radiography has been prototyped and tested. The test results show that the design is competitive with much more expensive calorimeter and range-counter designs. PMID:26843230

Wear Behavior of Plasma Spray Deposited and Post Heat-Treated Hydroxyapatite (HA)-Based Composite Coating on Titanium Alloy (Ti-6Al-4V) Substrate

NASA Astrophysics Data System (ADS)

Kumari, Renu; Majumdar, Jyotsna Dutta

2018-04-01

The present study concerns a detailed evaluation of wear resistance property of plasma spray deposited composite hydroxyapatite (HA)-based (HA-50 wt pct TiO2 and HA-10 wt pct ZrO2) bioactive coatings developed on Ti-6Al-4V substrate and studying the effect of heat treatment on it. Heat treatment of plasma spray deposited samples has been carried out at 650 °C for 2 hours (for HA-50 wt pct TiO2 coating) and at 750 °C for 2 hours (for HA-10 wt pct ZrO2 coating). There is significant deterioration in wear resistance for HA-50 wt pctTiO2 coating and a marginal deterioration in wear resistance for HA-10 wt pct ZrO2 coating in as-sprayed state (as compared to as-received Ti-6Al-4V) which is, however, improved after heat treatment. The coefficient of friction is marginally increased for both HA-50 wt pct TiO2 and HA-10 wt pct ZrO2 coatings in as-sprayed condition as compared to Ti-6Al-4V substrate. However, coefficient of friction is decreased for both HA-50 wt pct TiO2 and HA-10 wt pct ZrO2 coatings after heat-treated condition as compared to Ti-6Al-4V substrate. The maximum improvement in wear resistance property is, however, observed for HA-10 wt pct ZrO2 sample after heat treatment. The mechanism of wear has been investigated.

Proton range shift analysis on brain pseudo-CT generated from T1 and T2 MR.

PubMed

Pileggi, Giampaolo; Speier, Christoph; Sharp, Gregory C; Izquierdo Garcia, David; Catana, Ciprian; Pursley, Jennifer; Amato, Francesco; Seco, Joao; Spadea, Maria Francesca

2018-05-29

In radiotherapy, MR imaging is only used because it has significantly better soft tissue contrast than CT, but it lacks electron density information needed for dose calculation. This work assesses the feasibility of using pseudo-CT (pCT) generated from T1w/T2w MR for proton treatment planning, where proton range comparisons are performed between standard CT and pCT. MR and CT data from 14 glioblastoma patients were used in this study. The pCT was generated by using conversion libraries obtained from tissue segmentation and anatomical regioning of the T1w/T2w MR. For each patient, a plan consisting of three 18 Gy beams was designed on the pCT, for a total of 42 analyzed beams. The plan was then transferred onto the CT that represented the ground truth. Range shift (RS) between pCT and CT was computed at R 80 over 10 slices. The acceptance threshold for RS was according to clinical guidelines of two institutions. A γ-index test was also performed on the total dose for each patient. Mean absolute error and bias for the pCT were 124 ± 10 and -16 ± 26 Hounsfield Units (HU), respectively. The median and interquartile range of RS was 0.5 and 1.4 mm, with highest absolute value being 4.4 mm. Of the 42 beams, 40 showed RS less than the clinical range margin. The two beams with larger RS were both in the cranio-caudal direction and had segmentation errors due to the partial volume effect, leading to misassignment of the HU. This study showed the feasibility of using T1w and T2w MRI to generate a pCT for proton therapy treatment, thus avoiding the use of a planning CT and allowing better target definition and possibilities for online adaptive therapies. Further improvements of the methodology are still required to improve the conversion from MRI intensities to HUs.

The efficacy of procalcitonin as a biomarker in the management of sepsis: slaying dragons or tilting at windmills?

PubMed

Sridharan, Prasanna; Chamberlain, Ronald S

2013-12-01

Sepsis is defined as systemic inflammatory response syndrome (SIRS) in the context of an underlying infectious process, and is associated with high rates of morbidity and mortality, particularly when initial therapy is delayed. Numerous biomarkers, including but not limited to cytokines (interleukins-2 and -6 [IL-2, IL-6] and tumor necrosis factor-α [TNF-α]), leukotrienes, acute-phase proteins (C-reactive protein [CRP]), and adhesion molecules, have been evaluated and rejected as unsuitable for the diagnosis of sepsis, predicting its severity, and guiding its treatment. Most recently, procalcitonin (PCT) has been suggested as a novel biomarker that may be useful in guiding therapeutic decision making in the management of sepsis. This article assesses critically the published literature on the clinical utility of PCT concentrations for guiding the treatment of sepsis in adult patients. A comprehensive search of all published studies of the use of serum concentrations of PCT to guide the treatment of sepsis in adult patients (1996 to 2011) was conducted with PubMed and Google Scholar. The search focused on the value of PCT concentrations to guide the diagnosis, prognosis, monitoring, and escalation and de-escalation of antbiotic therapy in these patients. Keywords searched included "procalcitonin," "sepsis," "sepsis biomarker," "sepsis diagnosis," "sepsis prognosis," "sepsis mortality," "antibiotic escalation," "antibiotic de-escalation," "antibiotic duration," and "antimicrobial stewardship." Forty-six trials evaluating the efficacy of PCT concentrations in diagnosing sepsis have been published, with 39 of these trials yielding positive results and 7 yielding negative results. Wanner et al. published the largest study (n=405) demonstrating that peak PCT concentrations occur early after injury in both patients with sepsis and those with multiple organ dysfunction syndrome (MODS). Among 17 trials assessing the prognostic value of PCT concentrations with regard to clinical outcome and morbidity, 12 trials yielded positive results and five showed negative or equivocal results. Reith et al. published the largest study of the prognostic use of PCT concentrations (n=246), demonstrating that median PCT values on post-operative days (POD) one, four, and 10 were predictive of mortality in patients with abdominal sepsis (p<0.01). Among 14 trials of the utility of PCT concentrations for establishing an infectious cause of sepsis, 13 yielded positive results and only one yielded negative results. The largest study of this use of PCT concentrations, conducted by Baykut et al. (n=400), evaluated these concentrations in post-operative patients with infection, and demonstrated that concentrations of PCT remained elevated until POD 4, with a second increase observed between POD 4 and POD 6. In uninfected patients, PCT concentrations began to decrease on POD 2. Only a single study has assessed the utility of PCT concentrations in guiding the escalation of antibiotic therapy, and its results were negative. Specifically, Jensen et al. (n=1,200) compared a PCT-guided antibiotic escalation strategy with the standard of care for sepsis and found no difference in outcomes. They also found that the PCT group had a longer average stay in the intensive care unit (ICU), greater rates of mechanical ventilation, and a decreased estimated glomerular filtration rate (eGFR). Among four trials focusing on PCT concentrations and antibiotic de-escalation, all showed positive results with the measurement of PCT concentrations. The largest such study, by Bouadma et al. (n=621), demonstrated a four-day decrease in antibiotic duration when PCT concentrations were used to guide therapy relative to the study arm given the standard of care, with no increase in mortality (p=0.003). The diagnostic value of serum PCT concentrations for discriminating among SIRS, sepsis, severe sepsis, and septic shock remains to be established. Although higher PCT concentrations suggest a systemic bacterial infection as opposed to a viral, fungal, or inflammatory etiology of sepsis, serum PCT concentrations do not correlate with the severity of sepsis or with mortality. At present, PCT concentrations are solely investigational with regard to determining the timing and appropriateness of escalation of antimicrobial therapy in sepsis. Nevertheless, serum PCT concentrations have established utility in monitoring the clinical response to medical and surgical therapy for sepsis, and in surveillance for the development of sepsis in burn and ICU patients, and may have a role in guiding the de-escalation of antibiotic therapy.

Experimental and analytical comparison of flowfields in a 110 N (25 lbf) H2/O2 rocket

NASA Technical Reports Server (NTRS)

Reed, Brian D.; Penko, Paul F.; Schneider, Steven J.; Kim, Suk C.

1991-01-01

A gaseous hydrogen/gaseous oxygen 110 N (25 lbf) rocket was examined through the RPLUS code using the full Navier-Stokes equations with finite rate chemistry. Performance tests were conducted on the rocket in an altitude test facility. Preliminary parametric analyses were performed for a range of mixture ratios and fuel film cooling pcts. It is shown that the computed values of specific impulse and characteristic exhaust velocity follow the trend of the experimental data. Specific impulse computed by the code is lower than the comparable test values by about two to three percent. The computed characteristic exhaust velocity values are lower than the comparable test values by three to four pct. Thrust coefficients computed by the code are found to be within two pct. of the measured values. It is concluded that the discrepancy between computed and experimental performance values could not be attributed to experimental uncertainty.

Automated screening of propulsion system test data by neural networks, phase 1

NASA Technical Reports Server (NTRS)

Hoyt, W. Andes; Whitehead, Bruce A.

1992-01-01

The evaluation of propulsion system test and flight performance data involves reviewing an extremely large volume of sensor data generated by each test. An automated system that screens large volumes of data and identifies propulsion system parameters which appear unusual or anomalous will increase the productivity of data analysis. Data analysts may then focus on a smaller subset of anomalous data for further evaluation of propulsion system tests. Such an automated data screening system would give NASA the benefit of a reduction in the manpower and time required to complete a propulsion system data evaluation. A phase 1 effort to develop a prototype data screening system is reported. Neural networks will detect anomalies based on nominal propulsion system data only. It appears that a reasonable goal for an operational system would be to screen out 95 pct. of the nominal data, leaving less than 5 pct. needing further analysis by human experts.

Final Report - IHLW PCT, Spinel T1%, Electrical Conductivity, and Viscosity Model Development, VSL-07R1240-4

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

Kruger, Albert A.; Piepel, Gregory F.; Landmesser, S. M.

2013-11-13

This report is the last in a series of currently scheduled reports that presents the results from the High Level Waste (HLW) glass formulation development and testing work performed at the Vitreous State Laboratory (VSL) of the Catholic University of America (CUA) and the development of IHLW property-composition models performed jointly by Pacific Northwest National Laboratory (PNNL) and VSL for the River Protection Project-Waste Treatment and Immobilization Plant (RPP-WTP). Specifically, this report presents results of glass testing at VSL and model development at PNNL for Product Consistency Test (PCT), one-percent crystal fraction temperature (T1%), electrical conductivity (EC), and viscosity ofmore » HLW glasses. The models presented in this report may be augmented and additional validation work performed during any future immobilized HLW (IHLW) model development work. Completion of the test objectives is addressed.« less

The effect of aluminum on the work hardening and wear resistance of hadfield manganese steel

NASA Astrophysics Data System (ADS)

Zuidema, B. K.; Subramanyam, D. K.; Leslie, W. C.

1987-09-01

A study has been made of the work-hardening and wear resistance of aluminum-modified Hadfield manganese steels ranging in composition from 1.00 to 1.75 Pct carbon and from 0.0 to 4.0 Pct aluminum. Aluminum additions reduced carbon activity and diffusivity in austenites of Hadfield’s composition, increasing the metastable solubility of carbon in Hadfield steel. Aluminum additions inhibited mechanical twinning and, by inference, increased the stacking fault energy of austenite. Increasing carbon in solution in austenite expanded the temperature range over which dynamic strain aging and rapid work hardening occurred. Simultaneous aluminum additions and increased carbon content increased the work-hardening rate and high-stress abrasion resistance of Hadfield steel, but there was an optimum aluminum content beyond which both declined. Maximum work-hardening rate was exhibited by an alloy containing nominally 1.75 Pct C, 13.5 Pct Mn, and 1.3 Pct Al. Improved high-stress abrasion resistance was also found in an alloy containing nominally 1.00 Pct C, 13.5 Pct Mn, and 4.0 Pct Al.

Enriching and Separating Primary Copper Impurity from Pb-3 Mass Pct Cu Melt by Super-Gravity Technology

NASA Astrophysics Data System (ADS)

Yang, Yuhou; Song, Bo; Song, Gaoyang; Yang, Zhanbing; Xin, Wenbin

2016-10-01

In this study, super-gravity technology was introduced in the lead bullion-refining process to investigate the enriching and separating laws of copper impurity from Pb-3 mass pct Cu melt. With the gravity coefficient G = 700 at the cooling rate of ν = 5 K min-1, the entire copper phase gathers at the upper area of the sample, and it is hard to find any copper particles at the bottom area of the sample. The floatation movement of copper phase was greatly intensified by super gravity and the mass pct of copper in tailing lead is up to 8.631 pct, while that in the refined lead is only 0.113 pct. The refining rate of lead bullion reached up to 94.27 pct. Copper-phase impurity can be separated effectively from Pb-3 mass pct Cu melt by filtration method in super-gravity field, and the separation efficiency increased with the increasing gravity coefficient in the range of G ≥ 10. After filtration at 613 K (340 °C) with gravity coefficient G = 100 for 10 minutes, the refined lead, with just 0.157 mass pct copper impurity, was separated to the bottom of the crucible, and the copper dross containing only 23.56 mass pct residual lead was intercepted by the carbon fiber felt, leading to the separation efficiency up to 96.18 pct (meaning a great reduction in metal loss).

Procalcitonin, C-reactive protein and serum lactate dehydrogenase in the diagnosis of bacterial sepsis, SIRS and systemic candidiasis.

PubMed

Miglietta, Fabio; Faneschi, Maria Letizia; Lobreglio, Giambattista; Palumbo, Claudio; Rizzo, Adriana; Cucurachi, Marco; Portaccio, Gerolamo; Guerra, Francesco; Pizzolante, Maria

2015-09-01

The aim of this study was to evaluate procalcitonin (PCT), C-reactive protein (CRP), platelet count (PLT) and serum lactate dehydrogenase (LDH) as early markers for diagnosis of SIRS, bacterial sepsis and systemic candidiasis in intensive care unit (ICU) patients. Based on blood culture results, the patients were divided into a sepsis group (70 patients), a SIRS group (42 patients) and a systemic candidiasis group (33 patients). PCT, CRP, LDH and PLT levels were measured on day 0 and on day 2 from the sepsis symptom onset. PCT levels were higher in Gram negative sepsis than those in Gram positive sepsis, although the P value between the two subgroups is not significant (P=0.095). Bacterial sepsis group had higher PCT and CRP levels compared with the systemic candidiasis group, whereas PLT and LDH levels showed similar levels in these two subgroups. The AUC for PCT (AUC: 0.892, P <0.001) was larger than for CRP (AUC: 0.738, P <0.001). The best cut-off values for PCT and CRP were 0.99 ng/mL and 76.2 mg/L, respectively. Diagnostic sensitivity and specificity for PCT were 84.3% and 81.8% whereas CRP showed a sensitivity of 77.2% and a specificity of 63.6%. However, PCT was unable to discriminate between SIRS and systemic candidiasis groups (P=0.093 N.S.). In conclusion, PCT can be used as a preliminary marker in the event of clinical suspicion of systemic candidiasis; however, low PCT levels (<0.99 ng/mL) necessarily require the use of other specific markers of candidaemia to confirm the diagnosis, due to great uniformity of PCT levels in systemic candidiasis and SIRS groups.

Plasma procalcitonin concentrations are increased in dogs with sepsis

PubMed Central

Goggs, Robert; Milloway, Matthew; Troia, Roberta; Giunti, Massimo

2018-01-01

Sepsis, the life-threatening organ dysfunction caused by a dysregulated host response to infection, is difficult to identify and to prognosticate for. In people with sepsis, procalcitonin (PCT) measurement aids diagnosis, enables therapeutic monitoring and improves prognostic accuracy. This study used a commercial canine PCT assay to measure plasma PCT concentrations in dogs with gastric dilatation volvulus (GDV) syndrome and in dogs with sepsis. It was hypothesised that dogs with GDV syndrome and with sepsis have greater plasma PCT concentrations than healthy dogs and that dogs with sepsis have greater PCT concentrations than dogs with GDV syndrome. Before analysing canine plasma samples, the ability of the assay to identify canine PCT, in addition to assay imprecision and the lower limit of detection were established. The assay had low imprecision with coefficients of variation ≤4.5 per cent. The lower limit of detection was 3.4 pg/ml. Plasma PCT concentrations were measured in 20 dogs with sepsis, in 32 dogs with GDV syndrome and in 52 healthy dogs. Median (IQR) PCT concentration in dogs with sepsis 78.7 pg/ml (39.1–164.7) was significantly greater than in healthy dogs 49.8 pg/ml (36.2–63.7) (P=0.019), but there were no significant differences between PCT concentrations in dogs with GDV syndrome and controls (P=0.072) or between dogs with sepsis and GDV syndrome (P=1.000). Dogs with sepsis have significantly increased plasma PCT concentrations compared with healthy dogs, although considerable overlap between these populations was identified. Future investigations should confirm this finding in other populations and evaluate the diagnostic and prognostic value of PCT in dogs with sepsis. PMID:29682292

Crystal Phases Formed in a CaO-Fe2O3 System Under a High Cooling Rate in Air

NASA Astrophysics Data System (ADS)

Kashiwaya, Yoshiaki

2017-12-01

A CaO-Fe2O3 system is a fundamental binary system for the iron ore sintering process. Although the basic reactions have been investigated since the 1960s, melting and solidification caused by the combustion of coke results in an unstable state owing to extreme temperature variations. In this study, using a hot thermocouple method, samples of 10 pct CaO-90 pct Fe2O3 and 20 pct CaO-80 pct Fe2O3 were melted on a thermocouple and quenched with several techniques. The obtained samples were precisely examined by XRD. It was found that the sample containing 10 pct CaO-90 pct Fe2O3 changed to 10 pct CaO-13 pct FeO-77 pct Fe2O3 under an oxygen partial pressure ( P_{{{O}2 }} ) of 0.21 during melting. For the 10 pct CaO sample, the crystal phases found at a low cooling rate (509 K/s) were WFss, C4WF8 (C: CaO, W: FeO, F: Fe2O3), and C2W4F9. When the sample composition was 20 pct CaO, the precipitated crystal phases were C4WF4, C4F7, and C4WF8. On the other hand, the crystal phases for high cooling rates (1590 and 7900 K/s) with 10 pct CaO were WFss (solid solution of WF and F), F, and C2W4F9. The formation of the equilibrium phases WFss, F, C4WF4, and C4WF8 can be understood by examining the isothermal section of the phase diagrams, while the unstable phases C2W4F9 and C4F7 are discussed on the basis of the reactions under an equilibrium state.

Acid sphingomyelinase serum activity predicts mortality in intensive care unit patients after systemic inflammation: a prospective cohort study.

PubMed

Kott, Matthias; Elke, Gunnar; Reinicke, Maike; Winoto-Morbach, Supandi; Schädler, Dirk; Zick, Günther; Frerichs, Inéz; Weiler, Norbert; Schütze, Stefan

2014-01-01

Acid sphingomyelinase is involved in lipid signalling pathways and regulation of apoptosis by the generation of ceramide and plays an important role during the host response to infectious stimuli. It thus has the potential to be used as a novel diagnostic marker in the management of critically ill patients. The objective of our study was to evaluate acid sphingomyelinase serum activity (ASM) as a diagnostic and prognostic marker in a mixed intensive care unit population before, during, and after systemic inflammation. 40 patients admitted to the intensive care unit at risk for developing systemic inflammation (defined as systemic inflammatory response syndrome plus a significant procalcitonin [PCT] increase) were included. ASM was analysed on ICU admission, before (PCT before), during (PCT peak) and after (PCT low) onset of SIRS. Patients undergoing elective surgery served as control (N = 8). Receiver-operating characteristics curves were computed. ASM significantly increased after surgery in the eight control patients. Patients from the intensive care unit had significantly higher ASM on admission than control patients after surgery. 19 out of 40 patients admitted to the intensive care unit developed systemic inflammation and 21 did not, with no differences in ASM between these two groups on admission. In patients with SIRS and PCT peak, ASM between admission and PCT before was not different, but further increased at PCT peak in non-survivors and was significantly higher at PCT low compared to survivors. Survivors exhibited decreased ASM at PCT peak and PCT low. Receiver operating curve analysis on discrimination of ICU mortality showed an area under the curve of 0.79 for ASM at PCT low. In summary, ASM was generally higher in patients admitted to the intensive care unit compared to patients undergoing uncomplicated surgery. ASM did not indicate onset of systemic inflammation. In contrast to PCT however, it remained high in non-surviving ICU patients after systemic inflammation.

Crystal structures of resorcin[4]arene and pyrogallol[4]arene complexes with DL-pipecolinic acid. Model compounds for the recognition of the pipecolinyl ring, a key fragment of FK506, through C-H⋯π interaction

NASA Astrophysics Data System (ADS)

Fujisawa, Ikuhide; Kitamura, Yuji; Kato, Ryo; Murayama, Kazutaka; Aoki, Katsuyuki

2014-01-01

Resorcin[4]arene (resorcinol cyclic tetramer, abbreviated as RCT) or pyrogallol[4]arene (pyrogallol cyclic tetramer, PCT) form host-guest 1:1 complexes with DL-pipecolinic acid (DL-pipeH), RCT·DL-pipeH·EtOH·8H2O (1), PCT DL-pipeH·EtOH·4H2O (2), and PCT·DL-pipeH·3H2O (3), whose crystal structures have been determined. In each complex, the pipeH ligand is incorporated into the bowl-shaped cavity of the RCT or PCT host molecules through C-H⋯π interactions between alkyl protons of the piperidine ring of pipeH and π-rings of RCT or PCT, forming an [(RCT/PCT)·pipeH] structural fragment. In 1 and 3, two [(RCT/PCT) pipeH] fragments self-associate across an inversion center to form a guest-mediated, obliquely declined dimeric structure [(RCT/PCT)·L-pipeH·D-pipeH (RCT/PCT)]. In 2, each PCT-capped pipeH ligand bridges to two adjacent PCT molecules to form guest-mediated, optically-discrete helical polymers [PCT·L-pipeH]n or [PCT·D-pipeH]n. An 1H NMR experiment shows that the complexation through C-H⋯π interaction between the piperidine ring of pipeH and π-rings of RCT or PCT occurs also in solution, with the binding constants of 9.7 ± 0.6 M-1 for RCT and 26.5 ± 1.5 M-1 for PCT. These complexes provide a synthetic model for the recognition of the pipecolinyl-ring moiety, a key constituent of immunosuppressant drugs such as FK506, FK520 or rapamycin, by their binding proteins through C-H⋯π interaction.

Microstructure, Mechanical Properties, and Electrochemical Behavior of Ti-Nb-Fe Alloys Applied as Biomaterials

NASA Astrophysics Data System (ADS)

Lopes, Éder Sócrates Najar; Salvador, Camilo Augusto Fernandes; Andrade, Denis Renato; Cremasco, Alessandra; Campo, Kaio Niitsu; Caram, Rubens

2016-06-01

New β metastable Ti alloys based on Ti-30Nb alloy with the addition of 1, 3, or 5 wt pct Fe have been developed using the bond order and the metal d-orbital energy level ( overline{{Bo}} {-} overline{{Md}} ) design theory. The samples were prepared by arc melting, hot working, and solution heat treatment above the β transus followed by water quenching (WQ) or furnace cooling (FC). The effect of the cooling rate on the microstructure of Ti-30Nb-3Fe wt pct was investigated in detail using a modified Jominy end quench test. The results show that Fe acts as a strong β-stabilizing alloying element. The addition of Fe also leads to a reduction in the ω and α phases volumetric fractions, although the ω phase was still detected in the WQ Ti-30Nb-5Fe samples, as shown by TEM, and α phase clusters were detected by SEM in the FC Ti-30Nb-3Fe samples. Among the WQ samples, the addition of 5 wt pct Fe improves the ultimate tensile strength (from 601 to 689 MPa), reduces the final elongation (from 28 to 16 pct), and impairs the electrochemical corrosion resistance, as evaluated by potentiodynamic polarization tests in Ringer's solution. The microstructural variation arising from the addition of Fe did not change the elastic modulus (approximately 80 GPa for all experimental WQ samples). This study shows that small Fe additions can tailor the microstructure of Ti-Nb alloys, modifying α and ω phase precipitation and improving mechanical strength.

The Effect of Aging on the Microstructure of Selective Laser Melted Cu-Ni-Si

NASA Astrophysics Data System (ADS)

Ventura, Anthony P.; Marvel, Christopher J.; Pawlikowski, Gregory; Bayes, Martin; Watanabe, Masashi; Vinci, Richard P.; Misiolek, Wojciech Z.

2017-12-01

Precipitation hardening copper alloy C70250 was selectively laser melted to successfully produce components around 98 pct dense with high mechanical strength and electrical conductivity. Aging heat treatments were carried out at 723 K (450 °C) directly on as-printed samples up to 128 hours. Mechanical testing found that peak yield strength of around 590 MPa could be attained with an electrical conductivity of 34.2 pct IACS after 8 hours of aging. Conductivity continues to increase with further aging while the peak strength appears to be less sensitive to aging time exhibiting a broad range of time where near-peak properties exist. After aging for 128 hours, there is a drop in yield strength to 546 MPa with an increase in conductivity to 43.2 pct IACS. Electron microscopy analysis revealed nanometer-scale silicon-rich oxide particles throughout the material that persist during aging. Deformation twinning is observed in the peak-age condition after tensile testing and several strengthening mechanisms appear to be active to varying degrees throughout aging which account for the broad range of aging time where nearly the peak mechanical properties exist.

7 CFR 51.2954 - Tolerances for grade defects.

Code of Federal Regulations, 2010 CFR

2010-01-01

... chart. Tolerances for Grade Defects Grade External (shell) defects Internal (kernel) defects Color of kernel U.S. No. 1. 10 pct, by count for splits. 5 pct. by count, for other shell defects, including not... tolerance to reduce the required 70 pct of “light amber” kernels or the required 40 pct of “light” kernels...

Long cycle life rechargeable lithium batteries

NASA Technical Reports Server (NTRS)

Pasquariello, D. M.; Willstaedt, E. B.; Abraham, K. M.

1992-01-01

Cycle life and safety of delta-LiAl/TiS2 cells were evaluated using laboratory and AA-size cells. Analysis of the alloys (which contained 60, 70, 80, or 85 wt-pct. lithium and are designated 60 LiAl etc.) showed them to contain a mixture of elemental Li and Al4Li9. Cycling efficiencies correlated with the amount of free lithium in the anode. Using an electrolyte with the composition 48 v/o THF:48 v/o 2-MeTHF:4 v/o 2-MeF/LiAsF6(1.5M), a 70 LiAl/TiS2 laboratory cell yielded a cycling efficiency of 96.4 pct. when cycled at a 100 pct. discharge depth which compares well with Li anode cycling efficiencies of 96 to 97.5 pct. obtained previously in this electrolyte. The highest cycling efficiency of any delta-LiAl/TiS2 laboratory cell was 96.7 pct. when the 60 LiAl alloy was used with the 35 v/o PC:35 v/o EC:30 v/o triglyme/LiAsF6(1.0M) electrolyte. The 70 LiAl alloy was selected for further testing in AA cells since it was malleable for the fabrication of spirally wound electrodes, and its overall cycling performance was sufficiently good. AA-size 70 LiAl/TiS2 cells appear to have capacity/rate properties similar to those for identical Li/TiS2 cells. The use of the delta-LiAl alloy anodes does not appear to offer any safety advantage when cycled cells are shorted or heated.

Role of Si on the Diffusional Interactions Between U-Mo and Al-Si Alloys at 823 K (550 °C)

NASA Astrophysics Data System (ADS)

Perez, Emmanuel; Sohn, Yong-Ho; Keiser, Dennis D.

2013-01-01

U-Mo dispersions in Al-alloy matrix and monolithic fuels encased in Al-alloy are under development to fulfill the requirements for research and test reactors to use low-enriched molybdenum stabilized uranium alloy fuels. Significant interaction takes place between the U-Mo fuel and Al during manufacturing and in-reactor irradiation. The interaction products are Al-rich phases with physical and thermal characteristics that adversely affect fuel performance and result in premature failure. Detailed analysis of the interdiffusion and microstructural development of this system was carried through diffusion couples consisting of U-7 wt pct Mo, U-10 wt pct Mo and U-12 wt pct Mo in contact with pure Al, Al-2 wt pct Si, and Al-5 wt pct Si, annealed at 823 K (550 °C) for 1, 5 and 20 hours. Scanning electron microscopy and transmission electron microscopy were employed for the analysis. Diffusion couples consisting of U-Mo in contact with pure Al contained UAl3, UAl4, U6Mo4Al43, and UMo2Al20 phases. Additions of Si to the Al significantly reduced the thickness of the interdiffusion zone. The interdiffusion zones developed Al- and Si-enriched regions, whose locations and size depended on the Si and Mo concentrations in the terminal alloys. In these couples, the (U,Mo)(Al,Si)3 phase was observed throughout the interdiffusion zone, and the U6Mo4Al43 and UMo2Al20 phases were observed only where the Si concentrations were low.

Solid-State Metalized Reduction of Magnesium-Rich Low-Nickel Oxide Ores Using Coal as the Reductant Based on Thermodynamic Analysis

NASA Astrophysics Data System (ADS)

Ma, Baozhong; Xing, Peng; Yang, Weijiao; Wang, Chengyan; Chen, Yongqiang; Wang, Hua

2017-08-01

The solid-state metalized reduction of magnesium-rich low-nickel oxide ore using coal as a reductant was studied based on thermodynamic analysis. The major constituent minerals of the ore were silicates and goethite. The former was the main nickel-bearing mineral, and the latter was the main iron-bearing mineral. Single factor tests were conducted to investigate the effects of reduction temperature, duration, and coal dosage on the beneficiation of nickel and iron such that optimal conditions were achieved. Considering the low recoveries of nickel and iron (Ni, 13.9 pct; Fe, 30.3 pct) under the obtained optimal conditions, an improved process, adding CaF2 before the reaction, was proposed to modify the solid-state metalized process. The results showed that the recoveries of nickel and iron reached to 96.5 and 73.4 pct, respectively, and that the grades of nickel and iron in the concentrate increased from 2.5 and 62.6 wt pct to 6.9 and 71.4 wt pct, respectively. Nickel and iron in the absence of CaF2 were metalized; nevertheless, the size of ferronickel particles was only 1 μm. Furthermore, alloys in the presence of CaF2 aggregated and exhibited bands with a length greater than 200 µm. These observations suggested that CaF2 could effectively reduce the surface tension of the newly generated alloy interface and promote the migration and polymerization of the alloy particles, which improves the beneficiation of nickel and iron by magnetic separation.

A randomised controlled trial among cleaners--effects on strength, balance and kinesiophobia.

PubMed

Jørgensen, Marie Birk; Ektor-Andersen, John; Sjøgaard, Gisela; Holtermann, Andreas; Søgaard, Karen

2011-10-10

Cleaners constitute a job group with poor health and low socioeconomic resources. Therefore, there is a great need for scientifically documented health promoting initiatives for cleaners. However, both workplace initiatives and high quality intervention studies are lacking. The aim of this study was to evaluate the effects of a 3-month workplace trial with interventions to improve physical or cognitive behavioural resources among cleaners. A cluster randomised controlled trial was conducted among 294 female cleaners from 9 workplaces. The participants were allocated to three groups: Physical coordination training (PCT, n = 95), Cognitive behavioural theory-based training (CBTr, n = 99) and Reference group (REF, n = 100). Interventions were conducted during work hours for an average of 1 hour/week. Muscle strength was measured by maximal voluntary contractions in trunk/extension, and shoulder abduction/elevation. Postural balance was measured on a force platform. Kinesiophobia was measured with Tampa Scale for Kinesiophobia. Test and questionnaires were completed at baseline and at 3-month follow-up and analyses followed the intention-to-treat (ITT) principle with last observation carried forward in case of missing data at follow-up. Reports and analyses are given on true observations as well. ITT-analyses revealed that PCT improved strength of the trunk (p < .05) and postural balance (p < .05) compared to CBTr and REF. Based on true observations the strength and balance improvements corresponded to ~20% and ~16%, respectively. ITT-analyses showed that CBTr reduced kinesiophobia compared to PCT and REF (p < .05). Based on true observations, the improvement corresponded to a ~16% improvement. This workplace-based intervention study including PCT and CBTr among cleaners improved strength and postural balance from PCT, and kinesiophobia from CBTr. The improved strength, postural balance and kinesiophobia may improve the cleaners' tolerance for high physical work demands. Future studies should investigate the potential in the combination of PCT and CBTr in a workplace intervention. Current controlled trials ISRCTN96241850.

[Value of procalcitonin on predicting the severity and prognosis in patients with early ARDS: a prospective observation study].

PubMed

Yu, Zhixin; Ji, Musen; Hu, Xiulan; Yan, Jun; Jin, Zhaochen

2017-01-01

To investigate the value of procalcitonin (PCT) on predicting the severity and prognosis in patients with early acute respiratory distress syndrome (ARDS). A prospective observation study was conducted. A total of 113 patients with ARDS undergoing mechanical ventilation admitted to intensive care unit (ICU) of Affiliated People's Hospital of Jiangsu University from October 2012 to April 2016 were enrolled. Based on oxygenation index (PaO 2 /FiO 2 ), the patients were classified into mild, moderate, and severe groups according to Berlin Definition. Twenty-five healthy volunteers were served as controls. Demographics, acute physiology and chronic health evaluation II (APACHE II) score, and Murray lung injury score were recorded. Within 24 hours after diagnosis of ARDS, the serum levels of PCT and C-reactive protein (CRP) were determined by enzyme-linked fluorescence analysis (ELFA) and immune turbidimetric method, respectively. The patients were also divided into survival and non-survival groups according to clinical outcome within 28-day follow-up, and the clinical data were compared between the two groups. Spearman rank correlation was applied to determine the correlation between variables. The predictive value of the parameters on 28-day mortality was evaluated with receiver operating characteristic curve (ROC). Kaplan-Meier survival curve analysis was used to compare different PCT levels of patients with 28-day cumulative survival rate. After excluding patients who did not meet the inclusion criteria and loss to follow-up, the final 89 patients were enrolled in the analysis. Among 89 ARDS patients analyzed, 27 of them were mild, 34 moderate, and 28 severe ARDS. No significant differences were found in age and gender between ARDS and healthy control groups. Infection and trauma were the most common etiology of ARDS (55.1% and 34.8%, respectively). Compared with healthy control group, both CRP and PCT in serum of ARDS group were higher [CRP (mg/L): 146.32 (111.31, 168.49) vs. 6.08 (4.47, 7.89), PCT (μg/L): 3.46 (1.98, 5.56) vs. 0.02 (0.01, 0.04), both P < 0.01], and the two showed sustained upward trends with the ARDS course of disease. Compared with mild group, severe group had significantly higher APACHE II and Murray scores. Spearman rank correlation analysis showed that both serum PCT and CRP in patients with ARDS was correlated well with APACHE II score (r values were 0.669 and 0.601, respectively, both P < 0.001), while PCT was weakly but positively correlated with Murray score (r = 0.294, P = 0.005), but not the case of CRP (r = 0.203, P = 0.052). APACHE II score and serum PCT in non-survival group (n = 38) were significantly higher than those of the survival group [n = 51; APACHE II score: 26.00 (23.00, 28.50) vs. 21.00 (17.00, 25.00), PCT (μg/L): 6.38 (2.82, 9.49) vs. 3.09 (1.08, 3.57), both P < 0.01], but Murray score and CRP level were similar between survivors and non-survivors. The areas under ROC curve (AUC) of APACHE II score and PCT for predicting 28-day mortality were 0.781 and 0.793, respectively, which were better than those of AUC of Murray score and CRP (0.606 and 0.561, respectively, all P < 0.05). The AUC of APACHE II score combined with PCT was significantly higher than that of PCT (0.859 vs. 0.793, P = 0.048) or APACHE II score alone (0.859 vs. 0.781, P = 0.038). Using a PCT cut-off value of > 4.35 μg/L for predicting 28-day mortality, the sensitivity and specificity was 92.2% and 63.2%, respectively, and the positive and negative likelihood ratios were 2.50 and 0.12 respectively. Kaplan-Meier survival curve analysis indicated that the patients whose PCT more than 4.35 μg/L, had lower 28-day cummulative survival rate as compared with those with PCT ≤ 4.35 μg/L (log-rank test: χ 2 = 5.013, P = 0.025). The elevated serum PCT level in patients with ARDS seems to be correlated well with the severity of lung injury, and appears to be a useful prognostic marker of outcome in the early phases of ARDS.

The mechanisms of dispersion strengthening and fracture in Al-based XD(tm) alloys, part 1

NASA Technical Reports Server (NTRS)

Aikin, R. M., Jr.

1990-01-01

The influence of reinforcement size, volume fraction, and matrix deformation behavior on room and elevated temperature strength; the fracture toughness; and the fatigue crack growth rate of metal matrix composites of Al-4(pct)Cu-1.5(pct)Mg with TiB2 were examined. The influence of reinforcement volume fraction was also examined for pure aluminum with TiB2. Higher TiB2 volume fractions increased the tensile yield strength at both room and elevated temperatures, and reduced the elongation to fracture. Tensile tests also indicate that small particles provided a greater increase in strength for a given volume fraction than larger particles, whereas elongation to fracture appeared to be insensitive to reinforcement size. Interparticle spacing appears to be the factor that controls the strength of these alloys, with the exact nature of the dependence relying on the nature of dislocation slip in the matrix (planar vs. diffuse). The isothermal aging response of the precipitation strengthened Al-4(pct)Cu-1.5(pct)Mg alloys was not accelerated by the presence of TiB2. Cold work prior to artificial aging created additional geometrically necessary dislocations which serve as heterogeneous nucleation sites leading to accelerated aging, a finer precipitate size, and an increase in the strength of the alloy.

The diagnostic value of CRP, IL-8, PCT, and sTREM-1 in the detection of bacterial infections in pediatric oncology patients with febrile neutropenia.

PubMed

Miedema, Karin G E; de Bont, Eveline S J M; Elferink, Rob F M Oude; van Vliet, Michel J; Nijhuis, Claudi S M Oude; Kamps, Willem A; Tissing, Wim J E

2011-10-01

In this study, we evaluated C-reactive protein (CRP), interleukin (IL)-8, procalcitonin (PCT), and soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) as predictors for bacterial infection in febrile neutropenia, plus their usefulness in febrile neutropenia during chemotherapy-induced gastrointestinal mucositis. Plasma was obtained from pediatric oncology patients at presentation with febrile neutropenia (n = 43) and 24-48 h later (n = 17). The patients were classified as having or not having a bacterial infection. Plasma was also obtained of patients in the absence and in the presence of mucositis (n = 26). At presentation with febrile neutropenia, median IL-8 and PCT levels were significantly increased in patients with a bacterial infection, in contrast to CRP and sTREM-1. IL-8 was the most sensitive marker for the early detection of bacterial infection, in combination with clinical parameters or PCT the sensitivity reached 100%. After 24-48 h, only PCT was significantly elevated during bacterial infection. IL-8 levels were significantly increased during mucositis. Mucositis did not cause considerable changes in PCT levels. IL-8 is the most useful marker for the early detection of bacterial infections, compared with CRP, PCT, and sTREM-1. IL-8 in combination with clinical parameters or PCT might be even more useful. Gastrointestinal mucositis alone does not affect PCT levels, in contrast to IL-8 levels, and therefore, PCT might be more useful for the detection of bacterial infections during mucositis than IL-8.

Thermodynamics and Kinetics of Boron Removal from Metallurgical Grade Silicon by Addition of High Basic Potassium Carbonate to Calcium Silicate Slag

NASA Astrophysics Data System (ADS)

Wu, Jijun; Wang, Fanmao; Ma, Wenhui; Lei, Yun; Yang, Bin

2016-06-01

In this study, we investigated the thermodynamics and kinetics of boron removal from metallurgical grade silicon (MG-Si) using a calcium silicate slag containing a high basic potassium carbonate. The distribution of boron between slag and silicon was theoretically derived and the distribution coefficients ( L B) of boron with different compositions of CaO, SiO2, and K2CO3 in slag reagents were determined. The maximal value of L B reached 2.08 with a high basicity slag of 40 pctCaO-40 pctSiO2-20 pctK2CO3 (Λ = 0.73). The boron removal rates from MG-Si using CaO-SiO2 and CaO-SiO2-K2CO3 slags at 1823 K (1550 °C) were investigated in an electromagnetic induction furnace. The results showed that the boron concentration in MG-Si can be reduced from 22 to 1.8 ppmw at 1823 K (1550 °C) with 20 pct K2CO3 addition to calcium silicate slag, where the removal efficiency of boron reached 91.8 pct. The mass transfer coefficient ( β S) of boron in binary 50 pctCaO-50 pctSiO2 slag was 3.16 × 10-6 m s-1 at 1823 K (1550 °C) and was 2.43 × 10-5 m s-1 in ternary 40 pctCaO-40 pctSiO2-20 pctK2CO3 slag.

Serum Procalcitonin in Patients with Acute Liver Failure

PubMed Central

Sugihara, Takaaki; Koda, Masahiko; Okamoto, Toshiaki; Miyoshi, Kenichi; Matono, Tomomitsu; Oyama, Kenji; Hosho, Keiko; Okano, Jun-ichi; Isomoto, Hajime

2017-01-01

Background Procalcitonin (PCT) is a known diagnostic marker of bacterial infection. There are no previous reports of PCT concerning acute liver failure (ALF). We evaluated the clinical value of serum PCT levels in patients with ALF. Methods Forty-four patients with acute hepatitis (19 men and 25 women; median age, 40 years; range, 20–79 years) were retrospectively enrolled from January 2001 and June 2015. PCT levels were measured by saved serum samples obtained within 3 days after admission. ALF was defined as prothrombin time (PT) < 40% regardless of hepatic encephalopathy. Results Serum PCT levels were significantly higher in the patients with ALF (n = 16) than in those with non-ALF (n = 28) [0.25 (0.13–2.66) ng/mL vs. 0.165 (0.03–1.08), P = 0.00967]. Creatinine, total bilirubin, and direct bilirubin were positively correlated, and PT was negatively correlated with PCT. Receiver operating characteristic curve analysis showed an area under the curve of 0.74 for detecting ALF. With a PCT cut-off value of 0.5 ng/mL, the presence of ALF could be demonstrated with low sensitivity (37.5%) and high specificity (96.5%) with high positive (85.7%) and negative (72.9%) predictive value. Multivariate analysis showed that PCT was an independent factor associated with the presence of ALF. The cumulative survival rate was also significantly lower in patients with PCT ≥ 0.5 ng/mL (P = 0.0314), but it was not an independent prognostic factor. Conclusion Serum PCT level was significantly higher in patients with ALF. PMID:28331420

Stability of procalcitonin at room temperature.

PubMed

Milcent, Karen; Poulalhon, Claire; Fellous, Christelle Vauloup; Petit, François; Bouyer, Jean; Gajdos, Vincent

2014-01-01

The aim was to assess procalcitonin (PCT) stability after two days of storage at room temperature. Samples were collected from febrile children aged 7 to 92 days and were rapidly frozen after sampling. PCT levels were measured twice after thawing: immediately (named y) and 48 hours later after storage at room temperature (named x). PCT values were described with medians and interquartile ranges or by categorizing them into classes with thresholds 0.25, 0.5, and 2 ng/mL. The relationship between x and y PCT levels was analyzed using fractional polynomials in order to predict the PCT value immediately after thawing (named y') from x. A significant decrease in PCT values was observed after 48 hours of storage at room temperature, either in median, 30% lowering (p < 0.001), or as categorical variable (p < 0.001). The relationship between x and y can be accurately modeled with a simple linear model: y = 1.37 x (R2 = 0.99). The median of the predicted PCT values y' was quantitatively very close to the median of y and the distributions of y and y' across categories were very similar and not statistically different. PCT levels noticeably decrease after 48 hours of storage at room temperature. It is possible to pre- dict accurately effective PCT values from the values after 48 hours of storage at room temperature with a simple statistical model.

Superplastic behavior of two ultrahigh boron steels

NASA Astrophysics Data System (ADS)

Jiménez, J. A.; González-Doncel, G.; Acosta, P.; Ruano, O. A.

1994-06-01

The high-temperature deformation behavior of two ultrahigh boron steels containing 2.2 pct and 4.9 pct B was investigated. Both alloys were processed via powder metallurgy involving gas atomization and hot isostatic pressing (hipping) at various temperatures. After hipping at 700 °C, the Fe-2.2 pct B alloy showed a fine microstructure consisting of l- µm grains and small elongated borides (less than 1 µm) . At 1100 °C, a coarser microstructure with rounded borides was formed. This alloy was superplastic at 850 °C with stress exponents of about two and tensile elongations as high as 435 pct. The microstructure of the Fe-4.9 pct B alloy was similar to that of the Fe-2.2 pct B alloy showing, in addition, coarse borides. This alloy also showed low stress exponent values but lacked high tensile elongation (less than 65 pct), which was attributed to the presence of stress accumulation at the interface between the matrix and the large borides. A change in the activation energy value at the α-γ transformation temperature was seen in the Fe-2.2 pct B alloy. The plastic flow data were in agreement with grain boundary sliding and slip creep models.

Summary Report For The Analysis Of The Sludge Batch 7b (Macrobatch 9) DWPF Pour Stream Glass Sample For Canister S04023

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

Johnson, F. C.

2013-11-18

In order to comply with the Defense Waste Processing Facility (DWPF) Waste Form Compliance Plan for Sluldge Batch 7b, Savannah River National Laboratory (SRNL) personnel characterized the Defense Waste Processing Facility (DWPF) pour stream (PS) glass sample collected while filling canister S04023. This report summarizes the results of the compositional analysis for reportable oxides and radionuclides and the normalized Product Consistency Test (PCT) results. The PCT responses indicate that the DWPF produced glass that is significantly more durable than the Environmental Assessment glass.

Improvement in surface fatigue life of hardened gears by high-intensity shot peening

NASA Astrophysics Data System (ADS)

Townsend, Dennis P.

1992-04-01

Two groups of carburized, hardened, and ground spur gears that were manufactured from the same heat vacuum induction melted vacuum arc melted (VIM VAR) AISI 9310 steel were endurance tested for surface fatigue. Both groups were manufactured with a standard ground 16 rms surface finish. One group was subjected to a shot peening (SP) intensity of 7 to 9A, and the second group was subjected to a SP intensity of 15 to 17A. All gears were honed after SP to a surface finish of 16 rms. The gear pitch diameter was 8.89 cm. Test conditions were a maximum Hertz stress of 1.71 GPa, a gear temperature of 350 K, and a speed of 10000 rpm. The lubricant used for the tests was a synthetic paraffinic oil with an additive package. The following results were obtained: The 10 pct. surface fatigue (pitting) life of the high intensity (15 to 17A) SPed gears was 2.15 times that of the medium intensity (7 to 9A) SPed gears, the same as that calculated from measured residual stress at a depth of 127 microns. The measured residual stress for the high intensity SPed gears was 57 pct. higher than that for the medium intensity SPed gears at a depth of 127 microns and 540 pct. higher at a depth of 51 microns.

Improvement in surface fatigue life of hardened gears by high-intensity shot peening

NASA Technical Reports Server (NTRS)

Townsend, Dennis P.

1992-01-01

Two groups of carburized, hardened, and ground spur gears that were manufactured from the same heat vacuum induction melted vacuum arc melted (VIM VAR) AISI 9310 steel were endurance tested for surface fatigue. Both groups were manufactured with a standard ground 16 rms surface finish. One group was subjected to a shot peening (SP) intensity of 7 to 9A, and the second group was subjected to a SP intensity of 15 to 17A. All gears were honed after SP to a surface finish of 16 rms. The gear pitch diameter was 8.89 cm. Test conditions were a maximum Hertz stress of 1.71 GPa, a gear temperature of 350 K, and a speed of 10000 rpm. The lubricant used for the tests was a synthetic paraffinic oil with an additive package. The following results were obtained: The 10 pct. surface fatigue (pitting) life of the high intensity (15 to 17A) SPed gears was 2.15 times that of the medium intensity (7 to 9A) SPed gears, the same as that calculated from measured residual stress at a depth of 127 microns. The measured residual stress for the high intensity SPed gears was 57 pct. higher than that for the medium intensity SPed gears at a depth of 127 microns and 540 pct. higher at a depth of 51 microns.

Effect of Carbon on Microstructure and Mechanical Properties of Low C-1.6 pct Mn-0.1 pct Cr-0.3 pct Mo-0.0005 pct B Dual-Phase Steels

NASA Astrophysics Data System (ADS)

Jeong, W. C.

2014-11-01

Effect of carbon on the microstructure and mechanical properties of 0.011 and 0.032 pct carbon dual-phase steels was investigated. r m value was increased to 1.52 at around 400 MPa tensile strength level through the optimal design in the steel chemistry and proper control of phase transformation during continuous galvanizing cycle. The isolated martensite particles are expected to increase the strength but are expected not to be desirable for the deep drawability.

Primary care team working in Ireland: a qualitative exploration of team members' experiences in a new primary care service.

PubMed

Kennedy, Norelee; Armstrong, Claire; Woodward, Oonagh; Cullen, Walter

2015-07-01

Team working is an integral aspect of primary care, but barriers to effective team working can limit the effectiveness of a primary care team (PCT). The establishment of new PCTs in Ireland provides an excellent opportunity to explore team working in action. The aim of this qualitative study was to explore the experiences of team members working in a PCT. Team members (n = 19) from two PCTs were interviewed from May to June 2010 using a semi-structured interview guide. All interviews were audio-recorded and transcribed. Data were analysed using NVivo (version 8). Thematic analysis was used to explore the data. We identified five main themes that described the experiences of the team members. The themes were support for primary care, managing change, communication, evolution of roles and benefits of team working. Team members were generally supportive of primary care and had experienced benefits to their practice and to the care of their patients from participation in the team. Regular team meetings enabled communication and discussion of complex cases. Despite the significant scope for role conflict due to the varied employment arrangements of the team members, neither role nor interpersonal conflict was evident in the teams studied. In addition, despite the unusual team structure in Irish PCTs - where there is no formally appointed team leader or manager - general issues around team working and its benefits and challenges were very similar to those found in other international studies. This suggests, in contrast to some studies, that some aspects of the leadership role may not be as important in successful PCT functioning as previously thought. Nonetheless, team leadership was identified as an important issue in the further development of the teams. © 2014 John Wiley & Sons Ltd.

Development of a high resolution voxelised head phantom for medical physics applications.

PubMed

Giacometti, V; Guatelli, S; Bazalova-Carter, M; Rosenfeld, A B; Schulte, R W

2017-01-01

Computational anthropomorphic phantoms have become an important investigation tool for medical imaging and dosimetry for radiotherapy and radiation protection. The development of computational phantoms with realistic anatomical features contribute significantly to the development of novel methods in medical physics. For many applications, it is desirable that such computational phantoms have a real-world physical counterpart in order to verify the obtained results. In this work, we report the development of a voxelised phantom, the HIGH_RES_HEAD, modelling a paediatric head based on the commercial phantom 715-HN (CIRS). HIGH_RES_HEAD is unique for its anatomical details and high spatial resolution (0.18×0.18mm 2 pixel size). The development of such a phantom was required to investigate the performance of a new proton computed tomography (pCT) system, in terms of detector technology and image reconstruction algorithms. The HIGH_RES_HEAD was used in an ad-hoc Geant4 simulation modelling the pCT system. The simulation application was previously validated with respect to experimental results. When compared to a standard spatial resolution voxelised phantom of the same paediatric head, it was shown that in pCT reconstruction studies, the use of the HIGH_RES_HEAD translates into a reduction from 2% to 0.7% of the average relative stopping power difference between experimental and simulated results thus improving the overall quality of the head phantom simulation. The HIGH_RES_HEAD can also be used for other medical physics applications such as treatment planning studies. A second version of the voxelised phantom was created that contains a prototypic base of skull tumour and surrounding organs at risk. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Analytical evaluation of the novel Lumipulse G BRAHMS procalcitonin immunoassay.

PubMed

Ruzzenente, Orazio; Salvagno, Gian Luca; Gelati, Matteo; Lippi, Giuseppe

2016-12-01

This study was designed to evaluate the analytical performance of the novel Lumipulse G1200 BRAHMS procalcitonin (PCT) immunoassay. This analytical evaluation encompassed the calculation of the limit of blank (LOB), limit of detection (LOD), functional sensitivity, intra- and inter-assay imprecision, confirmation of linearity and a comparison with the Vidas BRAHMS PCT assay. The LOB, LOD and functional sensitivity were 0.0010 ng/mL, 0.0016 ng/mL and 0.008 ng/mL, respectively. The total analytical imprecision was found to be 2.1% and the linearity was excellent (r=1.00) in the range of concentrations between 0.006-75.5 ng/mL. The correlation coefficient with Vidas BRAHMS PCT was 0.995 and the equation of the Passing and Bablok regression analysis was [Lumipulse G BRAHMS PCT]=0.76×[Vidas BRAHMS PCT]+0.04. The mean overall bias of Lumipulse G BRAHMS PCT versus Vidas BRAHMS PCT was -3.03 ng/mL (95% confidence interval [CI]: -4.32 to -1.74 ng/mL), whereas the mean bias in samples with PCT concentration between 0-10 ng/mL was -0.49 ng/mL (95% CI: -0.77 to -0.24 ng/mL). The diagnostic agreement was 100% at 0.5 ng/mL, 97% at 2.0 ng/mL and 95% at 10 ng/mL, respectively. These results attest that Lumipulse G BRAHMS PCT exhibits excellent analytical performance, among the best of the methods currently available on the diagnostic market. However, the significant bias compared to the Vidas BRAHMS PCT suggests that the methods cannot be used interchangeably.

Procalcitonin Identifies Cell Injury, Not Bacterial Infection, in Acute Liver Failure.

PubMed

Rule, Jody A; Hynan, Linda S; Attar, Nahid; Sanders, Corron; Korzun, William J; Lee, William M

2015-01-01

Because acute liver failure (ALF) patients share many clinical features with severe sepsis and septic shock, identifying bacterial infection clinically in ALF patients is challenging. Procalcitonin (PCT) has proven to be a useful marker in detecting bacterial infection. We sought to determine whether PCT discriminated between presence and absence of infection in patients with ALF. Retrospective analysis of data and samples of 115 ALF patients from the United States Acute Liver Failure Study Group randomly selected from 1863 patients were classified for disease severity and ALF etiology. Twenty uninfected chronic liver disease (CLD) subjects served as controls. Procalcitonin concentrations in most samples were elevated, with median values for all ALF groups near or above a 2.0 ng/mL cut-off that generally indicates severe sepsis. While PCT concentrations increased somewhat with apparent liver injury severity, there were no differences in PCT levels between the pre-defined severity groups-non-SIRS and SIRS groups with no documented infections and Severe Sepsis and Septic Shock groups with documented infections, (p = 0.169). PCT values from CLD patients differed from all ALF groups (median CLD PCT value 0.104 ng/mL, (p ≤0.001)). Subjects with acetaminophen (APAP) toxicity, many without evidence of infection, demonstrated median PCT >2.0 ng/mL, regardless of SIRS features, while some culture positive subjects had PCT values <2.0 ng/mL. While PCT appears to be a robust assay for detecting bacterial infection in the general population, there was poor discrimination between ALF patients with or without bacterial infection presumably because of the massive inflammation observed. Severe hepatocyte necrosis with inflammation results in elevated PCT levels, rendering this biomarker unreliable in the ALF setting.

Evaluation of procalcitonin for diagnosis of neonatal sepsis of vertical transmission

PubMed Central

López Sastre, José B; Solís, David Pérez; Serradilla, Vicente Roqués; Colomer, Belén Fernández; Cotallo, Gil D Coto

2007-01-01

Background The results of recent studies suggest the usefulness of PCT for early diagnosis of neonatal sepsis, with varying results. The aim of this prospective multicenter study was to determine the behavior of serum PCT concentrations in both uninfected and infected neonates, and to assess the value of this marker for diagnosis of neonatal sepsis of vertical transmission. Methods PCT was measured in 827 blood samples collected prospectively from 317 neonates admitted to 13 acute-care teaching hospitals in Spain over one year. Serum PCT concentrations were determined by a specific immunoluminometric assay. The diagnostic efficacy of PCT at birth and within 12–24 h and 36–48 h of life was evaluated calculating the sensitivity, specificity, and likelihood ratio of positive and negative results. Results 169 asymptomatic newborns and 148 symptomatic newborns (confirmed vertical sepsis: 31, vertical clinical sepsis: 38, non-infectious diseases: 79) were studied. In asymptomatic neonates, PCT values at 12–24 h were significantly higher than at birth and at 36–48 h of life. Resuscitation at birth and chorioamnionitis were independently associated to PCT values. Neonates with confirmed vertical sepsis showed significantly higher PCT values than those with clinical sepsis. PCT thresholds for the diagnosis of sepsis were 0.55 ng/mL at birth (sensitivity 75.4%, specificity 72.3%); 4.7 ng/mL within 12–24 h of life (sensitivity 73.8%, specificity 80.8%); and 1.7 ng/mL within 36–48 h of life (sensitivity 77.6%, specificity 79.2%). Conclusion Serum PCT was moderately useful for the detection of sepsis of vertical transmission, and its reliability as a maker of bacterial infection requires specific cutoff values for each evaluation point over the first 48 h of life. PMID:17324267

Directional solidification of eutectic composites in space environment

NASA Technical Reports Server (NTRS)

Yue, A. S.

1972-01-01

The Ni-Ni3Ta eutectic and a nickel-base alloy containing 30 wt pct Ta were solidified unidirectionally in an electron beam floating zone melting apparatus. It was found that the volume fraction of the Ni3Ta phase in the Ni-Ni3Ta eutectic mixture was increased from 7.6 to 36 volume pct in agreement with the theory as predicted. Tensile properties of the randomly solidified and unidirectionally solidified Ni-Ni3Ta eutectic were determined as function of solidification rate and temperature. It was found that the ultimate tensile strength decreased as both the test temperature and solidification rate increased. An elongation of 40 pct was obtained for a nickelbase alloy containing 30 wt at room temperature. This unusually large elongation was attributed to the superplastic behavior of the alloy. The critical currents versus the external fields at 2.5, 3.0, 3.5 and 4.2 deg for the unidirectionally solidified Pb-Sn eutectic were measured. The values of critical fields at zero critical currents were obtained by extrapolation.

Low-dose cerebral perfusion computed tomography image restoration via low-rank and total variation regularizations

PubMed Central

Niu, Shanzhou; Zhang, Shanli; Huang, Jing; Bian, Zhaoying; Chen, Wufan; Yu, Gaohang; Liang, Zhengrong; Ma, Jianhua

2016-01-01

Cerebral perfusion x-ray computed tomography (PCT) is an important functional imaging modality for evaluating cerebrovascular diseases and has been widely used in clinics over the past decades. However, due to the protocol of PCT imaging with repeated dynamic sequential scans, the associative radiation dose unavoidably increases as compared with that used in conventional CT examinations. Minimizing the radiation exposure in PCT examination is a major task in the CT field. In this paper, considering the rich similarity redundancy information among enhanced sequential PCT images, we propose a low-dose PCT image restoration model by incorporating the low-rank and sparse matrix characteristic of sequential PCT images. Specifically, the sequential PCT images were first stacked into a matrix (i.e., low-rank matrix), and then a non-convex spectral norm/regularization and a spatio-temporal total variation norm/regularization were then built on the low-rank matrix to describe the low rank and sparsity of the sequential PCT images, respectively. Subsequently, an improved split Bregman method was adopted to minimize the associative objective function with a reasonable convergence rate. Both qualitative and quantitative studies were conducted using a digital phantom and clinical cerebral PCT datasets to evaluate the present method. Experimental results show that the presented method can achieve images with several noticeable advantages over the existing methods in terms of noise reduction and universal quality index. More importantly, the present method can produce more accurate kinetic enhanced details and diagnostic hemodynamic parameter maps. PMID:27440948

Serum procalcitonin has negative predictive value for bacterial infection in active systemic lupus erythematosus.

PubMed

Bador, K M; Intan, S; Hussin, S; Gafor, A H A

2012-10-01

Previous studies in systemic lupus erythematosus (SLE) patients have produced conflicting results regarding the diagnostic utility of procalcitonin (PCT). The aim of this study was to determine predictive values of PCT and C-reactive protein (CRP) for bacterial infection in SLE patients. This was a cross-sectional study of clinic and hospitalized SLE patients with and without bacterial infection recruited over 18 months. Bacterial infection was defined as positive culture results. SLE disease activity was measured using SLEDAI. PCT and CRP were measured by automated immunoassays. Sixty-eight patients (57 females) were studied. Ten patients (15%) had infection. The areas under the receiver operating characteristic curves for PCT and CRP were not significantly different [0.797 (CI 0.614-0.979) versus 0.755 (CI 0.600-0.910)]. In lupus flare patients, PCT but not CRP was higher with infection (p = 0.019 versus 0.195). A PCT of <0.17 ng/ml ruled out infection with 94% negative predictive value (NPV). In remission patients, CRP but not PCT was elevated with infection (p = 0.036 versus 0.103). CRP < 0.57 mg/dl had 96% NPV. PCT may be a better marker to rule out bacterial infection in lupus flare but not in remission or general screening.

Memo, "Incorporation of HLW Glass Shell V2.0 into the Flowsheets," to ED Lee, CCN: 184905, October 20, 2009

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

Gimpel, Rodney F.; Kruger, Albert A.

2013-12-18

Efforts are being made to increase the efficiency and decrease the cost of vitrifying radioactive waste stored in tanks at the U.S. Department of Energy Hanford Site. The compositions of acceptable and processable high-level waste (HL W) glasses need to be optimized to minimize the waste-form volume and, hence, to reduce cost. A database of glass properties of waste glass and associated simulated waste glasses was collected and documented in PNNL 18501, Glass Property Data and Models for Estimating High-Level Waste Glass Volume and glass property models were curve-fitted to the glass compositions. A routine was developed that estimates HLmore » W glass volumes using the following glass property models: II Nepheline, II One-Percent Crystal Temperature (T1%), II Viscosity (11) II Product Consistency Tests (PCT) for boron, sodium, and lithium, and II Liquidus Temperature (TL). The routine, commonly called the HL W Glass Shell, is presented in this document. In addition to the use of the glass property models, glass composition constraints and rules, as recommend in PNNL 18501 and in other documents (as referenced in this report) were incorporated. This new version of the HL W Glass Shell should generally estimate higher waste loading in the HL W glass than previous versions.« less

The Evaluation of Anatomic and Functional Changes in Unilateral Moderate Amblyopic Eyes Using Optical Coherence Tomography and Pupil Cycle Time.

PubMed

Kusbeci, Tuncay; Karti, Omer; Karahan, Eyyup; Oguztoreli, Mustafa

2017-12-01

To investigate whether macular anatomic structure and afferent visual system function differ among amblyopic eyes, non-amblyopic fellow eyes, and controls, using spectral-domain optical coherence tomography (SD-OCT), and pupil cycle time (PCT). This observational, cross-sectional study included 30 patients with unilateral amblyopia and 30 healthy subjects. Optical coherence tomography (OCT) and pupil cycle time (PCT) were used to evaluate patients with unilateral amblyopia and were compared with their non-amblyopic fellow eyes and age- and gender-matched healthy eyes (30 participants). The amblyopic eyes were separated into two groups: anisometropic amblyopia (n = 16) and strabismic amblyopia (n = 14). OCT maps were used to calculate central macular thickness (CMT), retinal nerve fiber layer thickness (RNFLT), and ganglion cell-inner plexiform layer (GC-IPL) thickness. The average RNFLT, GC-IPL thickness, and CMT did not show any significant differences among the amblyopic eyes, non-amblyopic fellow eyes and controls (p > 0.05, Kruskal-Wallis test). Mean PCT was 773.57 ± 64 msn in strabismic eyes, 771.25 ± 58 msn in anisometropic eyes, 778.00 ± 72 msn in non-amblyopic fellow eyes, and 774.75 ± 69 msn in control eyes. The differences among the amblyopic eyes, its fellow and control eyes were not statistically significant (p > 0.05, Kruskal-Wallis test). In this study, we investigated morphological and functional differences among amblyopic eyes, non-amblyopic fellow eyes and controls by using SD-OCT and PCT. We did not find anatomical or functional changes in amblyopic eyes.

Dynamic perfusion CT in brain tumors.

PubMed

Yeung, Timothy Pok Chi; Bauman, Glenn; Yartsev, Slav; Fainardi, Enrico; Macdonald, David; Lee, Ting-Yim

2015-12-01

Dynamic perfusion CT (PCT) is an imaging technique for assessing the vascular supply and hemodynamics of brain tumors by measuring blood flow, blood volume, and permeability-surface area product. These PCT parameters provide information complementary to histopathologic assessments and have been used for grading brain tumors, distinguishing high-grade gliomas from other brain lesions, differentiating true progression from post-treatment effects, and predicting prognosis after treatments. In this review, the basic principles of PCT are described, and applications of PCT of brain tumors are discussed. The advantages and current challenges, along with possible solutions, of PCT are presented. Copyright © 2015. Published by Elsevier Ireland Ltd.

The Effect of Sr Modifier Additions on Double Oxide Film Defects in 2L99 Alloy Castings

NASA Astrophysics Data System (ADS)

Chen, Qi; Griffiths, W. D.

2017-11-01

In this paper, Sr modifier (300 ppm) was added to 2L99 alloy sand castings to investigate its effect on bifilm defects in the castings. Two different sand molds were used in this study, with good and bad running system designs, to introduce different amounts of bifilm defects into the castings. The mechanical properties of the modified 2L99 castings were compared to the properties of unmodified castings and showed that with high bifilm defect contents (H) the Sr addition reduced the Weibull modulus of the UTS by 67 pct and the Position Parameter by 5 pct, and introduced a bimodal distribution into the Weibull plot of the pct Elongation. However, for castings with low bifilm defect content (L), the Weibull moduli of both the UTS and pct Elongation were significantly improved (by 78 and 73 pct, respectively) with the addition of Sr. The Position Parameter of the pct Elongation was improved by 135 pct. The results suggested that a desirable modification effect can only be achieved while the bifilm defect content in a casting was low.

A new ELISA for the quantification of equine procalcitonin in plasma as potential inflammation biomarker in horses.

PubMed

Rieger, Martin; Kochleus, Christian; Teschner, Dana; Rascher, Daniela; Barton, Ann Kristin; Geerlof, Arie; Kremmer, Elisabeth; Schmid, Michael; Hartmann, Anton; Gehlen, Heidrun

2014-09-01

In human medicine, procalcitonin (PCT) is a very common and well-established biomarker for sepsis. Even though sepsis is also a leading cause of death in foals and adult horses, up to now, no data about the role of equine PCT in septic horses has been available. Based on monoclonal antibodies targeted against human PCT, we report here the development of a sandwich ELISA for the quantification of equine PCT in equine plasma samples. The ELISA was characterized for intra- and interassay variance and a working range from 25 to 1,000 ng mL(-1) was defined as within this range; both intra- and interassay variances were below 15 %. The target recovery ranged between 73 and 106 %. The ELISA was used to determine the equine PCT concentration in 24 healthy and 5 septic horses to show the potential for clinical evaluation of equine PCT. Significantly different (P = 0.0006) mean equine PCT concentrations were found for the healthy control group and the sepsis group (47 and 8,450 ng mL(-1)).

Microstructures and Surface Stabilities of {Ni-0.4C-6Ta- xCr, 0 ≤ x ≤ 50 Wt Pct} Cast Alloys at High Temperature

NASA Astrophysics Data System (ADS)

Berthod, Patrice

2018-06-01

Nickel-based cast alloys rich in chromium and reinforced by TaC carbides are potentially very interesting alloys for applications at elevated temperatures. Unfortunately, unlike cobalt-chromium and iron-chromium alloys, it is difficult to obtain exclusively TaC as primary carbides in Ni-Cr alloys. In alloys containing 30 wt pct Cr tantalum, carbides coexist with chromium carbides. The latter tend to weaken the alloy at elevated temperatures because they become rapidly spherical and then quickly lose their reinforcing effect. In this work, we attempted to stabilize TaC as a single carbide phase by testing different chromium contents in the [0, 50 wt pct] range. Six alloys containing 0.4C and 6Ta, weight contents corresponding to equivalent molar contents, were elaborated by foundry, and their as-cast microstructures were characterized. Samples of all alloys were exposed to 1127 °C and 1237 °C for 24 hours to characterize their stabilized microstructures. The surface fractions of chromium carbides and tantalum carbides were measured by image analysis, and their evolutions vs the chromium content were studied. For the chosen C and Ta contents, it appears that obtaining TaC only is possible by decreasing the chromium content to 10 wt pct. At the same time, TaC fractions are unfortunately too low because a large portion of tantalum integrates into the solid solution in the matrix. A second consequence is a critical decrease in oxidation resistance. Other possible methods to stabilize TaC as a single carbide are evocated, such as the simultaneous increase in Ta and decrease in chromium from 30 wt pct Cr.

Migrainous aura as stroke-mimic: The role of perfusion-computed tomography.

PubMed

Ridolfi, Mariana; Granato, Antonio; Polverino, Paola; Furlanis, Giovanni; Ukmar, Maja; Zorzenon, Irene; Manganotti, Paolo

2018-03-01

The acute-onset of migrainuos aura (MA) can be erroneously diagnosed in Emergency Department (ED) as acute stroke (AS) and it can be classified as "stroke mimic" (SM). Perfusion computer tomography (PCT) may be useful to improve detection of infarcts. The aim of the study was to investigate the role in ED of PCT in improving diagnosis of migrainous aura. Data were compared with the well-defined perfusion patterns in patients with acute ischemic stroke. A standardized Stroke Protocol was planned. The protocol consisted in centralizing in ED all the patients with acute-onset of neurological symptoms compatible with cerebrovascular disease and in performing a general and neurological examination, hematological tests, brain non-contrast computed tomography (NCCT), CT angiography (CTA) of the supra-aortic and intracranial arteries and cerebral PCT. Patients with diagnosis of definite or probable acute stroke were hospitalized in Stroke Unit (SU). A six-months retrospective analysis of all the patients included in the Stroke Protocol and discharged from ED or from SU with a diagnosis of migraine with aura was performed. 172 patients were included in the Stroke Protocol and 6 patients were enrolled. NCCT, CTA and PCT were performed after 60-90 min from symptoms onset and revealed normal perfusion. Intravenous thrombolysis was performed only in one patient. Patients with acute-onset of neurological symptoms, who have rapid progressive improvement of symptoms, normal neuroimaging, in particular PCT, and preceding episodes of migraine with aura, may be considered as suffering from MA. In these cases, even if thrombolysis is safe, clinicians may defer a prompt aggressive treatment. Copyright © 2018 Elsevier B.V. All rights reserved.

SU-D-BRD-01: An Automated Physics Weekly Chart Checking System Supporting ARIA

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

Chang, X; Yang, D

Purpose: A software tool was developed in this study to perform automatic weekly physics chart check on the patient data in ARIA. The tool accesses the electronic patient data directly from ARIA server and checks the accuracy of treatment deliveries, and generates reports which summarize the delivery history and highlight the errors. Methods: The tool has four modules. 1) The database interface is designed to directly access treatment delivery data from the ARIA database before reorganizing the data into the patient chart tree (PCT). 2) PCT is a core data structure designed to store and organize the data in logicalmore » hierarchies, and to be passed among functions. 3) The treatment data check module analyzes the organized data in PCT and stores the checking results into PCT. 4) Report generation module generates reports containing the treatment delivery summary, chart checking results and plots of daily treatment setup parameters (couch table positions, shifts of image guidance). The errors that are found by the tool are highlighted with colors. Results: The weekly check tool has been implemented in MATLAB and clinically tested at two major cancer centers. Javascript, cascading style sheets (CSS) and dynamic HTML were employed to create the user-interactive reports. It takes 0.06 second to search the delivery records of one beam with PCT and compare the delivery records with beam plan. The reports, saved in the HTML files on shared network folder, can be accessed by web browser on computers and mobile devices. Conclusion: The presented weekly check tool is useful to check the electronic patient treatment data in Varian ARIA system. It could be more efficient and reliable than the manually check by physicists. The work was partially supported by a research grant from Varian Medical System.« less

Advanced characterization techniques in understanding the roles of nickel in enhancing strength and toughness of submerged arc welding high strength low alloy steel multiple pass welds in the as-welded condition

NASA Astrophysics Data System (ADS)

Sham, Kin-Ling

Striving for higher strength along with higher toughness is a constant goal in material properties. Even though nickel is known as an effective alloying element in improving the resistance of a steel to impact fracture, it is not fully understood how nickel enhances toughness. It was the goal of this work to assist and further the understanding of how nickel enhanced toughness and maintained strength in particular for high strength low alloy (HSLA) steel submerged arc welding multiple pass welds in the as-welded condition. Using advanced analytical techniques such as electron backscatter diffraction, x-ray diffraction, electron microprobe, differential scanning calorimetry, and thermodynamic modeling software, the effect of nickel was studied with nickel varying from one to five wt. pct. in increments of one wt. pct. in a specific HSLA steel submerged arc welding multiple pass weldment. The test matrix of five different nickel compositions in the as-welded and stress-relieved condition was to meet the targeted mechanical properties with a yield strength greater than or equal to 85 ksi, a ultimate tensile strength greater than or equal to 105 ksi, and a nil ductility temperature less than or equal to -140 degrees F. Mechanical testing demonstrated that nickel content of three wt. pct and greater in the as-welded condition fulfilled the targeted mechanical properties. Therefore, one, three, and five wt. pct. nickel in the as-welded condition was further studied to determine the effect of nickel on primary solidification mode, nickel solute segregation, dendrite thickness, phase transformation temperatures, effective ferrite grain size, dislocation density and strain, grain misorientation distribution, and precipitates. From one to five wt. pct nickel content in the as-welded condition, the primary solidification was shown to change from primary delta-ferrite to primary austenite. The nickel partitioning coefficient increased and dendrite/cellular thickness was refined. Austenite decomposition temperatures into different ferrite products were also suppressed to refine the effective ferrite grain size with increasing nickel. Finally, dislocation density and strain increased and a more preferred orientation behavior was observed. At five wt. pct nickel, a precipitate in the form of MnNi3 or FeNi3 was observed. Its presence in both inter and intragranular regions enhanced strength and toughness by limiting the ferrite grain size and precipitation strengthening.

Mechanical properties of particulate composites based on a body-centered-cubic Mg-Li alloy containing boron

NASA Technical Reports Server (NTRS)

Whalen, R. T.; Gonzalez-Doncel, G.; Robinson, S. L.; Sherby, O. D.

1989-01-01

The effect of substituting the Mg metal in Mg-B composites by a Mg-14 wt pct Li solid solution on the ductility of the resulting composite was investigated using elastic modulus measurements on the P/M composite material prepared with a dispersion of B particles (in a vol pct range of 0-30) in a matrix of Mg-14 wt pct Li-1.5 wt pct Al. It was found that the elastic modulus of the composites increased rapidly with increasing boron, with specific stiffness values reaching about two times that of most structural materials. The values of the compression and tensile strengths increased significantly with boron additions. Good tensile ductility was achieved at the level of 10 vol pct B. However, at 20 vol pct B, the Mg-Li composite exhibited only limited tensile ductility (about 2 percent total elongation).

42 CFR Appendix - Tables to Subpart I of Part 84

Code of Federal Regulations, 2014 CFR

2014-10-01

... Test condition Test atmosphere Gas or vapor Concentration (parts per million) Flow rate (liters per... indicated penetration. 2 Relative humidity of test atmosphere will be 95 ±3pct; temperature of test atmosphere will be 25 ±2.5 °C. 3 Maximum allowable CO penetration will be 385 cm 3 during the minimum life...

42 CFR Appendix - Tables to Subpart I of Part 84

Code of Federal Regulations, 2013 CFR

2013-10-01

... Test condition Test atmosphere Gas or vapor Concentration (parts per million) Flow rate (liters per... indicated penetration. 2 Relative humidity of test atmosphere will be 95 ±3pct; temperature of test atmosphere will be 25 ±2.5 °C. 3 Maximum allowable CO penetration will be 385 cm 3 during the minimum life...

42 CFR Appendix - Tables to Subpart I of Part 84

Code of Federal Regulations, 2012 CFR

2012-10-01

... Test condition Test atmosphere Gas or vapor Concentration (parts per million) Flow rate (liters per... indicated penetration. 2 Relative humidity of test atmosphere will be 95 ±3pct; temperature of test atmosphere will be 25 ±2.5 °C. 3 Maximum allowable CO penetration will be 385 cm 3 during the minimum life...

Thermodynamics Calculation and Experimental Study on Separation of Bismuth from a Bismuth Glance Concentrate Through a Low-Temperature Molten Salt Smelting Process

NASA Astrophysics Data System (ADS)

Yang, Jian-Guang; He, De-Wen; Tang, Chao-Bo; Chen, Yong-Ming; Sun, Ya-Hui; Tang, Mo-Tang

2011-08-01

The main purpose of this study is to characterize and separate bismuth from a bismuth glance concentrate through a low-temperature, sulfur-fixing smelting process. This article reports on a study conducted on the optimization of process parameters, such as Na2CO3 and zinc oxide wt pct in charging, smelting temperature, smelting duration on the bismuth yield, resultant crude bismuth grade, and sulfur-fixing rate. A maximum bismuth recovery of 97.31 pct, crude bismuth grade of 96.93 pct, and 98.23 pct sulfur-fixing rate are obtained when a charge (containing 63.50 wt pct of Na2CO3 and 22.50 wt pct of bismuth glance, as well as 5 pct in excess of the stoichiometric requirement of zinc oxide dosage) is smelted at 1000 K (727 °C) for 150 minutes. This smelting operation is free from atmospheric pollution because zinc oxide is used as the sulfur-fixing agent, which can capture sulfur from bismuth sulfide and form the more thermodynamic-stable compound, zinc sulfide. The solid residue is subjected to a mineral dressing operation to obtain suspension, which is filtered to produce a cake, representing the solid particles of zinc sulfide. Based on the results of the chemical content analysis of the as-resultant zinc sulfide, more than 93 pct zinc sulfide can be recovered, and the recovered zinc sulfide grade can reach 60.20 pct. This material can be sold as zinc sulfide concentrate or roasted to be regenerated as zinc oxide.

Insulin resistance in porphyria cutanea tarda.

PubMed

Calcinaro, F; Basta, G; Lisi, P; Cruciani, C; Pietropaolo, M; Santeusanio, F; Falorni, A; Calafiore, R

1989-06-01

It has been reported that patients with porphyria cutanea tarda (PCT) develop carbohydrate (CHO) intolerance and manifest diabetes melitus (DM) more frequently than the normal population. In order to verify whether this is due to insulin resistance we studied 5 patients with PCT and 5 normal subjects matched for age, sex and weight. In all the patients an evaluation consisted of the glycemic curve and insulin response to an iv glucose tolerance test (IVGTT: 0.33 g/kg) as well as of an evaluation of the circulating monocyte insulin receptors. Blood samples were drawn in the basal state to measure plasma levels of NEFA, glycerol, and intermediate metabolites. The patients with PCT showed normal glucose tolerance which was obtained, however, at the expense of the elevated insulin levels: therefore a condition of insulin resistance was demonstrated in these subjects. An involvement of the lipid metabolism, observed by the raised levels of plasma NEFA and glycerol, was also evident. The insulin binding to circulating monocytes was reduced but not enough to justify the degree of insulin resistance observed. Therefore, it could be hypothesized, in agreement with similar studies, that a postreceptor defect is responsible for the insulin-resistance observed in patients with PCT and that the reduction of insulin receptors is determined by the down regulation in response to elevated insulinemic levels. An alteration of the porphyrin metabolism might be responsible for this disorder.

Computer-Aided Design of Manufacturing Chain Based on Closed Die Forging for Hardly Deformable Cu-Based Alloys

NASA Astrophysics Data System (ADS)

Pietrzyk, Maciej; Kuziak, Roman; Pidvysots'kyy, Valeriy; Nowak, Jarosław; Węglarczyk, Stanisław; Drozdowski, Krzysztof

2013-07-01

Two copper-based alloys were considered, Cu-1 pct Cr and Cu-0.7 pct Cr-1 pct Si-2 pct Ni. The thermal, electrical, and mechanical properties of these alloys are given in the paper and compared to pure copper and steel. The role of aging and precipitation kinetics in hardening of the alloys is discussed based upon the developed model. Results of plastometric tests performed at various temperatures and various strain rates are presented. The effect of the initial microstructure on the flow stress was investigated. Rheologic models for the alloys were developed. A finite element (FE) model based on the Norton-Hoff visco-plastic flow rule was applied to the simulation of forging of the alloys. Analysis of the die wear for various processes of hot and cold forging is presented as well. A microstructure evolution model was implemented into the FE code, and the microstructure and mechanical properties of final products were predicted. Various variants of the manufacturing cycles were considered. These include different preheating schedules, hot forging, cold forging, and aging. All variants were simulated using the FE method and loads, die filling, tool wear, and mechanical properties of products were predicted. Three variants giving the best combination of forging parameters were selected and industrial trials were performed. The best manufacturing technology for the copper-based alloys is proposed.

Syntactic error modeling and scoring normalization in speech recognition: Error modeling and scoring normalization in the speech recognition task for adult literacy training

NASA Technical Reports Server (NTRS)

Olorenshaw, Lex; Trawick, David

1991-01-01

The purpose was to develop a speech recognition system to be able to detect speech which is pronounced incorrectly, given that the text of the spoken speech is known to the recognizer. Better mechanisms are provided for using speech recognition in a literacy tutor application. Using a combination of scoring normalization techniques and cheater-mode decoding, a reasonable acceptance/rejection threshold was provided. In continuous speech, the system was tested to be able to provide above 80 pct. correct acceptance of words, while correctly rejecting over 80 pct. of incorrectly pronounced words.

A Reaction Between High Mn-High Al Steel and CaO-SiO2-Type Molten Mold Flux: Part I. Composition Evolution in Molten Mold Flux

NASA Astrophysics Data System (ADS)

Kim, Min-Su; Lee, Su-Wan; Cho, Jung-Wook; Park, Min-Seok; Lee, Hae-Geon; Kang, Youn-Bae

2013-04-01

In order to elucidate the reaction mechanism between high Mn-high Al steel such as twin-induced plasticity steel and molten mold flux composed mainly of CaO-SiO2 during continuous casting process, a series of laboratory-scale experiments were carried out in the present study. Molten steel and molten flux were brought to react in a refractory crucible in a temperature range between 1713 K to 1823 K (1440 °C to 1550 °C) and composition evolution in the steel and the flux was analyzed using inductively coupled plasma atomic emission spectroscopy, X-ray fluorescence, and electron probe microanalysis. The amount of SiO2 in the flux was significantly reduced by Al in the steel; thus, Al2O3 was accumulated in the flux as a result of a chemical reaction, 4[Al] + 3(SiO2) = 3[Si] + 2(Al2O3). In order to find a major factor which governs the reaction, a number of factors ((pct CaO/pct SiO2), (pct Al2O3), [pct Al], [pct Si], and temperature) were varied in the experiments. It was found that the above chemical reaction was mostly governed by [pct Al] in the molten steel. Temperature had a mild effect on the reaction. On the other hand, (pct CaO/pct SiO2), (pct Al2O3), and [pct Si] did not show any noticeable effect on the reaction. Apart from the above reaction, the following reactions are also thought to happen simultaneously: 2[Mn] + (SiO2) = [Si] + 2(MnO) and 2[Fe] + (SiO2) = [Si] + 2(FeO). These oxide components were subsequently reduced by Al in the molten steel. Na2O in the molten flux was gradually decreased and the decrease was accelerated by increasing [pct Al] and temperature. Possible reactions affecting the Al2O3 accumulation are summarized.

Effects of Non-metallic Inclusions on Hot Ductility of High Manganese TWIP Steels Containing Different Aluminum Contents

NASA Astrophysics Data System (ADS)

Wang, Yu-Nan; Yang, Jian; Wang, Rui-Zhi; Xin, Xiu-Ling; Xu, Long-Yun

2016-06-01

The characteristics of inclusions in Fe-16Mn- xAl-0.6C ( x = 0.002, 0.033, 0.54, 2.10 mass pct) steels have been investigated and their effects on hot ductility of the high manganese TWIP steels have been discussed. Ductility is very poor in the steel containing 0.54 mass pct aluminum, which is lower than 20 pct in the temperature range of 873 K to 1473 K (600 °C to 1200 °C). For the steels containing 0.002 and 2.10 mass pct aluminum, ductility is higher than 40 pct in the same temperature range. The hot ductility of steel containing 0.033 mass pct aluminum is higher than 30 pct throughout the temperature range under examination. With increasing aluminum content, the main inclusions in the steels change along the route of MnO/(MnO + MnS) → MnS/(Al2O3 + MnS) → AlN/(Al2O3 + MnS)/(MgAl2O4 + MnS) → AlN. The thermodynamic results of inclusion types calculated with FactSage software are in agreement with the experimental observation results. The inclusions in the steels containing 0.002 mass pct aluminum do not deteriorate the hot ductility. MnS inclusions whose average size, number density, and volume ratio are 1.12 μm, 15.62 mm-2, and 2.51 × 10-6 in the steel containing 0.033 mass pct aluminum reduce the ductility. In the steel containing 0.54 mass pct aluminum, AlN inclusions whose average size, number density, and volume ratio are 0.878 μm, 16.28 mm-2 and 2.82 × 10-6 can precipitate at the austenite grain boundaries, prevent dynamic recrystallization and deteriorate the hot ductility. On the contrary, in the steel containing 2.10 mass pct aluminum, the average size, number density and volume ratio of AlN inclusions change to 2.418 μm, 35.95 mm-2, and 2.55 × 10-5. They precipitate in the matrix, which do not inhibit dynamic recrystallization and thereby do not lead to poor hot ductility.

High temperature static strain gage development

NASA Technical Reports Server (NTRS)

Hulse, C. O.; Bailey, R. S.; Grant, H. P.; Anderson, W. L.; Przybyszewski, J. S.

1991-01-01

Final results are presented from a program to develop a thin film static strain gage for use on the blades and vanes of running, test stand gas turbine engines with goals of an 3 x 3 mm gage area and total errors of less than 10 pct. of + or - 2,000 microstrain after 50 hrs at 1250 K. Pd containing 13 Wt. pct. Cr was previously identified as a new strain sensor alloy that appeared to be potentially usable to 1250 K. Subsequently, it was discovered, in contrast with its behavior in bulk, that Pd-13Cr suffered from oxidation attack when prepared as a 4.5 micron thick thin film. Continuing problems with electrical leakage to the substrate and the inability of sputtered alumina overcoats to prevent oxidation led to the discovery that sputtered alumina contains appreciable amounts of entrapped argon. After the argon has been exsolved by heating to elevated temperatures, the alumina films undergo a linear shrinkage of about 2 pct. resulting in formation of cracks. These problems can be largely overcome by sputtering the alumina with the substrate heated to 870 K. With 2 micron thick hot sputtered alumina insulation and overcoat films, total 50 hr drifts of about 100 microstrain (2 tests) and about 500 microstrain (1 test) were observed at 1000 and 1100 K, respectively. Results of tests on complete strain gage systems on constant moment bend bars with Pd temperature compensation grids revealed that oxidation of the Pd grid was a major problem even when the grid was overcoated with a hot or cold sputtered alumina overcoat.

Clinical pulmonary infection score and a spot serum procalcitonin level to guide discontinuation of antibiotics in ventilator-associated pneumonia: a study in a single institution with high prevalence of nonfermentative gram-negative bacilli infection.

PubMed

Wongsurakiat, Phunsup; Tulatamakit, Sirapat

2018-01-01

Background We wanted to determine the impact of combined Clinical Pulmonary Infection Score (CPIS) and a spot serum procalcitonin (PCT)-guided protocol to shorten the duration of antibiotic treatment in patients with ventilator-associated pneumonia (VAP), mainly caused by nonfermentative gram-negative bacilli (NF-GNB). Methods Patients with VAP who received appropriate antibiotics for 7 days, temperature ⩽ 37.8°C, without shock, and CPIS ⩽ 6 were allocated to the PCT group or conventional group according to the treating physicians' decisions. In the PCT group, antibiotics were stopped if the PCT level on day 8 < 0.5 ng/ml. In the conventional group, antibiotics were stopped according to physicians' discretion. Results There were 24 patients in the PCT group and 26 patients in the conventional group. NF-GNB were responsible for VAP in 79.2% of the PCT group and 65.4% of the conventional group. PCT group had a greater number of antibiotic-free days alive during the 28 days after VAP onset than the conventional group (14.6 ± 5.4 days versus 5.9 ± 5.7 days, respectively; p <.001). In the multivariate, propensity score-adjusted analysis, the PCT group [coefficient = -9.1 (-12.2 to -6); p <.001] and extrapulmonary infections [coefficient = 6.4 (3.3-9.5); p <.001] were independent predictors of total antibiotic exposure days. There was no relapse in both groups. Meanwhile, 12.5% of the PCT group and 26.9% of the conventional group subsequently developed recurrent VAP compatible with superinfections. Conclusions CPIS and a spot serum PCT level appeared effective and safe to guide discontinuation of antibiotic treatment in patients with VAP caused by NF-GNB. TCTR20160726002.

Predictive comparisons of procalcitonin (PCT) level, arterial ketone body ratio (AKBR), APACHE III score and multiple organ dysfunction score (MODS) in systemic inflammatory response syndrome (SIRS).

PubMed

Lee, Young-Joo; Park, Chan-Hee; Yun, Jang-Woon; Lee, Young-Suk

2004-02-29

Procalcitonin (PCT) is a newly introduced marker of systemic inflammation and bacterial infection. A marked increase in circulating PCT level in critically ill patients has been related with the severity of illness and poor survival. The goal of this study was to compare the prognostic power of PCT and three other parameters, the arterial ketone body ratio (AKBR), the acute physiology, age, chronic health evaluation (APACHE) III score and the multiple organ dysfunction score (MODS), in the differentiation between survivors and nonsurvivors of systemic inflammatory response syndrome (SIRS). The study was performed in 95 patients over 16 years of age who met the criteria of SIRS. PCT and AKBR were assayed in arterial blood samples. The APACHE III score and MODS were recorded after the first 24 hours of surgical ICU (SICU) admission and then daily for two weeks or until either discharge or death. The patients were divided into two groups, survivors (n=71) and nonsurvivors (n=24), in accordance with the ICU outcome. They were also divided into three groups according to the trend of PCT level: declining, increasing or no change. Significant differences between survivors and nonsurvivors were found in APACHE III score and MODS throughout the study period, but in PCT value only up to the 7th day and in AKBR only up to the 3rd day. PCT values of the three groups were not significantly different on the first day between survivors and nonsurvivors. Receiver operating characteristic (ROC) curves for prediction of mortality by PCT, AKBR, APACHE III score and MODS were 0.690, 0.320, 0.915 and 0.913, respectively, on the admission day. In conclusion, PCT could have some use as a mortality predictor in SIRS patients but was less reliable than APACHE III score or MODS.

Analysis of NiAlTa precipitates in beta-NiAl + 2 at. pct Ta alloy

NASA Technical Reports Server (NTRS)

Pathare, V.; Michal, G. M.; Vedula, K.; Nathal, M. V.

1987-01-01

Results are reported from experiments performed to identify the precipitates, and their orientation in the matrix, in a beta-NiAl alloy containing 2 at. pct. Ta after undergoing creep test at 1300 K. Test specimens formed by extruding hot powders were compressed at 1300 K for about 50 hr at a strain rate averaging 6/1 million per sec. The specimens were then thinned and examined under an electron microscope and by X-ray diffractometry. An intermetallic NiAlTa compound with a hexagonal Cl4 structure appeared as second phase precipitates in the samples, exhibiting plate-like shapes and a habit plane close to (012). The prism planes of the hexagonal NiAlTa precipitates paralleled the closest packed planes in the cubic beta-NiAl matrix.

Development of proton CT imaging system using plastic scintillator and CCD camera

NASA Astrophysics Data System (ADS)

Tanaka, Sodai; Nishio, Teiji; Matsushita, Keiichiro; Tsuneda, Masato; Kabuki, Shigeto; Uesaka, Mitsuru

2016-06-01

A proton computed tomography (pCT) imaging system was constructed for evaluation of the error of an x-ray CT (xCT)-to-WEL (water-equivalent length) conversion in treatment planning for proton therapy. In this system, the scintillation light integrated along the beam direction is obtained by photography using the CCD camera, which enables fast and easy data acquisition. The light intensity is converted to the range of the proton beam using a light-to-range conversion table made beforehand, and a pCT image is reconstructed. An experiment for demonstration of the pCT system was performed using a 70 MeV proton beam provided by the AVF930 cyclotron at the National Institute of Radiological Sciences. Three-dimensional pCT images were reconstructed from the experimental data. A thin structure of approximately 1 mm was clearly observed, with spatial resolution of pCT images at the same level as that of xCT images. The pCT images of various substances were reconstructed to evaluate the pixel value of pCT images. The image quality was investigated with regard to deterioration including multiple Coulomb scattering.

Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), Platelet Count and Plateletcrit (PCT) as predictors of in-hospital paediatric mortality: a case-control Study.

PubMed

Golwala, Zainab Mohammedi; Shah, Hardik; Gupta, Neeraj; Sreenivas, V; Puliyel, Jacob M

2016-06-01

Thrombocytopenia has been shown to predict mortality. We hypothesize that platelet indices may be more useful prognostic indicators. Our study subjects were children one month to 14 years old admitted to our hospital. To determine whether platelet count, plateletcrit (PCT), mean platelet volume (MPV) and platelet distribution width (PDW) and their ratios can predict mortality in hospitalised children. Children who died during hospital stay were the cases. Controls were age matched children admitted contemporaneously. The first blood sample after admission was used for analysis. Receiver operating characteristic (ROC) curve was used to identify the best threshold for measured variables and the ratios studied. Multiple regression analysis was done to identify independent predictors of mortality. Forty cases and forty controls were studied. Platelet count, PCT and the ratios of MPV/Platelet count, MPV/PCT, PDW/Platelet count, PDW/PCT and MPV × PDW/Platelet count × PCT were significantly different among children who survived compared to those who died. On multiple regression analysis the ratio of MPV/PCT, PDW/Platelet count and MPV/Platelet count were risk factors for mortality with an odds ratio of 4.31(95% CI, 1.69-10.99), 3.86 (95% CI, 1.53-9.75), 3.45 (95% CI, 1.38-8.64) respectively. In 67% of the patients who died MPV/PCT ratio was above 41.8 and PDW/Platelet count was above 3.86. In 65% of patients who died MPV/Platelet count was above 3.45. The MPV/PCT, PDW/Platelet count and MPV/Platelet count, in the first sample after admission in this case control study were predictors of mortality and could predict 65% to 67% of deaths accurately.

High-permeability region size on perfusion CT predicts hemorrhagic transformation after intravenous thrombolysis in stroke

PubMed Central

Puig, Josep; Blasco, Gerard; Daunis-i-Estadella, Pepus; van Eendendburg, Cecile; Carrillo-García, María; Aboud, Carlos; Hernández-Pérez, María; Serena, Joaquín; Biarnés, Carles; Nael, Kambiz; Liebeskind, David S.; Thomalla, Götz; Menon, Bijoy K.; Demchuk, Andrew; Wintermark, Max; Pedraza, Salvador

2017-01-01

Objective Blood-brain barrier (BBB) permeability has been proposed as a predictor of hemorrhagic transformation (HT) after tissue plasminogen activator (tPA) administration; however, the reliability of perfusion computed tomography (PCT) permeability imaging for predicting HT is uncertain. We aimed to determine the performance of high-permeability region size on PCT (HPrs-PCT) in predicting HT after intravenous tPA administration in patients with acute stroke. Methods We performed a multimodal CT protocol (non-contrast CT, PCT, CT angiography) to prospectively study patients with middle cerebral artery occlusion treated with tPA within 4.5 hours of symptom onset. HT was graded at 24 hours using the European-Australasian Acute Stroke Study II criteria. ROC curves selected optimal volume threshold, and multivariate logistic regression analysis identified predictors of HT. Results The study included 156 patients (50% male, median age 75.5 years). Thirty-seven (23,7%) developed HT [12 (7,7%), parenchymal hematoma type 2 (PH-2)]. At admission, patients with HT had lower platelet values, higher NIHSS scores, increased ischemic lesion volumes, larger HPrs-PCT, and poorer collateral status. The negative predictive value of HPrs-PCT at a threshold of 7mL/100g/min was 0.84 for HT and 0.93 for PH-2. The multiple regression analysis selected HPrs-PCT at 7mL/100g/min combined with platelets and baseline NIHSS score as the best model for predicting HT (AUC 0.77). HPrs-PCT at 7mL/100g/min was the only independent predictor of PH-2 (OR 1, AUC 0.68, p = 0.045). Conclusions HPrs-PCT can help predict HT after tPA, and is particularly useful in identifying patients at low risk of developing HT. PMID:29182658

Procalcitonin does discriminate between sepsis and systemic inflammatory response syndrome.

PubMed

Arkader, R; Troster, E J; Lopes, M R; Júnior, R R; Carcillo, J A; Leone, C; Okay, T S

2006-02-01

To evaluate whether procalcitonin (PCT) and C reactive protein (CRP) are able to discriminate between sepsis and systemic inflammatory response syndrome (SIRS) in critically ill children. Prospective, observational study in a paediatric intensive care unit. Kinetics of PCT and CRP were studied in patients undergoing open heart surgery with cardiopulmonary bypass (CPB) (SIRS model; group I1) and patients with confirmed bacterial sepsis (group II). In group I, PCT median concentration was 0.24 ng/ml (reference value <2.0 ng/ml). There was an increment of PCT concentrations which peaked immediately after CPB (median 0.58 ng/ml), then decreased to 0.47 ng/ml at 24 h; 0.33 ng/ml at 48 h, and 0.22 ng/ml at 72 h. CRP median concentrations remained high on POD1 (36.6 mg/l) and POD2 (13.0 mg/l). In group II, PCT concentrations were high at admission (median 9.15 ng/ml) and subsequently decreased in 11/14 patients who progressed favourably (median 0.31 ng/ml). CRP levels were high in only 11/14 patients at admission. CRP remained high in 13/14 patients at 24 h; in 12/14 at 48 h; and in 10/14 patients at 72 h. Median values were 95.0, 50.9, 86.0, and 20.3 mg/l, respectively. The area under the ROC curve was 0.99 for PCT and 0.54 for CRP. Cut off concentrations to differentiate SIRS from sepsis were >2 ng/ml for PCT and >79 mg/l for CRP. PCT is able to differentiate between SIRS and sepsis while CRP is not. Moreover, unlike CRP, PCT concentrations varied with the evolution of sepsis.

Effects of Fine Particle Peening Conditions on the Rotational Bending Fatigue Strength of a Vacuum-Carburized Transformation-Induced Plasticity-Aided Martensitic Steel

NASA Astrophysics Data System (ADS)

Sugimoto, Koh-ichi; Hojo, Tomohiko; Mizuno, Yuta

2018-02-01

The effects of fine particle peening conditions on the rotational bending fatigue strength of a vacuum-carburized transformation-induced plasticity-aided martensitic steel with a chemical composition of 0.20 pct C, 1.49 pct Si, 1.50 pct Mn, 0.99 pct Cr, 0.02 pct Mo, and 0.05 pct Nb were investigated for the fabrication of automotive drivetrain parts. The maximum fatigue limit, resulting from high hardness and compressive residual stress in the surface-hardened layer caused by the severe plastic deformation and the strain-induced martensite transformation of the retained austenite during fine particle peening, was obtained by fine particle peening at an arc height of 0.21 mm (N). The high fatigue limit was also a result of the increased martensite fraction and the active plastic relaxation via the strain-induced martensite transformation during fatigue deformation, as well as preferential crack initiation on the surface or at the subsurface.

Diagnostic and prognostic value of procalcitonin for early intracranial infection after craniotomy

PubMed Central

Yu, Y.; Li, H.J.

2017-01-01

Intracranial infection is a common clinical complication after craniotomy. We aimed to explore the diagnostic and prognostic value of dynamic changing procalcitonin (PCT) in early intracranial infection after craniotomy. A prospective study was performed on 93 patients suspected of intracranial infection after craniotomy. Routine peripheral venous blood was collected on the day of admission, and C reactive protein (CRP) and PCT levels were measured. Cerebrospinal fluid (CSF) was collected for routine biochemical, PCT and culture assessment. Serum and CSF analysis continued on days 1, 2, 3, 5, 7, 9, and 11. The patients were divided into intracranial infection group and non-intracranial infection group; intracranial infection group was further divided into infection controlled group and infection uncontrolled group. Thirty-five patients were confirmed with intracranial infection after craniotomy according to the diagnostic criteria. The serum and cerebrospinal fluid PCT levels in the infected group were significantly higher than the non-infected group on day 1 (P<0.05, P<0.01). The area under curve of receiver operating characteristics was 0.803 for CSF PCT in diagnosing intracranial infection. The diagnostic sensitivity and specificity of CSF PCT was superior to other indicators. The serum and CSF PCT levels have potential value in the early diagnosis of intracranial infection after craniotomy. Since CSF PCT levels have higher sensitivity and specificity, dynamic changes in this parameter could be used for early detection of intracranial infection after craniotomy, combined with other biochemical indicators. PMID:28443989

Procalcitonin-guided antibiotic treatment in critically ill patients.

PubMed

Hohn, Andreas; Heising, Bernhard; Schütte, Jan-Karl; Schroeder, Olaf; Schröder, Stefan

2017-02-01

In critically ill patients, length of antibiotic treatment can be effectively guided by procalcitonin (PCT) protocols. International sepsis guidelines and guidelines on antibiotic stewardship strategies recommend PCT as helpful laboratory marker for a rational use of antibiotics. A number of studies and meta-analyses have confirmed the effectiveness of PCT-protocols for shortening antibiotic treatment without compromising clinical outcome in critically ill patients. But in clinical practice, there is still uncertainty how to interpret PCT levels and how to adjust antibiotic treatment in various infectious situations, especially in the perioperative period. This narrative review gives an overview on the application of PCT-protocols in critically ill patients with severe bacterial infections on the basis of 5 case reports and the available literature. Beside strengths and limitations of this biomarker, also varying kinetics and different maximum values with regard to the infectious focus and pathogens are discussed. PCT-guided antibiotic treatment appears to be safe and effective. Most of the studies revealed a shorter antibiotic treatment without negative clinical outcomes. Cost effectiveness is still a matter of debate and effects on bacterial resistance due to shorter treatments, possible lower rates of drug-related adverse events, or decreased rates of Clostridium difficile infections are not yet evaluated. Guidance of antibiotic treatment can effectively be supported by PCT-protocols. However, it is important to consider the limitations of this biomarker and to use PCT protocols along with antibiotic stewardship programmes and regular clinical rounds together with infectious diseases specialists.

Effects of Mode of Deformation and Extent of Reduction on Evolution of {111}-Fiber During Cold Rolling of Ni-16Cr Alloy

NASA Astrophysics Data System (ADS)

Mehta, K. K.; Mandal, R. K.; Singh, A. K.

2018-07-01

The high ratio of relative resolved shear stress on a twin to planar slip system results in microstructural latent hardening (some kind of overshooting) by the twin system on the primary slip planes, which leads to development of the {111}-fiber in Ni-16Cr alloy. The development of {111}-fiber starts as early as around 16 pct cold reduction in Ni-16Cr alloy and persists with maximum average intensity ranging from 35 to 40 pct additional deformation, i.e., around 50 pct cold reduction in unidirectional (U) and two-step cross (T)-rolling modes. In between 50 and 68 pct reductions in U and T modes, the fiber becomes unstable and starts disappearing. However, in multistep cross (M) rolling, the {111}-fiber formation starts late, i.e., at around 50 pct reduction, and maintains its stability up to additional deformation ranging from 35 to 40 pct, i.e., around 90 pct cold reduction. Thus, the life of {111}-fiber remains stable only within the range from 35 to 40 pct intermediate deformation during cold rolling of Ni-16Cr alloy irrespective of modes of rolling. However, the start and end of fiber stabilities depend on the modes of deformation by rolling. The maximum average intensity of {111}-fiber that can be attained in Ni-16Cr alloy is around 3.6× random in any of the deformation modes.

Effects of Mode of Deformation and Extent of Reduction on Evolution of {111}-Fiber During Cold Rolling of Ni-16Cr Alloy

NASA Astrophysics Data System (ADS)

Mehta, K. K.; Mandal, R. K.; Singh, A. K.

2018-04-01

The high ratio of relative resolved shear stress on a twin to planar slip system results in microstructural latent hardening (some kind of overshooting) by the twin system on the primary slip planes, which leads to development of the {111}-fiber in Ni-16Cr alloy. The development of {111}-fiber starts as early as around 16 pct cold reduction in Ni-16Cr alloy and persists with maximum average intensity ranging from 35 to 40 pct additional deformation, i.e., around 50 pct cold reduction in unidirectional (U) and two-step cross (T)-rolling modes. In between 50 and 68 pct reductions in U and T modes, the fiber becomes unstable and starts disappearing. However, in multistep cross (M) rolling, the {111}-fiber formation starts late, i.e., at around 50 pct reduction, and maintains its stability up to additional deformation ranging from 35 to 40 pct, i.e., around 90 pct cold reduction. Thus, the life of {111}-fiber remains stable only within the range from 35 to 40 pct intermediate deformation during cold rolling of Ni-16Cr alloy irrespective of modes of rolling. However, the start and end of fiber stabilities depend on the modes of deformation by rolling. The maximum average intensity of {111}-fiber that can be attained in Ni-16Cr alloy is around 3.6× random in any of the deformation modes.

Personal Construct Theory and Systemic Therapies: Parallel or Convergent Trends?

ERIC Educational Resources Information Center

Feixas, Guillem

1990-01-01

Explores similarities between Kelly's Personal Construct Theory (PCT) and systemic therapies. Asserts that (1) PCT and systemic therapies share common epistemological stance, constructivism; (2) personal construct systems possess properties of open systems; and (3) PCT and systemic therapies hold similar positions on relevant theoretical and…

Microstructures, Mechanical Properties, and Strain Hardening Behavior of an Ultrahigh Strength Dual Phase Steel Developed by Intercritical Annealing of Cold-Rolled Ferrite/Martensite

NASA Astrophysics Data System (ADS)

Mazaheri, Y.; Kermanpur, A.; Najafizadeh, A.

2015-07-01

A dual phase (DP) steel was produced by a new process utilizing an uncommon cold-rolling and subsequent intercritical annealing of a martensite-ferrite duplex starting structure. Ultrafine grained DP steels with an average grain size of about 2 μm and chain-networked martensite islands were achieved by short intercritical annealing of the 80 pct cold-rolled duplex microstructure. The strength of the low carbon steel with the new DP microstructure was reached about 1300 MPa (140 pct higher than that of the as-received state, e.g., 540 MPa), without loss of ductility. Tensile testing revealed good strength-elongation balance for the new DP steels (UTS × UE ≈ 11,000 to 15,000 MPa pct) in comparison with the previous works and commercially used high strength DP steels. Two strain hardening stages with comparable exponents were observed in the Holloman analysis of all DP steels. The variations of hardness, strength, elongation, and strain hardening behavior of the specimens with thermomechanical parameters were correlated to microstructural features.

Improving treatment plan evaluation with automation.

PubMed

Covington, Elizabeth L; Chen, Xiaoping; Younge, Kelly C; Lee, Choonik; Matuszak, Martha M; Kessler, Marc L; Keranen, Wayne; Acosta, Eduardo; Dougherty, Ashley M; Filpansick, Stephanie E; Moran, Jean M

2016-11-08

The goal of this work is to evaluate the effectiveness of Plan-Checker Tool (PCT) which was created to improve first-time plan quality, reduce patient delays, increase the efficiency of our electronic workflow, and standardize and automate the phys-ics plan review in the treatment planning system (TPS). PCT uses an application programming interface to check and compare data from the TPS and treatment management system (TMS). PCT includes a comprehensive checklist of automated and manual checks that are documented when performed by the user as part of a plan readiness check for treatment. Prior to and during PCT development, errors identified during the physics review and causes of patient treatment start delays were tracked to prioritize which checks should be automated. Nineteen of 33checklist items were automated, with data extracted with PCT. There was a 60% reduction in the number of patient delays in the six months after PCT release. PCT was suc-cessfully implemented for use on all external beam treatment plans in our clinic. While the number of errors found during the physics check did not decrease, automation of checks increased visibility of errors during the physics check, which led to decreased patient delays. The methods used here can be applied to any TMS and TPS that allows queries of the database. © 2016 The Authors.

Electron Nuclear Dynamics Simulations of Proton Cancer Therapy Reactions: Water Radiolysis and Proton- and Electron-Induced DNA Damage in Computational Prototypes.

PubMed

Teixeira, Erico S; Uppulury, Karthik; Privett, Austin J; Stopera, Christopher; McLaurin, Patrick M; Morales, Jorge A

2018-05-06

Proton cancer therapy (PCT) utilizes high-energy proton projectiles to obliterate cancerous tumors with low damage to healthy tissues and without the side effects of X-ray therapy. The healing action of the protons results from their damage on cancerous cell DNA. Despite established clinical use, the chemical mechanisms of PCT reactions at the molecular level remain elusive. This situation prevents a rational design of PCT that can maximize its therapeutic power and minimize its side effects. The incomplete characterization of PCT reactions is partially due to the health risks associated with experimental/clinical techniques applied to human subjects. To overcome this situation, we are conducting time-dependent and non-adiabatic computer simulations of PCT reactions with the electron nuclear dynamics (END) method. Herein, we present a review of our previous and new END research on three fundamental types of PCT reactions: water radiolysis reactions, proton-induced DNA damage and electron-induced DNA damage. These studies are performed on the computational prototypes: proton + H₂O clusters, proton + DNA/RNA bases and + cytosine nucleotide, and electron + cytosine nucleotide + H₂O. These simulations provide chemical mechanisms and dynamical properties of the selected PCT reactions in comparison with available experimental and alternative computational results.

Role of biomarkers in the management of antibiotic therapy: an expert panel review II: clinical use of biomarkers for initiation or discontinuation of antibiotic therapy

PubMed Central

2013-01-01

Biomarker-guided initiation of antibiotic therapy has been studied in four conditions: acute pancreatitis, lower respiratory tract infection (LRTI), meningitis, and sepsis in the ICU. In pancreatitis with suspected infected necrosis, initiating antibiotics best relies on fine-needle aspiration and demonstration of infected material. We suggest that PCT be measured to help predict infection; however, available data are insufficient to decide on initiating antibiotics based on PCT levels. In adult patients suspected of community-acquired LRTI, we suggest withholding antibiotic therapy when the serum PCT level is low (<0.25 ng/mL); in patients having nosocomial LRTI, data are insufficient to recommend initiating therapy based on a single PCT level or even repeated measurements. For children with suspected bacterial meningitis, we recommend using a decision rule as an aid to therapeutic decisions, such as the Bacterial Meningitis Score or the Meningitest®; a single PCT level ≥0.5 ng/mL also may be used, but false-negatives may occur. In adults with suspected bacterial meningitis, we suggest integrating serum PCT measurements in a clinical decision rule to help distinguish between viral and bacterial meningitis, using a 0.5 ng/mL threshold. For ICU patients suspected of community-acquired infection, we do not recommend using a threshold serum PCT value to help the decision to initiate antibiotic therapy; data are insufficient to recommend using PCT serum kinetics for the decision to initiate antibiotic therapy in patients suspected of ICU-acquired infection. In children, CRP can probably be used to help discontinue therapy, although the evidence is limited. In adults, antibiotic discontinuation can be based on an algorithm using repeated PCT measurements. In non-immunocompromised out- or in- patients treated for RTI, antibiotics can be discontinued if the PCT level at day 3 is < 0.25 ng/mL or has decreased by >80-90%, whether or not microbiological documentation has been obtained. For ICU patients who have nonbacteremic sepsis from a known site of infection, antibiotics can be stopped if the PCT level at day 3 is < 0.5 ng/mL or has decreased by >80% relative to the highest level recorded, irrespective of the severity of the infectious episode; in bacteremic patients, a minimal duration of therapy of 5 days is recommended. PMID:23830525

Effects of ethinyl estradiol and ibuprofen compared to placebo on endometrial bleeding, cervical mucus and the postcoital test in levonorgestrel subcutaneous implant users.

PubMed

Archer, David F; Philput, Christine B; Levine, Adam S; Cullins, Vanessa; Stovall, Thomas G; Bacon, Janice; Weber, Margaret E

2008-08-01

The study was conducted to evaluate ethinyl estradiol (EE) or ibuprofen (IBU) compared to placebo (PL) on spotting and bleeding (S/B) and a postcoital test (PCT) in women using the levonorgestrel subcutaneous implant. Women experiencing excessive S/B were enrolled in a multicenter prospective randomized study using EE, IBU or PL. Duration of S/B and a PCT were evaluated. Statistical analysis used a general linear model procedure with Duncan's multiple range tests for individual variables. One hundred seven women were evaluated, and there was no difference in the duration of bleeding among the three therapies, while the mean number of spotting days were 1.8 for EE and 2.8 for PL (p=.04). There was no effect of IBU on S/B. No effect on cervical mucus or sperm was found between treatments. There was a decrease in spotting but no effect on bleeding with EE compared to PL.

The effect of cathodic polarization on the corrosion fatigue behavior of a precipitation hardened aluminum alloy

NASA Astrophysics Data System (ADS)

Smith, E. F.; Duquette, D. J.

1986-02-01

Fatigue experiments were conducted on polycrystalline and monocrystalline samples of a high purity Al, 5.5 wt pct Zn, 2.5 wt pct Mg, 1.5 wt pct Cu alloy in the peak-hardened heat treatment condition. These experiments were conducted in dry laboratory air and in 0.5 N NaCl solutions at the corrosion potential and at applied potentials cathodic to the corrosion potential. It has been shown that saline solutions severely reduce the fatigue resistance of the alloy, resulting in considerable amounts of intergranular crack initiation and propagation under freely corroding conditions for polycrystalline samples. Applied cathodic potentials resulted in still larger decreases in fatigue resistance and, for poly crystals, increases in the degree of transgranular crack initiation and propagation. Increasing amounts of intergranular cracking were observed when applied cyclic stresses were reduced (longer test times). The characteristics of cracking, combined with results obtained on tensile tests of deformed and hydrogen charged samples, suggest that environmental cracking of these alloys is associated with a form of hydrogen embrittlement of the process zones of growing cracks. Further, it is suggested that stress corrosion cracking and corrosion fatigue of these alloys occurs by essentially the same mechanism, but that the often observed transgranular cracking under cyclic loading conditions occurs due to enhanced hydrogen transport and/or concentrations associated with mobile dislocations at growing crack tips.

Development of Ultra-high Purity (UHP) Fe-Based Alloys with High Creep and Oxidation Resistance for A-USC Technology

NASA Astrophysics Data System (ADS)

Hamdani, Fethi; Das, Nishith K.; Shoji, Tetsuo

2018-06-01

The design of ultra-high purity (UHP) Fe-based model alloys for advanced ultra-supercritical (A-USC) technology is attempted in this work. Creep testing has been performed in air at 700 °C and a stress level of 150 MPa. Analysis of the fracture surface and cross section of the crept specimen was performed. To evaluate the oxidation resistance in A-USC conditions, oxidation testing was performed in supercritical water (SCW) at 700 °C and 25 MPa. Weight gain (WG) measurements and meticulous characterization of the oxide scale were carried out. Based on thermodynamics and density functional theory calculations, some reactive elements in the Fe-Cr-Ni system were designated to promote precipitation strengthening and to improve the hydrogen-accelerated oxidation resistance. The addition of a 2 wt pct Mo into Fe-22Cr-22Ni-0.6Nb wt pct-based matrix did not significantly improve the creep resistance. The addition of 0.26 wt pct Zr coupled with cold working was effective for improving creep properties. The Mo-modified model alloy showed almost the same WG value as SUS310, while the Zr-modified alloy showed a higher WG value. Meanwhile, a Cr-enriched continuous oxide layer was formed at the oxidation front of the Zr-modified alloy and SUS310S after exposure to SCW conditions.

Effects of Sn Addition on the Microstructures and Mechanical Properties of Mg-6Zn-3Cu- xSn Magnesium Alloys

NASA Astrophysics Data System (ADS)

Zhang, Tao; Shen, Jun; Sang, Jia-Xin; Li, Yang; He, Pei-Pei

2015-08-01

In this paper, Mg-6Zn-3Cu- xSn (ZC63- xSn) magnesium alloys with different Sn contents (0, 1, 2, 4 wt pct) were fabricated and subjected to different heat treatments. The microstructures and mechanical properties of the obtained ZC63- xSn samples were investigated by optical microscopy, X-ray diffraction, scanning electron microscopy, Vickers hardness testing, and tensile testing. It was found that the As-cast Mg-6Zn-3Cu (ZC63) magnesium alloy mainly contained α-Mg grains and Mg(Zn,Cu) particles. Sn dissolved in α-Mg grains when Sn content was below 2 wt pct while Mg2Sn phase forms in the case of Sn content was above 4 wt pct. Addition of Sn refined both α-Mg grains and Mg(Zn,Cu) particles, and increased the volume fraction of Mg(Zn,Cu) particles. Compared with the Sn-free alloy, the microhardness of Sn-containing alloys increased greatly and that of As-extrude ZC63-4Sn sample achieved the highest value. The strength of ZC63 magnesium alloy was significantly enhanced because of Sn addition, which was attributed to grain refinement strengthening, solid solution strengthening, and precipitation strengthening. Furthermore, the ultimate yield stress, yield strength, and elongation of ZC63- xSn magnesium alloys were increased owing to the deceasing grain size induced by extrusion process.

Development of Ultra-high Purity (UHP) Fe-Based Alloys with High Creep and Oxidation Resistance for A-USC Technology

NASA Astrophysics Data System (ADS)

Hamdani, Fethi; Das, Nishith K.; Shoji, Tetsuo

2018-03-01

The design of ultra-high purity (UHP) Fe-based model alloys for advanced ultra-supercritical (A-USC) technology is attempted in this work. Creep testing has been performed in air at 700 °C and a stress level of 150 MPa. Analysis of the fracture surface and cross section of the crept specimen was performed. To evaluate the oxidation resistance in A-USC conditions, oxidation testing was performed in supercritical water (SCW) at 700 °C and 25 MPa. Weight gain (WG) measurements and meticulous characterization of the oxide scale were carried out. Based on thermodynamics and density functional theory calculations, some reactive elements in the Fe-Cr-Ni system were designated to promote precipitation strengthening and to improve the hydrogen-accelerated oxidation resistance. The addition of a 2 wt pct Mo into Fe-22Cr-22Ni-0.6Nb wt pct-based matrix did not significantly improve the creep resistance. The addition of 0.26 wt pct Zr coupled with cold working was effective for improving creep properties. The Mo-modified model alloy showed almost the same WG value as SUS310, while the Zr-modified alloy showed a higher WG value. Meanwhile, a Cr-enriched continuous oxide layer was formed at the oxidation front of the Zr-modified alloy and SUS310S after exposure to SCW conditions.

Influence of polychemotherapy on the morphology of metastases and kidney of resistant RLS-bearing mice.

PubMed

Zonov, E V; Voronina, E I; Zenkova, M A; Ageeva, T A; Ryabchikova, E I

2013-03-01

Polychemotherapy (PCT), widely used for the antitumor treatment has a pronounced toxic effect on the organism, and its cytostatic effect sometimes is canceled by multidrug resistance of a neoplasia. Comprehension of the nature and development of pathological changes caused by the PCT during the treatment of cancer is very important to improve the efficiency of the therapy and to clarify the mechanisms of tumor-host interactions. This study was aimed to examine PCT impact on kidney cells and tissues in mice with transplanted resistant lymphosacroma (RLS) and to analyze morphology of metastases of the tumor in kidney during PCT. Male mice CBA/LacSto (55 animals) were intramuscularly implanted in the right hind paw by 105 cells/ml of tumor RLS (a diffuse large B-cell lymphosarcoma) with multi-drug resistance (MDR) phenotype. Mice received combination of cyclophosphamide (50 mg/kg), oncovin (0.1 mg/kg), hydroxydaunorubicin (4 mg/kg), and prednisone (5 mg/kg) accordingly to CHOP scheme each 7 days after inoculation of the tumor. The kidneys were sampled on days 1, 3 and 7 after each series of injection of PCT preparations and processed for light and electron microscopy, immunohistochemical analysis of Ki-67 and Apaf-1 proteins also was performed. Tumor RLS produced metastases comprised of small cells in the kidneys of mice after 8 days post inoculation. Application of PCT resulted in destruction of small-cell metastases and development of many large-cell metastases in kidney. Application of PCT induced the development of prominent damage of nephron cells, primarily in S3 segments of proximal tubules. Even one series of PCT caused reduction of basal plasma folds in these cells and alteration of mitochondria. Damage of proximal tubules and involvement of distal tubules, renal bodies and interstitial tissue in the pathologic process, increased during the experiment. This work presents the description of morphological changes in kidney as well as of the tumor metastases under PCT influence. The obtained data should be considered while designing of remedies for recovery of internal organs functions after antitumor PCT.

Procalcitonin-guided antibiotic therapy in patients with fever in a general emergency department population: a multicenter noninferiority randomized clinical trial (HiTEMP study).

PubMed

van der Does, Yuri; Limper, Maarten; Jie, Kim E; Schuit, Stephanie C E; Jansen, Henry; Pernot, Niki; van Rosmalen, Joost; Poley, Marten J; Ramakers, Christian; Patka, Peter; van Gorp, Eric C M; Rood, Pleunie P M

2018-06-02

Overuse of broad-spectrum antibiotics in emergency departments(EDs) results in antibiotic resistance. We determined if procalcitonin(PCT)-guided therapy can be used to reduce antibiotic regimens in EDs by investigating efficacy, safety and accuracy. This was a noninferiority multicenter randomized clinical trial, performed in two Dutch hospitals. Adult patients with fever ≥38.2°C(100.8°F) in triage were randomized between standard diagnostic workup(control group) and PCT-guided therapy, defined as standard workup with addition of one single PCT measurement. Treatment algorithm encouraged withholding antibiotic regimens with PCT<0.5μg/L, and starting antibiotic regimens PCT≥0.5μg/L. Exclusion criteria were immunocompromised conditions, pregnancy, moribund patients, patients <72h after surgery or requiring primary surgical intervention. Primary outcomes were efficacy, defined as number of prescribed antibiotic regimens; safety, defined as combined-safety-endpoint(CSE) consisting of 30-days mortality, intensive-care unit admission, ED-return-visit within 2 weeks; accuracy, defined as sensitivity, apecificity and area-under-the-curve(AUC) of PCT for bacterial infections. Noninferiority margin for safety outcome was 7.5%. Between August 2014 and January 2017, 551 patients were included. In the PCT-guided group(n=275) 200(73%)patients were prescribed antibiotic regimens, in the control group(n=276) 212(77%)(p=0.28). There was no significant difference in CSE between the PCT-guided group, 29(11%), and control group, 46(16%)(p=0.16), with a noninferiority margin of 0.46%(n=526). AUC for confirmed bacterial infections for PCT was 0.681(95%CI0.633-0.730), for CRP 0.619(95%CI 0.569-0.669).: CONCLUSIONS.: PCT-guided therapy was noninferior in terms of safety, but did not reduce prescription of antibiotic regimens in an ED population with fever. In this heterogeneous population, the accuracy of PCT in diagnosing bacterial infections was poor. TRIAL REGISTRATION IN NETHERLANDS TRIAL REGISTER: http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4949. Copyright © 2018. Published by Elsevier Ltd.

Acute Effects of Two Different Resistance Circuit Training Protocols on Performance and Perceived Exertion in Semiprofessional Basketball Players.

PubMed

Freitas, Tomás T; Calleja-González, Julio; Alarcón, Francisco; Alcaraz, Pedro E

2016-02-01

This study aimed to investigate the acute effects of two different resistance circuit training protocols on basketball players' physical and technical performance and rating of perceived exertion (RPE). In a repeated-measures, crossover experimental design, 9 semiprofessional basketball players performed a Power Circuit Training (PCT; 45% 1RM) and a High-Resistance Circuit Training (HRC; 6RM), on consecutive weeks. Vertical and horizontal jump performance, 3-points shooting accuracy, repeated-sprint ability (RSA), agility, and upper body power output were measured before and after training. The RPE was assessed 20 minutes after resistance training. One-way repeated-measures analysis of variance showed performance decrements in vertical jump height and peak power, horizontal jump distance, 3-points percentage, bench-press power output, RSA total and ideal time, and agility T-Test at total time following HRC, but not PCT (p ≤ 0.05). The RPE was higher in HRC compared with PCT. The results of this study indicated that HRC was perceived as being harder and produced higher fatigue levels, which in turn lowered acute performance. However, low-to-moderate intensity loads did not negatively affect performance. Thus, completing a PCT session may be the most appropriate option before a practice or game as it avoids acute-resistance-training-induced performance decrements. However, if the objective of the basketball session is to develop or perfect technical skills during fatiguing conditions, HRC may be the more suitable option.

Perceptual control models of pursuit manual tracking demonstrate individual specificity and parameter consistency.

PubMed

Parker, Maximilian G; Tyson, Sarah F; Weightman, Andrew P; Abbott, Bruce; Emsley, Richard; Mansell, Warren

2017-11-01

Computational models that simulate individuals' movements in pursuit-tracking tasks have been used to elucidate mechanisms of human motor control. Whilst there is evidence that individuals demonstrate idiosyncratic control-tracking strategies, it remains unclear whether models can be sensitive to these idiosyncrasies. Perceptual control theory (PCT) provides a unique model architecture with an internally set reference value parameter, and can be optimized to fit an individual's tracking behavior. The current study investigated whether PCT models could show temporal stability and individual specificity over time. Twenty adults completed three blocks of 15 1-min, pursuit-tracking trials. Two blocks (training and post-training) were completed in one session and the third was completed after 1 week (follow-up). The target moved in a one-dimensional, pseudorandom pattern. PCT models were optimized to the training data using a least-mean-squares algorithm, and validated with data from post-training and follow-up. We found significant inter-individual variability (partial η 2 : .464-.697) and intra-individual consistency (Cronbach's α: .880-.976) in parameter estimates. Polynomial regression revealed that all model parameters, including the reference value parameter, contribute to simulation accuracy. Participants' tracking performances were significantly more accurately simulated by models developed from their own tracking data than by models developed from other participants' data. We conclude that PCT models can be optimized to simulate the performance of an individual and that the test-retest reliability of individual models is a necessary criterion for evaluating computational models of human performance.

Hot Ductility Behavior of an 8 Pct Cr Roller Steel

NASA Astrophysics Data System (ADS)

Wang, Zhenhua; Sun, Shuhua; Shi, Zhongping; Wang, Bo; Fu, Wantang

2015-04-01

The hot ductility of an 8 pct Cr roller steel was determined between 1173 K and 1473 K (900 °C and 1200 °C) at strain rates of 0.01 to 10 s-1 through tensile testing. The fracture morphology was observed using scanning electron microscopy, and the microstructure was examined through optical microscopy and transmission electron microscopy. The dependence of the hot ductility behavior on the deformation conditions, grain size, and precipitation was analyzed. The relationship between the reduction in area and the natural logarithm of the Zener-Hollomon parameter (ln Z) was found to be a second-order polynomial. When ln Z was greater than 40 s-1, the hot ductility was poor and fracture was mainly caused by incompatible deformation between the grains. When ln Z was between 32 and 40 s-1, the hot ductility was excellent and the main fracture mechanism was void linking. When ln Z was below 32 s-1, the hot ductility was poor and fracture was mainly caused by grain boundary sliding. A fine grain structure is beneficial for homogenous deformation and dynamic recrystallization, which induces better hot ductility. The effect of M7C3 carbide particles dispersed in the matrix on the hot ductility was small. The grain growth kinetics in the 8 pct Cr steel were obtained between 1373 K and 1473 K (1100 °C and 1200 °C). Finally, optimized preheating and forging procedures for 8 pct Cr steel rollers are provided.

On the Corrosion Performance of Monel 400 in Molten LiCl-Li2O-Li at 923 K

NASA Astrophysics Data System (ADS)

Phillips, William; Merwin, Augustus; Chidambaram, Dev

2018-06-01

The corrosion resistance of a Ni-Cu alloy, Monel 400, in molten LiCl-Li2O-Li at 923 K (650 °C) was investigated. Exposure testing of Monel 400 samples submerged in molten LiCl-2 wt pct Li2O solutions with Li concentrations between zero and 1 wt pct was performed at 923 K (650°C) for 20 hours. Post exposure surface analysis was performed using X-ray diffraction, scanning electron microscopy, energy dispersive X-ray spectroscopy, optical microscopy, micro-Vickers hardness testing, and X-ray photoelectron spectroscopy, while inductively coupled plasma optical emission spectroscopy was used to quantify the rate of material leaching. The extent of material degradation was observed to be strongly correlated to the concentration of metallic Li in the molten LiCl-Li2O system.

Corrosion and Mechanical Properties of Al-5 At. Pct Cr Produced by Cryomilling and Subsequent Consolidation at Various Temperatures

NASA Astrophysics Data System (ADS)

Esquivel, J.; Darling, K. A.; Murdoch, H. A.; Gupta, R. K.

2018-04-01

An Al-5 at. pct Cr alloy was produced by high-energy ball milling at liquid nitrogen temperature followed by consolidation using equal-channel axial extrusion at 200 °C, 300 °C and 450 °C. The microstructure and corrosion response were compared with a cast alloy of the same composition. Rather than the intermetallics expected by the phase diagram and seen in the cast alloy, consolidated HEBM alloys exhibited extended solid solubility of Cr in the aluminum matrix in addition to a finely dispersed Cr-rich phase. This led to improvement in the corrosion behavior as investigated via potentiodynamic polarization and constant immersion tests in NaCl solution. Hardness and tensile tests were performed to evaluate the mechanical properties. The highest consolidation temperature (450 °C) contributed to significant grain growth and Cr diffusion, lessening the beneficial effects of processing with HEBM.

Can procalcitonin reduce unnecessary voiding cystoureterography in children with first febrile urinary tract infection?

PubMed

Halimi-Asl, Aliasghar; Hosseini, Amir Hossein; Nabavizadeh, Pooneh

2014-08-01

Recently, new predictors of vesicoureteral reflux (VUR) in children with a first febrile UTI such as Procalcitonin (PCT) were introduced as selective approaches for cystography. This study wants to show the capability of PCT in predicting presence of VUR at the first febrile UTI in children. Patients between 1 month and 15 years of age with febrile UTI were included in this prospective study. PCT values were measured through a semi-quantitative method in four grades comprising values less than 0.5, 0.5-2.0, 2.0-10.0 and above 10.0 ng/ml. The independence of PCT levels in predicting VUR were assessed after adjustment for all potential confounders using a logistic-regression model. A total of 68 patients, 54 (79.4%) girls and 14 (20.6%) boys were evaluated. PCT level demonstrated a significant difference between patients with positive VUR and those with negative VUR (P=0.012). To calculate the independent factors that may predict the presence of VUR, all included variables were adjusted for age and sex. Results of logistic regression showed that a PCT level between 2.0 and 10.0 ng/mL could independently predict presence of VUR (Odds ratio=6.11, CI 95%= 1.22-30.77, P=0.03). Our finding in this study showed that readily available semi-quantitative measures for PCT are feasible for detecting patients with VUR. We suggest that in semi-quantitative measurements of PCT, levels between 2.0 and 10.0 ng/ml could be an independent predictor of positive VUR.

Changes of procalcitonin level in multiple trauma patients.

PubMed

Wojtaszek, Marek; Staśkiewicz, Grzegorz; Torres, Kamil; Jakubowski, Krzysztof; Rácz, Oliver; Cipora, Elżbieta

2014-01-01

Some aspects of the pathophysiology of complications in multiple-trauma patients still remain unclear. Mediators of inflammation have been postulated as playing a key role in being responsible for life threatening complications of multiple trauma patients. The objective of this study was to evaluate the prognostic value of procalcitonin (PCT) level in multiple trauma patients. A prospective study took place including patients with multiple trauma hospitalised in several hospital units. PCT level was measured in blood from 45 patients, aged 18-70 years using enzyme-linked immunoassay. The patients were divided into three groups: group I - individuals with multiple trauma with central nervous system injury; group II - those with multiple trauma without CNS injury; and group III - patients with isolated central nervous system injury. Initial PCT levels were below 0.5 ng mL(-1) regardless of the cause of trauma. In the 24th hour of observation, a statistically significant increase of PCT concentration vs. initial levels was recorded in all groups of patients. Then PCT levels decreased significantly at the 3rd measurement point in all groups, and they remained unchanged until the last measurement. The highest levels of PCT were observed in multiple trauma patients without CNS injury (group II). In this group of patients, a significantly longer duration of surgery in the post-trauma period affected PCT levels. PCT concentrations in patients who died were significantly greater than in survivors. A long lasting elevated concentration of procalcitonin in the post-traumatic period, or its repeated increase, is a good marker of developing complications observed earlier than clinical manifestations.

Environment-Assisted Cracking in Custom 465 Stainless Steel

NASA Astrophysics Data System (ADS)

Lee, E. U.; Goswami, R.; Jones, M.; Vasudevan, A. K.

2011-02-01

The influence of cold work and aging on the environment-assisted cracking (EAC) behavior and mechanical properties of Custom 465 stainless steel (SS) was studied. Four sets of specimens were made and tested. All specimens were initially solution annealed, rapidly cooled, and refrigerated (SAR condition). The first specimen set was steel in the SAR condition. The second specimen set was aged to the H1000 condition. The third specimen set was 60 pct cold worked, and the fourth specimen set was 60 pct cold worked and aged at temperatures ranging from 755 K to 825 K (482 °C to 552 °C) for 4 hours in air. The specimens were subsequently subjected to EAC and mechanical testing. The EAC testing was conducted, using the rising step load (RSL) technique, in aqueous solutions of NaCl of pH 7.3 with concentrations ranging from 0.0035 to 3.5 pct at room temperature. The microstructure, dislocation substructure, and crack paths, resulting from the cold work, aging, or subsequent EAC testing, were examined by optical microscopy, transmission electron microscopy (TEM), and scanning electron microscopy (SEM). The aging of the cold-worked specimens induced carbide precipitation within the martensite lath, but not at the lath or packet boundaries. In the aged specimens, as aging temperature rose, the threshold stress intensity for EAC (KIEAC), elongation, and fracture toughness increased, but the strength and hardness decreased. The KIEAC also decreased with increasing yield strength and NaCl concentration. In the SAR and H1000 specimens, the EAC propagated along the prior austenite grain boundary, while in the cold-worked and cold-worked and aged specimens, the EAC propagated along the martensite lath, and its packet and prior austenite grain boundaries. The controlling mechanism for the observed EAC was identified to be hydrogen embrittlement.

Long Range Plan: 1992-1995.

ERIC Educational Resources Information Center

Pennsylvania Coll. of Technology, Williamsport.

Intended to enhance strategic planning and enable staff to work as a team toward a shared vision and common goals, this report presents the 1992-95 long-range plan of the Pennsylvania College of Technology (PCT). Part I defines long-range planning; describes the structure and use of the plan at PCT; presents PCT's philosophy, mission, and vision…

Letter report on PCT/Monolith glass ceramic corrosion tests

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

Crawford, Charles L.

2015-09-24

The Savannah River National Laboratory (SRNL) is collaborating with personnel from Pacific Northwest National Laboratory (PNNL) to study advanced waste form glass ceramics for immobilization of waste from Used Nuclear Fuel (UNF) separations processes. The glass ceramic waste forms take advantage of both crystalline and glassy phases where ‘troublesome’ elements (e.g., low solubility in glass or very long-lived) partition to highly durable ceramic phases with the remainder of elements residing in the glassy phase. The ceramic phases are tailored to create certain minerals or unique crystalline structures that can host the radionuclides by binding them in their specific crystalline networkmore » while not adversely impacting the residual glass network (Crum et al., 2011). Glass ceramics have been demonstrated using a scaled melter test performed in a pilot scale (1/4 scale) cold crucible induction melter (CCIM) (Crum et al., 2014; Maio et al., 2015). This report summarizes recent results from both Phase I and Phase II bench scale tests involving crucible fabrication and corrosion testing of glass ceramics using the Product Consistency Test (PCT). Preliminary results from both Phase I and Phase II bench scale tests involving statistically designed matrices have previously been reported (Crawford, 2013; Crawford, 2014).« less

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

Covington, E; Younge, K; Chen, X

Purpose: To evaluate the effectiveness of an automated plan check tool to improve first-time plan quality as well as standardize and document performance of physics plan checks. Methods: The Plan Checker Tool (PCT) uses the Eclipse Scripting API to check and compare data from the treatment planning system (TPS) and treatment management system (TMS). PCT was created to improve first-time plan quality, reduce patient delays, increase efficiency of our electronic workflow, and to standardize and partially automate plan checks in the TPS. A framework was developed which can be configured with different reference values and types of checks. One examplemore » is the prescribed dose check where PCT flags the user when the planned dose and the prescribed dose disagree. PCT includes a comprehensive checklist of automated and manual checks that are documented when performed by the user. A PDF report is created and automatically uploaded into the TMS. Prior to and during PCT development, errors caught during plan checks and also patient delays were tracked in order to prioritize which checks should be automated. The most common and significant errors were determined. Results: Nineteen of 33 checklist items were automated with data extracted with the PCT. These include checks for prescription, reference point and machine scheduling errors which are three of the top six causes of patient delays related to physics and dosimetry. Since the clinical roll-out, no delays have been due to errors that are automatically flagged by the PCT. Development continues to automate the remaining checks. Conclusion: With PCT, 57% of the physics plan checklist has been partially or fully automated. Treatment delays have declined since release of the PCT for clinical use. By tracking delays and errors, we have been able to measure the effectiveness of automating checks and are using this information to prioritize future development. This project was supported in part by P01CA059827.« less

Relationship between acute kidney injury and serum procalcitonin (PCT) concentration in critically ill patients with influenza infection.

PubMed

Rodríguez, A; Reyes, L F; Monclou, J; Suberviola, B; Bodí, M; Sirgo, G; Solé-Violán, J; Guardiola, J; Barahona, D; Díaz, E; Martín-Loeches, I; Restrepo, M I

2018-02-09

Serum procalcitonin (PCT) concentration could be increased in patients with renal dysfunction in the absence of bacterial infection. To determine the interactions among serum renal biomarkers of acute kidney injury (AKI) and serum PCT concentration, in patients admitted to the intensive care unit (ICU) due to lung influenza infection. Secondary analysis of a prospective multicentre observational study. 148 Spanish ICUs. ICU patients admitted with influenza infection without bacterial co-infection. Clinical, laboratory and hemodynamic variables were recorded. AKI was classified as AKI I or II based on creatinine (Cr) concentrations (≥1.60-2.50mg/dL and Cr≥2.51-3.99mg/dL, respectively). Patients with chronic renal disease, receiving renal replacement treatment or with Cr>4mg/dL were excluded. Spearman's correlation, simple and multiple linear regression analysis were performed. None. Out of 663 patients included in the study, 52 (8.2%) and 10 (1.6%) developed AKI I and II, respectively. Patients with AKI were significantly older, had more comorbid conditions and were more severally ill. PCT concentrations were higher in patients with AKI (2.62 [0.60-10.0]ng/mL vs. 0.40 [0.13-1.20]ng/mL, p=0.002). Weak correlations between Cr/PCT (rho=0.18) and Urea (U)/PCT (rho=0.19) were identified. Simple linear regression showed poor interaction between Cr/U and PCT concentrations (Cr R 2 =0.03 and U R 2 =0.018). Similar results were observed during multiple linear regression analysis (Cr R 2 =0.046 and U R 2 =0.013). Although PCT concentrations were slightly higher in patients with AKI, high PCT concentrations are not explained by AKI and could be warning sign of a potential bacterial infection. Copyright © 2018 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

A PCT algorithm for discontinuation of antibiotic therapy is a cost-effective way to reduce antibiotic exposure in adult intensive care patients with sepsis.

PubMed

Kip, Michelle M A; Kusters, Ron; IJzerman, Maarten J; Steuten, Lotte M G

2015-01-01

Procalcitonin (PCT) is a specific marker for differentiating bacterial from non-infective causes of inflammation. It can be used to guide initiation and duration of antibiotic therapy in intensive care unit (ICU) patients with suspected sepsis, and might reduce the duration of hospital stay. Limiting antibiotic treatment duration is highly important because antibiotic over-use may cause patient harm, prolonged hospital stay, and resistance development. Several systematic reviews show that a PCT algorithm for antibiotic discontinuation is safe, but upfront investment required for PCT remains an important barrier against implementation. The current study investigates to what extent this PCT algorithm is a cost-effective use of scarce healthcare resources in ICU patients with sepsis compared to current practice. A decision tree was developed to estimate the health economic consequences of the PCT algorithm for antibiotic discontinuation from a Dutch hospital perspective. Input data were obtained from a systematic literature review. When necessary, additional information was gathered from open interviews with clinical chemists and intensivists. The primary effectiveness measure is defined as the number of antibiotic days, and cost-effectiveness is expressed as incremental costs per antibiotic day avoided. The PCT algorithm for antibiotic discontinuation is expected to reduce hospital spending by circa € 3503 per patient, indicating savings of 9.2%. Savings are mainly due to reductions in length of hospital stay, number of blood cultures performed, and, importantly, days on antibiotic therapy. Probabilistic and one-way sensitivity analyses showed the model outcome to be robust against changes in model inputs. Proven safe, a PCT algorithm for antibiotic discontinuation is a cost-effective means of reducing antibiotic exposure in adult ICU patients with sepsis, compared to current practice. Additional resources required for PCT are more than offset by downstream cost savings. This finding is highly important given the aim of preventing widespread antibiotic resistance.

Monitoring Procalcitonin in Febrile Neutropenia: What Is Its Utility for Initial Diagnosis of Infection and Reassessment in Persistent Fever?

PubMed Central

Bally, Frank; Knaup, Marlies; Calandra, Thierry; Marchetti, Oscar

2011-01-01

Background Management of febrile neutropenic episodes (FE) is challenged by lacking microbiological and clinical documentation of infection. We aimed at evaluating the utility of monitoring blood procalcitonin (PCT) in FE for initial diagnosis of infection and reassessment in persistent fever. Methods PCT kinetics was prospectively monitored in 194 consecutive FE (1771 blood samples): 65 microbiologically documented infections (MDI, 33.5%; 49 due to non-coagulase-negative staphylococci, non-CNS), 68 clinically documented infections (CDI, 35%; 39 deep-seated), and 61 fever of unexplained origin (FUO, 31.5%). Results At fever onset median PCT was 190 pg/mL (range 30–26'800), without significant difference among MDI, CDI and FUO. PCT peak occurred on day 2 after onset of fever: non-CNS-MDI/deep-seated-CDI (656, 80–86350) vs. FUO (205, 33–771; p<0.001). PCT >500 pg/mL distinguished non-CNS-MDI/deep-seated-CDI from FUO with 56% sensitivity and 90% specificity. PCT was >500 pg/ml in only 10% of FUO (688, 570–771). A PCT peak >500 pg/mL (1196, 524–11950) occurred beyond 3 days of persistent fever in 17/21 (81%) invasive fungal diseases (IFD). This late PCT peak identified IFD with 81% sensitivity and 57% specificity and preceded diagnosis according to EORTC-MSG criteria in 41% of cases. In IFD responding to therapy, median days to PCT <500 pg/mL and defervescence were 5 (1–23) vs. 10 (3–22; p = 0.026), respectively. Conclusion While procalcitonin is not useful for diagnosis of infection at onset of neutropenic fever, it may help to distinguish a minority of potentially severe infections among FUOs on day 2 after onset of fever. In persistent fever monitoring procalcitonin contributes to early diagnosis and follow-up of invasive mycoses. PMID:21541027

Monitoring procalcitonin in febrile neutropenia: what is its utility for initial diagnosis of infection and reassessment in persistent fever?

PubMed

Robinson, James Owen; Lamoth, Frédéric; Bally, Frank; Knaup, Marlies; Calandra, Thierry; Marchetti, Oscar

2011-04-25

Management of febrile neutropenic episodes (FE) is challenged by lacking microbiological and clinical documentation of infection. We aimed at evaluating the utility of monitoring blood procalcitonin (PCT) in FE for initial diagnosis of infection and reassessment in persistent fever. PCT kinetics was prospectively monitored in 194 consecutive FE (1771 blood samples): 65 microbiologically documented infections (MDI, 33.5%; 49 due to non-coagulase-negative staphylococci, non-CNS), 68 clinically documented infections (CDI, 35%; 39 deep-seated), and 61 fever of unexplained origin (FUO, 31.5%). At fever onset median PCT was 190 pg/mL (range 30-26'800), without significant difference among MDI, CDI and FUO. PCT peak occurred on day 2 after onset of fever: non-CNS-MDI/deep-seated-CDI (656, 80-86350) vs. FUO (205, 33-771; p<0.001). PCT >500 pg/mL distinguished non-CNS-MDI/deep-seated-CDI from FUO with 56% sensitivity and 90% specificity. PCT was >500 pg/ml in only 10% of FUO (688, 570-771). A PCT peak >500 pg/mL (1196, 524-11950) occurred beyond 3 days of persistent fever in 17/21 (81%) invasive fungal diseases (IFD). This late PCT peak identified IFD with 81% sensitivity and 57% specificity and preceded diagnosis according to EORTC-MSG criteria in 41% of cases. In IFD responding to therapy, median days to PCT <500 pg/mL and defervescence were 5 (1-23) vs. 10 (3-22; p = 0.026), respectively. While procalcitonin is not useful for diagnosis of infection at onset of neutropenic fever, it may help to distinguish a minority of potentially severe infections among FUOs on day 2 after onset of fever. In persistent fever monitoring procalcitonin contributes to early diagnosis and follow-up of invasive mycoses.

Analytical evaluation of Lumipulse® BRAHMS PCT CLEIA assay and clinical performances in an unselected population as compared with central lab PCT assay.

PubMed

Dupuy, Anne Marie; Né, Maxence; Bargnoux, Anne Sophie; Badiou, Stéphanie; Cristol, Jean Paul

2017-03-01

We report the analytical performances of the Lumipulse®G BRAHMS PCT assay (Fujirebio, Courteboeuf, France) and the concordance with BRAHMS PCT Kryptor CompactPlus© results from central laboratory. Lumipulse®G BRAHMS PCT immunoassay on Lumipulse®G600II instrument is a chemiluminescence enzyme immunoassay (CLEIA). Analytical performances included imprecision study, linearity, limit of detection and comparison study on 138 plasma specimen on Lumipulse®G600II vs plasma on Kryptor CompactPlus©. The intra and inter assay imprecision of Lumipulse®G BRAHMS PCT was between 2 and 5%. The LoD in our condition was 0.0029ng/mL in accordance with the LoD provided by the manufacturer (0.0048ng/mL). The linear equation of linearity was y=1,001×-0,052 with r 2 =0.99, with a mean recovery (SD) percentage of 1.8% (8%). Correlation studies showed a good correlation (r=0.99) between plasma on Kryptor and Lumipulse, with a bias of 0.02 in the range from 0.12 to 1ng/mL. The new adaptation developed from Fujirebio on quantification of PCT with CLEIA technology from monoclonal antibodies from ThermoFisher appears to be acceptable for clinical use. Copyright © 2016 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Detection of PCT and urinary β2 -MG enhances the accuracy for localization diagnosing pediatric urinary tract infection.

PubMed

Fang, Jian; Luan, Jiangwei; Zhu, Gaohong; Qi, Chang; Wang, Dandan

2017-09-01

The purpose of this article was to investigate whether the combination of urinary beta 2 microglobulin (urinary β 2 -MG) and procalcitonin (PCT) diagnosis could enhance the localization diagnostic precision of pediatric urinary tract infection comparing with single diagnosis. A study was conducted in the Nephrology Department of Wuhan women and children's health care centre. This study incorporated 85 participants, including 35 children who were diagnosed as upper urinary tract infection (UUTI) with the symptom of fever and 50 children who conducted lower urinary tract infection (LUTI). Levels of PCT and urinary β 2 -MG in both UUTI and LUTI patients were measured and compared. The level of PCT and β 2 -MG were both significantly higher in UUTI group compared with in LUTI group. AUC of urinary β 2 -MG ROC (sensitivity of 71.4%, specificity of 90.0%) was significantly smaller than that of PCT ROC (sensitivity of 77.1%, specificity of 96.0%) in the single diagnosis. Although in the combined diagnosis, the sensitivity and specificity increased to 88.6% and 98%, respectively. Both PCT and β 2 -MG could be used to localize the UTI. Introducing urinary β 2 -MG into PCT diagnosis could increase the sensitivity and specificity of UTI lesion diagnosis in clinical practice. © 2016 The Authors Journal of Clinical Laboratory Analysis Published by Wiley Periodicals, Inc.

Improving treatment plan evaluation with automation

PubMed Central

Covington, Elizabeth L.; Chen, Xiaoping; Younge, Kelly C.; Lee, Choonik; Matuszak, Martha M.; Kessler, Marc L.; Keranen, Wayne; Acosta, Eduardo; Dougherty, Ashley M.; Filpansick, Stephanie E.

2016-01-01

The goal of this work is to evaluate the effectiveness of Plan‐Checker Tool (PCT) which was created to improve first‐time plan quality, reduce patient delays, increase the efficiency of our electronic workflow, and standardize and automate the physics plan review in the treatment planning system (TPS). PCT uses an application programming interface to check and compare data from the TPS and treatment management system (TMS). PCT includes a comprehensive checklist of automated and manual checks that are documented when performed by the user as part of a plan readiness check for treatment. Prior to and during PCT development, errors identified during the physics review and causes of patient treatment start delays were tracked to prioritize which checks should be automated. Nineteen of 33 checklist items were automated, with data extracted with PCT. There was a 60% reduction in the number of patient delays in the six months after PCT release. PCT was successfully implemented for use on all external beam treatment plans in our clinic. While the number of errors found during the physics check did not decrease, automation of checks increased visibility of errors during the physics check, which led to decreased patient delays. The methods used here can be applied to any TMS and TPS that allows queries of the database. PACS number(s): 87.55.‐x, 87.55.N‐, 87.55.Qr, 87.55.tm, 89.20.Bb PMID:27929478

Procalcitonin for the early prediction of renal parenchymal involvement in children with UTI: preliminary results.

PubMed

Kotoula, Aggeliki; Gardikis, Stefanos; Tsalkidis, Aggelos; Mantadakis, Elpis; Zissimopoulos, Athanassios; Kambouri, Katerina; Deftereos, Savvas; Tripsianis, Gregorios; Manolas, Konstantinos; Chatzimichael, Athanassios; Vaos, George

2009-01-01

In order to establish the most reliable marker for distinguishing urinary tract infections (UTI) with and without renal parenchymal involvement (RPI), we recorded the clinical features and admission leukocyte count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and serum procalcitonin (PCT) in 57 children (including 43 girls) aged 2-108 months admitted with a first episode of UTI. RPI was evaluated by Tc-99m dimercaptosuccinic acid (DMSA) scintigraphy within 7 days of admission. To establish cut-off points for ESR, CRP, and PCT, we used receiver operating characteristics curves and compared the area under the curve for ESR, CRP, and PCT. Twenty-seven children were diagnosed as having RPI based on positive renal scintigraphy. A body temperature of >38 degrees C, a history of diarrhea, and poor oral intake were more common in patients with RPI. ESR, CRP, and PCT, but not leukocyte count, were significantly higher in patients with RPI (P < 0.001). PCT was more sensitive and specific for the diagnosis of upper versus lower UTI than ESR and CRP. Using a cut-off value of 0.85 ng/ml, PCT had the best performance, with sensitivity, specificity, and positive and negative predictive values of 89%, 97%, 96%, and 91% respectively. Serum PCT is a better marker than ESR, CRP, and leukocyte count for the early prediction of RPI in children with a first episode of UTI.

Role of procalcitonin in infected diabetic foot ulcer.

PubMed

Park, Jung Ho; Suh, Dong Hun; Kim, Hak Jun; Lee, Yong In; Kwak, Il Hoon; Choi, Gi Won

2017-06-01

Procalcitonin (PCT) has been recently accepted as a marker for diagnosing infection. The aim of the present study was to determine whether PCT levels are associated with infection severity of diabetic foot ulcers and whether PCT levels would be helpful to differentiate infected diabetic foot ulcer (IDFU) from IDFU associated with other infectious diseases (IDFU+O). We prospectively included 123 diabetic patients hospitalized for IDFU. Infection severity of diabetic foot ulcers was graded according to the Infectious Diseases Society of America-International Working Group on the Diabetic Foot clinical classification of diabetic foot infection. Chest radiograph, urinalysis, urine microscopy, urine culture, and blood cultures (if fever was present) were performed for all patients to diagnose other infectious diseases. Laboratory parameters were measured from blood venous samples. PCT (Spearman's ρ=0.338, P<0.001) and C-reactive protein (Spearman's ρ=0.477, P<0.001) levels were significantly associated with infection severity of diabetic foot ulcers. However, only PCT levels could differentiate patients with associated infectious diseases from patients with no concomitant infection (area under the receiver-operator characteristic curve 0.869, P<0.0001; cut-off value 0.59; sensitivity 94.7; specificity 88.5). PCT and CRP levels positively correlated with infection severity of diabetic foot ulcers and PCT levels>0.59ng/mL in patients with IDFU may be associated with other systemic bacterial infection. Copyright © 2017 Elsevier B.V. All rights reserved.

Experimental Determination of the Phase Diagram of the CaO-SiO2-5 pctMgO-10 pctAl2O3-TiO2 System

NASA Astrophysics Data System (ADS)

Shi, Junjie; Sun, Lifeng; Zhang, Bo; Liu, Xuqiang; Qiu, Jiyu; Wang, Zhaoyun; Jiang, Maofa

2016-02-01

Ti-bearing CaO-SiO2-MgO-Al2O3-TiO2 slags are important for the smelting of vanadium-titanium bearing magnetite. In the current study, the pseudo-melting temperatures were determined by the single-hot thermocouple technique for the specified content of 5 to 25 pct TiO2 in the CaO-SiO2-5 pctMgO-10 pctAl2O3-TiO2 phase diagram system. The 1573 K to 1773 K (1300 °C to 1500 °C) liquidus lines were first calculated based on the pseudo-melting temperatures according to thermodynamic equations in the specific primary crystal field. The phase equilibria at 1573 K (1300 °C) were determined experimentally using the high-temperature equilibrium and quench method followed by X-ray fluorescence, X-ray diffraction, scanning electron microscope, and energy dispersive X-ray spectroscope analysis; the liquid phase, melilite solid solution phase (C2MS2,C2AS)ss, and perovskite phase of CaO·TiO2 were found. Therefore, the phase diagram was constructed for the specified region of the CaO-SiO2-5 pctMgO-10 pctAl2O3-TiO2 system.

78 FR 75336 - Notice of Intent To Grant an Exclusive License; Aviation Devices and Electronic Components, L.L.C.

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-11

..., Mexico, Canada, Brazil, Russian Federation, Australia, Indonesia, Taiwan, Thailand, Israel and South...-Resistant Coatings'', Navy Case No. PAX81//PCT Application No. PCT/US2013/046094: filed June 17, 2013... Application No. PCT/US2013/045190: filed June 13, 2013 entitled ``Coated Aluminum Alloy Pigments and Corrosion...

Coating of 6028 Aluminum Alloy Using Aluminum Piston Alloy and Al-Si Alloy-Based Nanocomposites Produced by the Addition of Al-Ti5-B1 to the Matrix Melt

NASA Astrophysics Data System (ADS)

El-Labban, Hashem F.; Abdelaziz, M.; Mahmoud, Essam R. I.

2014-10-01

The Al-12 pctSi alloy and aluminum-based composites reinforced with TiB2 and Al3Ti intermetallics exhibit good wear resistance, strength-to-weight ratio, and strength-to-cost ratio when compared to equivalent other commercial Al alloys, which make them good candidates as coating materials. In this study, structural AA 6028 alloy is used as the base material. Four different coating materials were used. The first one is Al-Si alloy that has Si content near eutectic composition. The second, third, and fourth ones are Al-6 pctSi-based reinforced with TiB2 and Al3Ti nano-particles produced by addition of Al-Ti5-B1 master alloy with different weight percentages (1, 2, and 3 pct). The coating treatment was carried out with the aid of GTAW process. The microstructures of the base and coated materials were investigated using optical microscope and scanning electron microscope equipped with EDX analyzer. Microhardness of the base material and the coated layer were evaluated using a microhardness tester. GTAW process results in almost sound coated layer on 6028 aluminum alloy with the used four coating materials. The coating materials of Al-12 pct Si alloy resulted in very fine dendritic Al-Si eutectic structure. The interface between the coated layer and the base metal was very clean. The coated layer was almost free from porosities or other defects. The coating materials of Al-6 pct Si-based mixed with Al-Ti5-B1 master alloy with different percentages (1, 2, and 3 pct), results in coated layer consisted of matrix of fine dendrite eutectic morphology structure inside α-Al grains. Many fine in situ TiAl3 and TiB2 intermetallics were precipitated almost at the grain boundary of α-Al grains. The amounts of these precipitates are increased by increasing the addition of Al-Ti5-B1 master alloy. The surface hardness of the 6028 aluminum alloy base metal was improved with the entire four used surface coating materials. The improvement reached to about 85 pct by the first type of coating material (Al-12 pctSi alloy), while it reached to 77, 83, and 89 pct by the coating materials of Al-6 pct Si-based mixed with Al-Ti5-B1 master alloy with different percentages 1, 2, and 3 pct, respectively.

Can procalcitonin help identify associated bacterial infection in patients with severe influenza pneumonia? A multicentre study.

PubMed

Cuquemelle, E; Soulis, F; Villers, D; Roche-Campo, F; Ara Somohano, C; Fartoukh, M; Kouatchet, A; Mourvillier, B; Dellamonica, J; Picard, W; Schmidt, M; Boulain, T; Brun-Buisson, C

2011-05-01

To determine whether procalcitonin (PCT) levels could help discriminate isolated viral from mixed (bacterial and viral) pneumonia in patients admitted to the intensive care unit (ICU) during the A/H1N1v2009 influenza pandemic. A retrospective observational study was performed in 23 French ICUs during the 2009 H1N1 pandemic. Levels of PCT at admission were compared between patients with confirmed influenzae A pneumonia associated or not associated with a bacterial co-infection. Of 103 patients with confirmed A/H1N1 infection and not having received prior antibiotics, 48 (46.6%; 95% CI 37-56%) had a documented bacterial co-infection, mostly caused by Streptococcus pneumoniae (54%) or Staphylococcus aureus (31%). Fifty-two patients had PCT measured on admission, including 19 (37%) having bacterial co-infection. Median (range 25-75%) values of PCT were significantly higher in patients with bacterial co-infection: 29.5 (3.9-45.3) versus 0.5 (0.12-2) μg/l (P < 0.01). For a cut-off of 0.8 μg/l or more, the sensitivity and specificity of PCT for distinguishing isolated viral from mixed pneumonia were 91 and 68%, respectively. Alveolar condensation combined with a PCT level of 0.8 μg/l or more was strongly associated with bacterial co-infection (OR 12.9, 95% CI 3.2-51.5; P < 0.001). PCT may help discriminate viral from mixed pneumonia during the influenza season. Levels of PCT less than 0.8 μg/l combined with clinical judgment suggest that bacterial infection is unlikely.

Procalcitonin-guided protocol is not useful to manage antibiotic therapy in febrile neutropenia: a randomized controlled trial.

PubMed

Lima, Stella Sala Soares; Nobre, Vandack; de Castro Romanelli, Roberta Maia; Clemente, Wanessa Trindade; da Silva Bittencourt, Henrique Neves; Melo, Ana Catarina Mourão; Salomão, Luciana Caetano Botelho; Serufo, José Carlos

2016-06-01

Febrile neutropenia (FN) requires immediate use of antibiotics (ATB), and procalcitonin (PCT) is proven to be useful in guiding antibiotic therapy in different settings. This study investigated the use of PCT as a guide for the duration of ATB in FN. A randomized controlled trial was carried out from January-December 2010. A total of 62 hematological adult patients with FN were randomized, in 1:1 ratio, into two groups: (1) PCT group: length of ATB guided by institutional protocol plus PCT dynamics, and (2) control group: duration of ATB in accordance with institutional protocol. There was no difference between groups regarding the use of ATB for the first episode of fever (HR 1.14, 95 % CI 0.66-1.95, p = 0.641), with equivalent median duration of ATB therapy (PCT group 9.0 days and control group 8.0 days, p = 0.67), and median number of days without ATB (0 days, IQR 0-2 days for both groups, p = 0.96). We observed no difference in clinical cure rate (p = 0.68), infection relapse (p = 1.0), superinfection (p = 0.85), length of hospitalization (p = 0.64), and mortality at 28 days (p = 0.39) and at 90 days (p = 0.72). Considering the cut-off of 0.5 ng/ml, PCT was correlated with bacteremia (sensitivity of 51.9 % and specificity of 76.5 %). In this randomized controlled trial, adding a PCT-guided protocol to the standard recommendations did not reduce the use of antibiotics in febrile neutropenia, although no apparent harm was caused. PCT proved to be a marker of bacteremia in this setting.

Predictive Value of Procalcitonin for Infection and Survival in Adult Cardiogenic Shock Patients Treated with Extracorporeal Membrane Oxygenation

PubMed Central

Kim, Do Wan; Cho, Hwa Jin; Kim, Gwan Sic; Song, Sang Yun; Na, Kook Joo; Oh, Sang Gi

2018-01-01

Procalcitonin (PCT) is a predictive marker for the occurrence of bacterial infection and the decision to terminate antibiotic treatment in critically ill patients. An unusual increase in PCT, regardless of infection, has been observed during extracorporeal membrane oxygenation (ECMO) support. We evaluated trends and the predictive value of PCT levels in adult cardiogenic shock during treatment with ECMO. We reviewed the clinical records of 38 adult cardiogenic shock patients undergoing veno-arterial ECMO support between January 2014 and December 2016. The exclusion criteria were age <18 years, pre-ECMO infection, and less than 48 hours of support. The mean patient age was 56.7±14.7 years and 12 (31.6%) patients were female. The mean duration of ECMO support was 9.0±7.6 days. The rates of successful ECMO weaning and survival to discharge were 55.3% (n=21) and 52.6% (n=20), respectively. There were 17 nosocomial infections in 16 (42.1%) patients. Peak PCT levels (mean 25.6±9.4 ng/mL) were reached within 48 hours after initiation of ECMO support and decreased to ≤5 ng/mL within one week. The change in PCT levels was not useful in predicting the occurrence of new nosocomial infections during the ECMO run. However, a PCT level >10 ng/mL during the first week of ECMO support was significantly associated with mortality (p<0.01). The change in PCT level was not useful in predicting new infection during ECMO support. However, higher PCT levels within the first week of the ECMO run are associated with significantly higher mortality. PMID:29399566

Procalcitonin fails to predict bacteremia in SIRS patients: a cohort study.

PubMed

Hoenigl, M; Raggam, R B; Wagner, J; Prueller, F; Grisold, A J; Leitner, E; Seeber, K; Prattes, J; Valentin, T; Zollner-Schwetz, I; Schilcher, G; Krause, R

2014-10-01

Procalcitonin (PCT) has previously been proposed as useful marker to rule out bloodstream-infection (BSI). The objective of this study was to evaluate the sensitivity of different PCT cut-offs for prediction of BSI in patients with community (CA)- and hospital-acquired (HA)-BSI. A total of 898 patients fulfilling systemic-inflammatory-response-syndrome (SIRS) criteria were enrolled in this prospective cohort study at the Medical University of Graz, Austria. Of those 666 patients had positive blood cultures (282 CA-BSI, 384 HA-BSI, enrolled between January 2011 and December 2012) and 232 negative blood cultures (enrolled between January 2011 and July 2011 at the emergency department). Blood samples for determination of laboratory infection markers (e.g. PCT) were collected simultaneously with blood cultures. Procalcitonin was significantly (p < 0.001) higher in SIRS patients with bacteremia/fungemia than in those without. Receiver operating characteristic curve analysis revealed an area under the curve (AUC) value of 0.675 for PCT (95% CI 0.636-0.714) for differentiating patients with BSI from those without. AUC for IL-6 was 0.558 (95% CI 0.515-0.600). However, even at the lowest cut-off evaluated (i.e. 0.1 ng/ml) PCT failed to predict BSI in 7% (n = 46) of patients. In the group of patients with SIRS and negative blood culture 79% (n = 185) had PCT levels > 0.1. Procalcitonin was significantly higher in patients with BSI than in those without and superior to IL-6 and CRP. The clinical importance of this is questionable, because a suitable PCT threshold for excluding BSI was not established. An approach where blood cultures are guided by PCT only can therefore not be recommended. © 2014 John Wiley & Sons Ltd.

Procalcitonin and C-reactive protein as markers of systemic inflammatory response syndrome severity in critically ill children.

PubMed

Rey, Corsino; Los Arcos, Marta; Concha, Andrés; Medina, Alberto; Prieto, Soledad; Martinez, Pablo; Prieto, Belen

2007-03-01

To analyse the clinical value of procalcitonin (PCT), C-reactive protein (CRP) and leucocyte count in the diagnosis of paediatric sepsis and in the stratification of patients according to severity. Prospective, observational study. Paediatric intensive care unit (PICU). Ninety-four children. Leucocyte count, PCT and CRP were measured when considered necessary during the PICU stay. Patients were classified, when PCT and CRP were measured, into one of six categories (negative, SIRS, localized infection, sepsis, severe sepsis, and septic shock) according to the definitions of the American College of Chest Physicians /Society of Critical Care Medicine. A total of 359 patient day episodes were obtained. Leucocyte count did not differ across the six diagnostic classes considered. Median plasma PCT concentrations were 0.17, 0.43, 0.79, 1.80, 15.40 and 19.13 ng/ml in negative, systemic inflammatory response syndrome (SIRS), localized infection, sepsis, severe sepsis, and septic shock groups, respectively, whereas median plasma CRP concentrations were 1.35, 3.80, 6.45, 5.70, 7.60 and 16.2 mg/dl, respectively. The area under the ROC curve for the diagnosis of septic patients was 0.532 for leucocyte count (95% CI, 0.462-0.602), 0.750 for CRP (95% CI, 0.699-0.802) and 0.912 for PCT (95% CI, 0.882-0.943). We obtained four groups using CRP values and five groups using PCT values that classified a significant percentage of patients according to the severity of the different SIRS groups. PCT is a better diagnostic marker of sepsis in critically ill children than CRP. The CRP, and especially PCT, may become a helpful clinical tool to stratify patients with SIRS according to disease severity.

Biaxial extrusion of polyimide LARC-TPI and LARC-TPI blends

NASA Technical Reports Server (NTRS)

Haghighat, R. Ross; Elandjian, Lucy; Lusignea, Richard W.

1990-01-01

Biaxial films of polyimide LARC-TPI and LARC-TPI/liquid crystal polymer Xydar were extruded directly from the melt for the first time via an innovative extrusion technique. Three types of films, neat LARC-TPI, LARC-TPI/10 wt pct and 30 wt pct blends were processed as a part of this NASA-funded program. Processability was greatly enhanced by incorporating Xydar. The coefficient of thermal expansion was reduced from 34 ppm/C for the neat LARC-TPI to 15 ppm/C for the 10 wt pct Xydar blend and ultimately down to 1 to 3 ppm/C for the 30 wt pct blend films in the direction of extrusion. The maximum improvement in stiffness was realized by incorporating 10 wt pct Xydar (2.8 GPa up to 4.9 GPa). Tensile strength, however, experienced a drop as a result of Xydar addition, probably caused by inefficient mixing of the two phases.

ILAW Glass Testing for Disposal at IDF: Phase 1 Testing

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

Papathanassiu, Adonia; Muller, Isabelle S.; Brandys, Marek

2011-04-11

This document reports the results of the testing of phase 1 ORP LAW (low activity waste) glasses, also identified as enhanced LAW glasses. Testing involved are SPFT (Single Pass Flow Through), VHT (Vapor Hydration Test), and PCT (Product Consistency Test), along with the analytical tests (XRD and SEM-EDS). This report contains the data of the high waste loading ORP LAW glasses that will be used for the performance assessment of the IDF (Integrated Disposal Facility).

7 CFR 51.2954 - Tolerances for grade defects.

Code of Federal Regulations, 2011 CFR

2011-01-01

... damaged by mold or insects or seriously damaged by other means, of which not more than 5/6 or 5 pct may be damaged by insects, but no part of any tolerance shall be allowed for walnuts containing live insects No... adhering hulls 15 pct total, by count, including not more than 8 pct which are damaged by mold or insects...

Growth classification systems for red fir and white fir in northern California

Treesearch

George T. Ferrell

1983-01-01

Selected crown and bole characteristics were predictor variables in growth classification equations developed for California red fir, Shasta red fir, and white fir in northern California. Individual firs were classified on the basis of percent basal area increment (PCTBAI ) as Class 1 (≤ 1 pct), Class 2 (> 1 pct and ≤ 3 pct), or Class 3 (> 3...

Effects of laser-shock processing on the microstructure and surface mechanical properties of hadfield manganese steel

NASA Astrophysics Data System (ADS)

Chu, J. P.; Rigsbee, J. M.; Banaś, G.; Lawrence, F. V.; Elsayed-Ali, H. E.

1995-06-01

The effects of laser-shock processing (LSP) on the microstructure, hardness, and residual stress of Hadfield manganese (1 pct C and 14 pct Mn) steels were studied. Laser-shock processing was performed using a Nd: glass phosphate laser with 600 ps pulse width and up to 120 J/pulse energy at power density above 1012 W/cm2. The effects of cold rolling and shot peening were also studied for comparison. Laser-shock processing caused extensive formation of ɛ hexagonal close-packed (hep) martensite (35 vol pct), producing up to a 130 pct increase of surface hardness. The surface hardness increase was 40 to 60 pct for the shot-peened specimen and about 60 pct for the cold-rolled specimen. The LSP strengthening effect on Hadfield steel was attributed to the combined effects of the partial dislocation/stacking fault arrays and the grain refinement due to the presence of the ɛ-hcp martensite. For the cold-rolled and shot-peened specimens, the strengthening was a result of ɛ-hcp martensite and twins with dislocation effects, respectively. Shot peening resulted in a relatively higher compressive residual stress throughout the specimen than LSP.

Effect of Cooling Rate and Chemical Composition on Microstructure and Properties of Naturally Cooled Vanadium-Microalloyed Steels

NASA Astrophysics Data System (ADS)

Karmakar, Anish; Sahu, Pooja; Neogy, Suman; Chakrabarti, Debalay; Mitra, Rahul; Mukherjee, Subrata; Kundu, Saurabh

2017-04-01

Samples from two V-microalloyed steels (0.05 wt pct V) having different C and N levels, namely high-C low-N steel, HCLN (0.22 wt pct C, 0.007 wt pct N) and low-C high-N steel, LCHN (0.06 wt pct C, 0.013 wt pct N) were naturally cooled from 1373 K (1100 °C) to room temperature over a range of cooling rates (0.07 to 3.33 K/s). Samples from a plain C-Mn steel (0.06 wt pct C, 0.007 wt pct N) were also subjected to the same heat treatment for comparison. The effect of cooling rate and steel composition on microstructures, precipitates, and tensile properties has been investigated. Due to the presence of large fraction of harder constituents, like pearlite and bainite, HCLN steel showed higher strength and lower ductility than LCHN steel. LCHN steel, on the other hand, showed good combination of strength and ductility due to its predominantly ferrite matrix with precipitation strengthening. The V-precipitate size was more refined and the precipitate density was higher in HCLN steel than that in LCHN steel. This observation confirms the importance of C content in V-microalloyed steel in terms of precipitation strengthening. An intermediate cooling rate ( 1.4 K/s) has been found to be the optimum choice in order to maximize the precipitation strengthening in V-containing steels.

Wettability of Molten Aluminum-Silicon Alloys on Graphite and Surface Tension of Those Alloys at 1273 K (1000 °C)

NASA Astrophysics Data System (ADS)

Mao, Weiji; Noji, Takayasu; Teshima, Kenichiro; Shinozaki, Nobuya

2016-06-01

The wettability of molten aluminum-silicon alloys with silicon contents of 0, 6, 10, and 20 mass pct on graphite substrates by changing the placing sequence of aluminum and silicon and the surface tension of those alloys were investigated at 1273 K (1000 °C) using the sessile drop method under vacuum. The results showed that the wetting was not affected by changing the placing sequence of the Al-Si alloys on the graphite substrates. The wettability was not improved significantly upon increasing the Si content from 0 to 10 mass pct, whereas a notable decrease of 22 deg in the contact angle was observed when increasing the Si content from 10 to 20 mass pct. This was attributed to the transformation of the interfacial reaction product from Al4C3 into SiC, provided the addition of Si to Al was sufficient. It was verified that the liquid Al can wet the SiC substrate very well in nature, which might explain why the occurrence of SiC would improve the wettability of the Al-20 mass pct Si alloy on the graphite substrate. The results also showed that the surface tension values of the molten Al-Si alloys decreased monotonously with an increase in Si content, being 875, 801, 770, and 744 mN/m for molten Al, Al-6 mass pct Si, Al-10 mass pct Si, and Al-20 mass pct Si alloys, respectively.

1200 and 1300 K slow plastic compression properties of Ni-50Al composites

NASA Technical Reports Server (NTRS)

Whittenberger, J. D.; Kumar, K. S.; Mannan, S. K.

1991-01-01

XD synthesis, powder blending, and hot pressing techniques have been utilized to produce NiAl composites containing 4, 7.5, 15, and 25 vol pct alumina whiskers and hybrid composite materials with 15 vol pct Al2O3 + 10 or 20 vol pct, nominally 1 micron TiB2 particles. The resistance to slow plastic flow was determined at 1200 and 1300 K via compression testing in air under constant velocity conditions. The stress-strain behavior of the intermetallic composites depended on the fraction of second phases where the 4 and 7.5 percent Al2O3 materials flowed at a nominally constant stress after about 2 percent deformation, while all the other composites exhibited diffuse yielding followed by strain softening. The flow stress-strain rate properties increased with volume fraction of Al2O3 whiskers except for the 4 and 7.5 percent materials, which had similar strengths. The hybrid composite NiAl + 15Al2O3 + 10TiB2 was substantially stronger than the materials simply containing alumina. Deformation in these composites can be described by the Kelly and Street model of creep in perfectly bonded, rigid, discontinuous fiber materials.

Biomarkers and Molecular Analysis to Improve Bloodstream Infection Diagnostics in an Emergency Care Unit

PubMed Central

Loonen, Anne J. M.; de Jager, Cornelis P. C.; Tosserams, Janna; Kusters, Ron; Hilbink, Mirrian; Wever, Peter C.; van den Brule, Adriaan J. C.

2014-01-01

Molecular pathogen detection from blood is still expensive and the exact clinical value remains to be determined. The use of biomarkers may assist in preselecting patients for immediate molecular testing besides blood culture. In this study, 140 patients with ≥ 2 SIRS criteria and clinical signs of infection presenting at the emergency department of our hospital were included. C-reactive protein (CRP), neutrophil-lymphocyte count ratio (NLCR), procalcitonin (PCT) and soluble urokinase plasminogen activator receptor (suPAR) levels were determined. One ml EDTA blood was obtained and selective pathogen DNA isolation was performed with MolYsis (Molzym). DNA samples were analysed for the presence of pathogens, using both the MagicPlex Sepsis Test (Seegene) and SepsiTest (Molzym), and results were compared to blood cultures. Fifteen patients had to be excluded from the study, leaving 125 patients for further analysis. Of the 125 patient samples analysed, 27 presented with positive blood cultures of which 7 were considered to be contaminants. suPAR, PCT, and NLCR values were significantly higher in patients with positive blood cultures compared to patients without (p < 0.001). Receiver operating characteristic curves of the 4 biomarkers for differentiating bacteremia from non-bacteremia showed the highest area under the curve (AUC) for PCT (0.806 (95% confidence interval 0.699–0.913)). NLCR, suPAR and CRP resulted in an AUC of 0.770, 0.793, and 0.485, respectively. When compared to blood cultures, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for SepsiTest and MagicPlex Sepsis Test were 11%, 96%, 43%, 80%, and 37%, 77%, 30%, 82%, respectively. In conclusion, both molecular assays perform poorly when one ml whole blood is used from emergency care unit patients. NLCR is a cheap, fast, easy to determine, and rapidly available biomarker, and therefore seems most promising in differentiating BSI from non-BSI patients for subsequent pathogen identification using molecular diagnostics. PMID:24475269

Biomarkers and molecular analysis to improve bloodstream infection diagnostics in an emergency care unit.

PubMed

Loonen, Anne J M; de Jager, Cornelis P C; Tosserams, Janna; Kusters, Ron; Hilbink, Mirrian; Wever, Peter C; van den Brule, Adriaan J C

2014-01-01

Molecular pathogen detection from blood is still expensive and the exact clinical value remains to be determined. The use of biomarkers may assist in preselecting patients for immediate molecular testing besides blood culture. In this study, 140 patients with ≥ 2 SIRS criteria and clinical signs of infection presenting at the emergency department of our hospital were included. C-reactive protein (CRP), neutrophil-lymphocyte count ratio (NLCR), procalcitonin (PCT) and soluble urokinase plasminogen activator receptor (suPAR) levels were determined. One ml EDTA blood was obtained and selective pathogen DNA isolation was performed with MolYsis (Molzym). DNA samples were analysed for the presence of pathogens, using both the MagicPlex Sepsis Test (Seegene) and SepsiTest (Molzym), and results were compared to blood cultures. Fifteen patients had to be excluded from the study, leaving 125 patients for further analysis. Of the 125 patient samples analysed, 27 presented with positive blood cultures of which 7 were considered to be contaminants. suPAR, PCT, and NLCR values were significantly higher in patients with positive blood cultures compared to patients without (p < 0.001). Receiver operating characteristic curves of the 4 biomarkers for differentiating bacteremia from non-bacteremia showed the highest area under the curve (AUC) for PCT (0.806 (95% confidence interval 0.699-0.913)). NLCR, suPAR and CRP resulted in an AUC of 0.770, 0.793, and 0.485, respectively. When compared to blood cultures, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for SepsiTest and MagicPlex Sepsis Test were 11%, 96%, 43%, 80%, and 37%, 77%, 30%, 82%, respectively. In conclusion, both molecular assays perform poorly when one ml whole blood is used from emergency care unit patients. NLCR is a cheap, fast, easy to determine, and rapidly available biomarker, and therefore seems most promising in differentiating BSI from non-BSI patients for subsequent pathogen identification using molecular diagnostics.

37 CFR 1.480 - Demand for international preliminary examination.

Code of Federal Regulations, 2010 CFR

2010-07-01

... been submitted (PCT Rule 54bis.1(b)). [52 FR 20048, May 28, 1987, as amended at 53 FR 47810, Nov. 28... (§ 1.482(a)(1)) and the handling fee (§ 1.482(b)) shall be due within the applicable time limit set forth in PCT Rule 57.3. (b) The Demand shall be made on a standardized form (PCT Rule 53). Copies of the...

37 CFR 1.480 - Demand for international preliminary examination.

Code of Federal Regulations, 2014 CFR

2014-07-01

... been submitted (PCT Rule 54bis.1(b)). [52 FR 20048, May 28, 1987, as amended at 53 FR 47810, Nov. 28... (§ 1.482(a)(1)) and the handling fee (§ 1.482(b)) shall be due within the applicable time limit set forth in PCT Rule 57.3. (b) The Demand shall be made on a standardized form (PCT Rule 53). Copies of the...

37 CFR 1.480 - Demand for international preliminary examination.

Code of Federal Regulations, 2012 CFR

2012-07-01

... been submitted (PCT Rule 54bis.1(b)). [52 FR 20048, May 28, 1987, as amended at 53 FR 47810, Nov. 28... (§ 1.482(a)(1)) and the handling fee (§ 1.482(b)) shall be due within the applicable time limit set forth in PCT Rule 57.3. (b) The Demand shall be made on a standardized form (PCT Rule 53). Copies of the...

37 CFR 1.480 - Demand for international preliminary examination.

Code of Federal Regulations, 2013 CFR

2013-07-01

... been submitted (PCT Rule 54bis.1(b)). [52 FR 20048, May 28, 1987, as amended at 53 FR 47810, Nov. 28... (§ 1.482(a)(1)) and the handling fee (§ 1.482(b)) shall be due within the applicable time limit set forth in PCT Rule 57.3. (b) The Demand shall be made on a standardized form (PCT Rule 53). Copies of the...

37 CFR 1.480 - Demand for international preliminary examination.

Code of Federal Regulations, 2011 CFR

2011-07-01

... been submitted (PCT Rule 54bis.1(b)). [52 FR 20048, May 28, 1987, as amended at 53 FR 47810, Nov. 28... (§ 1.482(a)(1)) and the handling fee (§ 1.482(b)) shall be due within the applicable time limit set forth in PCT Rule 57.3. (b) The Demand shall be made on a standardized form (PCT Rule 53). Copies of the...

Manage Your Life Online (MYLO): a pilot trial of a conversational computer-based intervention for problem solving in a student sample.

PubMed

Gaffney, Hannah; Mansell, Warren; Edwards, Rachel; Wright, Jason

2014-11-01

Computerized self-help that has an interactive, conversational format holds several advantages, such as flexibility across presenting problems and ease of use. We designed a new program called MYLO that utilizes the principles of METHOD of Levels (MOL) therapy--based upon Perceptual Control Theory (PCT). We tested the efficacy of MYLO, tested whether the psychological change mechanisms described by PCT mediated its efficacy, and evaluated effects of client expectancy. Forty-eight student participants were randomly assigned to MYLO or a comparison program ELIZA. Participants discussed a problem they were currently experiencing with their assigned program and completed measures of distress, resolution and expectancy preintervention, postintervention and at 2-week follow-up. MYLO and ELIZA were associated with reductions in distress, depression, anxiety and stress. MYLO was considered more helpful and led to greater problem resolution. The psychological change processes predicted higher ratings of MYLO's helpfulness and reductions in distress. Positive expectancies towards computer-based problem solving correlated with MYLO's perceived helpfulness and greater problem resolution, and this was partly mediated by the psychological change processes identified. The findings provide provisional support for the acceptability of the MYLO program in a non-clinical sample although its efficacy as an innovative computer-based aid to problem solving remains unclear. Nevertheless, the findings provide tentative early support for the mechanisms of psychological change identified within PCT and highlight the importance of client expectations on predicting engagement in computer-based self-help.

Contouring variability of human- and deformable-generated contours in radiotherapy for prostate cancer

NASA Astrophysics Data System (ADS)

Gardner, Stephen J.; Wen, Ning; Kim, Jinkoo; Liu, Chang; Pradhan, Deepak; Aref, Ibrahim; Cattaneo, Richard, II; Vance, Sean; Movsas, Benjamin; Chetty, Indrin J.; Elshaikh, Mohamed A.

2015-06-01

This study was designed to evaluate contouring variability of human-and deformable-generated contours on planning CT (PCT) and CBCT for ten patients with low-or intermediate-risk prostate cancer. For each patient in this study, five radiation oncologists contoured the prostate, bladder, and rectum, on one PCT dataset and five CBCT datasets. Consensus contours were generated using the STAPLE method in the CERR software package. Observer contours were compared to consensus contour, and contour metrics (Dice coefficient, Hausdorff distance, Contour Distance, Center-of-Mass [COM] Deviation) were calculated. In addition, the first day CBCT was registered to subsequent CBCT fractions (CBCTn: CBCT2-CBCT5) via B-spline Deformable Image Registration (DIR). Contours were transferred from CBCT1 to CBCTn via the deformation field, and contour metrics were calculated through comparison with consensus contours generated from human contour set. The average contour metrics for prostate contours on PCT and CBCT were as follows: Dice coefficient—0.892 (PCT), 0.872 (CBCT-Human), 0.824 (CBCT-Deformed); Hausdorff distance—4.75 mm (PCT), 5.22 mm (CBCT-Human), 5.94 mm (CBCT-Deformed); Contour Distance (overall contour)—1.41 mm (PCT), 1.66 mm (CBCT-Human), 2.30 mm (CBCT-Deformed); COM Deviation—2.01 mm (PCT), 2.78 mm (CBCT-Human), 3.45 mm (CBCT-Deformed). For human contours on PCT and CBCT, the difference in average Dice coefficient between PCT and CBCT (approx. 2%) and Hausdorff distance (approx. 0.5 mm) was small compared to the variation between observers for each patient (standard deviation in Dice coefficient of 5% and Hausdorff distance of 2.0 mm). However, additional contouring variation was found for the deformable-generated contours (approximately 5.0% decrease in Dice coefficient and 0.7 mm increase in Hausdorff distance relative to human-generated contours on CBCT). Though deformable contours provide a reasonable starting point for contouring on CBCT, we conclude that contours generated with B-Spline DIR require physician review and editing if they are to be used in the clinic.

The Usefulness of Procalcitonin and C-Reactive Protein as Early Diagnostic Markers of Bacteremia in Cancer Patients with Febrile Neutropenia

PubMed Central

Kim, Dae Yong; Ahn, Shin; Chun, Yeon Hee; Lim, Kyung Soo

2011-01-01

Purpose Procalcitonin (PCT) and C-reactive protein (CRP) are well known inflammatory markers. This study was designed to determine whether PCT and CRP are useful as early diagnostic markers for bacteremia in cancer patients with febrile neutropenia (FN) in the emergency department (ED). Materials and Methods In this retrospective study, 286 episodes of FN in the ED were consecutively included between June 2009 and August 2010. From medical records, clinical characteristics including PCT and CRP were extracted and analyzed. Results Bacteremia was identified in 38 (13.3%) of the 286 episodes. The median values of PCT (2.8 ng/mL vs. 0.0 ng/mL, p=0.000) and CRP (15.9 mg/dL vs. 5.6 mg/dL, p=0.002) were significantly higher in the group with bacteremia compared to the group without bacteremia. In univariate analysis, elevated PCT (>0.5 ng/mL) and CRP (>10 mg/dL) as well as older age, hypotension, tachycardia, tachypnea, and high body temperature were significantly associated with bacteremia. On multivariate analysis, elevated PCT (>0.5 ng/mL) (odds ratio [OR], 3.6; 95% confidence interval [CI], 1.4 to 9.2; p<0.01) and tachypnea (OR, 3.4; 95% CI, 1.4 to 8.5; p<0.01) were independent early diagnostic markers for bacteremia in FN patients. The area under the curve of PCT was 74.8% (95% CI, 65.1 to 84.6%) and that of CRP was 65.5% (95% CI, 54.8 to 76.1%). With a PCT cut-off value of 0.5 ng/mL, sensitivity and specificity were 60.5% and 82.3%, respectively, while the sensitivity and specificity were 57.6% and 67.3%, respectively, with a CRP cutoff of 10 mg/dL. Conclusion These findings suggest that PCT is a useful early diagnostic marker for the detection of bacteremia in FN at the ED and has better diagnostic value than CRP. PMID:22022295

Procalcitonin reflects bacteremia and bacterial load in urosepsis syndrome: a prospective observational study

PubMed Central

2010-01-01

Introduction Guidelines recommend that two blood cultures be performed in patients with febrile urinary tract infection (UTI), to detect bacteremia and help diagnose urosepsis. The usefulness and cost-effectiveness of this practice have been criticized. This study aimed to evaluate clinical characteristics and the biomarker procalcitonin (PCT) as an aid in predicting bacteremia. Methods A prospective observational multicenter cohort study included consecutive adults with febrile UTI in 35 primary care units and 8 emergency departments of 7 regional hospitals. Clinical and microbiological data were collected and PCT and time to positivity (TTP) of blood culture were measured. Results Of 581 evaluable patients, 136 (23%) had bacteremia. The median age was 66 years (interquartile range 46 to 78 years) and 219 (38%) were male. We evaluated three different models: a clinical model including seven bed-side characteristics, the clinical model plus PCT, and a PCT only model. The diagnostic abilities of these models as reflected by area under the curve of the receiver operating characteristic were 0.71 (95% confidence interval (CI): 0.66 to 0.76), 0.79 (95% CI: 0.75 to 0.83) and 0.73 (95% CI: 0.68 to 0.77) respectively. Calculating corresponding sensitivity and specificity for the presence of bacteremia after each step of adding a significant predictor in the model yielded that the PCT > 0.25 μg/l only model had the best diagnostic performance (sensitivity 0.95; 95% CI: 0.89 to 0.98, specificity 0.50; 95% CI: 0.46 to 0.55). Using PCT as a single decision tool, this would result in 40% fewer blood cultures being taken, while still identifying 94 to 99% of patients with bacteremia. The TTP of E. coli positive blood cultures was linearly correlated with the PCT log value; the higher the PCT the shorter the TTP (R2 = 0.278, P = 0.007). Conclusions PCT accurately predicts the presence of bacteremia and bacterial load in patients with febrile UTI. This may be a helpful biomarker to limit use of blood culture resources. PMID:21083886

Electrolytic Deposition and Diffusion of Lithium onto Magnesium-9 Wt Pct Yttrium Bulk Alloy in Low-Temperature Molten Salt of Lithium Chloride and Potassium Chloride

NASA Astrophysics Data System (ADS)

Dong, Hanwu; Wu, Yaoming; Wang, Lidong; Wang, Limin

2009-10-01

The electrolytic deposition and diffusion of lithium onto bulk magnesium-9 wt pct yttrium alloy cathode in molten salt of 47 wt pct lithium chloride and 53 wt pct potassium chloride at 693 K were investigated. Results show that magnesium-yttrium-lithium ternary alloys are formed on the surface of the cathodes, and a penetration depth of 642 μm is acquired after 2 hours of electrolysis at the cathodic current density of 0.06 A·cm-2. The diffusion of lithium results in a great amount of precipitates in the lithium containing layer. These precipitates are the compound of Mg41Y5, which arrange along the grain boundaries and hinder the diffusion of lithium, and solid solution of yttrium in magnesium. The grain boundaries and the twins of the magnesium-9 wt pct yttrium substrate also have negative effects on the diffusion of lithium.

Streamlining antibiotic therapy with procalcitonin protocols: consensus and controversies.

PubMed

Haubitz, Sebastian; Mueller, Beat; Schuetz, Philipp

2013-04-01

Accumulating evidence supports procalcitonin (PCT) as an accurate surrogate biomarker for likelihood and severity of bacterial infections. In community-acquired pneumonia and other respiratory infections, PCT-guided antibiotic therapy algorithms resulted in reduced antibiotic exposure while maintaining a similar or even better level of safety compared with standard care. Reductions in antibiotic use translate into lower treatment costs, decreased risk of side effects and decreased bacterial multiresistance. This is especially important, as acute respiratory infections represent the most frequent reason for antibiotic prescriptions worldwide. Still, there is some controversy about the benefits of PCT measurement in sepsis patients in the intensive care unit and for nonrespiratory infections. Highly sensitive PCT assays are readily available in many hospitals today, and point-of-care assays with high enough sensitivity for antibiotic guidance are expected to be available soon. Herein, the authors provide an overview of recent studies evaluating PCT in different clinical situations and an outlook of currently enrolling or upcoming interventional trials.

Selective Oxidation and Reactive Wetting during Galvanizing of a CMnAl TRIP-Assisted Steel

NASA Astrophysics Data System (ADS)

Bellhouse, E. M.; McDermid, J. R.

2011-09-01

A transformation induced plasticity (TRIP)-assisted steel with 0.2 pct C, 1.5 pct Mn, and 1.5 pct Al was successfully galvanized using a thermal cycle previously shown to produce an excellent combination of strength and ductility. The steel surface chemistry and oxide morphology were determined as a function of process atmosphere oxygen partial pressure. For the 220 K (-53 °C) dew point (dp) + 20 pct H2 atmosphere, the oxide morphology was a mixture of films and nodules. For the 243 K (-30 °C) dp + 5 pct H2 atmosphere, nodules of MnO were found primarily at grain boundaries. For the 278 K (+5 °C) dp + 5 pct H2 atmosphere, nodules of metallic Fe were found on the surface as a result of alloy element internal oxidation. The steel surface chemistry and oxide morphology were then related to the reactive wetting behavior during continuous hot dip galvanizing. Good wetting was obtained using the two lower oxygen partial pressure process atmospheres [220 K dp and 243 K dp (-53 °C dp and -30 °C dp)]. An increase in the number of bare spots was observed when using the higher oxygen partial pressure process atmosphere (+5 °C dp) due to the increased thickness of localized oxide films.

Influence of dihydroxybenzenes on paracetamol and ciprofloxacin degradation and iron(III) reduction in Fenton processes.

PubMed

Costa E Silva, Beatriz; de Lima Perini, João Angelo; Nogueira, Raquel F Pupo

2017-03-01

The degradation of paracetamol (PCT) and ciprofloxacin (CIP) was compared in relation to the generation of dihydroxylated products, Fe(III) reduction and reaction rate in the presence of dihydroxybenzene (DHB) compounds, or under irradiation with free iron (Fe 3+ ) or citrate complex (Fecit) in Fenton or photo-Fenton process. The formation of hydroquinone (HQ) was observed only during PCT degradation in the dark, which increased drastically the rate of PCT degradation, since HQ formed was able to reduce Fe 3+ and contributed to PCT degradation efficiency. When HQ was initially added, PCT and CIP degradation rate in the dark was much higher in comparison to the absence of HQ, due to the higher and faster formation of Fe 2+ at the beginning of reaction. In the absence of HQ, no CIP degradation was observed; however, when HQ was added after 30 min, the degradation rate increased drastically. Ten PCT hydroxylated intermediates were identified in the absence of HQ, which could contribute for Fe(III) reduction and consequently to the degradation in a similar way as HQ. During CIP degradation, only one product of hydroxyl radical attack on benzene ring and substitution of the fluorine atom was identified when HQ was added to the reaction medium.

The thermodynamic activity of ZnO in silicate melts

NASA Astrophysics Data System (ADS)

Reyes, R. A.; Gaskell, D. R.

1983-12-01

The activity of ZnO in ZnO-SiO2 and CaO-ZnO-SiO2 melts has been measured at 1560 °C using a transpiration technique with CO-CO2 mixtures as the carrier gas. The activities of ZnO in dilute solution in 42 wt pct SiO2-38 wt pct CaO-20 wt pct A12O3 in the range 1400° to 1550 °C and in 62 wt pct SiO2-23.3 wt pct CaO-14.7 wt pct A12O3 at 1550 °C have also been measured. The measured free energies of formation of ZnO-SiO2 melts are significantly more negative than published estimated values and this, together with the behavior observed in the system CaO-Al2O3-SiO2, indicate that ZnO is a relatively basic oxide. The results are discussed in terms of the polymerization model of binary silicate melts and ideal silicate mixing in ternary silicate melts. The behavior of ZnO in dilute solution in CaO-Al2O3-SiO2 melts is discussed in terms of the possibility of the fluxing of ZnO by iron blast furnace slags.

Intrathoracic administration of OK-432 elevates the serum procalcitonin levels.

PubMed

Ogasawara, Takashi; Umezawa, Hiroki; Kato, Shinpei; Yano, Toshiaki; Kasamatsu, Norio; Hashizume, Ikko

2012-01-01

The intrathoracic administration of OK-432, a lyophilized preparation of the heat- and penicillin-treated Su-strain of type 3, group A Streptococcus pyogenes, is performed in Japan for pleurodesis of malignant pleural effusion or pneumothorax. Persistent fever is often observed after pleurodesis. To elucidate whether procalcitonin (PCT) is useful for distinguishing between the side effects of OK-432 and infection, we measured the serum PCT levels before and after pleurodesis. We performed a prospective study of 12 patients with refractory pleural effusion or pneumothorax who required pleurodesis using OK-432 between August 2011 and February 2012. The serum PCT and C-reactive protein (CRP) levels were measured on days 1 and 3. Of the 12 patients, five had pneumothorax and seven had uncontrolled pleural effusion with carcinomatous pleurisy. The median serum levels of PCT and CRP increased from 0.055 to 1.59 ng/mL (p=0.0022) and from 1.52 to 16.82 mg/dL (p=0.0022), respectively. The fevers subsided without antibiotic administration. The serum PCT level may not be useful for distinguishing fever caused by side effects of OK-432 from that caused by bacterial infection. The intrathoracic administration of OK-432 increased the serum levels of both PCT and CRP in the absence of any bacterial infection.

Procalcitonin - Assisted Antibiotic Strategy in Sepsis.

PubMed

Trásy, Domonkos; Molnár, Zsolt

2017-05-01

Sepsis is one of the biggest challenges in critical care nowadays. Defining sepsis is a difficult task on its own and its diagnosis and treatment requires well trained, devoted personnel with interdisciplinary collaboration in order to provide the patients the best chance for survival. Immediate resuscitation, early adequate antimicrobial therapy, source control and highly sophisticated organ support on the intensive care units are all inevitable necessities for successful recovery. To help fast and accurate diagnosis biomarkers have been measured for decades. Procalcitonin (PCT) is one of the most studied, but the results are conflicting. Sepsis means a very loose cohort of a large heterogeneous patient population, hence defining certain cut off values for PCT to differentiate between different severities of the disease is almost impossible. Clinicians first have to understand the pathophysiological background of sepsis to be able to interpret correctly the PCT results. Nevertheless, PCT has been shown to have the best sensitivity and specificity to indicate infection, antibiotic appropriateness and stopping therapy. In this article we will focus on some important aspects of pathophysiology and advice on how to implement that in the everyday clinical practice. We believe that this multimodal evaluation of the clinical picture together with PCT results can be a useful tool to make the most out of the PCT results, and do the best for patients on the ICU.

Procalcitonin as a diagnostic marker of meningococcal disease in children presenting with fever and a rash

PubMed Central

Carrol, E; Newland, P; Riordan, F; Thomson, A; Curtis, N; Hart, C

2002-01-01

Background: Procalcitonin (PCT), a precursor of calcitonin, is a recognised marker of bacterial sepsis, and high concentrations correlate with the severity of sepsis. PCT has been proposed as an earlier and better diagnostic marker than C reactive protein (CRP) and white cell count (WCC). This comparison has never been reported in the differentiation of meningococcal disease (MCD) in children presenting with a fever and rash. Aim: To determine if PCT might be a useful marker of MCD in children presenting with fever and rash. Methods: PCT, CRP, and WCC were measured on admission in 108 children. Patients were classified into two groups: group I, children with a microbiologically confirmed clinical diagnosis of MCD (n = 64); group II, children with a self limiting illness (n = 44). Median ages were 3.57 (0.07–15.9) versus 1.75 (0.19–14.22) years respectively. Severity of disease in patients with MCD was assessed using the Glasgow Meningococcal Septicaemia Prognostic Score (GMSPS). Results: PCT and CRP values were significantly higher in group I than in group II (median 38.85 v 0.27 ng/ml and 68.35 v 9.25 mg/l; p < 0.0005), but there was no difference in WCC between groups. Sensitivity, specificity, and positive and negative predictive values were higher for PCT than CRP and WCC. In group I, procalcitonin was significantly higher in those with severe disease (GMSPS ≥8). Conclusions: PCT is a more sensitive and specific predictor of MCD than CRP and WCC in children presenting with fever and a rash. PMID:11919107

[Acceptance of lot sampling: its applicability to the evaluation of the primary care services portfolio].

PubMed

López-Picazo Ferrer, J

2001-05-15

To determine the applicability of the acceptance of lot quality assurance sampling (LQAS) in the primary care service portfolio, comparing its results with those given by classic evaluation. Compliance with the minimum technical norms (MTN) of the service of diabetic care was evaluated through the classic methodology (confidence 95%, accuracy 5%, representativeness of area, sample of 376 histories) and by LQAS (confidence 95%, power 80%, representativeness of primary care team (PCT), defining a lot by MTN and PCT, sample of 13 histories/PCT). Effort, information obtained and its operative nature were assessed. 44 PCTs from Murcia Primary Care Region. Classic methodology: compliance with MTN ranged between 91.1% (diagnosis, 95% CI, 84.2-94.0) and 30% (repercussion in viscera, 95% CI, 25.4-34.6). Objectives in three MTN were reached (diagnosis, history and EKG). LQAS: no MTN was accepted in all the PCTs, <01-diagnosis> being the most accepted (42 PCT, 95.6%) and <07-Funduscopy> the least accepted (24 PCT, 55.6%). In 9 PCT all were accepted (20.4%), and in 2 none were accepted (4.5%). Data were analysed through Pareto charts. Classic methodology offered accurate results, but did not identify which centres were those that did not comply (general focus). LQAS was preferable for evaluating MTN and probably coverage because: 1) it uses small samples, which foment internal quality-improvement initiatives; 2) it is easy and rapid to execute; 3) it identifies the PCT and criteria where there is an opportunity for improvement (specific focus), and 4) it can be used operatively for monitoring.

Diagnostic performance of procalcitonin for hospitalised children with acute pyelonephritis presenting to the paediatric emergency department.

PubMed

Chen, Shan-Ming; Chang, Hung-Ming; Hung, Tung-Wei; Chao, Yu-Hua; Tsai, Jeng-Dau; Lue, Ko-Huang; Sheu, Ji-Nan

2013-05-01

Urinary tract infection (UTI) is a common bacterial infection in children that can result in permanent renal damage. This study prospectively assessed the diagnostic performance of procalcitonin (PCT) for predicting acute pyelonephritis (APN) among children with febrile UTI presenting to the paediatric emergency department (ED). Children aged ≤10 years with febrile UTI admitted to hospital from the paediatric ED were prospectively studied. Blood PCT, C reactive protein (CRP) and white blood cell (WBC) count were measured in the ED. Sensitivity, specificity, predictive values, multilevel likelihood ratios, receiver operating characteristic (ROC) curve analysis and multivariate logistic regression were used to assess quantitative variables for diagnosing APN. The 136 enrolled patients (56 boys and 80 girls; age range 1 month to 10 years) were divided into APN (n=87) and lower UTI (n=49) groups according to (99m)Tc-dimercaptosuccinic acid scan results. The cut-off value for maximum diagnostic performance of PCT was 1.3 ng/ml (sensitivity 86.2%, specificity 89.8%). By multivariate regression analysis, only PCT and CRP were retained as significant predictors of APN. Comparing ROC curves, PCT had a significantly greater area under the curve than CRP, WBC count and fever for differentiating between APN and lower UTI. PCT has better sensitivity and specificity than CRP and WBC count for distinguishing between APN and lower UTI. PCT is a valuable marker for predicting APN in children with febrile UTI. It may be considered in the initial investigation and therapeutic strategies for children presenting to the ED.

Diagnostic value of decoy receptor 3 combined with procalcitonin and soluble urokinase-type plasminogen activator receptor for sepsis.

PubMed

Zhao, Jing-Jing; Lou, Xiao-Li; Chen, Hong-Wei; Zhu, Feng-Ting; Hou, Yan-Qiang

2018-01-01

The levels of decoy receptor 3 (DcR3), soluble urokinase type plasminogen activator receptor (suPAR) and procalcitonin (PCT) are significantly increased in sepsis. We investigated the diagnostic value of DcR3 combined with suPAR and PCT in sepsis. Patients with sepsis, non-infectious systemic inflammatory response comprehensive syndrome (SIRS) and healthy controls were recruited according to the diagnostic standard. We measured DcR3, suPAR, PCT, interleukin-6 (IL-6) and C-reactive protein (CRP), and the diagnostic value was evaluated by receiver operating characteristics (ROC) curves. In our analysis, serum DcR3, suPAR and PCT levels of the sepsis group were significantly higher than those of the SIRS and control groups. However, IL-6, CRP and WBC showed no significant difference between the SIRS group and the sepsis group. The serum DcR3 level was positively correlated with the serum suPAR level ( r  = 0.37, p  = 0.0022) and PCT level ( r  = 0.37, p  = 0.0021). Using DcR3, suPAR and PCT to distinguish SIRS from sepsis, the area under the curve (AUC) values were 0.892, 0.778 and 0.692. When DcR3, suPAR and PCT combined were used for diagnosis of sepsis, the AUC was 0.933, at a cut-off point of 0.342. This combination improved the sensitivity and specificity of diagnosis of sepsis, suggesting that use of the combination of three indexes enhanced the efficiency of sepsis diagnosis.

Impact of Oral Commensal Bacteria on Degradation of Periodontal Connective Tissue in Mice.

PubMed

Irie, Koichiro; Tomofuji, Takaaki; Ekuni, Daisuke; Morita, Manabu; Shimazaki, Yoshihiro; Darveau, Richard P

2015-07-01

Innate and adaptive immunosurveillance mechanisms in response to the normal commensal bacteria can affect periodontal innate defense status. However, it is still unclear how commensal bacteria contribute to the inflammatory responses of junctional epithelium (JE) and periodontal connective tissue (PCT). The aim of the present study is to investigate the contribution of commensal bacteria on inflammatory responses in JE and PCT in mice. The periodontal tissue of germ-free (GF) and specific-pathogen-free (SPF) mice were compared at age 11 to 12 weeks (n = 6 per group). In this study, the number of neutrophils and expression of intercellular adhesion molecule (ICAM)-1, fibroblast growth factor receptor (FGFR)-1, matrix metalloproteinase (MMP)-1, and MMP-8 within the JE and the PCT are evaluated. The collagen density was also determined in PCT stained with picrosirius red (PSR). PSR staining combined with or without polarized light microscopy has been used to assess the organization and maturation of collagen matrix. In the present findings, the area of JE in SPF mice was significantly greater than that in GF mice (P <0.05). In addition, the JE and PCT in SPF mice showed greater migration of neutrophils and higher expression of ICAM-1, FGFR-1, MMP-1, and MMP-8 than those in GF mice (P <0.05). Furthermore, the density of collagen in PCT in SPF mice was lower compared to GF mice (P <0.05). These results indicate that commensal bacteria induced a low-grade inflammatory state in JE and that such conditions may contribute to degradation of collagen in PCT in mice.

40 CFR 86.129-80 - Road load power, test weight, and inertia weight class determination.

Code of Federal Regulations, 2012 CFR

2012-07-01

... power, test weight, and inertia weight class determination. (a) Flywheels, electrical or other means of... equipment exceeding 0.1 ft2 which are anticipated to be sold on more than 33 pct of the car line. Frontal... expected that more than 33 percent of a car line within an engine-system combination will be equipped with...

40 CFR 86.129-80 - Road load power, test weight, and inertia weight class determination.

Code of Federal Regulations, 2013 CFR

2013-07-01

... power, test weight, and inertia weight class determination. (a) Flywheels, electrical or other means of... equipment exceeding 0.1 ft2 which are anticipated to be sold on more than 33 pct of the car line. Frontal... expected that more than 33 percent of a car line within an engine-system combination will be equipped with...

40 CFR 86.129-80 - Road load power, test weight, and inertia weight class determination.

Code of Federal Regulations, 2010 CFR

2010-07-01

... power, test weight, and inertia weight class determination. (a) Flywheels, electrical or other means of... equipment exceeding 0.1 ft2 which are anticipated to be sold on more than 33 pct of the car line. Frontal... expected that more than 33 percent of a car line within an engine-system combination will be equipped with...

40 CFR 86.129-80 - Road load power, test weight, and inertia weight class determination.

Code of Federal Regulations, 2011 CFR

2011-07-01

... power, test weight, and inertia weight class determination. (a) Flywheels, electrical or other means of... equipment exceeding 0.1 ft2 which are anticipated to be sold on more than 33 pct of the car line. Frontal... expected that more than 33 percent of a car line within an engine-system combination will be equipped with...

The Gendered Monitoring of Juvenile Delinquents: A Test of Power-Control Theory Using a Retrospective Cohort Study

ERIC Educational Resources Information Center

Schulze, Corina; Bryan, Valerie

2017-01-01

Through the framework of power-control theory (PCT), we provide a model of juvenile offending that places the gendered-raced treatment of juveniles central to the analysis. We test the theory using a unique sample that is predominately African American, poor, and composed entirely of juvenile offenders. Multivariate models compare the predictive…

Increasing Childhood Influenza Vaccination

PubMed Central

Nowalk, Mary Patricia; Lin, Chyongchiou J.; Hannibal, Kristin; Reis, Evelyn C.; Gallik, Gregory; Moehling, Krissy K.; Huang, Hsin-Hui; Allred, Norma J.; Wolfson, David H.; Zimmerman, Richard K.

2014-01-01

Background Since the 2008 inception of universal childhood influenza vaccination, national rates have risen more dramatically among younger children than older children and reported rates across racial/ethnic groups are inconsistent. Interventions may be needed to address age and racial disparities to achieve the recommended childhood influenza vaccination target of 70%. Purpose To evaluate an intervention to increase childhood influenza vaccination across age and racial groups. Methods In 2011–2012, 20 primary care practices treating children were randomly assigned to Intervention and Control arms of a cluster randomized controlled trial to increase childhood influenza vaccination uptake using a toolkit and other strategies including early delivery of donated vaccine, in-service staff meetings, and publicity. Results The average vaccination differences from pre-intervention to the intervention year were significantly larger in the Intervention arm (n=10 practices) than the Control arm (n=10 practices), for children aged 2–8 years (10.2 percentage points (pct pts) Intervention vs 3.6 pct pts Control) and 9–18 years (11.1 pct pts Intervention vs 4.3 pct pts Control, p<0.05), for non-white children (16.7 pct pts Intervention vs 4.6 pct pts Control, p<0.001), and overall (9.9 pct pts Intervention vs 4.2 pct pts Control, p<0.01). In multi-level modeling that accounted for person- and practice-level variables and the interactions among age, race and intervention, the likelihood of vaccination increased with younger age group (6–23 months), white race, commercial insurance, the practice’s pre-intervention vaccination rate, and being in the Intervention arm. Estimates of the interaction terms indicated that the intervention increased the likelihood of vaccination for non-white children in all age groups and white children aged 9–18 years. Conclusions A multi-strategy intervention that includes a practice improvement toolkit can significantly improve influenza vaccination uptake across age and racial groups without targeting specific groups, especially in practices with large percentages of minority children. PMID:25113138

Procalcitonin as a Biomarker of Bacterial Infection in Sickle Cell Vaso-Occlusive Crisis

PubMed Central

Patel, Dilip Kumar; Mohapatra, Manoj Kumar; Thomas, Ancil George; Patel, Siris; Purohit, Prasanta

2014-01-01

Sickle cell anaemia (SCA) patients with vaso-occlusive crisis (VOC) have signs of inflammation and it is often difficult to diagnose a bacterial infection in them. This study was undertaken to evaluate the role of serum procalcitonin (PCT) as a biomarker of bacterial infection in acute sickle cell vaso-occlusive crisis. Hundred homozygous SCA patients were studied at Sickle Cell Clinic and Molecular Biology Laboratory, V.S.S. Medical College, Burla, Odisha, India. All the patients were divided into three categories namely category-A (VOC/ACS with SIRS but without evidence of bacterial infection - 66 patients), category-B (VOC/ACS with SIRS and either proven or suspected bacterial infection - 24 patients) and category-C (SCA patients in steady state without VOC/ACS or SIRS - 10 patients). Complete blood count, C-reactive protein (CRP) estimation and PCT measurement were done in all the patients. There was no significant difference in TLC and CRP values between category-A and B. In category-A, the PCT level was <0.5 ng/mL in 83.3% and 0.5–2 ng/mL in 16.7% of cases. In category-B, all the patients had PCT value >0.5 ng/mL with 87.5% of patients having >2 ng/mL. In category-C, PCT value was <0.5 ng/mL. PCT had a high sensitivity (100%) and negative predictive value (100%) for bacterial infection at a cutoff value of 0.5 ng/mL; whereas the specificity is excellent at a cut-off value of 2 ng/mL. SCA patients with VOC/ACS and SIRS having a PCT level of <0.5 ng/mL have a low probability of bacterial infection whereas PCT value of >2 ng/mL is indicative of bacterial infection necessitating early antimicrobial therapy. PMID:24678395

SU-C-207A-03: Development of Proton CT Imaging System Using Thick Scintillator and CCD Camera

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

Tanaka, S; Uesaka, M; Nishio, T

2016-06-15

Purpose: In the treatment planning of proton therapy, Water Equivalent Length (WEL), which is the parameter for the calculation of dose and the range of proton, is derived by X-ray CT (xCT) image and xCT-WEL conversion. However, about a few percent error in the accuracy of proton range calculation through this conversion has been reported. The purpose of this study is to construct a proton CT (pCT) imaging system for an evaluation of the error. Methods: The pCT imaging system was constructed with a thick scintillator and a cooled CCD camera, which acquires the two-dimensional image of integrated value ofmore » the scintillation light toward the beam direction. The pCT image is reconstructed by FBP method using a correction between the light intensity and residual range of proton beam. An experiment for the demonstration of this system was performed with 70-MeV proton beam provided by NIRS cyclotron. The pCT image of several objects reconstructed from the experimental data was evaluated quantitatively. Results: Three-dimensional pCT images of several objects were reconstructed experimentally. A finestructure of approximately 1 mm was clearly observed. The position resolution of pCT image was almost the same as that of xCT image. And the error of proton CT pixel value was up to 4%. The deterioration of image quality was caused mainly by the effect of multiple Coulomb scattering. Conclusion: We designed and constructed the pCT imaging system using a thick scintillator and a CCD camera. And the system was evaluated with the experiment by use of 70-MeV proton beam. Three-dimensional pCT images of several objects were acquired by the system. This work was supported by JST SENTAN Grant Number 13A1101 and JSPS KAKENHI Grant Number 15H04912.« less

Quantification of confounding factors in MRI-based dose calculations as applied to prostate IMRT

NASA Astrophysics Data System (ADS)

Maspero, Matteo; Seevinck, Peter R.; Schubert, Gerald; Hoesl, Michaela A. U.; van Asselen, Bram; Viergever, Max A.; Lagendijk, Jan J. W.; Meijer, Gert J.; van den Berg, Cornelis A. T.

2017-02-01

Magnetic resonance (MR)-only radiotherapy treatment planning requires pseudo-CT (pCT) images to enable MR-based dose calculations. To verify the accuracy of MR-based dose calculations, institutions interested in introducing MR-only planning will have to compare pCT-based and computer tomography (CT)-based dose calculations. However, interpreting such comparison studies may be challenging, since potential differences arise from a range of confounding factors which are not necessarily specific to MR-only planning. Therefore, the aim of this study is to identify and quantify the contribution of factors confounding dosimetric accuracy estimation in comparison studies between CT and pCT. The following factors were distinguished: set-up and positioning differences between imaging sessions, MR-related geometric inaccuracy, pCT generation, use of specific calibration curves to convert pCT into electron density information, and registration errors. The study comprised fourteen prostate cancer patients who underwent CT/MRI-based treatment planning. To enable pCT generation, a commercial solution (MRCAT, Philips Healthcare, Vantaa, Finland) was adopted. IMRT plans were calculated on CT (gold standard) and pCTs. Dose difference maps in a high dose region (CTV) and in the body volume were evaluated, and the contribution to dose errors of possible confounding factors was individually quantified. We found that the largest confounding factor leading to dose difference was the use of different calibration curves to convert pCT and CT into electron density (0.7%). The second largest factor was the pCT generation which resulted in pCT stratified into a fixed number of tissue classes (0.16%). Inter-scan differences due to patient repositioning, MR-related geometric inaccuracy, and registration errors did not significantly contribute to dose differences (0.01%). The proposed approach successfully identified and quantified the factors confounding accurate MRI-based dose calculation in the prostate. This study will be valuable for institutions interested in introducing MR-only dose planning in their clinical practice.

Operation of the Preclinical Head Scanner for Proton CT.

PubMed

Sadrozinski, H F-W; Geoghegan, T; Harvey, E; Johnson, R P; Plautz, T E; Zatserklyaniy, A; Bashkirov, V; Hurley, R F; Piersimoni, P; Schulte, R W; Karbasi, P; Schubert, K E; Schultze, B; Giacometti, V

2016-09-21

We report on the operation and performance tests of a preclinical head scanner developed for proton computed tomography (pCT). After extensive preclinical testing, pCT is intended to be employed in support of proton therapy treatment planning and pre-treatment verification in patients undergoing particle-beam therapy. In order to assess the performance of the scanner, we have performed CT scans with 200 MeV protons from both the synchrotron of the Loma Linda University Medical Center (LLUMC) and the cyclotron of the Northwestern Medicine Chicago Proton Center (NMCPC). The very high sustained rate of data acquisition, exceeding one million protons per second, allowed a full 360° scan to be completed in less than 7 minutes. The reconstruction of various phantoms verified accurate reconstruction of the proton relative stopping power (RSP) and the spatial resolution in a variety of materials. The dose for an image with better than 1% uncertainty in the RSP is found to be close to 1 mGy.

Effect of a solid solution on the steady-state creep behavior of an aluminum matrix composite

NASA Astrophysics Data System (ADS)

Pandey, A. B.; Mishra, R. S.; Mahajan, Y. R.

1996-02-01

The effect of an alloying element, 4 wt pct Mg, on the steady-state creep behavior of an Al-10 vol pct SiCp composite has been studied. The Al-4 wt pct Mg-10 vol pct SiCp composite has been tested under compression creep in the temperature range 573 to 673 K. The steady-state creep data of the composite show a transition in the creep behavior (regions I and II) depending on the applied stress at 623 and 673 K. The low stress range data (region I) exhibit a stress exponent of about 7 and an activation energy of 76.5 kJ mol-1. These values conform to the dislocation-climb-controlled creep model with pipe diffusion as a rate-controlling mechanism. The intermediate stress range data (region II) exhibit high and variable apparent stress exponents, 18 to 48, and activation energy, 266 kJ mol-1, at a constant stress, σ = 50 MPa, for creep of this composite. This behavior can be rationalized using a substructure-invariant model with a stress exponent of 8 and an activation energy close to the lattice self-diffusion of aluminum together with a threshold stress. The creep data of the Al-Mg-A12O3f composite reported by Dragone and Nix also conform to the substructure-invariant model. The threshold stress and the creep strength of the Al-Mg-SiCp, composite are compared with those of the Al-Mg-Al2O3f and 6061 Al-SiCp.w, composites and discussed in terms of the load-transfer mechanism. Magnesium has been found to be very effective in improving the creep resistance of the Al-SiCp composite.

Infection biomarkers in primary care patients with acute respiratory tract infections-comparison of Procalcitonin and C-reactive protein.

PubMed

Meili, Marc; Kutz, Alexander; Briel, Matthias; Christ-Crain, Mirjam; Bucher, Heiner C; Mueller, Beat; Schuetz, Philipp

2016-03-24

There is a lack of studies comparing the utility of C-reactive protein (CRP) with Procalcitonin (PCT) for the management of patients with acute respiratory tract infections (ARI) in primary care. Our aim was to study the correlation between these markers and to compare their predictive accuracy in regard to clinical outcome prediction. This is a secondary analysis using clinical and biomarker data of 458 primary care patients with pneumonic and non-pneumonic ARI. We used correlation statistics (spearman's rank test) and multivariable regression models to assess association of markers with adverse outcome, namely days with restricted activities and persistence of discomfort from infection at day 14. At baseline, CRP and PCT did not correlate well in the overall population (r(2) = 0.16) and particularly in the subgroup of patients with non-pneumonic ARI (r(2) = 0.08). Low correlation of biomarkers were also found when comparing cut-off ranges, day seven levels or changes from baseline to day seven. High baseline levels of CRP (>100 mg/dL, regression coefficient 1.6, 95 % CI 0.5 to 2.6, sociodemographic-adjusted model) as well as PCT (>0.5ug/L regression coefficient 2.0, 95 % CI 0.0 to 4.0, sociodemographic-adjusted model) were significantly associated with larger number of days with restricted activities. There were no associations of either biomarker with persistence of discomfort at day 14. CRP and PCT levels do not well correlate, but both have moderate prognostic accuracy in primary care patients with ARI to predict clinical outcomes. The low correlation between the two biomarkers calls for interventional research comparing these markers head to head in regard to their ability to guide antibiotic decisions. Current Controlled Trials, ISRCTN73182671.

Fabrication and Tribological Behavior of Stir Cast Mg/B4C Metal Matrix Composites

NASA Astrophysics Data System (ADS)

Singh, Amandeep; Bala, Niraj

2017-10-01

Magnesium-based metal matrix composites (MMMCs) have emerged as good alternative material to conventional materials due to their promising advanced properties. In the present work, magnesium-based metal matrix composites (MMMCs) reinforced with B4C particles were successfully fabricated by cost-effective conventional stir casting technique. MMMCs with an average particle size of 63 µm and different weight percent (wt pct) of B4C between 3 and 12 were fabricated. Wear tests were carried out using a pin-on-disk against a steel disk under dry sliding condition at loads that varied between 1 and 5 kg at fixed sliding velocity of 1 m/s. The wear data clearly showed that wear resistance of cast composites is better than that of unreinforced magnesium, which is attributed to dispersion hardening caused by carbide particles. An increase in wt pct of B4C showed the wear resistance and hardness to increase significantly. The wear rate and coefficient of friction increased with an increase in applied load. The SEM and EDS analysis of the worn surfaces delineated the dominant wear mechanisms to be abrasion, adhesion, and oxidation under the different sliding conditions. At lower loads, the wear mechanism transformed from severe abrasive wear in pure magnesium (Mg) to mild abrasion, slight delamination, and oxidation in the Mg/12 wt pct B4C fabricated composite. At higher loads, severe abrasion, adhesion, delamination, and oxidation were found to be the major wear mechanisms in pure Mg, whereas in the Mg/12 wt pct B4C fabricated composites the corresponding mechanisms were mild abrasion, mild adhesion, slight delamination, and oxidation.

Properties of silicon carbide fiber-reinforced silicon nitride matrix composites

NASA Technical Reports Server (NTRS)

Bhatt, Ramakrishna T.

1988-01-01

The mechanical properties of NASA Lewis developed SiC/RBSN composites and their thermal and environmental stability havd been studied. The composites consist of nearly 30 vol pct of aligned 142 micron diameter chemically vapor-deposited SiC fibers in a relatively porous silicon nitride matrix. In the as-fabricated condition, the unidirectional and 2-D composites exhibited metal-like stress-strain behavior, graceful failure, and showed improved properties when compared with unreinforced matrix of comparable density. Furthermore, the measured room temperature tensile properties were relativley independent of tested volume and were unaffected by artifical notches normal to the loading direction or by thermal shocking from temperatures up to 800 C. The four-point bend strength data measured as a function of temperature to 1400 C in air showed that as-fabricated strength was maintained to 1200 C. At 1400 C, however, nearly 15 pct loss in strength was observed. Measurement of room temperature tensile strength after 100 hr exposure at temperatures to 1400 C in a nitrogen environment indicated no loss from the as-fabricated composite strength. On the other hand, after 100 hr exposure in flowing oxygen at 1200 and 1400 C, the composites showed approximately 40 pct loss from their as-fabricated ultimate tensile strength. Those exposed between 400 to 1200 C showed nearly 60 pct strength loss. Oxidation of the fiber/matrix interface as well as internal oxidation of the porous Si3N4 matrix are likely mechanisms for strength degradation. The excellent strength reproducibility, notch insensitivity, and high temperature strength of the composite makes it an ideal candidate for advanced heat engine applications provided coating or densification methods are developed to avoid internal oxidation attack.

Use of a Combination Biomarker Algorithm To Identify Medical Intensive Care Unit Patients with Suspected Sepsis at Very Low Likelihood of Bacterial Infection.

PubMed

Han, Jennifer H; Nachamkin, Irving; Coffin, Susan E; Gerber, Jeffrey S; Fuchs, Barry; Garrigan, Charles; Han, Xiaoyan; Bilker, Warren B; Wise, Jacqueleen; Tolomeo, Pam; Lautenbach, Ebbing

2015-10-01

Sepsis remains a diagnostic challenge in the intensive care unit (ICU), and the use of biomarkers may help in differentiating bacterial sepsis from other causes of systemic inflammatory syndrome (SIRS). The goal of this study was to assess test characteristics of a number of biomarkers for identifying ICU patients with a very low likelihood of bacterial sepsis. A prospective cohort study was conducted in a medical ICU of a university hospital. Immunocompetent patients with presumed bacterial sepsis were consecutively enrolled from January 2012 to May 2013. Concentrations of nine biomarkers (α-2 macroglobulin, C-reactive protein [CRP], ferritin, fibrinogen, haptoglobin, procalcitonin [PCT], serum amyloid A, serum amyloid P, and tissue plasminogen activator) were determined at baseline and at 24 h, 48 h, and 72 h after enrollment. Performance characteristics were calculated for various combinations of biomarkers for discrimination of bacterial sepsis from other causes of SIRS. Seventy patients were included during the study period; 31 (44%) had bacterial sepsis, and 39 (56%) had other causes of SIRS. PCT and CRP values were significantly higher at all measured time points in patients with bacterial sepsis. A number of combinations of PCT and CRP, using various cutoff values and measurement time points, demonstrated high negative predictive values (81.1% to 85.7%) and specificities (63.2% to 79.5%) for diagnosing bacterial sepsis. Combinations of PCT and CRP demonstrated a high ability to discriminate bacterial sepsis from other causes of SIRS in medical ICU patients. Future studies should focus on the use of these algorithms to improve antibiotic use in the ICU setting. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Use of a Combination Biomarker Algorithm To Identify Medical Intensive Care Unit Patients with Suspected Sepsis at Very Low Likelihood of Bacterial Infection

PubMed Central

Nachamkin, Irving; Coffin, Susan E.; Gerber, Jeffrey S.; Fuchs, Barry; Garrigan, Charles; Han, Xiaoyan; Bilker, Warren B.; Wise, Jacqueleen; Tolomeo, Pam; Lautenbach, Ebbing

2015-01-01

Sepsis remains a diagnostic challenge in the intensive care unit (ICU), and the use of biomarkers may help in differentiating bacterial sepsis from other causes of systemic inflammatory syndrome (SIRS). The goal of this study was to assess test characteristics of a number of biomarkers for identifying ICU patients with a very low likelihood of bacterial sepsis. A prospective cohort study was conducted in a medical ICU of a university hospital. Immunocompetent patients with presumed bacterial sepsis were consecutively enrolled from January 2012 to May 2013. Concentrations of nine biomarkers (α-2 macroglobulin, C-reactive protein [CRP], ferritin, fibrinogen, haptoglobin, procalcitonin [PCT], serum amyloid A, serum amyloid P, and tissue plasminogen activator) were determined at baseline and at 24 h, 48 h, and 72 h after enrollment. Performance characteristics were calculated for various combinations of biomarkers for discrimination of bacterial sepsis from other causes of SIRS. Seventy patients were included during the study period; 31 (44%) had bacterial sepsis, and 39 (56%) had other causes of SIRS. PCT and CRP values were significantly higher at all measured time points in patients with bacterial sepsis. A number of combinations of PCT and CRP, using various cutoff values and measurement time points, demonstrated high negative predictive values (81.1% to 85.7%) and specificities (63.2% to 79.5%) for diagnosing bacterial sepsis. Combinations of PCT and CRP demonstrated a high ability to discriminate bacterial sepsis from other causes of SIRS in medical ICU patients. Future studies should focus on the use of these algorithms to improve antibiotic use in the ICU setting. PMID:26239984

A sintering study on the β-spodumene-based glass ceramics prepared from gel-derived precursor powders with LiF additive

NASA Astrophysics Data System (ADS)

Wang, Moo-Chin; Wu, Nan-Chung; Yang, Sheng; Wen, Shaw-Bing

2002-01-01

Beta-spodumene (Li2O·Al2O3·4SiO2, LAS) powders were prepared by a sol-gel process using Si(OC2H5)4, Al(OC4H9)3, and LiNO3 as precursors and LiF as a sintering aid agent. Dilatometry, X-ray diffraction (XRD), scanning electron microscopy (SEM), scanning transmission electron microscopy (STEM), and electron diffraction (ED) were utilized to study the sintering, phase transformation, microstructure, and properties of the β-spodumene glass-ceramics prepared from the gel-derived precursor powders with and without LiF additives. For the LAS precursor powders containing no LiF, the only crystalline phase obtained was β-spodumene. For the pellets containing less than 4 wt pct LiF and sintered at 1050 °C for 5 hours the crystalline phases were β-spodumene and β-eucryptite (Li2O·Al2O3·2SiO2). When the LiF content was 5 wt pct and the sintering process was carried out at 1050 °C for 5 hours, the crystalline phases were β-spodumene, β-eucryptite (triclinic), and eucryptite (rhombohedral (hex.)) phases. With the LiF additive increased from 0.5 to 4 wt pct and sintering at 1050 °C for 5 hours, the open porosity of the sintered bodies decrease from 30 to 2.1 pct. The grains size is about to 4 to 5 µm when pellect LAS compact contains LiF 3 wt pct as sintered at 1050 °C for 5 hours. The grains size grew to 8 to 25 µm with a remarkable discontinuous grain growth for pellet LAS compact contain LiF 5 wt pct sintered at 1050 °C for 5 hours. Relative densities greater than 90 pct could be obtained for the LAS precursor powders with LiF > 2 wt pct when sintered at 1050 °C for 5 hours. The coefficient of thermal expansion of the sintered bodies decreased from 8.3 × 10-7 to 5.2 × 10-7/°C (25 °C to 900 °C) as the LiF addition increased from 0 to 5 wt pct.

Procalcitonin and C-reactive protein as early markers of anastomotic leak after laparoscopic colorectal surgery within an enhanced recovery after surgery (ERAS) program.

PubMed

Muñoz, José Luis; Alvarez, María Oliva; Cuquerella, Vicent; Miranda, Elena; Picó, Carlos; Flores, Raquel; Resalt-Pereira, Marta; Moya, Pedro; Pérez, Ana; Arroyo, Antonio

2018-03-08

C-reactive protein (CRP) and procalcitonin (PCT) have been described as good predictors of anastomotic leak after colorectal surgery, obtaining the highest diagnostic accuracy on the 5th postoperative day. However, if an enhanced recovery after surgery (ERAS) program is performed, early predictors are needed in order to ensure a safe and early discharge. The aim of this study was to investigate the efficacy of CRP, PCT, and white blood cell (WBC) count determined on first postoperative days, in predicting septic complications, especially anastomotic leak, after laparoscopic colorectal surgery performed within an ERAS program. We conducted a prospective study including 134 patients who underwent laparoscopic colorectal surgery within an ERAS program between 2015 and 2017. The primary endpoint investigated was anastomotic leak. CRP, PCT, and WBC count were determined in the blood sample extracted on postoperative day 1 (POD 1), POD 2 and POD 3. Anastomotic leak (AL) was detected in 6 patients (4.5%). Serum levels of CRP and PCT, but not WBC, determined on POD 1, POD 2, and POD 3 were significantly higher in patients who had AL in the postoperative course. Using ROC analysis, the best AUC of the CRP and PCT levels was on POD 3 (0.837 and 0.947, respectively). A CRP cutoff level at 163 mg/l yielded 85% sensitivity, 80% specificity, and 99% negative predictive value (NPV). A PCT cutoff level at 2.5 ng/ml achieved 85% sensitivity, 95% specificity, 44% positive predictive value, and 99% NPV. CRP and PCT are relevant markers for detecting postoperative AL after laparoscopic colorectal surgery. Furthermore, they can ensure an early discharge with a low probability of AL when an ERAS program is performed.

A prospective, active haemovigilance study with combined cohort analysis of 19 175 transfusions of platelet components prepared with amotosalen–UVA photochemical treatment

PubMed Central

Knutson, F; Osselaer, J; Pierelli, L; Lozano, M; Cid, J; Tardivel, R; Garraud, O; Hervig, T; Domanovic, D; Cukjati, M; Gudmundson, S; Hjalmarsdottir, I B; Castrillo, A; Gonzalez, R; Brihante, D; Santos, M; Schlenke, P; Elliott, A; Lin, J-S; Tappe, D; Stassinopoulos, A; Green, J; Corash, L

2015-01-01

Background and Objectives A photochemical treatment process (PCT) utilizing amotosalen and UVA light (INTERCEPT™ Blood System) has been developed for inactivation of viruses, bacteria, parasites and leucocytes that can contaminate blood components intended for transfusion. The objective of this study was to further characterize the safety profile of INTERCEPT-treated platelet components (PCT-PLT) administered across a broad patient population. Materials and Methods This open-label, observational haemovigilance programme of PCT-PLT transfusions was conducted in 21 centres in 11 countries. All transfusions were monitored for adverse events within 24 h post-transfusion and for serious adverse events (SAEs) up to 7 days post-transfusion. All adverse events were assessed for severity (Grade 0–4), and causal relationship to PCT-PLT transfusion. Results Over the course of 7 years in the study centres, 4067 patients received 19 175 PCT-PLT transfusions. Adverse events were infrequent, and most were of Grade 1 severity. On a per-transfusion basis, 123 (0·6%) were classified an acute transfusion reaction (ATR) defined as an adverse event related to the transfusion. Among these ATRs, the most common were chills (77, 0·4%) and urticaria (41, 0·2%). Fourteen SAEs were reported, of which 2 were attributed to platelet transfusion (<0·1%). No case of transfusion-related acute lung injury, transfusion-associated graft-versus-host disease, transfusion-transmitted infection or death was attributed to the transfusion of PCT-PLT. Conclusion This longitudinal haemovigilance safety programme to monitor PCT-PLT transfusions demonstrated a low rate of ATRs, and a safety profile consistent with that previously reported for conventional platelet components. PMID:25981525

Cell-Free DNA, High-Mobility Group Box-1, and Procalcitonin Concentrations in Dogs With Gastric Dilatation–Volvulus Syndrome

PubMed Central

Troia, Roberta; Giunti, Massimo; Calipa, Stefano; Goggs, Robert

2018-01-01

Canine gastric dilatation–volvulus (GDV) is a life-threatening disease characterized by extensive tissue ischemia, tissue hypoperfusion, and systemic inflammation. Biomarkers that better reflect the severity of gastric necrosis and systemic inflammation would aid clinicians in the management of these patients. This study aimed to investigate the prognostic significance of cell-free DNA (cfDNA), high-mobility group box-1 (HMGB1), and procalcitonin (PCT) in dogs with GDV. Concentrations of cfDNA, HMGB1, and PCT were measured in citrated plasma samples collected from 29 dogs with GDV at hospital admission. Additional data collected included baseline lactate concentrations, APPLEfast score, evidence of gastric necrosis, occurrence of postoperative complications, and outcome. Twenty-four healthy dogs were sampled as controls. Continuous variables between groups were compared with the Mann–Whitney U and correlations between continuous variables were assessed by calculation of Spearman’s correlation coefficient. Alpha was set at 0.05. Dogs with GDV had significantly greater concentrations of cfDNA, HMGB1, and PCT compared to controls (P = 0.0009, P = 0.004, and P = 0.009, respectively). PCT concentrations were significantly higher in non-survivors compared to survivors (P = 0.008). Dogs with gastric necrosis had significantly greater lactate concentrations compared to dogs without gastric necrosis (P = 0.0005). The APPLEfast score was not prognostic. Lactate and PCT concentrations were moderately, positively correlated (rs 0.51, P = 0.0005). Concentrations of the inflammatory biomarkers cfDNA, HMGB1, and PCT are increased in canine GDV. Only lactate and PCT concentrations were prognostic in this population of GDV dogs and were predictive of the presence of gastric necrosis and of non-survival to hospital discharge, respectively. PMID:29686994

Cell-Free DNA, High-Mobility Group Box-1, and Procalcitonin Concentrations in Dogs With Gastric Dilatation-Volvulus Syndrome.

PubMed

Troia, Roberta; Giunti, Massimo; Calipa, Stefano; Goggs, Robert

2018-01-01

Canine gastric dilatation-volvulus (GDV) is a life-threatening disease characterized by extensive tissue ischemia, tissue hypoperfusion, and systemic inflammation. Biomarkers that better reflect the severity of gastric necrosis and systemic inflammation would aid clinicians in the management of these patients. This study aimed to investigate the prognostic significance of cell-free DNA (cfDNA), high-mobility group box-1 (HMGB1), and procalcitonin (PCT) in dogs with GDV. Concentrations of cfDNA, HMGB1, and PCT were measured in citrated plasma samples collected from 29 dogs with GDV at hospital admission. Additional data collected included baseline lactate concentrations, APPLE fast score, evidence of gastric necrosis, occurrence of postoperative complications, and outcome. Twenty-four healthy dogs were sampled as controls. Continuous variables between groups were compared with the Mann-Whitney U and correlations between continuous variables were assessed by calculation of Spearman's correlation coefficient. Alpha was set at 0.05. Dogs with GDV had significantly greater concentrations of cfDNA, HMGB1, and PCT compared to controls ( P  = 0.0009, P  = 0.004, and P  = 0.009, respectively). PCT concentrations were significantly higher in non-survivors compared to survivors ( P  = 0.008). Dogs with gastric necrosis had significantly greater lactate concentrations compared to dogs without gastric necrosis ( P  = 0.0005). The APPLE fast score was not prognostic. Lactate and PCT concentrations were moderately, positively correlated ( r s 0.51, P  = 0.0005). Concentrations of the inflammatory biomarkers cfDNA, HMGB1, and PCT are increased in canine GDV. Only lactate and PCT concentrations were prognostic in this population of GDV dogs and were predictive of the presence of gastric necrosis and of non-survival to hospital discharge, respectively.

Serum Procalcitonin for Differential Diagnosis of Acute Exacerbation and Bacterial Pneumonia in Patients With Interstitial Lung Disease.

PubMed

Sim, Jae Kyeom; Oh, Jee Youn; Lee, Eun Joo; Hur, Gyu Young; Lee, Seung Heon; Lee, Sung Yong; Lee, Sang Yeub; Kim, Je Hyeong; Shin, Chol; Shim, Jae Jeong; In, Kwang Ho; Kang, Kyung Ho; Min, Kyung Hoon

2016-05-01

Acute exacerbation and bacterial pneumonia are major life-threatening conditions in patients with interstitial lung disease (ILD). The rapid recognition of these 2 different conditions is important for their proper treatment. An elevated procalcitonin (PCT) level is commonly detected in patients with bacterial infections. This study assessed the usefulness of the serum PCT level as a biomarker for the differential diagnosis of acute exacerbation and bacterial pneumonia in patients with ILD. In this prospective observational study, we enrolled patients with ILD who had experienced recently progressive dyspnea and exhibited new infiltrations on chest radiographs. We classified these patients into an acute exacerbation group and a bacterial pneumonia group and compared their baseline characteristics and laboratory parameters, including the PCT level. Of 21 patients with ILD, 9 patients had bacterial pneumonia. Both the groups showed similar baseline characteristics. The bacterial pneumonia group demonstrated a high PCT level. The PCT level in the acute exacerbation group was significantly lower than that in the bacterial pneumonia group (0.05 versus 0.91ng/mL, respectively; P < 0.001). Other parameters, such as the C-reactive protein level, leukocyte count and body temperature, were also lower in the acute exacerbation group. At a cutoff value of 0.1ng/mL, the sensitivity, specificity and negative predictive values of the serum PCT level were 88.9%, 100.0% and 92.3%, respectively. These findings suggest that the serum PCT level is useful in the differential diagnosis of acute exacerbation and bacterial pneumonia in patients with ILD. Copyright © 2016 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

The utility of biomarkers in differentiating bacterial from non-bacterial lower respiratory tract infection in hospitalized children: difference of the diagnostic performance between acute pneumonia and bronchitis.

PubMed

Hoshina, Takayuki; Nanishi, Etsuro; Kanno, Shunsuke; Nishio, Hisanori; Kusuhara, Koichi; Hara, Toshiro

2014-10-01

The aim of this study is to investigate the utility of several biomarkers in differentiating bacterial community-acquired lower respiratory tract infection (CA-LRTI) from non-bacterial CA-LRTI in children and the difference of their diagnostic performance between pneumonia and bronchitis. A retrospective cohort study composed of 108 pediatric patients hospitalized for CA-LRTI was performed during 2010-2013. Based on the findings of chest X-ray and sputum samples, patients were divided into 4 categories, group of bacterial pneumonia or bronchitis, and non-bacterial (viral or etiology-unknown) pneumonia or bronchitis. Peripheral white blood cell and neutrophil counts, and serum C-reactive protein (CRP) and procalcitonin (PCT) levels were compared among the 4 groups. Finally, 54 patients were the subject of this study. In the patients with pneumonia, serum CRP and PCT levels were significantly elevated in the group of bacterial pneumonia (CRP: p = 0.02, PCT: p = 0.0008). The area under the receiver operating characteristic curve for PCT for distinguishing between bacterial and non-bacterial pneumonia was the largest, and sensitivity, specificity, positive predictive value and negative predictive value of PCT were best among 4 markers. On the other hand, in the patients with bronchitis, neutrophil count was significantly decreased in non-bacterial bronchitis whereas no significant differences of WBC count, CRP level or PCT level were seen. In conclusion, PCT was the most useful marker to differentiate bacterial pneumonia whereas neutrophil count contributed most to the discrimination of bacterial bronchitis. The diagnostic performance of biomarkers may be different between pneumonia and bronchitis. Copyright © 2014. Published by Elsevier Ltd.

Correlation between CD64 and PCT levels in cerebrospinal fluid and degree of hearing impairment sequelae in neonates with purulent meningitis.

PubMed

Liu, Cui; Zhao, Dongchi

2017-12-01

This study investigated the possible correlation between the degree of hearing impairment caused by neonatal purulent meningitis and the levels of CD64 and PCT in cerebrospinal fluid of patients, and assessed the prognostic value of such levels. We recorded data from 156 cases of neonatal purulent meningitis retrospectively. All the patients received brainstem response audiometry, and cerebrospinal fluid samples were collected within the first day after admission through lumbar puncture. Flow cytometry was used to detect CD64 levels and enzyme-linked fluorescent assay was used to detect PCT levels. The children with hearing impairment were followed up for 1 year and brainstem response audiometry was performed again in them. We found that 43.59% of the children showed different degrees of hearing impairment, and 55% of them did not fully recover. The levels of PCT and CD64 in cerebrospinal fluid of children with hearing impairment were significantly higher than those of children with normal hearing (P<0.01). The levels of PCT and CD64 in mild, moderate and severe hearing impaired children increased gradually with higher degrees of impairment, and the differences between groups were significant (P<0.01). During the follow-up, it was found that the levels of PCT and CD64 in children correlated well with the degree of hearing recovery, and the differences between groups were significant (P<0.01). In our study, approximately 1/4 children with purulent meningitis showed long-term hearing impairment. Based on our analyses, the levels of CD64 and PCT in cerebrospinal fluid can be used to predict the degree and long-term prognosis of hearing impairment caused by purulent meningitis in children.

Peripapillary Choroidal Thickness Variation With Age and Race in Normal Eyes

PubMed Central

Rhodes, Lindsay A.; Huisingh, Carrie; Johnstone, John; Fazio, Massimo A.; Smith, Brandon; Wang, Lan; Clark, Mark; Downs, J. Crawford; Owsley, Cynthia; Girard, Michael J. A.; Mari, Jean Martial; Girkin, Christopher A.

2015-01-01

Purpose. This study examined the association between peripapillary choroidal thickness (PCT) with age and race in a group of African descent (AD) and European descent (ED) subjects with normal eyes. Methods. Optic nerve head images from enhanced depth imaging spectral-domain optical coherence tomography of 166 normal eyes from 84 subjects of AD and ED were manually delineated to identify the principal surfaces of Bruch's membrane (BM), Bruch's membrane opening (BMO), and anterior sclera (AS). Peripapillary choroidal thickness was measured between BM and AS at increasing distance away from BMO. The mean PCT was compared between AD and ED subjects and generalized estimating equation (GEE) regression analysis was used to examine the association between race and PCT overall, in each quadrant, and by distance from BMO. Models were adjusted for age, BMO area, and axial length in the regression analysis. Results. Overall, the mean PCT increased from 63.9 μm ± 18.1 at 0 to 250 μm to 170.3 μm ± 56.7 at 1500 to 2000 μm from BMO. Individuals of AD had a greater mean PCT than those of ED at all distances from BMO (P < 0.05 at each distance) and in each quadrant (P < 0.05 in each quadrant). Results from multivariate regression indicate that ED subjects had significantly lower PCT compared to AD overall and in all quadrants and distances from BMO. Increasing age was also significantly associated with a lower PCT in both ED and AD participants. Conclusions. Peripapillary choroidal thickness varies with race and age, as individuals of AD have a thicker peripapillary choroid than those of ED. (ClinicalTrials.gov number, NCT00221923.) PMID:25711640

Preparation, mechanical strengths, and thermal

NASA Astrophysics Data System (ADS)

Inoue, A.; Furukawa, S.; Hagiwara, M.; Masumoto, T.

1987-05-01

Ni-based amorphous wires with good bending ductility have been prepared for Ni75Si8B17 and Ni78P12B10 alloys containing 1 to 2 at. pct Al or Zr by melt spinning in rotating water. The enhancement of the wire-formation tendency by the addition of Al has been clarified to be due to the increase in the stability of the melt jet through the formation of a thin A12O3 film on the outer surface. The maximum wire diameter is about 190 to 200 μm for the Ni-Si (or P)-B-Al alloys and increases to about 250 μm for the Ni-Si-B-Al-Cr alloys containing 4 to 6 at. pct Cr. The tensile fracture strength and fracture elongation are 2730 MPa and 2.9 pct for (Ni0.75Si0.08B0.17 99Al1) wire and 2170 MPa and 2.4 pct for (Ni0.78P0.12B0.1)99Al1 wire. These wires exhibit a fatigue limit under dynamic bending strain in air with a relative humidity of 65 pct; this limit is 0.50 pct for a Ni-Si-B-Al wire, which is higher by 0.15 pct than that of a Fe75Si10B15 amorphous wire. Furthermore, the Ni-base wires do not fracture during a 180-deg bending even for a sample annealed at temperatures just below the crystallization temperature, in sharp contrast to high embrittlement tendency for Fe-base amorphous alloys. Thus, the Ni-based amorphous wires have been shown to be an attractive material similar to Fe- and Co-based amorphous wires because of its high static and dynamic strength, high ductility, high stability to thermal embrittlement, and good corrosion resistance.

High concentrations of N-BNP are related to non-infectious severe SIRS associated with cardiovascular dysfunction occurring after off-pump coronary artery surgery.

PubMed

Kerbaul, F; Giorgi, R; Oddoze, C; Collart, F; Guidon, C; Lejeune, P J; Villacorta, J; Gouin, F

2004-11-01

Procalcitonin (PCT) blood concentrations are known to be an appropriate marker of severe systemic inflammatory response syndrome (SIRS) induced by coronary artery surgery with and without cardiopulmonary bypass. Pro-brain natriuretic peptide (N-BNP) is a newly described cardiac hormone considered to be an effective marker of severity and prognosis of acute coronary syndromes and congestive heart failure. We evaluated the perioperative time courses of PCT and N-BNP and investigated their role as early markers of severe SIRS (SIRS with cardiovascular dysfunction) induced by off-pump coronary artery bypass (OPCAB). Sixty-three patients were prospectively included. The American College of Chest Physicians Classification was used to diagnose SIRS and organ system failure to define severe SIRS. Serum concentrations of PCT and N-BNP were determined before, during and after surgery. Receiver operating characteristic curves and cut-off values were used to assess the ability of these markers to predict postoperative severe SIRS. SIRS occurred in 25 (39%) patients. Nine of them (14%) showed severe SIRS. Significantly higher serum concentrations of N-BNP and PCT were found in patients with severe SIRS with peak concentrations respectively at 8887 pg ml(-1) (range 2940-29372 pg ml(-1)) for N-BNP and 9.50 ng ml(-1) (range 1-65 ng ml(-1)) for PCT. The area under the curve using N-BNP to detect postoperative severe SIRS was 0.799 before surgery (0.408 for PCT; P<0.01) and 0.824 at the end of surgery (0.762 for PCT; P<0.05). N-BNP may be an appropriate marker indicating the early development of non-infectious postoperative severe SIRS after OPCAB.

Comparison of Procalcitonin Guidance-Administered Antibiotics with Standard Guidelines on Antibiotic Therapy in Children with Lower Respiratory Tract Infections: A Retrospective Study in China

PubMed Central

Wu, Guo; Wu, Gao; Wu, Shuxie; Wu, Hanbin

2017-01-01

Objective To establish the efficacy of an algorithm based on the biomarker procalcitonin (PCT) to reduce antibiotic exposure in pediatric patients with lower respiratory tract infection (LRTI). Materials and Methods The clinical data of 357 patients (<14 years of age) who were discharged home with LRTI from January 1, 2010 to July 31, 2016 were analyzed. Antibiotic exposure, antibiotic prescription rate, length of hospital stay, and antibiotic-associated adverse effects were compared between the PCT group (n = 183) and the standard group (n = 174) using SAS 9.1.3 software. Results The overall adverse effect rates were similar in both the PCT and standard groups: 42 (22.95%) and 51 (29.31%), respectively. The length of hospital stay was not significantly different between the PCT (9.96 ± 5.81 days) and standard groups (10.58 ± 4.24 days) (difference: −0.62%; 95% CI: −1.68 to 0.43). Antibiotic prescribing rates were significantly different in the PCT group compared to the standard group: 54.64% versus 83.91% (difference: −29.26%; 95% CI: −38.31, −20.22; p = 0.23). Mean duration of antibiotic exposure in the PCT group (3.98 ± 2.17 days) was lower than the standard groups (6.66 ± 5.59 days) (difference: −2.68%; 95% CI: −3.21 to −2.16). Conclusion This study showed that PCT guidance of antibiotic treatment in children and adolescents with LRTI reduced the duration of antibiotic exposure and antibiotic prescribing rates, but did not affect the adverse effect rate and length of hospital stay. PMID:28578344

C-reactive protein and procalcitonin for the early detection of anastomotic leakage after elective colorectal surgery: pilot study in 100 patients.

PubMed

Lagoutte, N; Facy, O; Ravoire, A; Chalumeau, C; Jonval, L; Rat, P; Ortega-Deballon, P

2012-10-01

Anastomotic leakage is the most important complication after colorectal surgery. Its prognosis depends on its early diagnosis. C-reactive protein (CRP) has already shown its usefulness for the early detection of anastomotic leaks. Procalcitonin (PCT) is widely used in intensive care units and is more expensive, but its usefulness in the postoperative period of digestive surgery is not well established. Between May 2010 and June 2011, 100 patients undergoing elective colorectal surgery were prospectively included in a database. CRP and PCT were measured before surgery and daily until postoperative day 4. All intraabdominal infections were considered as anastomotic leaks, regardless of their clinical impact and their management. The kinetics of PCT and CRP were recorded, as well as their accuracy for the detection of anastomotic fistula. The incidence of fistula was 13% and the overall mortality rate was 2%. Both CRP and PCT were significantly higher in patients with leakage. Areas under the receiver-operating characteristics (ROC) for CRP were higher than those for PCT each day. The best accuracy was obtained for CRP on postoperative day 4 (areas under the ROC curve were 0.869 for CRP and 0.750 for PCT). Procalcitonin is neither earlier nor more accurate than CRP for the detection of anastomotic leakage after elective colorectal surgery. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Early changes of procalcitonin may advise about prognosis and appropriateness of antimicrobial therapy in sepsis.

PubMed

Georgopoulou, Antonia-Panagiota; Savva, Athina; Giamarellos-Bourboulis, Evangelos J; Georgitsi, Marianna; Raftogiannis, Maria; Antonakos, Nicolaos; Apostolidou, Efterpi; Carrer, Dionyssia-Pinelopi; Dimopoulos, George; Economou, Aggelos; Efthymiou, George; Galanakis, Nearchos; Galani, Labrini; Gargalianos, Panagiotis; Karaiskos, Ilias; Katsenos, Chrisostomos; Kavatha, Dimitra; Koratzanis, Evangelos; Labropoulos, Panagiotis; Lada, Malvina; Nakos, George; Paggalou, Evgenia; Panoutsopoulos, George; Paraschos, Michael; Pavleas, Ioannis; Pontikis, Konstantinos; Poulakou, Garyfallia; Prekates, Athanassios; Sybardi, Styliani; Theodorakopoulou, Maria; Trakatelli, Christina; Tsiaoussis, Panagiotis; Gogos, Charalambos; Giamarellou, Helen; Armaganidis, Apostolos; Meisner, Michael

2011-06-01

The objective of this study is to define if early changes of procalcitonin (PCT) may inform about prognosis and appropriateness of administered therapy in sepsis. A prospective multicenter observational study was conducted in 289 patients. Blood samples were drawn on day 1, that is, within less than 24 hours from advent of signs of sepsis, and on days 3, 7, and 10. Procalcitonin was estimated in serum by the ultrasensitive Kryptor assay (BRAHMS GmbH, Hennigsdorf, Germany). Patients were divided into the following 2 groups according to the type of change of PCT: group 1, where PCT on day 3 was decreased by more than 30% or was below 0.25 ng/mL, and group 2, where PCT on day 3 was either increased above 0.25 ng/mL or decreased less than 30%. Death occurred in 12.3% of patients of group 1 and in 29.9% of those of group 2 (P < .0001). Odds ratio for death of patients of group 1 was 0.328. Odds ratio for the administration of inappropriate antimicrobials of patients of group 2 was 2.519 (P = .003). Changes of serum PCT within the first 48 hours reflect the benefit or not of the administered antimicrobial therapy. Serial PCT measurements should be used in clinical practice to guide administration of appropriate antimicrobials. Copyright © 2011 Elsevier Inc. All rights reserved.

Effect of Zn Concentration on the Microstructure and Mechanical Properties of Al-Mg-Si-Zn Alloys Processed by Gravity Die Casting

NASA Astrophysics Data System (ADS)

Li, Longfei; Ji, Shouxun; Zhu, Qiang; Wang, Yun; Dong, Xixi; Yang, Wenchao; Midson, Stephen; Kang, Yonglin

2018-06-01

The microstructure and mechanical properties of Al-8.1Mg-2.6Si-(0.08 to 4.62)Zn alloys (in wt pct) have been investigated by the permanent mold casting process. X-ray diffraction analysis shows that the τ-Mg32(Al, Zn)49 phase forms when the Zn content is 1.01 wt pct. With higher Zn contents of 2.37 and 3.59 wt pct, the η-MgZn2 and τ-Mg32(Al, Zn)49 phases precipitate in the microstructure, and the η-MgZn2 phase forms when the Zn content is 4.62 wt pct. Metallurgical analysis shows that the η-MgZn2 and τ-Mg32(Al, Zn)49 phases strengthen the Al-8.1Mg-2.6Si-(0.08 to 4.62)Zn alloys. After solutionizing at 510 °C for 180 minutes and aging at 180 °C for 90 minutes, the η'-MgZn2 phase precipitates in the α-Al matrix, which significantly enhances the mechanical properties. Addition of 3.59 wt pct Zn to the Al-8.1Mg-2.6Si alloy with heat treatment increases the yield strength from 96 to 280 MPa, increases the ultimate tensile strength from 267 to 310 MPa, and decreases the elongation from 9.97 to 1.74 pct.

Microbial Beneficiation of Salem Iron Ore Using Penicillium purpurogenum

NASA Astrophysics Data System (ADS)

Mishra, M.; Pradhan, M.; Sukla, L. B.; Mishra, B. K.

2011-02-01

High alumina and silica content in the iron ore affects coke rate, reducibility, and productivity in a blast furnace. Iron ore is being beneficiated all around the world to meet the quality requirement of iron and steel industries. Choosing a beneficiation treatment depends on the nature of the gangue present and its association with the ore structure. The advanced physicochemical methods used for the beneficiation of iron ore are generally unfriendly to the environment. Biobeneficiation is considered to be ecofriendly, promising, and revolutionary solutions to these problems. A characterization study of Salem iron ore indicates that the major iron-bearing minerals are hematite, magnetite, and goethite. Samples on average contains (pct) Fe2O3-84.40, Fe (total)-59.02, Al2O3-7.18, and SiO2-7.53. Penicillium purpurogenum (MTCC 7356) was used for the experiment . It removed 35.22 pct alumina and 39.41 pct silica in 30 days in a shake flask at 10 pct pulp density, 308 K (35 °C), and 150 rpm. In a bioreactor experiment at 2 kg scale using the same organism, it removed 23.33 pct alumina and 30.54 pct silica in 30 days at 300 rpm agitation and 2 to 3 l/min aeration. Alumina and silica dissolution follow the shrinking core model for both shake flask and bioreactor experiments.

Microstructure and Ductility-Dip Cracking Susceptibility of Circumferential Multipass Dissimilar Weld Between 20MND5 and Z2CND18-12NS with Ni-Base Filler Metal 52

NASA Astrophysics Data System (ADS)

Qin, Renyao; Duan, Zhaoling; He, Guo

2013-10-01

The large circumferential multipass dissimilar weld between 20MND5 steel and Z2CND18-12NS stainless steel welded with FM52 filler material was investigated in terms of the diluted composition, the grain boundary precipitation, and the ductility-dip cracking (DDC) susceptibility of the weld. The diluted composition of the weld is composed of 37 to 47 pct Ni, 21 to 24 pct Cr, and 28 to 40 pct Fe, which are inhomogeneous along the depth and over the width of the deep weld. The carbon content has a distribution in the region of the surface weld from a high level (~0.20 pct) in the zone near 20MND5 steel to a normal level (~0.03 pct) in the zone near Z2CND18-12NS stainless steel. The carbon distribution is corresponding to the grain boundary carbides. The minimum threshold strains for DDC occur in the temperature range of 1223 K to 1323 K (950 °C to 1050 °C), which are 0.5, 0.35, and 0.4 pct for the root weld, middle region, and the surface weld, respectively. The dissimilar weld has the largest susceptibility to the DDC compared to the filler metal 52 and the Inconel 690.

Enhanced truncated-correlation photothermal coherence tomography with application to deep subsurface defect imaging and 3-dimensional reconstructions

NASA Astrophysics Data System (ADS)

Tavakolian, Pantea; Sivagurunathan, Koneswaran; Mandelis, Andreas

2017-07-01

Photothermal diffusion-wave imaging is a promising technique for non-destructive evaluation and medical applications. Several diffusion-wave techniques have been developed to produce depth-resolved planar images of solids and to overcome imaging depth and image blurring limitations imposed by the physics of parabolic diffusion waves. Truncated-Correlation Photothermal Coherence Tomography (TC-PCT) is the most successful class of these methodologies to-date providing 3-D subsurface visualization with maximum depth penetration and high axial and lateral resolution. To extend the depth range and axial and lateral resolution, an in-depth analysis of TC-PCT, a novel imaging system with improved instrumentation, and an optimized reconstruction algorithm over the original TC-PCT technique is developed. Thermal waves produced by a laser chirped pulsed heat source in a finite thickness solid and the image reconstruction algorithm are investigated from the theoretical point of view. 3-D visualization of subsurface defects utilizing the new TC-PCT system is reported. The results demonstrate that this method is able to detect subsurface defects at the depth range of ˜4 mm in a steel sample, which exhibits dynamic range improvement by a factor of 2.6 compared to the original TC-PCT. This depth does not represent the upper limit of the enhanced TC-PCT. Lateral resolution in the steel sample was measured to be ˜31 μm.

Effects of Small Addition of Ti on Strength and Microstructure of a Cu-Ni-Si Alloy

NASA Astrophysics Data System (ADS)

Watanabe, Chihiro; Takeshita, Satoshi; Monzen, Ryoichi

2015-06-01

The effect of addition of 0.04 or 0.2 mass pct Ti on the mechanical properties of a Cu-2.0 mass pct Ni-0.5 mass pct Si alloy has been investigated. The addition of 0.04 mass pct Ti enhances the strength of the Cu-Ni-Si alloy without reducing its electrical conductivity. This increase in strength is caused by the decrease in inter-precipitate spacing of δ-Ni2Si precipitates. The addition of trace Ti reduces the equilibrium concentration of Ni and Si atoms in the alloy bearing the δ precipitates, resulting in an increase in the volume fraction of δ precipitates and decrease in the inter-precipitate spacing. However, the addition of 0.2 mass pct Ti to the Cu-Ni-Si alloy decreases the strength of the alloy. The reduction in strength is attributed to the decrease in the volume fraction of δ precipitates caused by the reduction in Ni and Si atoms in the Cu matrix resulting from the formation of Ni16Si7Ti6 particles.

Structural Characterization of Sputter-Deposited 304 Stainless Steel+10 wt pct Al Coatings

NASA Astrophysics Data System (ADS)

Seelam, Uma Maheswara Rao; Suryanarayana, C.; Heinrich, Helge; Ohkubo, Tadakatsu; Hono, Kazuhiro; Cheruvu, N. S.

2012-08-01

An SS304 + 10 wt pct Al (with a nominal composition of Fe-18Cr-8Ni-10Al by wt pct and corresponding to Fe-17Cr-6Ni-17Al by at. pct) coating was deposited on a 304-type austenitic stainless steel (Fe-18Cr-8Ni by wt pct) substrate by the magnetron sputter-deposition technique using two targets: 304-type stainless steel (SS304) and Al. The as-deposited coatings were characterized by X-ray diffraction, transmission electron microscopy, and three-dimensional (3-D) atom probe techniques. The coating consists of columnar grains with α ferrite with the body-centered cubic (bcc) (A2) structure and precipitates with a B2 structure. It also has a deposition-induced layered structure with two alternative layers (of 3.2 nm wavelength): one rich in Fe and Cr, and the other enriched with Al and Ni. The layer with high Ni and Al contents has a B2 structure. Direct confirmation of the presence of B2 phase in the coating was obtained by electron diffraction and 3-D atom probe techniques.

PCT Databank: A Tool for Planning, Implementation and Monitoring of Integrated Preventive Chemotherapy for Control of Neglected Tropical Diseases (NTD)

PubMed Central

Mikhailov, Alexei; Yajima, Aya; Mbabazi, PS; Gabrielli, Albis F.; Montresor, Antonio; Engels, Dirk

2017-01-01

The integration of vertical control programmes of neglected tropical diseases (NTDs) aims at containing operational cost, simplifies the application of the control measures and extends the intervention coverage. The Preventive Chemotherapy and Transmission Control (PCT) Databank was established by the World Health Organization to facilitate the sharing of data among the different partners involved in control activities and collects and compiles historical and current information on disease-specific epidemiological situation, the geographical overlapping of NTDs and the progress of control activities in all the NTD-endemic countries. The summary of country-specific epidemiological maps and the progress of control activities is available online as the online PCT Databank and Country Profiles. The annual progress of preventive chemotherapy (PC) interventions targeting at specific NTDs is also annually reported in the Weekly Epidemiological Record (WER). In this paper, we elucidated the methodology of data collection, compilation and mapping to establish the PCT Databank and presented the key features of the associated three online outputs, i.e. the online PCT Databank, the Country Profile and the WER. PMID:22357399

Impact, thermal, and shock sensitivity of molten TNT and of asphalt-contaminated molten TNT

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

Mainiero, R.J.; Miron, Y.; Kwak, S.S.W.

1996-12-01

The research reported here was part of an effort to evaluate the safety of a process to recover TNT from MK-9 depth bombs by the autoclave meltout process. In this process the depth bombs are heated to 121 C so that the TNT will melt and run into a vat. Unfortunately, asphalt lining the inside surface of the bomb also melts and flows out with the TNT. Testing was conducted on molten TNT and molten TNT contaminated with 2 pct asphalt at 90, 100, 110, 120, 125, and 130 C. In the liquid drop test apparatus with a 2-kg weight,more » the molten TNT yielded a 50 pct probability of initiation at a drop height of 6.5 cm at 110 C, decreasing to 4.5 cm at 130 C. Asphalt-contaminated TNT was somewhat less impact-sensitive than pure TNT at temperatures of 110 to 125 C, but became more sensitive at 130 C. There is a 50 pct probability of initiation at a drop height of 7.8 cm at 110 C, decreasing to 3.3 cm at 130 C. In the card gap test, the molten TNT detonated at high velocity for a gap of 0.25 inches at 90 to 125 C and detonated at high velocity for a gap of 0.5 inches at 130 C. For gaps of 0.5 to 3 inches at 90 to 125 C and 0.75 inches to 3 inches at 130 C, the TNT did not detonate at high velocity but produced a violent explosion that caused significant damage to the test fixture. The thermal analysis test results showed that when asphalt is present in TNT, it greatly accelerates the exothermic decomposition of TNT, starting at temperatures near 200 C. It appears that at relatively low shock stimulus levels, the molten TNT may be undergoing a low velocity detonation, wherein the shock wave traveling through the gap test pipe cavitates the molten TNT, greatly increasing its sensitivity. These results are crucial for assuring continued safety in recovering TNT from munitions through the autoclave meltout process.« less

Formation of the lamellar structure in Group IA and IIID iron meteorites

NASA Technical Reports Server (NTRS)

Kowalik, J. A.; Williams, D. B.; Goldstein, J. I.

1988-01-01

Analytical EM, light microscopy, and electron microprobe analysis are used to study the lamellar plessite structure of Group IA and IIID iron meteorites. The alpha lamellae in IIID structures contained a compositional gradient from 6.1 + or - 0.7 wt pct Ni at the center of the alpha lamellae to 3.6 + or - 0.5 wt pct at the alpha/gamma interface. For the Group IA irons, compositions of 4 wt pct Ni in alpha and about 48 wt pct Ni in gamma are found. Convergent beam electron diffraction was used to characterize the orientation relations at the alpha/gamma interface in the lamellar regions of both Group IA and IIID. The phase transformations responsible for the observed lamellar structure in the IA and IIID chemical groups were also investigated.

Hepatoerythropoietic porphyria precipitated by viral hepatitis.

PubMed Central

Hift, R J; Meissner, P N; Todd, G

1993-01-01

Porphyria cutanea tarda (PCT), the condition resulting from a deficiency of hepatic uroporphyrinogen decarboxylase activity, is the commonest form of porphyria. Both acquired and familial form exist and are commonly associated in adults with liver disease and hepatic iron overload. The condition is extremely rare in children; most cases of childhood PCT are familial and some particularly severe cases have been shown to have a hepatoerythropoietic porphyria or homozygous uroporphyrinogen decarboxylase deficiency. A case is described of hepatoerythropoietic porphyria in which the disease was first precipitated at the age of two by a coincidental hepatitis A infection and improved as the hepatitis cleared. This paper reviews the evidence that viral hepatitis may precipitate overt PCT in children in a manner analogous to the precipitation of PCT in adults by alcohol associated liver disease. PMID:7902313

Enhanced Densification of PM Steels by Liquid Phase Sintering with Boron-Containing Master Alloy

NASA Astrophysics Data System (ADS)

Vattur Sundaram, Maheswaran; Surreddi, Kumar Babu; Hryha, Eduard; Veiga, Angela; Berg, Sigurd; Castro, Fransisco; Nyborg, Lars

2018-01-01

Reaching high density in PM steels is important for high-performance applications. In this study, liquid phase sintering of PM steels by adding gas-atomized Ni-Mn-B master alloy was investigated for enhancing the density levels of Fe- and Mo- prealloyed steel powder compacts. The results indicated that liquid formation occurs in two stages, beginning with the master alloy melting (LP-1) below and eutectic phase formation (LP-2) above 1373 K (1100 °C). Mo and C addition revealed a significant influence on the LP-2 temperatures and hence on the final densification behavior and mechanical properties. Microstructural embrittlement occurs with the formation of continuous boride networks along the grain boundaries, and its severity increases with carbon addition, especially for 2.5 wt pct of master alloy content. Sintering behavior, along with liquid generation, microstructural characteristics, and mechanical testing revealed that the reduced master alloy content from 2.5 to 1.5 wt pct (reaching overall boron content from 0.2 to 0.12 wt pct) was necessary for obtaining good ductility with better mechanical properties. Sintering with Ni-Mn-B master alloy enables the sintering activation by liquid phase formation in two stages to attain high density in PM steels suitable for high-performance applications.

ELIMINATION OF THE CHARACTERIZATION OF DWPF POUR STREAM SAMPLE AND THE GLASS FABRICATION AND TESTING OF THE DWPF SLUDGE BATCH QUALIFICATION SAMPLE

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

Amoroso, J.; Peeler, D.; Edwards, T.

2012-05-11

A recommendation to eliminate all characterization of pour stream glass samples and the glass fabrication and Product Consistency Test (PCT) of the sludge batch qualification sample was made by a Six-Sigma team chartered to eliminate non-value-added activities for the Defense Waste Processing Facility (DWPF) sludge batch qualification program and is documented in the report SS-PIP-2006-00030. That recommendation was supported through a technical data review by the Savannah River National Laboratory (SRNL) and is documented in the memorandums SRNL-PSE-2007-00079 and SRNL-PSE-2007-00080. At the time of writing those memorandums, the DWPF was processing sludge-only waste but, has since transitioned to a coupledmore » operation (sludge and salt). The SRNL was recently tasked to perform a similar data review relevant to coupled operations and re-evaluate the previous recommendations. This report evaluates the validity of eliminating the characterization of pour stream glass samples and the glass fabrication and Product Consistency Test (PCT) of the sludge batch qualification samples based on sludge-only and coupled operations. The pour stream sample has confirmed the DWPF's ability to produce an acceptable waste form from Slurry Mix Evaporator (SME) blending and product composition/durability predictions for the previous sixteen years but, ultimately the pour stream analysis has added minimal value to the DWPF's waste qualification strategy. Similarly, the information gained from the glass fabrication and PCT of the sludge batch qualification sample was determined to add minimal value to the waste qualification strategy since that sample is routinely not representative of the waste composition ultimately processed at the DWPF due to blending and salt processing considerations. Moreover, the qualification process has repeatedly confirmed minimal differences in glass behavior from actual radioactive waste to glasses fabricated from simulants or batch chemicals. In contrast, the variability study has significantly added value to the DWPF's qualification strategy. The variability study has evolved to become the primary aspect of the DWPF's compliance strategy as it has been shown to be versatile and capable of adapting to the DWPF's various and diverse waste streams and blending strategies. The variability study, which aims to ensure durability requirements and the PCT and chemical composition correlations are valid for the compositional region to be processed at the DWPF, must continue to be performed. Due to the importance of the variability study and its place in the DWPF's qualification strategy, it will also be discussed in this report. An analysis of historical data and Production Records indicated that the recommendation of the Six Sigma team to eliminate all characterization of pour stream glass samples and the glass fabrication and PCT performed with the qualification glass does not compromise the DWPF's current compliance plan. Furthermore, the DWPF should continue to produce an acceptable waste form following the remaining elements of the Glass Product Control Program; regardless of a sludge-only or coupled operations strategy. If the DWPF does decide to eliminate the characterization of pour stream samples, pour stream samples should continue to be collected for archival reasons, which would allow testing to be performed should any issues arise or new repository test methods be developed.« less

Expression of MMP-2 and TIMP-1 in cerebrospinal fluid and the correlation with dynamic changes of serum PCT in neonatal purulent meningitis

PubMed Central

Chen, Huilan; Wu, Fei; Fu, Rong; Feng, Xiangchun

2018-01-01

Matrix metalloproteinase 2 (MMP-2) and tissue inhibitor of metalloproteinase-1 (TIMP-1) levels in cerebrospinal fluid of pediatric patients with neonatal purulent meningitis were observed to analyze changes in serum procalcitonin (PCT) and the correlation among the three factors (MMP-2, TIMP-1 and PCT). Sixty pediatric patients with neonatal purulent meningitis from April 2015 to December 2016 were enrolled as the purulent meningitis group and 60 pediatric patients with viral encephalitis treated during the same period were enrolled as the viral encephalitis group. Additionally, 60 healthy newborns who underwent physical examinations in our hospital during the same period were enrolled as the control group. The levels of MMP-2 were 136.73±25.42 ng/ml in the purulent meningitis group, 45.32±6.57 ng/ml in the viral encephalitis group and 1.32±0.51 ng/ml in the control group and the differences between the three groups were statistically significant (F=15.052, p<0.05). The levels of TIMP-1 in cerebrospinal fluid were 374.55±36.04 ng/ml in the purulent meningitis group, 176.61±21.06 ng/ml in the viral encephalitis group and 7.72±2.44 ng/ml in the control group. The serum levels of PCT were 14.56±2.21 ng/ml in the purulent meningitis group, 9.04±1.17 ng/ml in the viral encephalitis group and 0.38±0.14 ng/ml in the control group. The level of MMP-2 in cerebrospinal fluid of pediatric patients in the purulent meningitis group was positively correlated with the level of serum PCT (r=0.582, p<0.05); the level of TIMP-1 in cerebrospinal fluid of pediatric patients in the viral encephalitis group was positively correlated with the level of serum PCT (r=0.635, p<0.05). In conclusion, MMP-2 and TIMP-1 were positively correlated with the levels of serum PCT, suggesting that MMP-2, TIMP-1 and PCT were involved in the occurrence and development of neonatal purulent meningitis. PMID:29399119

Slags in a Large Variation Range of Oxygen Potential Based on the Ion and Molecule Coexistence Theory

NASA Astrophysics Data System (ADS)

Yang, Xue-Min; Li, Jin-Yan; Zhang, Meng; Chai, Guo-Min; Zhang, Jian

2014-12-01

A thermodynamic model for predicting sulfide capacity of CaO-FeO-Fe2O3-Al2O3-P2O5 slags in a large variation range of oxygen potential corresponding to mass percentage of FetO from 1.88 to 55.50 pct, i.e., IMCT- model, has been developed by coupling with the deduced desulfurization mechanism of the slags based on the ion and molecule coexistence theory (IMCT). The developed IMCT- model has been verified through comparing the determined sulfide capacity after Ban-ya et al.[20] with the calculated by the developed IMCT- model and the calculated by the reported sulfide capacity models such as the KTH model. Mass percentage of FetO as 6.75 pct corresponding to the mass action concentration of FetO as 0.0637 or oxygen partial as 2.27 × 10-6 Pa is the criterion for distinguishing reducing and oxidizing zones for the slags. Sulfide capacity of the slags in reducing zone is controlled by reaction ability of CaO regardless of slag oxidization ability. However, sulfide capacity of the slags in oxidizing zone shows an obvious increase tendency with the increasing of slag oxidization ability. Sulfide capacity of the slags in reducing zone keeps almost constant with variation of the simplified complex basicity (pct CaO)/((pct Al2O3) + (pct P2O5)), or optical basicity, or the mass action concentration ratios of N FeO/ N CaO, , , and . Sulfide capacity of the slags in oxidizing zone shows an obvious increase with the increasing of the simplified complex basicity (pct CaO)/((pct Al2O3) + (pct P2O5)) or optical basicity, or the aforementioned mass action concentration ratios. Thus, the aforementioned mass action concentration ratios and the corresponding mass percentage ratios of various iron oxides to basic oxide CaO are recommended to represent the comprehensive effect of various iron oxides and basic oxide CaO on sulfide capacity of the slags.

A new sensitive automated assay for procalcitonin detection: LIAISON® BRAHMS PCT® II GEN.

PubMed

Fortunato, Antonio

2016-12-01

To assess the performance of LIAISON ® BRAHMS PCT ® II GEN (DiaSorin, Saluggia, Italy) in procalcitonin (PCT) determination by comparing it to the assay reference method B·R·A·H·M·S PCT KRYPTOR (Thermo Fisher Scientific Clinical Diagnostics, Hennigsdorf, Germany) and assessing its ability to discriminate between healthy subjects and patients with suspected infection. Diagnostic performance was evaluated on: a) 193 selected samples covering the assay range, whose procalcitonin levels were already evaluated with the B·R·A·H·M·S PCT ® KRYPTOR; b) prospective samples: 150 apparently healthy specimens obtained from a blood bank, 161 hospitalized patients (not with specific pathologies), 243 apparently healthy children. The comparison of LIAISON ® BRAHMS PCT ® II GEN to the reference method B·R·A·H·M·S PCT KRYPTOR yielded high correlation coefficients: slope of Deming fit equal to 1.04 (95% CI: 0.99-1.09) with an intercept equal to 0.05 (95% CI: -0.09 to 0.19) and a high concordance (98.4% (95% CI: 95.5-99.7%)) at the 0.5 ng/mL cut-off. Moreover, the results obtained using prospective samples showed: (i) no samples with PCT concentration >0.5 ng/mL (cut-off) for the apparently healthy adults (highest value=0.033 ng/mL, 95th percentile and 97.5th percentile <0.02 ng/mL); (ii) 2 samples >0.5 ng/mL for hospitalized patients (highest value=0.715 ng/mL, 95th percentile: 0.054 ng/mL; 97.5th percentile: 0.088 ng/mL); (iii) 3 samples >0.5 ng/mL for the healthy children population (highest value=0.713 ng/mL, 95th percentile: 0.155 ng/mL; 97.5th percentile: 0.275 ng/mL). The fully automated LIAISON ® BRAHMS PCT ® II GEN agrees well with the reference method and is suitable for early diagnosis of sepsis, severe bacterial infection and guiding antibiotic therapy.

SU-E-J-122: The CBCT Dose Calculation Using a Patient Specific CBCT Number to Mass Density Conversion Curve Based On a Novel Image Registration and Organ Mapping Method in Head-And-Neck Radiation Therapy

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

Zhou, J; Lasio, G; Chen, S

2015-06-15

Purpose: To develop a CBCT HU correction method using a patient specific HU to mass density conversion curve based on a novel image registration and organ mapping method for head-and-neck radiation therapy. Methods: There are three steps to generate a patient specific CBCT HU to mass density conversion curve. First, we developed a novel robust image registration method based on sparseness analysis to register the planning CT (PCT) and the CBCT. Second, a novel organ mapping method was developed to transfer the organs at risk (OAR) contours from the PCT to the CBCT and corresponding mean HU values of eachmore » OAR were measured in both the PCT and CBCT volumes. Third, a set of PCT and CBCT HU to mass density conversion curves were created based on the mean HU values of OARs and the corresponding mass density of the OAR in the PCT. Then, we compared our proposed conversion curve with the traditional Catphan phantom based CBCT HU to mass density calibration curve. Both curves were input into the treatment planning system (TPS) for dose calculation. Last, the PTV and OAR doses, DVH and dose distributions of CBCT plans are compared to the original treatment plan. Results: One head-and-neck cases which contained a pair of PCT and CBCT was used. The dose differences between the PCT and CBCT plans using the proposed method are −1.33% for the mean PTV, 0.06% for PTV D95%, and −0.56% for the left neck. The dose differences between plans of PCT and CBCT corrected using the CATPhan based method are −4.39% for mean PTV, 4.07% for PTV D95%, and −2.01% for the left neck. Conclusion: The proposed CBCT HU correction method achieves better agreement with the original treatment plan compared to the traditional CATPhan based calibration method.« less

Combustion of coal gas fuels in a staged combustor

NASA Technical Reports Server (NTRS)

Rosfjord, T. J.; Mcvey, J. B.; Sederquist, R. A.; Schultz, D. F.

1982-01-01

Gaseous fuels produced from coal resources generally have heating values much lower than natural gas; the low heating value could result in unstable or inefficient combustion. Coal gas fuels may contain ammonia which if oxidized in an uncontrolled manner could result in unacceptable nitrogen oxide exhaust emission levels. Previous investigations indicate that staged, rich-lean combustion represents a desirable approach to achieve stable, efficient, low nitrogen oxide emission operation for coal-derived liquid fuels contaning up to 0.8-wt pct nitrogen. An experimental program was conducted to determine whether this fuel tolerance can be extended to include coal-derived gaseous fuels. The results of tests with three nitrogen-free fuels having heating values of 100, 250, and 350 Btu/scf and a 250 Btu/scf heating value doped to contain 0.7 pct ammonia are presented.

Elevated temperature slow plastic deformation of NiAl/TiB2 particulate composites

NASA Technical Reports Server (NTRS)

Whittenberger, J. Daniel; Mannan, S. K.; Sprissler, B.; Viswanadham, R. K.

1988-01-01

The 'XD' process for production of discontinuously-reinforced metal-matrix composites has been used to enhance the high-temperature strength of NiAl-TiB2 composites with particulate densities of up to 30 vol pct. SEM, TEM, and optical characterizations of the resulting microstructures showed the average TiB2 particle size to be about 1 micron, while the average grain of the NiAl matrix was of the order of 10 microns. Elevated temperature compression tests conducted at 1200 and 1300 K indicated flow strengths to increase with TiB2 content, so that the 20 vol pct TiB2-reinforced composite was three times stronger than the unreinforced NiAl; this is ascribed to the very high density of microstructural tangled dislocations, loops, and subgrain boundaries connecting the particles.

Thermomechanical Processing of Fe-6.9Al-2Cr-0.88C Steel: Intercritical Annealing Followed by Quench Tempering

NASA Astrophysics Data System (ADS)

Farahat, Ahmed Ismail Zaky; Mohamed, Masoud Ibrahim

2015-01-01

A hot forged Fe-0.88 pct C-6.9 pct Al steel was intercritically annealed at temperatures in the range of 1173 K to 1283 K (900 °C to 1010 °C), and subsequently tempered at 623 K (350 °C) to enhance the mechanical properties by microstructure modification. Room temperature compression tests were carried out to evaluate the influence of the intercritical annealing temperature on the mechanical properties. A substructure was present in the microstructure after each intercritical annealing treatment. The substructure was absent after annealing at 1263 K (990 °C) and higher temperatures. Over-aging occurred when the annealing temperature was increased to 1283 K (1010 °C). A remarkable increase in strength and ductility was achieved after annealing at 1263 K (990 °C).

The effects of heat treatment on the chromium depletion, precipitate evolution, and corrosion resistance of INCONEL alloy 690

NASA Astrophysics Data System (ADS)

Kai, J. J.; Yu, G. P.; Tsai, C. H.; Liu, M. N.; Yao, S. C.

1989-10-01

A series of heat treatments were performed to study the sensitization and the stress corrosion cracking (SCC) behavior of INCONEL Alloy 690. The microstructural evaluation and the chromium depletion near grain boundaries were carefully studied using analytical electron microscopy (AEM). The measured chromium depletion profiles were matched well to the calculated results from a thermodynamic/kinetic model. The constant extension rate test (CERT) was performed in the solution containing 0.001 M sodium thiosulfate (Na2S2O3) to study the SCC resistance of this alloy. The Huey test was also performed in a boiling 65 pct HNO3 solution for 48 hours to study the intergranular attack (IGA) resistance of this alloy. Both tests showed that INCONEL 690 has very good corrosion resistance. It is believed that the superior IGA and SCC resistances of this alloy are due to the high chromium concentration (≈30 wt pct). It is concluded in this study that INCONEL 690 may be a better alloy than INCONEL 600 for use as the steam generator (S/G) tubing material for pressurized water reactors (PWR's)

Self-pressurization of a flightweight liquid hydrogen tank: Effects of fill level at low wall heat flux

NASA Technical Reports Server (NTRS)

Vandresar, N. T.; Hasan, M. M.; Lin, C.-S.

1991-01-01

Experimental results are presented for the self pressurization and thermal stratification of a 4.89 cu m liquid hydrogen storage tank subjected to low heat flux (2.0 and 3.5 W/sq m) in normal gravity. The test tank was representative of future spacecraft tankage, having a low mass to volume ratio and high performance multilayer thermal insulation. Tests were performed at fill levels of 29 and 49 pcts. (by volume) and complement previous tests at 83 pct. fill. As the heat flux increases, the pressure rise rate at each fill level exceeds the homogeneous rate by an increasing ratio. Herein, this ratio did not exceed a value of 2. The slowest pressure rise rate was observed for the 49 pct. fill level at both heat fluxes. This result is attributed to the oblate spheroidal tank geometry which introduces the variables of wetted wall area, liquid-vapor interfacial area, and ratio of side wall to bottom heating as a function of fill level or liquid depth. Initial tank thermal conditions were found to affect the initial pressure rise rate. Quasi steady pressure rise rates are independent of starting conditions.

Immature platelet fraction in bacterial sepsis severity assessment

NASA Astrophysics Data System (ADS)

Djuang, M. H.; Ginting, F.; Hariman, H.

2018-03-01

Sepsis is an infection-induced syndrome, mostly caused by bacteria, of organ dysfunctions that caused by host response dysregulations. One of the simplest sepsis-indicator is platelet and its indexes. A new platelet parameter called immature platelet count (IPF) became theinterest in this study. The study aims to see whether IPF could assess sepsis severity by procalcitonin (PCT).Sixty-four of seventy-one patients with increased PCT were included in this cross-sectional study and separated into three groups based on their PCT levels. IPF showed no significance among the three groups (p-value>0.05) while platelet count was significant (p-value<0.05). Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW) showed a strongpositive correlation with IPF. Higher sepsis severity based on PCT showed larger platelet count, as the result of platelet destructions caused by pro-inflammatory cytokines and endotoxins.

Waste management technology development and demonstration programs at Brookhaven National Laboratory

NASA Technical Reports Server (NTRS)

Kalb, Paul D.; Colombo, Peter

1991-01-01

Two thermoplastic processes for improved treatment of radioactive, hazardous, and mixed wastes were developed from bench scale through technology demonstration: polyethylene encapsulation and modified sulfur cement encapsulation. The steps required to bring technologies from the research and development stage through full scale implementation are described. Both systems result in durable waste forms that meet current Nuclear Regulatory Commission and Environmental Protection Agency regulatory criteria and provide significant improvements over conventional solidification systems such as hydraulic cement. For example, the polyethylene process can encapsulate up to 70 wt pct. nitrate salt, compared with a maximum of about 20 wt pct. for the best hydraulic cement formulation. Modified sulfur cement waste forms containing as much as 43 wt pct. incinerator fly ash were formulated, whereas the maximum quantity of this waste in hydraulic cement is 16 wt pct.

Thermally reversible gels in electrophoresis. I - Matrix characterization

NASA Technical Reports Server (NTRS)

Righetti, Pier Giorgio; Snyder, Robert S.

1988-01-01

Two series of thermally reversible hydrogen-bonded gels have been characterized: (5 pct) PVA-(4 pct) PEG and (5 pct) PVA-(0.04 pct) borate gels. They both have extremely low melting points (16-17 C) and could be of potential interest for recovery of proteins after preparative electrophoresis. The PVA-borate gels can be exploited in the pH range 7-11 by progressively increasing the borate content in the pH interval 8 to 7 and concomitantly decreasing the borate levels in the pH zone 8 to 11. It is hypothesized that the low melting point of these gels is due to the fact that they are sparingly and sparsely hydrogen bonded along the PVA chain: on the average, 1 OH group out of 3 or 4 OH groups in the PVA polymer should be engaged in H-bond formation.

Mechanical Properties of β-Ti-35Nb-2.5Sn Alloy Synthesized by Mechanical Alloying and Pulsed Current Activated Sintering

NASA Astrophysics Data System (ADS)

Omran, Abdel-Nasser; Woo, Kee-Do; Lee, Hyun Bom

2012-12-01

A developed Ti-35 pct Nb-2.5 pct Sn (wt pct) alloy was synthesized by mechanical alloying using high-energy ball-milled powders, and the powder consolidation was done by pulsed current activated sintering (PCAS). The starting powder materials were mixed for 24 hours and then milled by high-energy ball milling (HEBM) for 1, 4, and 12 hours. The bulk solid samples were fabricated by PCAS at 1073 K to 1373 K (800 °C to 1100 °C) for a short time, followed by rapid cooling to 773 K (500 °C). The relative density of the sintered samples was about 93 pct. The Ti was completely transformed from α to β-Ti phase after milling for 12 hours in powder state, and the specimen sintered at 1546 K (1273 °C) was almost transformed to β-Ti phase. The homogeneity of the sintered specimen increased with increasing milling time and sintering temperature, as did its hardness, reaching 400 HV after 12 hours of milling. The Young's modulus was almost constant for all sintered Ti-35 pct Nb-2.5 pct Sn specimens at different milling times. The Young's modulus was low (63.55 to 65.3 GPa) compared to that of the standard alloy of Ti-6Al-4V (100 GPa). The wear resistance of the sintered specimen increased with increasing milling time. The 12-hour milled powder exhibited the best wear resistance.

Elevation of serum procalcitonin in patients after chemical pleurodesis with intrapleural injection of OK-432.

PubMed

Xu, Bing-ling; Yu, Jin-quan; Tang, Ke-jing; Liu, Da-yue; Kuang, Yu-kun

2014-01-01

In patients with refractory pleural effusion or pneumothorax, fever and elevated level of white blood cell count (WBC) are frequently observed after chemical pleurodesis with intrapleural injection of OK-432, which make it difficult to differentiate whether it was from the side effects of OK-432 or concurrent bacterial infection. Procalcitonin (PCT) levels were measured before and after pleurodesis so as to discuss whether PCT is useful for distinguishing between the side effects of OK-432 and concurrent bacterial infection. Twenty-six patients with refractory pleural effusion or pneumothorax who underwent chemical pleurodesis with intrapleural injection of OK-432 at the First Affiliated Hospital of Sun Yat-sen University between August 2010 and August 2012 were included in our study. Levels of PCT and WBC were measured before and after pleurodesis. Of all 26 patients, 22 patients were with refractory pleural effusion, and the other four were with pneumothorax. The median serum levels of PCT and WBC elevated from 0.155 to 1.470 ng/mL (P = 0.009) and from 5.920 to 10.475 × 10(9) /L (P = 0.000), respectively. No patient was given antibiotics and fever subsided. Intrapleural injection of OK-432 could increase the serum level of PCT and WBC with no bacterial infection. The serum PCT level may not be useful to distinguish whether fever was caused by the side effects of OK-432 or concurrent bacterial infection. © 2013 John Wiley & Sons Ltd.

A meta-analysis of randomised controlled trials on preoperative oral carbohydrate treatment in elective surgery.

PubMed

Awad, Sherif; Varadhan, Krishna K; Ljungqvist, Olle; Lobo, Dileep N

2013-02-01

Whilst preoperative carbohydrate treatment (PCT) results in beneficial physiological effects, the effects on postoperative clinical outcomes remain unclear and were studied in this meta-analysis. Prospective studies that randomised adult non-diabetic patients to either PCT (≥50 g oral carbohydrates 2-4 h pre-anaesthesia) or control (fasted/placebo) were included. The primary outcome was length of hospital stay. Secondary outcomes included development of postoperative insulin resistance, complications, nausea and vomiting. Methodological quality was assessed using GRADEpro® software. Twenty-one randomised studies of 1685 patients (733 PCT: 952 control) were included. No overall difference in length of stay was noted for analysis of all studies or subgroups of patients undergoing surgery with an expected hospital stay ≤2 days or orthopaedic procedures. However, patients undergoing major abdominal surgery following PCT had reduced length of stay [mean difference, 95% confidence interval: -1.08 (-1.87 to -0.29); I² = 60%, p = 0.007]. PCT reduced postoperative insulin resistance with no effects on in-hospital complications over control (risk ratio, 95% confidence interval, 0.88 (0.50-1.53), I² = 41%; p = 0.640). There was significant heterogeneity amongst studies and, therefore, quality of evidence was low to moderate. PCT may be associated with reduced length of stay in patients undergoing major abdominal surgery, however, the included studies were of low to moderate quality. Copyright © 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Possible ecological risk of two pharmaceuticals diclofenac and paracetamol demonstrated on a model plant Lemna minor.

PubMed

Kummerová, Marie; Zezulka, Štěpán; Babula, Petr; Tříska, Jan

2016-01-25

Lemna minor is often used in environmental risk assessment and it can be supposed that usually evaluated parameters will be reliable even for assessing the risk of pharmaceuticals. Subtle changes in duckweed plant number, biomass production, and leaf area size induced by 10-day-exposure to diclofenac (DCF) and paracetamol (PCT) (0.1, 10, and 100 μg/L), excepting 100 μg/L DCF, are in contrast with considerable changes on biochemical and histochemical level. Both drugs caused a decrease in content of photosynthetic pigments (by up to 50%), an increase in non-photochemical quenching (by 65%) and decrease in relative chlorophyll fluorescence decay values (by up to 90% with DCF). Both DCF and especially PCT increased amount of reactive nitrogen and oxygen species in roots. DCF-induced effects included mainly increased lipid peroxidation (by 78%), disturbation in membrane integrity and lowering both oxidoreductase and dehydrogenase activities (by 30%). PCT increased the content of soluble proteins and phenolics. Higher concentrations of both DCF and PCT increased the levels of oxidised ascorbate (by 30%) and oxidised thiols (by up to 84% with DCF). Glutathion-reductase activity was elevated by both pharmaceuticals (nearly by 90%), glutathion-S-transferase activity increased mainly with PCT (by 22%). The early and sensitive indicators of DCF and PCT phytotoxicity stress in duckweed are mainly the changes in biochemical processes, connected with activation of defense mechanisms against oxidative stress. Copyright © 2015 Elsevier B.V. All rights reserved.

Filtration Efficiency of Functionalized Ceramic Foam Filters for Aluminum Melt Filtration

NASA Astrophysics Data System (ADS)

Voigt, Claudia; Jäckel, Eva; Taina, Fabio; Zienert, Tilo; Salomon, Anton; Wolf, Gotthard; Aneziris, Christos G.; Le Brun, Pierre

2017-02-01

The influence of filter surface chemistry on the filtration efficiency of cast aluminum alloys was evaluated for four different filter coating compositions (Al2O3—alumina, MgAl2O4—spinel, 3Al2O3·2SiO2—mullite, and TiO2—rutile). The tests were conducted on a laboratory scale with a filtration pilot plant, which facilitates long-term filtration tests (40 to 76 minutes). This test set-up allows the simultaneous use of two LiMCAs (before and after the filter) for the determination of the efficiency of inclusion removal. The four tested filter surface chemistries exhibited good thermal stability and mechanical robustness after 750 kg of molten aluminum had been cast. All four filter types exhibited a mean filtration efficiency of at least 80 pct. However, differences were also observed. The highest filtration efficiencies were obtained with alumina- and spinel-coated filter surfaces (>90 pct), and the complete removal of the largest inclusions (>90 µm) was observed. The efficiency was slightly lower with mullite- and rutile-coated filter surfaces, in particular for large inclusions. These observations are discussed in relation to the properties of the filters, in particular in terms of, for example, the surface roughness.

Effect of Multi-Scale Thermoelectric Magnetic Convection on Solidification Microstructure in Directionally Solidified Al-Si Alloys Under a Transverse Magnetic Field

NASA Astrophysics Data System (ADS)

Li, Xi; Du, Dafan; Gagnoud, Annie; Ren, Zhongming; Fautrelle, Yves; Moreau, Rene

2014-11-01

The influence of a transverse magnetic field ( B < 1 T) on the solidification structure in directionally solidified Al-Si alloys was investigated. Experimental results indicate that the magnetic field caused macrosegregation, dendrite refinement, and a decrease in the length of the mushy zone in both Al-7 wt pct Si alloy and Al-7 wt pct Si-1 wt pct Fe alloys. Moreover, the application of the magnetic field is capable of separating the Fe-rich intermetallic phases from Al-7 wt pct Si-1 wt pct Fe alloy. Thermoelectric magnetic convection (TEMC) was numerically simulated during the directional solidification of Al-Si alloys. The results reveal that the TEMC increases to a maximum () when the magnetic field reaches a critical magnetic field strength (), and then decreases as the magnetic field strength increases further. The TEMC exhibits the multi-scales effects: the and values are different at various scales, with decreasing and increasing as the scale decreases. The modification of the solidification structure under the magnetic field should be attributed to the TEMC on the sample and dendrite scales.

Microstructure stability during creep deformation of hard-oriented polysynthetically twinned crystal of TiAl alloy

NASA Astrophysics Data System (ADS)

Kim, Hee Y.; Maruyama, K.

2003-10-01

The hard-orientated polysynthetically twinned (PST) crystal with the lamellar plates oriented parallel to the compression axis was deformed at 1150 K under the applied stress of 158 to 316 MPa. Microstructural changes were examined quantitatively for the PST crystal during creep deformation. In the as-grown PST crystal of the present study, proportions of α 2/ γ, true twin, pseudotwin, and 120 deg rotational fault interfaces were 12, 59, 12, and 17 pct, respectively. After creep deformation, lamellar coarsening by dissolution of α 2 lamellae and migration of γ/γ interfaces were observed. The acceleration of creep rate after the minimum strain rate in the creep curve was attributed to the lamellar coarsening and destruction of lamellar structure during the creep deformation. Thirty-two percent of α 2/ γ interfaces, 51 pct of true twin interfaces, 74 pct of pseudotwin interfaces, and 80 pct of 120 deg rotational faults disappeared after 4 pct creep strain at 1150 K. The α 2/ γ interface was more stable than γ/γ interfaces during the creep deformation. The pseudotwin interface and 120 deg rotational fault were less thermally stable than the true twin interface for γ/γ interfaces.

High Temperature Strengthening in 12Cr-W-Mo Steels by Controlling the Formation of Delta Ferrite

NASA Astrophysics Data System (ADS)

Wang, Shushen; Chang, Li; Lin, Deye; Chen, Xiaohua; Hui, Xidong

2014-09-01

Novel 12Cr-W-Mo-Co heat resistance steels (HRSs) with excellent mechanical properties have been developed for ultra-supercritical (USC) applications above 923 K (650 °C). The thermal analysis of the present steels indicates that the remelting temperature of secondary phases is increased by Co alloying, resulting in the improvement of microstructural stability. Delta ferrite in these HRSs is completely suppressed as the content of Co is increased up to 5 pct. The room temperature tensile strength (TS), yield strength (YS), and the elongation (EL) of the HRS with 5 pct Co reach 887.9, 652.6 MPa, and 21.07 pct, respectively. At 948 K (675 °C), the TS and YS of the HRS with 5 pct Co attain 360 and 290 MPa, respectively, which are higher than those of T/P122 steel by 27.4 and 22.1 pct, respectively. TEM study of the microstructure confirmed that the strengthening effects for these 12Cr-W-Mo-Co HRSs are attributed to the suppression of delta ferrite, the formation of fine martensitic laths with substructure, dislocation networks and walls, and the precipitation of second nanoscale phases.

Post-test examination of a pool boiler receiver

NASA Technical Reports Server (NTRS)

Dreshfield, Robert L.; Moore, Thomas J.; Bartolotta, Paul A.

1992-01-01

A subscale pool boiler test apparatus to evaluate boiling stability developed a leak after being operated with boiling NaK for 791.4 hr at temperatures from 700 to 750 C. The boiler was constructed using Inconel 625 with a type 304L stainless steel wick for the boiler and type 316 stainless steel for the condenser. The boiler assembly was metallurgically evaluated to determine the cause of the leak and to assess the effects of the NaK on the materials. It was found that the leak was caused by insufficient (about 30 pct.) joint penetration in a butt joint. There was no general corrosion of the construction materials, but the room temperature ductility of the Inconel 625 was only about 6.5 pct. A crack in the heat affected zone of the Inconel 625 near the Inconel 625 to type 316 stainless steel butt joint was probably caused by excessive heat input. The crack was observed to have a zone depleted of iron at the crack surface and porosity below that zone. The mechanism of the iron depletion was not conclusively determined.

Elevated temperature slow plastic deformation of NiAl-TiB2 particulate composites at 1200 and 1300 K

NASA Technical Reports Server (NTRS)

Whittenberger, J. Daniel; Viswanadham, R. K.; Mannan, S. K.; Sprissler, B.

1990-01-01

Elevated temperature compression testing has been conducted in air at 1200 and 1300 K with strain rates varying from about 10 to the -4th to about 10 to the -7th/sec on NiAl-TiB2 particulate composites. These materials, which consisted of a B2 crystal structure intermetallic Ni-50 at. pct Al matrix and from 0 to 30 vol pct of approximately 1- micron diameter TiB2 particles, were fabricated by XD synthesis and hot pressed to full density. Flow strength of the composites increased with volume fraction of the strengthening phase with NiAl-30TiB2 being approximately three times stronger than NiAl. Comparison of the light optical and TEM microstructures of as-received and tested samples revealed that reactions did not occur between the two phases, and NiAl-TiB2 interfaces were not cracked during deformation. Additional TEM indicated that the particles stabilize a vastly different microstructure in the NiAl matrix of the composites than that formed in unreinforced NiAl.

Milestone Report - M3FT-15OR03120215 - Recommend HIP Conditions for AgZ

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

Bruffey, Stephanie H.; Jubin, Robert Thomas

2015-09-18

The purpose of this study was to continue research to determine if HIPing could directly convert I-Ag 0Z into a suitable waste form. Fiscal year (FY) 2015 work completed studies of Phase IIA, IIB, and IIC samples. Product consistency testing (PCT) of Phase IIA samples resulted in iodine release below detection limit for six of twelve samples. This is promising and indicates that a durable waste form may be produced through HIPing even if transformation of the zeolite to a distinct mineral phase does not occur. From PCT results of Phase IIA samples, it was determined that future pressing shouldmore » be conducted at a temperature of 900°C. Phase IIC testing continued production of samples to examine the effects of multiple source materials, compositional variations, and an expanded temperature range. The density of each sample was determined and x-ray diffraction (XRD) patterns were obtained. In all cases, there was nothing in the XRD analyses to indicate the creation of any AgI-containing silicon phase; the samples were found to be largely amorphous.« less

The proinflammatory environment in potential heart and lung donors: prevalence and impact of donor management and hormonal therapy.

PubMed

Venkateswaran, Rajamiyer V; Dronavalli, Vamsidhar; Lambert, Peter A; Steeds, Richard P; Wilson, Ian C; Thompson, Richard D; Mascaro, Jorge G; Bonser, Robert S

2009-08-27

Brain stem death can elicit a potentially manipulable cardiotoxic proinflammatory cytokine response. We investigated the prevalence of this response, the impact of donor management with tri-iodothyronine (T3) and methylprednisolone (MP) administration, and the relationship of biomarkers to organ function and transplant suitability. In a prospective randomized double-blinded factorially designed study of T3 and MP therapy, we measured serum levels of interleukin-1 and -6 (IL-1 and IL-6), tumor necrosis factor-alpha (TNF-alpha), C-reactive protein, and procalcitonin (PCT) levels in 79 potential heart or lung donors. Measurements were performed before and after 4 hr of algorithm-based donor management to optimize cardiorespiratory function and +/-hormone treatment. Donors were assigned to receive T3, MP, both drugs, or placebo. Initial IL-1 was elevated in 16% donors, IL-6 in 100%, TNF-alpha in 28%, CRP in 98%, and PCT in 87%. Overall biomarker concentrations did not change between initial and later measurements and neither T3 nor MP effected any change. Both PCT (P =0.02) and TNF-alpha (P =0.044) levels were higher in donor hearts with marginal hemodynamics at initial assessment. Higher PCT levels were related to worse cardiac index and right and left ventricular ejection fractions and a PCT level more than 2 ng x mL(-1) may attenuate any improvement in cardiac index gained by donor management. No differences were observed between initially marginal and nonmarginal donor lungs. A PCT level less than or equal to 2 ng x mL(-1) but not other biomarkers predicted transplant suitability following management. There is high prevalence of a proinflammatory environment in the organ donor that is not affected by tri-iodothyronine or MP therapy. High PCT and TNF-alpha levels are associated with donor heart dysfunction.

Improved proton CT imaging using a bismuth germanium oxide scintillator.

PubMed

Tanaka, Sodai; Nishio, Teiji; Tsuneda, Masato; Matsushita, Keiichiro; Kabuki, Shigeto; Uesaka, Mitsuru

2018-02-02

Range uncertainty is among the most formidable challenges associated with the treatment planning of proton therapy. Proton imaging, which includes proton radiography and proton computed tomography (pCT), is a useful verification tool. We have developed a pCT detection system that uses a thick bismuth germanium oxide (BGO) scintillator and a CCD camera. The current method is based on a previous detection system that used a plastic scintillator, and implements improved image processing techniques. In the new system, the scintillation light intensity is integrated along the proton beam path by the BGO scintillator, and acquired as a two-dimensional distribution with the CCD camera. The range of a penetrating proton is derived from the integrated light intensity using a light-to-range conversion table, and a pCT image can be reconstructed. The proton range in the BGO scintillator is shorter than in the plastic scintillator, so errors due to extended proton ranges can be reduced. To demonstrate the feasibility of the pCT system, an experiment was performed using a 70 MeV proton beam created by the AVF930 cyclotron at the National Institute of Radiological Sciences. The accuracy of the light-to-range conversion table, which is susceptible to errors due to its spatial dependence, was investigated, and the errors in the acquired pixel values were less than 0.5 mm. Images of various materials were acquired, and the pixel-value errors were within 3.1%, which represents an improvement over previous results. We also obtained a pCT image of an edible chicken piece, the first of its kind for a biological material, and internal structures approximately one millimeter in size were clearly observed. This pCT imaging system is fast and simple, and based on these findings, we anticipate that we can acquire 200 MeV pCT images using the BGO scintillator system.

Correlation of Microstructure and Texture in a Two-Phase High-Mn Twinning-Induced Plasticity Steel During Cold Rolling

NASA Astrophysics Data System (ADS)

Ashiq, Mohammad; Dhekne, Pushkar; Hamada, Atef Saad; Sahu, Puspendu; Mahato, B.; Minz, R. K.; Ghosh Chowdhury, Sandip; Pentti Karjalainen, L.

2017-10-01

The evolution of microstructure and texture of a two-phase austenite-ferrite twinning-induced plasticity steel during cold rolling was investigated and different deformation mechanisms were found to become active with increasing thickness reductions. Optical microscopy showed the formation of brass-type shear bands across several austenite grains at reductions greater than 50 pct. TEM observations reveal the presence of deformation twinning in austenite. The austenite phase initially shows the Cu-type texture, i.e., Cu {1 1 2}〈1 1 1〉, Goss {0 1 1}〈1 0 0〉 with a spread toward Brass {1 1 0}〈1 1 2〉. With continued cold rolling, the Cu {1 1 2}〈1 1 1〉 component moves toward CuT component {552}〈115〉 and the other two components increase in intensity. There is also emergence of {111} fiber after 90 pct cold rolling. The ferrite phase exhibits the evolution of ND-rotated Cube component {001}〈110〉 along with 〈110〉 fiber at lower as well as at higher rolling reductions. An exception is at 75 pct reduction, when the ferrite texture contains {111} fiber in place of 〈110〉 fiber with a weak rotated-Cube component. Phase fraction analysis by X-ray diffraction indicates a decrease in the austenite fraction up to 75 pct reduction followed by an increase at 90 pct reduction. After 90 pct cold rolling, the phase fraction is similar to that of the "as-received" state. Elongated grains of ferrite phase in finer dimensions after 90 pct cold rolling indicate softening within that phase; at similar stage, there are finer scale austenite grains mostly at the grain boundaries. The above has been suggested to be related with the adiabatic heating during cold rolling due to the high strain hardening of the austenite phase.

Whole-brain perfusion CT using a toggling table technique to predict final infarct volume in acute ischemic stroke.

PubMed

Schrader, I; Wilk, D; Jansen, O; Riedel, C

2013-09-01

To evaluate how accurately final infarct volume in acute ischemic stroke can be predicted with perfusion CT (PCT) using a 64-MDCT unit and the toggling table technique. Retrospective analysis of 89 patients with acute ischemic stroke who underwent CCT, CT angiography (CTA) and PCT using the "toggling table" technique within the first three hours after symptom onset. In patients with successful thrombolytic therapy (n = 48) and in those without effective thrombolytic therapy (n = 41), the infarct volume and the volume of the penumbra on PCT were compared to the infarct size on follow-up images (CT or MRI) performed within 8 days. The feasibility of complete infarct volume prediction by 8 cm cranio-caudal coverage was evaluated. The correlation between the volume of hypoperfusion on PCT defined by cerebral blood volume reduction and final infarct volume was strongest in patients with successful thrombolytic therapy with underestimation of the definite infarct volume by 8.5 ml on average. The CBV map had the greatest prognostic value. In patients without successful thrombolytic therapy, the final infarct volume was overestimated by 12.1 ml compared to the MTT map on PCT. All infarcts were detected completely. There were no false-positive or false-negative results. Using PCT and the "toggling table" technique in acute stroke patients is helpful for the rapid and accurate quantification of the minimal final infarct and is therefore a prognostic parameter which has to be evaluated in further studies to assess its impact on therapeutic decision. ▶ Using PCT and the “toggling table technique” allows accurate quantification of the infarct core and penumbra. ▶ It is possible to record dynamic perfusion parameters quickly and easily of almost the entire supratentorial brain volume on a 64-slice MDCT unit. ▶ The technique allows identification of those patients who could profit from thrombolytic therapy outside the established time intervals. © Georg Thieme Verlag KG Stuttgart · New York.

Can we predict pneumococcal bacteremia in patients with severe community-acquired pneumonia?

PubMed

Pereira, José Manuel; Teixeira-Pinto, Armando; Basílio, Carla; Sousa-Dias, Conceição; Mergulhão, Paulo; Paiva, José Artur

2013-12-01

This study aimed to evaluate the role of biomarkers as markers of pneumococcal bacteremia in severe community-acquired pneumonia (SCAP). A prospective, single-center, observational cohort study of 108 patients with SCAP admitted to the intensive care department of a university hospital in Portugal was conducted. Leucocytes, C-reactive protein (CRP), lactate, procalcitonin (PCT), d-dimer, brain natriuretic peptide (BNP), and cortisol were measured within 12 hours after the first antibiotic dose. Fifteen patients (14%) had bacteremic pneumococcal pneumonia (BPP). They had significantly higher levels of median CRP (301 [interquartile range, or IQR], 230-350] mg/L vs 201 [IQR, 103-299] mg/L; P = .023), PCT (40 [IQR, 25-102] ng/mL vs 8 [IQR, 2-26] ng/mL; P < .001), BNP (568 [IQR, 478-2841] pg/mL vs 407 [IQR, 175-989] pg/mL; P = .027), and lactate (5.5 [IQR, 4.5-9.8] mmol/L vs 3.1 [IQR, 1.9-6.2] mmol/L; P = .009) than did patients without BPP. The discriminatory power evaluated by the area under the receiver operating characteristic curve (aROC) for PCT (aROC, 0.79) was superior to lactate (aROC, 0.71), BNP (aROC, 0.67), and CRP (aROC, 0.70). At a cutoff point of 17 ng/mL, PCT showed a sensitivity of 87%, a specificity of 67%, a positive predictive value of 30% and a negative predictive value of 97%, as a marker of pneumococcal bacteremia. In this cohort, significantly higher PCT, BNP, lactate, and CRP levels were found in BPP, and PCT presented the best ability to identify pneumococcal bacteremia. A PCT serum level lower than 17 ng/mL could identify patients with SCAP unlikely to have pneumococcal bacteremia. Copyright © 2013 Elsevier Inc. All rights reserved.

Improved proton CT imaging using a bismuth germanium oxide scintillator

NASA Astrophysics Data System (ADS)

Tanaka, Sodai; Nishio, Teiji; Tsuneda, Masato; Matsushita, Keiichiro; Kabuki, Shigeto; Uesaka, Mitsuru

2018-02-01

Range uncertainty is among the most formidable challenges associated with the treatment planning of proton therapy. Proton imaging, which includes proton radiography and proton computed tomography (pCT), is a useful verification tool. We have developed a pCT detection system that uses a thick bismuth germanium oxide (BGO) scintillator and a CCD camera. The current method is based on a previous detection system that used a plastic scintillator, and implements improved image processing techniques. In the new system, the scintillation light intensity is integrated along the proton beam path by the BGO scintillator, and acquired as a two-dimensional distribution with the CCD camera. The range of a penetrating proton is derived from the integrated light intensity using a light-to-range conversion table, and a pCT image can be reconstructed. The proton range in the BGO scintillator is shorter than in the plastic scintillator, so errors due to extended proton ranges can be reduced. To demonstrate the feasibility of the pCT system, an experiment was performed using a 70 MeV proton beam created by the AVF930 cyclotron at the National Institute of Radiological Sciences. The accuracy of the light-to-range conversion table, which is susceptible to errors due to its spatial dependence, was investigated, and the errors in the acquired pixel values were less than 0.5 mm. Images of various materials were acquired, and the pixel-value errors were within 3.1%, which represents an improvement over previous results. We also obtained a pCT image of an edible chicken piece, the first of its kind for a biological material, and internal structures approximately one millimeter in size were clearly observed. This pCT imaging system is fast and simple, and based on these findings, we anticipate that we can acquire 200 MeV pCT images using the BGO scintillator system.

Isolation of Mitochondrial DNA from Single, Short Hairs without Roots Using Pressure Cycling Technology.

PubMed

Harper, Kathryn A; Meiklejohn, Kelly A; Merritt, Richard T; Walker, Jessica; Fisher, Constance L; Robertson, James M

2018-02-01

Hairs are commonly submitted as evidence to forensic laboratories, but standard nuclear DNA analysis is not always possible. Mitochondria (mt) provide another source of genetic material; however, manual isolation is laborious. In a proof-of-concept study, we assessed pressure cycling technology (PCT; an automated approach that subjects samples to varying cycles of high and low pressure) for extracting mtDNA from single, short hairs without roots. Using three microscopically similar donors, we determined the ideal PCT conditions and compared those yields to those obtained using the traditional manual micro-tissue grinder method. Higher yields were recovered from grinder extracts, but yields from PCT extracts exceeded the requirements for forensic analysis, with the DNA quality confirmed through sequencing. Automated extraction of mtDNA from hairs without roots using PCT could be useful for forensic laboratories processing numerous samples.

Selective Acidic Leaching of Spent Zinc-Carbon Batteries Followed by Zinc Electrowinning

NASA Astrophysics Data System (ADS)

Shalchian, Hossein; Rafsanjani-Abbasi, Ali; Vahdati-Khaki, Jalil; Babakhani, Abolfazl

2015-02-01

In this work, a selective acidic leaching procedure was employed for recycling zinc from spent zinc-carbon batteries. Leaching experiments were carried out in order to maximize zinc recovery and minimize manganese recovery in diluted sulfuric acid media. Response surface methodology and analysis of variance were employed for experimental design, data analysis, and leaching optimization. The experimental design has 28 experiments that include 24 main runs and four replicate in center point. The optimal conditions obtained from the selective acidic leaching experiments, were sulfuric acid concentration of 1 pct v/v, leaching temperature of 343 K (70 °C), pulp density of 8 pct w/v, and stirring speed of 300 rpm. The results show that the zinc and manganese recoveries after staged selective leaching are about 92 and 15 pct, respectively. Finally, metallic zinc with purity of 99.9 pct and electrolytic manganese dioxide were obtained by electrowinning.

Experimental Study on GFRP Surface Cracks Detection Using Truncated-Correlation Photothermal Coherence Tomography

NASA Astrophysics Data System (ADS)

Wang, Fei; Liu, Junyan; Mohummad, Oliullah; Wang, Yang

2018-04-01

In this paper, truncated-correlation photothermal coherence tomography (TC-PCT) was used as a nondestructive inspection technique to evaluate glass-fiber reinforced polymer (GFRP) composite surface cracks. Chirped-pulsed signal that combines linear frequency modulation and pulse excitation was proposed as an excitation signal to detect GFRP composite surface cracks. The basic principle of TC-PCT and extraction algorithm of the thermal wave signal feature was described. The comparison experiments between lock-in thermography, thermal wave radar imaging and chirped-pulsed photothermal radar for detecting GFRP artificial surface cracks were carried out. Experimental results illustrated that chirped-pulsed photothermal radar has the merits of high signal-to-noise ratio in detecting GFRP composite surface cracks. TC-PCT as a depth-resolved photothermal imaging modality was employed to enable three-dimensional visualization of GFRP composite surface cracks. The results showed that TC-PCT can effectively evaluate the cracks depth of GFRP composite.

Effect of Repair Welding on Electrochemical Corrosion and Stress Corrosion Cracking Behavior of TIG Welded AA2219 Aluminum Alloy in 3.5 Wt Pct NaCl Solution

NASA Astrophysics Data System (ADS)

Venugopal, A.; Sreekumar, K.; Raja, V. S.

2010-12-01

The stress corrosion cracking (SCC) behavior of AA2219 aluminum alloy in the as-welded (AW) and repair-welded (RW) conditions was examined and compared with that of the base metal (BM) in 3.5 wt pct NaCl solution using the slow strain rate technique (SSRT). The reduction in ductility was used as a parameter to evaluate the SCC susceptibility of both BM and welded joints. The results show that the ductility ratio ( ɛ NaCl/( ɛ air)) of the BM was close to one (0.97) and reduced to 0.9 for the AW joint. This value further reduced to 0.77 after carrying out one repair welding operation. However, the RW specimen exhibited higher ductility than the single-weld specimens even in 3.5 wt pct NaCl solution. SSRT results obtained using pre-exposed samples followed by post-test metallographic observations clearly showed localized pitting corrosion along the partially melted zone (PMZ), signifying that the reduction in ductility ratio of both the AW and RW joints was more due to mechanical overload failure, caused by the localized corrosion and a consequent reduction in specimen thickness, than due to SCC. Also, the RW joint exhibited higher ductility than the AW joint both in air and the environment, although SCC index (SI) for the former is lower than that of the latter. Fractographic examination of the failed samples, in general, revealed a typical ductile cracking morphology for all the base and welded joints, indicating the good environmental cracking resistance of this alloy. Microstructural examination and polarization tests further demonstrate grain boundary melting along the PMZ, and that provided the necessary electrochemical condition for the preferential cracking on that zone of the weldment.

The effect of tempering and aging on a low activation martensitic steel

NASA Astrophysics Data System (ADS)

Griffin, R. D.; Dodd, R. A.; Kulcinski, G. L.; Gelles, D. S.

1990-07-01

Tempering and aging studies were carried out on a martensitic stainless steel which was designed to have reduced long-life activation after exposure to neutrons. Nickel, molybdenum, and niobium additions were restricted in these low activation alloys. The composition of the steel in weight percent was 12 pct Cr, 0.1 pct C, 0.3 pct V, 0.9 pct W, 6.4 pct Mn, and 0.1 pct Si, where manganese is used to stabilize the steel against delta ferrite and tungsten is used for tempering resistance. The tempering conditions studied were 2 hours at 400 °C, 500 °C, 600 °C, 700 °C, 800 °C, and 900 °C and 24 hours at 500 °C and 700 °C. The steel was aged for 1000 and 5000 hours at 365 °C, 420 °C, 520 °C, and 600 °C. Microhardness, optical metallography, and transmission electron microscopy (TEM) were used to characterize the samples. The results indicated that the Ac1 in this steel lies between 700 °C and 800 °C. During the 2-hour tempers at 400 °C and 500 °C, M3C formed. After 24 hours at 500 °C, the M3C was starting to be replaced by M23C6. At higher tempering temperatures and in all the aged samples, M23C6 was the only carbide found. A manganese-rich chi phase was also seen in the samples aged at 420 °C and 520 °C.

Procalcitonin levels in gram-positive, gram-negative, and fungal bloodstream infections.

PubMed

Leli, Christian; Ferranti, Marta; Moretti, Amedeo; Al Dhahab, Zainab Salim; Cenci, Elio; Mencacci, Antonella

2015-01-01

Procalcitonin (PCT) can discriminate bacterial from viral systemic infections and true bacteremia from contaminated blood cultures. The aim of this study was to evaluate PCT diagnostic accuracy in discriminating Gram-positive, Gram-negative, and fungal bloodstream infections. A total of 1,949 samples from patients with suspected bloodstream infections were included in the study. Median PCT value in Gram-negative (13.8 ng/mL, interquartile range (IQR) 3.4-44.1) bacteremias was significantly higher than in Gram-positive (2.1 ng/mL, IQR 0.6-7.6) or fungal (0.5 ng/mL, IQR 0.4-1) infections (P < 0.0001). Receiver operating characteristic analysis showed an area under the curve (AUC) for PCT of 0.765 (95% CI 0.725-0.805, P < 0.0001) in discriminating Gram-negatives from Gram-positives at the best cut-off value of 10.8 ng/mL and an AUC of 0.944 (95% CI 0.919-0.969, P < 0.0001) in discriminating Gram-negatives from fungi at the best cut-off of 1.6 ng/mL. Additional results showed a significant difference in median PCT values between Enterobacteriaceae and nonfermentative Gram-negative bacteria (17.1 ng/mL, IQR 5.9-48.5 versus 3.5 ng/mL, IQR 0.8-21.5; P < 0.0001). This study suggests that PCT may be of value to distinguish Gram-negative from Gram-positive and fungal bloodstream infections. Nevertheless, its utility to predict different microorganisms needs to be assessed in further studies.

Evolution of procalcitonin, C-reactive protein and fibrinogen levels in neutropenic leukaemia patients with invasive pulmonary aspergillosis or mucormycosis.

PubMed

Roques, Marjorie; Chretien, Marie Lorraine; Favennec, Camille; Lafon, Ingrid; Ferrant, Emmanuelle; Legouge, Caroline; Plocque, Alexia; Golfier, Camille; Duvillard, Laurence; Amoureux, Lucie; Bastie, Jean Noel; Maurin-Bernier, Lory; Dalle, Frederic; Caillot, Denis

2016-06-01

Unlike bacterial infections, the value of procalcitonin (PCT) in detecting fungal infections in leukaemia patients is not clear. To determine whether the monitoring of PCT coupled with C-reactive protein (CRP) and fibrinogen (Fib) could be helpful in the management of pulmonary aspergillosis (IPA) or mucormycosis (PM), we retrospectively analysed the evolution of PCT, CRP and Fib levels in 94 leukaemia patients with proven/probable IPA (n = 77) or PM (n = 17) from D-12 to D12 relative to IFI onset defined as D0. Overall, 2140 assays were performed. From D-12 to D0, 12%, 5% and 1.4% of patients had PCT >0.5, 1 and 1.5 μg l(-1) , respectively, while CRP was >50, 75 and 100 mg l(-1) in 84%, 70% and 57% and Fib was >4, 5 and 6 g l(-1) in 96%, 80% and 61% of cases respectively (P < 10(-7) ). The same trends were observed from D1 to D12. Overall, between D-12 and D12, only 6.4% of patients had PCT >1.5 μg l(-1) , while CRP >100 mg l(-1) and Fib >6 g l(-1) were observed in 80% and 75% of cases respectively (P < 10(-7) ). In leukaemia patients, IPA or PM was accompanied by a significant increase in CRP and Fib while PCT remained low. © 2016 Blackwell Verlag GmbH.

IL-10 combined with procalcitonin improves early prediction of complications of febrile neutropenia in hematological patients.

PubMed

Vänskä, Matti; Koivula, Irma; Jantunen, Esa; Hämäläinen, Sari; Purhonen, Anna-Kaisa; Pulkki, Kari; Juutilainen, Auni

2012-12-01

Early diagnosis of complicated course in febrile neutropenia is cumbersome due to the non-specificity of clinical and laboratory signs of severe infection. This prospective study included 100 adult hematological patients with febrile neutropenia after intensive chemotherapy at the onset of fever (d0) and for 3 days (d1-d3) thereafter. The study aim was to find early predictors for complicated course of febrile neutropenia, defined as bacteremia or septic shock. Interleukin 6 (IL-6), interleukin 10 (IL-10), procalcitonin (PCT) and C-reactive protein (CRP) all predicted complicated course of febrile neutropenia on d0, but only PCT was predictive throughout the study period. For IL-10 on d0-1 with cut-off 37 ng/L, sensitivity was 0.71, specificity 0.82, positive predictive value 0.52 and negative predictive value 0.92. For PCT on d0-1 with cut-off 0.13 μg/L, the respective measures were 0.95, 0.53, 0.36, and 0.98. For the combination of IL-10 and PCT on d0-1 with the same cut-offs, specificity improved to 0.85 and positive predictive value to 0.56. In conclusion, the present study confirms the high negative predictive value of PCT and provides new evidence for IL-10 as an early predictor for complicated course of febrile neutropenia in hematological patients. Combining IL-10 with PCT improves the early prediction for complicated course of febrile neutropenia. Copyright © 2012 Elsevier Ltd. All rights reserved.

[Diagnostic value of serum procalcitonin for infection in the immunocompromised critically ill patients with suspected infection].

PubMed

Yu, Xin; Ma, Xinhua; Ai, Yuhang

2015-06-01

To evaluate the diagnostic and prognostic value of the serum procalcitonin (PCT) level in the non-acquired immune deficiency syndrome (AIDS) immunocompromised critically ill patients suspected to have infection. A retrospective study was conducted in the non-AIDS immunocompromised patients who were admitted to Department of Critical Care Medicine of Xiangya Hospital, Central South University during January 2011 to December 2014. Demographic characteristics, underlying disease, acute physiology and chronic health evaluation II (APACHEII) score at admission, and clinical records including baseline and peak levels of temperature, white blood count (WBC), PCT, and survival rate within 28 days, infection focus, infectious agents (bacterial, fungi or mixed infection), and the severity of infection (sepsis, severe sepsis, or septic shock) were recorded. Receiver operating characteristic (ROC) curve was plotted, and the diagnostic and protective value of above parameters was evaluated. A total of 98 patients (43 male and 55 female) were enrolled in the study with a median age of 44 (28, 52) years old and a median APACHEII score of 17 (11, 20); 47 with malignant hematological tumor, 45 with autoimmune diseases, and 6 post solid organ transplantation. Among them 53 patients (54.1%) died within 28 days. Twenty-seven patients were diagnosed as systemic inflammatory response syndrome (SIRS) without infection. Among 71 patients with infection, 45 were diagnosed as bacterial infection, 10 with fungal infection, and 16 with mixed infection. Sepsis was diagnosed in 7 patients, severe sepsis in 32 patients, and septic shock in 32 patients. (1) There was no statistical significance in the baseline and peak levels of PCT and WBC, or baseline level of temperature between the groups of SIRS patients without infection and infected patients. The peak level of temperature was significantly higher in the patients with infection as compared with that of the SIRS without infection patients [centigrade: 39.4 (38.9, 40.0) vs. 38.8 (37.8, 39.2), Z=-3.268, P=0.001]. It was showed by subgroup analysis that in patients with hematological malignant disease or autoimmune diseases, higher level of body temperature was found in infection group compared with non-infection SIRS group [centigrade: 39.5 (39.0, 40.0) vs. 39.0 (38.4, 39.4), Z=-2.349, P=0.019; 39.0 (38.4, 39.5) vs. 38.2 (37.0, 38.9), Z=-2.221, P=0.026]. (2) The baseline level of PCT (μg/L) were 0.54 (0.20, 4.19), 2.78 (0.50, 9.54), 1.00 (0.45, 6.89), and 0.22 (0.07, 1.86) in non-infection SIRS patients or the patients with bacterial, fungal, and mixed infection, respectively. The peak level of PCT (μg/L) were 4.19 (1.95, 13.42), 12.37 (3.82, 45.89), 1.82 (0.49, 17.86), and 5.14 (2.66, 12.62), respectively, in each subgroup. When the comparison was conducted among the patients with different infectious agent, the baseline level of PCT in patients with bacterial infection was significantly higher than that in SIRS patients without infection (P=0.026) and mixed infection patients (P=0.001), and the peak level of PCT was significantly higher than that in the SIRS patients without infection (P=0.009) and the patients with fungal infection (P=0.016). ROC curve showed that the higher value was found in the baseline and peak levels of PCT for diagnosis of septic shock in all patients [ area under ROC curve (AUC) of baseline level=0.681±0.054, P=0.001; AUC of peak level=0.690±0.054, P=0.002], and the same value was also found in the baseline and peak levels of PCT for diagnosis of bacterial infection in the patients with malignant hematological tumor (AUC of baseline level=0.687±0.080, P=0.008; AUC of peak level=0.697±0.079, P=0.021). (3) The peak level of PCT (μg/L) were 4.05 (0.53, 31.22), 5.78 (2.14, 16.68), and 11.64 (2.94, 58.14) in subgroup of patients with sepsis, severe sepsis and septic shock, respectively, and they showed no statistical significance among subgroups (P>0.05). A high serum level of peak PCT strongly indicated the presence of septic shock (AUC=0.646±0.060, P=0.019), especially in the subgroup of patients with systemic autoimmune disease (AUC=0.689±0.081, P=0.035). (4) The peak level of PCT (μg/L) in the APACHEII>18 group (38 cases) was significantly higher than that of APACHEII≤18 group [ 60 cases, PCT (μg/L): 11.64 (3.36, 39.39) vs. 4.42 (1.32, 14.70), P=0.016]; there was a certain correlation between the peak level of PCT and the severity of the disease. (5) The peak level of PCT in death group was significantly higher than that of the survival group [μg/L: 9.07 (3.05, 33.09) vs. 4.19 (1.26, 14.61), P=0.043]. ROC curve showed that the peak level of PCT might be valuable in predicting the prognosis in immunocompromised patients (AUC=0.619±0.057, P=0.043). The serum level of PCT is found to be a reliable marker for the diagnosis of bacterial infection in immunocompromised critical patients, especially in those with hematologic malignancy. Additionally, PCT provides a useful tool for evaluating the severity of infection and the prognosis of critically ill patients.

The impact of an oral hygiene education module on patient practices and nursing documentation.

PubMed

Coke, Lola; Otten, Karine; Staffileno, Beth; Minarich, Laura; Nowiszewski, Candice

2015-02-01

Oral hygiene is inconsistent among patients with cancer and is a national patient care issue. To promote comfort and nutritional status, oral hygiene for patients with cancer is important. The purpose of this study was to develop an evidence-based oral hygiene educational module (EM) for nursing and patient care technician (PCT) staff to promote consistent oral hygiene patient education; evaluate patient understanding of oral hygiene practices post-EM; and determine staff documentation frequency of oral hygiene care. Pre- and post-EM data were collected using a developed oral hygiene assessment tool; nursing documentation data were collected by chart review. Post-EM data were collected eight weeks post-EM. Data were analyzed using frequencies and the Mann-Whitney U test. Twenty-two patient documentation pairs were collected. Compared to pre-EM, admission teaching, patient education, and patient oral hygiene practices improved post-EM. Post-EM oral hygiene documentation and PCT teaching increased.

Applied-field MPD thruster geometry effects

NASA Technical Reports Server (NTRS)

Myers, Roger M.

1991-01-01

Eight MPD thruster configurations were used to study the effects of applied field strength, propellant, and facility pressure on thruster performance. Vacuum facility background pressures higher than approx. 0.12 Pa were found to greatly influence thruster performance and electrode power deposition. Thrust efficiency and specific impulse increased monotonically with increasing applied field strength. Both cathode and anode radii fundamentally influenced the efficiency specific impulse relationship, while their lengths influence only the magnitude of the applied magnetic field required to reach a given performance level. At a given specific impulse, large electrode radii result in lower efficiencies for the operating conditions studied. For all test conditions, anode power deposition was the largest efficiency loss, and represented between 50 and 80 pct. of the input power. The fraction of the input power deposited into the anode decreased with increasing applied field and anode radii. The highest performance measured, 20 pct. efficiency at 3700 seconds specific impulse, was obtained using hydrogen propellant.

1200 to 1400 K slow strain rate compressive properties of NiAl/Ni2AlTi-base materials

NASA Technical Reports Server (NTRS)

Whittenberger, J. Daniel; Viswanadham, R. K.; Mannan, S. K.; Kumar, K. S.

1989-01-01

An attempt to apply the Martin Marietta Corporation's XD technology to the fabrication of NiAl-Ni2AlTi materials with improved creep properties is presented. Composite materials, containing from 0 to 30 vol pct of nominally 1-micron-diameter TiB2 particles in the intermetallic matrix have been produced by the XD process and compacted by hot pressing. Such composites demonstrated significant strength increases, approaching 3-fold for the 20 vol pct materials, in comparison to the unreinforced aluminide. This behavior was accomplished without deleterious side effects as the grain boundaries and particle-matrix interfaces were intact after compressive deformation to 10 percent or more strain. Typical true compressive stress-strain diagrams for materials tested in air between 1200 and 1400 K at approximate strain rates of 1.7 x 10 to the -6th/sec are presented.

Predicting diffusion paths and interface motion in gamma/gamma + beta, Ni-Cr-Al diffusion couples

NASA Technical Reports Server (NTRS)

Nesbitt, J. A.; Heckel, R. W.

1987-01-01

A simplified model has been developed to predict Beta recession and diffusion paths in ternary gamma/gamma + beta diffusion couples (gamma:fcc, beta: NiAl structure). The model was tested by predicting beta recession and diffusion paths for four gamma/gamma + beta, Ni-Cr-Al couples annealed for 100 hours at 1200 C. The model predicted beta recession within 20 percent of that measured for each of the couples. The model also predicted shifts in the concentration of the gamma phase at the gamma/gamma + beta interface within 2 at. pct Al and 6 at. pct Cr of that measured in each of the couples. A qualitative explanation based on simple kinetic and mass balance arguments has been given which demonstrates the necessity for diffusion in the two-phase region of certain gamma/gamma + beta, Ni-Cr-Al couples.

Observations on the brittle to ductile transition temperatures of B2 nickel aluminides with and without zirconium

NASA Technical Reports Server (NTRS)

Raj, S. V.; Noebe, R. D.; Bowman, R.

1989-01-01

The effect of a zirconium addition (0.05 at. pct) to a stoichiometric NiAl alloy on the brittle-to-ductile transition temperature (BDTT) of this alloy was investigated. Constant velocity tensile tests were conducted to fracture between 300 and 1100 K under initial strain rate 0.00014/sec, and the true stress and true strain values were determined from plots of load vs time after subtracting the elastic strain. The inelastic strain was measured under a traveling microscope. Microstructural characterization of as-extruded and fractured specimens was carried out by SEM and TEM. It was found that, while the addition of 0.05 at. pct Zr strengthened the NiAl alloy, it increased its BDTT; this shift in the BDTT could not be attributed either to variations in grain size or to impurity contents. Little or no room-temperature ductility was observed for either alloy.

Decagonal quasicrystal and related crystalline phases in Mn-Ga alloys with 52 to 63 a/o Ga

NASA Astrophysics Data System (ADS)

Wu, J. S.; Kuo, K. H.

1997-03-01

A decagonal quasicrystal (DQC) and six related intermetallic phases with large unit cells have been found in binary Mn-Ga alloys with 52 to 63 at. pct Ga by means of transmission electron microscopy (TEM). As does the Al-Mn DQC, the Ga-Mn DQC also has a periodicity of 1.25 nm along its tenfold axis. However, its Mn content, determined by electron microprobe X-ray analysis (about 45 to 50 at. pct Mn), is much higher than that of the Al-Mn DQC (about 20 to 30 at. pct Mn). The compositions of the intermetallic phases are about 53, 56, 58, and 62 at. pct Ga, corresponding respectively to the unknown structures of MnGa (50.7 to 53.4 at. pct Ga), Mn5Ga6 (55 at pct Ga), Mn5Ga7 (57.9 at. pct Ga), and Mn3Ga5 (62.9 at. pct Ga) given in the binary Mn-Ga phase diagram ( Metals Hand-book, T.B. Massalski, J.L. Murray, L.H. Benneft, and H. Baker, eds., ASM, Metals Park, OH, 1986, vol. 2, p. 1144). Their lattice types have been determined by selected area electron diffraction. The ferromagnetic Mn3Ga5 is tetragonal, a=1.25 nm and c=2.50 nm; Mn5Ga7 is orthorhombic, a=4.57 nm, b=1.25 nm, and c=1.44 nm; Mn5Ga6 has two different but closely related orthorhombic unit cells, a=1.26 nm, b=1.25 nm, and c=1.48 nm as well as a=0.77 nm, b=1.25 nm, and c=2.36 nm; MnGa also has two different and related unit cells, one orthorhombic with a=2.04 nm, b=1.25 nm, and c=1.48 nm and the other monoclinic with a=2.59 nm, b=1.25 nm, c=1.15 nm, and β≈=110 deg. All these orthorhombic phases have b=1.25 nm, being the same as the periodicity along the tenfold axis of the Ga-Mn and Al-Mn DQCs. Moreover, all these six intermetallic phases give electron diffraction patterns displaying a pseudo-tenfold distribution of strong diffraction spots and are considered to be crystalline approximants of the Ga-Mn DQC.

Procalcitonin for diagnosis of bacterial pneumonia in critically ill patients during 2009 H1N1 influenza pandemic: a prospective cohort study, systematic review and individual patient data meta-analysis.

PubMed

Pfister, Roman; Kochanek, Matthias; Leygeber, Timo; Brun-Buisson, Christian; Cuquemelle, Elise; Machado, Mariana Benevides; Piacentini, Enrique; Hammond, Naomi E; Ingram, Paul R; Michels, Guido

2014-03-10

Procalcitonin (PCT) is helpful for diagnosing bacterial infections. The diagnostic utility of PCT has not been examined thoroughly in critically ill patients with suspected H1N1 influenza. Clinical characteristics and PCT were prospectively assessed in 46 patients with pneumonia admitted to medical ICUs during the 2009 and 2010 influenza seasons. An individual patient data meta-analysis was performed by combining our data with data from five other studies on the diagnostic utility of PCT in ICU patients with suspected 2009 pandemic influenza A(H1N1) virus infection identified by performing a systematic literature search. PCT levels, measured within 24 hours of ICU admission, were significantly elevated in patients with bacterial pneumonia (isolated or coinfection with H1N1; n = 77) (median = 6.2 μg/L, interquartile range (IQR) = 0.9 to 20) than in patients with isolated H1N1 influenza pneumonia (n = 84; median = 0.56 μg/L, IQR = 0.18 to 3.33). The area under the curve of the receiver operating characteristic curve of PCT was 0.72 (95% confidence interval (CI) = 0.64 to 0.80; P < 0.0001) for diagnosis of bacterial pneumonia, but increased to 0.76 (95% CI = 0.68 to 0.85; P < 0.0001) when patients with hospital-acquired pneumonia and immune-compromising disorders were excluded. PCT at a cut-off of 0.5 μg/L had a sensitivity (95% CI) and a negative predictive value of 80.5% (69.9 to 88.7) and 73.2% (59.7 to 84.2) for diagnosis of bacterial pneumonia, respectively, which increased to 85.5% (73.3 to 93.5) and 82.2% (68.0 to 92.0) in patients without hospital acquired pneumonia or immune-compromising disorder. In critically ill patients with pneumonia during the influenza season, PCT is a reasonably accurate marker for detection of bacterial pneumonia, particularly in patients with community-acquired disease and without immune-compromising disorders, but it might not be sufficient as a stand-alone marker for withholding antibiotic treatment.

Procalcitonin for diagnosis of bacterial pneumonia in critically ill patients during 2009 H1N1 influenza pandemic: a prospective cohort study, systematic review and individual patient data meta-analysis

PubMed Central

2014-01-01

Introduction Procalcitonin (PCT) is helpful for diagnosing bacterial infections. The diagnostic utility of PCT has not been examined thoroughly in critically ill patients with suspected H1N1 influenza. Methods Clinical characteristics and PCT were prospectively assessed in 46 patients with pneumonia admitted to medical ICUs during the 2009 and 2010 influenza seasons. An individual patient data meta-analysis was performed by combining our data with data from five other studies on the diagnostic utility of PCT in ICU patients with suspected 2009 pandemic influenza A(H1N1) virus infection identified by performing a systematic literature search. Results PCT levels, measured within 24 hours of ICU admission, were significantly elevated in patients with bacterial pneumonia (isolated or coinfection with H1N1; n = 77) (median = 6.2 μg/L, interquartile range (IQR) = 0.9 to 20) than in patients with isolated H1N1 influenza pneumonia (n = 84; median = 0.56 μg/L, IQR = 0.18 to 3.33). The area under the curve of the receiver operating characteristic curve of PCT was 0.72 (95% confidence interval (CI) = 0.64 to 0.80; P < 0.0001) for diagnosis of bacterial pneumonia, but increased to 0.76 (95% CI = 0.68 to 0.85; P < 0.0001) when patients with hospital-acquired pneumonia and immune-compromising disorders were excluded. PCT at a cut-off of 0.5 μg/L had a sensitivity (95% CI) and a negative predictive value of 80.5% (69.9 to 88.7) and 73.2% (59.7 to 84.2) for diagnosis of bacterial pneumonia, respectively, which increased to 85.5% (73.3 to 93.5) and 82.2% (68.0 to 92.0) in patients without hospital acquired pneumonia or immune-compromising disorder. Conclusions In critically ill patients with pneumonia during the influenza season, PCT is a reasonably accurate marker for detection of bacterial pneumonia, particularly in patients with community-acquired disease and without immune-compromising disorders, but it might not be sufficient as a stand-alone marker for withholding antibiotic treatment. PMID:24612487

Heat treatment for improvement in lower temperature mechanical properties of 0.40 pct C-Cr-Mo ultrahigh strength steel

NASA Astrophysics Data System (ADS)

Tomita, Yoshiyuki; Okabayashi, Kunio

1983-11-01

In the previous paper, it was reported that isothermal heat treatment of a commercial Japanese 0.40 pct C-Ni-Cr-Mo ultrahigh strength steel (AISI 4340 type) at 593 K for a short time followed by water quenching, in which a mixed structure of 25 vol pct lower bainite and 75 vol pct martensite is produced, results in the improvement of low temperature mechanical properties (287 to 123 K). The purpose of this paper is to study whether above new heat treatment will still be effective in commercial practice for improving low temperature mechanical properties of the ultrahigh strength steel when applied to a commercial Japanese 0.40 pct C-Cr-Mo ultrahigh strength steel which is economical because it lacks the expensive nickel component (AISI 4140 type). At and above 203 K this new heat treatment, as compared with the conventional 1133 K direct water quenching treatment, significantly improved the strength, tensile ductility, and notch toughness of the 0.40 pct C-Cr-Mo ultrahigh strength steel. At and above 203 K the new heat treatment also produced superior fracture ductility and notch toughness results at similar strength levels as compared to those obtained by using γ α' repetitive heat treatment for the same steel. However, the new heat treatment remarkably decreased fracture ductility and notch toughness of the 0.40 pct C-Cr-Mo ultrahigh strength steel below 203 K, and thus no significant improvement in the mechanical properties was noticeable as compared with the properties produced by the conventional 1133 K direct water quenching treatment and the γ α' repetitive heat treatment. This contrasts with the fact that the new heat treatment, as compared with the conventional 1133 K direct water quenching treatment and the γ α' repetitive heat treatment, dramatically improved the notch toughness of the 0.40 pct C-Ni-Cr-Mo ultrahigh strength steel, providing a better combination of strength and ductility throughout the 287 to 123 K temperature range. The difference in the observed mechanical properties between the above two ultrahigh strength steels is discussed on the basis of the effect of nickel content, fracture profile, and so forth.

Chemical Composition Analysis and Product Consistency Tests of the ORP Phase 5 Nepheline Study Glasses

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

Fox, K. M.; Edwards, T. B.; Caldwell, M. E.

In this report, the Savannah River National Laboratory (SRNL) provides chemical analyses and Product Consistency Test (PCT) results for a series of simulated high-level waste glass compositions fabricated by the Pacific Northwest National Laboratory (PNNL). These data will be used in the development of improved models for the prediction of nepheline crystallization in support of the Hanford Tank Waste Treatment and Immobilization Plant (WTP).

Hydrogen Storage Characteristics of Nanocrystalline and Amorphous Nd-Mg-Ni-Based NdMg12-Type Alloys Synthesized via Mechanical Milling

NASA Astrophysics Data System (ADS)

Zhang, Yanghuan; Shang, Hongwei; Hou, Zhonghui; Yuan, Zeming; Yang, Tai; Qi, Yan

2016-12-01

In this study, Mg was partially substituted by Ni with the intent of improving the hydrogen storage kinetics performance of NdMg12-type alloy. Mechanical milling technology was adopted to fabricate the nanocrystalline and amorphous NdMg11Ni + x wt pct Ni ( x = 100, 200) alloys. The effects of Ni content and milling duration on the microstructures and hydrogen storage kinetics of as-milled alloys have been systematically investigated. The structures were characterized by XRD and HRTEM. The electrochemical hydrogen storage properties were tested by an automatic galvanostatic system. Moreover, the gaseous hydrogen storage properties were investigated by Sievert apparatus and a differential scanning calorimeter connected with a H2 detector. Hydrogen desorption activation energy of alloy hydrides was estimated by using Arrhenius and Kissinger methods. The results reveal that the increase of Ni content dramatically ameliorates the gaseous and electrochemical hydrogen storage kinetics performance of the as-milled alloys. Furthermore, high rate discharge ability (HRD) reach the maximum value with the variation of milling time. The maximum HRDs of the NdMg11Ni + x wt pct Ni ( x = 100, 200) alloys are 80.24 and 85.17 pct. The improved gaseous hydrogen storage kinetics of alloys via increasing Ni content and milling time can be attributed to a decrease in the hydrogen desorption activation energy.

Comparative levels of macrophage migration inhibitory factor, procalcitonin, osteoprotegerin, interleukin-8, hs-C reactive protein, D-dimer in febrile neutropenia, newly diagnosed cancer patients, and infectious fever.

PubMed

Bilgir, Oktay; Bilgir, Ferda; Kebapcilar, Levent; Bozkaya, Giray; Çalan, Mehmet; Kırbıyık, Halil; Avci, Meltem; Sari, İsmail; Yuksel, Arif; Isikyakar, Tolgay

2012-02-01

The purpose of this study is to determine the levels of procalcitonin (PCT), IL-8 (interleukin-8), MIF (macrophage migration inhibitory factor), osteoprotegerin (OPG), hs-CRP and D-dimer during fever above 38.3°C due to various causes. Blood samples taken from a total of consecutive 65 hospitalized patients during fever were prospectively tested for hsCRP, PCT, IL-8, OPG, MIF and D-dimer. Of these patients, there were 26 patients presenting with chemotherapy-induced neutropenia who had no infectious agents found; 23 patients, who had a malignancy with a febrile episode which was neither a microbiologically documented infection nor a chemotherapy-induced neutropenia, and 16 patients who did not have a malignancy and were considered to have a clinically and microbiologically documented infection. IL-8 and D-dimer levels were higher in patients with febrile neutropenia than in the other two groups. Although MIF and OPG were higher in patients with newly diagnosed cancers, there were no differences among the three groups regarding PCT and hs-CRP values. High serum IL-8 and D-dimer levels can be useful markers to identify hospitalized chemotherapy-induced neutropenia patients. MIF and OPG were found to be higher in patients with newly diagnosed cancer. Copyright © 2011 Elsevier Ltd. All rights reserved.

Interpersonal Factors Are Associated with Lower Therapist Adherence in Cognitive-Behavioural Therapy for Panic Disorder.

PubMed

Zickgraf, Hana F; Chambless, Dianne L; McCarthy, Kevin S; Gallop, Robert; Sharpless, Brian A; Milrod, Barbara L; Barber, Jacques P

2016-05-01

The contributions of disorder severity, comorbidity and interpersonal variables to therapists' adherence to a cognitive-behavioural treatment (CBT) manual were tested. Thirty-eight patients received panic control therapy (PCT) for panic disorder. Trained observers watching videotapes of the sixth session of a 24-session protocol rated therapists' adherence to PCT and their use of interventions from outside the CBT model. Different observers rated patients' behavioural resistance to therapy in the same session using the client resistance code. Interview measures obtained before treatment included the Panic Disorder Severity Scale, the anxiety disorders interview schedule for Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV and the structured clinical interview for DSM-IV, Axis II. Questionnaire measures were the anxiety sensitivity index at intake, and, at session 2, the therapist and client versions of the working alliance inventory-short form. The higher the patients' resistance and the more Axis II traits a patient had, the less adherent the therapist. Moreover, the more resistant the client, the more therapists resorted to interventions from outside the CBT model. Stronger therapist and patient alliance was also generally related to better adherence, but these results were somewhat inconsistent across therapists. Pretreatment disorder severity and comorbidity were not related to adherence. Interpersonal variables, particularly behavioural resistance to therapy, are related to therapists' ability to adhere to a treatment manual and to their use of interventions from outside of the CBT model. Copyright © 2015 John Wiley & Sons, Ltd. Patients' behavioural resistance to therapy may make it more difficult for cognitive-behavioural clinicians to adhere to a structured treatment protocol and more likely for them to borrow interventions from outside the CBT model. Patients' Axis II traits may make adherence to treatment CBT protocol more difficult, although whether this is true varies across therapists. Therapists' adherence to a structured protocol and borrowing from outside of the CBT model do not appear to be affected by disorder severity or Axis I comorbidity. Copyright © 2015 John Wiley & Sons, Ltd.

Effects of Electromagnetic Stirring on the Microstructure and High-Temperature Mechanical Properties of a Hyper-eutectic Al-Si-Cu-Ni Alloy

NASA Astrophysics Data System (ADS)

Jang, Youngsoo; Choi, Byounghee; Kang, Byungkeun; Hong, Chun Pyo

2015-02-01

A liquid treatment method by electromagnetic stirring was applied to a hyper-eutectic Al-15wt pctSi-4wt pctCu-3wt pctNi alloy for the piston manufacturing with diecasting process in order to improve high-temperature mechanical properties of the piston heads. The mechanical properties, such as hardness, high-temperature tensile stress, thermal expansion, and high-temperature relative wear resistance, were estimated using the specimens taken from the liquid-treated diecast products, and the results were compared with those of a conventional metal-mold-cast piston.

Managing per Member per Month (PMPM). Findings Regarding Variation and Drivers of Cost

DTIC Science & Technology

2011-01-25

BenGrpDiag Desc RVU/100 Vst /100 RVU/100 Vst /100 Delta Pct 8 AD 7242 LUMBAGO 41.98 26.27 63.37 40.88 21.39 50.9% 71946 JOINT...Conference 30 All Enrollee AD MDC-19 MH Top 25 Primary Diagnosis with increases 2006 2009 MDC Adj BenGrpDiag Desc RVU/100 Vst /100 RVU/100 Vst /100 Delta Pct 19...Diagnosis with increases MDC Adj BenGrp Diag Desc RVU/100 Vst /100 RVU/100 Vst /100 Delta Pct 23 AD V705 HEALTH EXAMINATION OF DEFINED NATURE 300.25

NASA Sea Ice Validation Program for the Defense Meteorological Satellite Program Special Sensor Microwave Imager

NASA Technical Reports Server (NTRS)

Cavalieri, Donald J. (Editor); Crawford, John P.; Drinkwater, Mark R.; Emery, William J.; Eppler, Duane T.; Farmer, L. Dennis; Fowler, Charles W.; Goodberlet, Mark; Jentz, Robert R.; Milman, Andrew

1992-01-01

The history of the program is described along with the SSM/I sensor, including its calibration and geolocation correction procedures used by NASA, SSM/I data flow, and the NASA program to distribute polar gridded SSM/I radiances and sea ice concentrations (SIC) on CD-ROMs. Following a discussion of the NASA algorithm used to convert SSM/I radiances to SICs, results of 95 SSM/I-MSS Landsat IC comparisons for regions in both the Arctic and the Antarctic are presented. The Landsat comparisons show that the overall algorithm accuracy under winter conditions is 7 pct. on average with 4 pct. negative bias. Next, high resolution active and passive microwave image mosaics from coordinated NASA and Navy aircraft underflights over regions of the Beaufort and Chukchi seas in March 1988 were used to show that the algorithm multiyear IC accuracy is 11 pct. on average with a positive bias of 12 pct. Ice edge crossings of the Bering Sea by the NASA DC-8 aircraft were used to show that the SSM/I 15 pct. ice concentration contour corresponds best to the location of the initial bands at the ice edge. Finally, a summary of results and recommendations for improving the SIC retrievals from spaceborne radiometers are provided.

Procalcitonin for prediction of chorioamnionitis in preterm premature rupture of membranes.

PubMed

Thornburg, Loralei L; Queenan, Ruthanne; Brandt-Griffith, Brianne; Pressman, Eva K

2016-01-01

To assess serum procalcitonin (PCT), a marker of monocyte activity, in predicting chorioamnionitis in preterm premature rupture of membranes (PPROM). Prospective cohort study in singleton gestation patients with PPROM between 2 2 + 0 to 3 3 + 6 weeks gestation. Two blood samples were taken - admission and delivery or diagnosis of clinical chorioamnionitis. Maternal serum PCT > 0.1 ng/mL was considered positive. Patients were divided into four groups: clinical evidence of chorioamnionitis confirmed by placental pathology (group C + P); pathological evidence of chorioamnionitis without clinical signs (group P); clinical signs only (group C); and patients without clinical or pathological findings (group N). Groups were compared to gestational age matched controls. Forty eight patients recruited, with 28 eligible for analysis: 10 in C + P group, 10 P group, 3 C group, and 5 N group. None of the control or PPROM patients had positive PCT on admission. At delivery, 3 of 10 group C + P and 4 of 10 group P had positive PCT. Maternal serum PCT sensitivity was 50% and specificity 55.6% for diagnosis of pathological chorioamnionitis. Maternal serum PCT is not detectable in PPROM patients at admission or in uncomplicated pregnant controls and is a poor predictor for clinical or pathological chorioamnionitis.

Recycling of Magnesium Alloy Employing Refining and Solid Oxide Membrane (SOM) Electrolysis

NASA Astrophysics Data System (ADS)

Guan, Xiaofei; Zink, Peter A.; Pal, Uday B.; Powell, Adam C.

2013-04-01

Pure magnesium was recycled from partially oxidized 50.5 wt pct Mg-Al scrap alloy and AZ91 Mg alloy (9 wt pct Al, 1 wt pct Zn). Refining experiments were performed using a eutectic mixture of MgF2-CaF2 molten salt (flux). During the experiments, potentiodynamic scans were performed to determine the electrorefining potentials for magnesium dissolution and magnesium bubble nucleation in the flux. The measured electrorefining potential for magnesium bubble nucleation increased over time as the magnesium content inside the magnesium alloy decreased. Potentiostatic holds and electrochemical impedance spectroscopy were employed to measure the electronic and ionic resistances of the flux. The electronic resistivity of the flux varied inversely with the magnesium solubility. Up to 100 pct of the magnesium was refined from the Mg-Al scrap alloy by dissolving magnesium and its oxide into the flux followed by argon-assisted evaporation of dissolved magnesium and subsequently condensing the magnesium vapor. Solid oxide membrane electrolysis was also employed in the system to enable additional magnesium recovery from magnesium oxide in the partially oxidized Mg-Al scrap. In an experiment employing AZ91 Mg alloy, only the refining step was carried out. The calculated refining yield of magnesium from the AZ91 alloy was near 100 pct.

Relationship of neutrophil gelatinase-associated lipocalin (NGAL) and procalcitonin levels with the presence and severity of the preeclampsia.

PubMed

Artunc-Ulkumen, Burcu; Guvenc, Yesim; Goker, Asli; Gozukara, Ceyhun

2015-11-01

The aim of the present study was to evaluate changes in maternal serum neutrophil gelatinase-associated lipocalin (NGAL) and procalcitonin (PCT) concentrations in preeclampsia. This case-control study consisted of 40 preeclamptic and 40 healthy singleton pregnancies matched for age and body mass index. Serum NGAL and PCT levels were compared between the groups. Diagnostic performance and clinical association of these markers were evaluated. NGAL and PCT concentrations were significantly higher in preeclamptic group (p < 0.0001 and p = 0.001, respectively) and their levels were correlated with the severity of the preeclampsia. There were significant positive correlation between these markers and mean arterial pressure (MAP) and spot urine protein excretion. There was negative correlation between NGAL and apgar scores and fetal birth weight. Pregnancies with higher NGAL (OR: 4.89; 95% CI: 1.81-13.21) and higher PCT (OR: 6.67; 95% CI: 2.44-18.21) concentrations had higher risk for preeclampsia. NGAL and PCT may be potential biomarkers for preeclampsia. Their levels increase significantly in preeclampsia and they are related to the severity of the disease. These results are in agreement with the generalized endothelial damage and persistant inflammatory status in preeclampsia. NGAL may also be an indicator for adverse neonatal outcomes with decreased placental hypoperfusion.

Evaluation of brain perfusion in Alzheimer disease with perfusion computed tomography and comparison to elderly patient without dementia.

PubMed

Yildirim, Tülin; Karakurum Göksel, Başak; Demir, Şenay; Tokmak, Naime; Tan, Meliha

2016-04-19

The aim of this study was to evaluate perfusion computed tomography (PCT) findings in patients with Alzheimer disease and to compare them with those of patients without dementia. PCT was performed in 35 patients: 20 with Alzheimer disease (mean age, 69.7 ± 5.5 years) and 15 control subjects (mean age, 67.5 ± 3.5 years). Control subjects were elderly individuals with no cognitive problems who were admitted with headaches. All PCT examinations were performed on a 4-slice CT unit. The PCT analysis software program was used to calculate regional cerebral blood flow (rCBF), regional cerebral blood volume (rCBV), regional time-to-peak (rTTP) values in the bilateral frontal, temporal, and occipital cortices, and bilateral lentiform nucleus. rCBF values in the bilateral frontal and temporal cortices and bilateral lentiform nucleus were significantly lower in the patients with Alzheimer disease than in the control subjects. There were no significant differences in rCBV values between Alzheimer disease and the control group. rTTP values in all cortical areas and bilateral lentiform nucleus were significantly higher in the patients with Alzheimer disease than in the control subjects. PCT is a rapid and reliable imaging modality for evaluating brain perfusion in Alzheimer disease.

[Diagnostic value of procalcitonin, interleukin 8, interleukin 6, and C-reactive protein for detecting bacteremia and fungemia in cancer patients].

PubMed

Aznar-Oroval, Eduardo; Sánchez-Yepes, Marina; Lorente-Alegre, Pablo; San Juan-Gadea, Mari Carmen; Ortiz-Muñoz, Blanca; Pérez-Ballestero, Pilar; Picón-Roig, Isabel; Maíquez-Richart, Joaquín

2010-05-01

Bacteremia is one of the most important causes of morbidity and mortality in cancer patients. The aim of this study was to evaluate the diagnostic usefulness of procalcitonin (PCT), interleukin 8 (IL-8), interleukin 6 (IL-6), and C-reactive protein (CRP) in the detection of bacteremia in cancer patients. PCT, IL-8, IL-6, and CPR levels were measured in 2 groups of cancer patients who had fever: one group with true bacteremia and another without bacteremia. Seventy-nine febrile episodes were analyzed in 79 patients, 43 men and 36 women. Forty-four patients were in the true bacteremia group. Significant differences in PCT (P<0.001), IL-8 (P<0.001), and IL-6 (P=0.002) values were found between patients with and without true bacteremia. CPR results were not significantly different between the groups (P=0.23). The cut-off point for PCT was 0.5 ng/mL and this parameter yielded the best specificity at 91.4%, with a sensitivity of 59.1%. Among the infection markers studied, PCT provided the most information for diagnosing bacteremia in cancer patients. (c) 2009 Elsevier España, S.L. All rights reserved.

Preparation of Rutile from Ilmenite Concentrate Through Pressure Leaching with Hydrochloric Acid

NASA Astrophysics Data System (ADS)

Xiang, Junyi; Liu, Songli; Lv, Xuewei; Bai, Chenguang

2017-04-01

Take into account the fact that the natural rutile utilized for the production of titanium dioxide pigment through chloride process is desperately lacking worldwide especially in China, an attempt was exploited for extracting synthetic rutile from Yunnan ilmenite concentrate with hydrochloric acid pressure leaching process. The leaching parameters for one step leaching process were investigated. The results shown that the optimum condition is leaching temperature of 413 K (140 °C), acid concentration of 20 pct HCl, leaching time of 4 hours and liquid/solid mass ratio of 8:1. A two steps leaching process was also suggested to reutilize the leaching liquor which with a high content of HCl. The results showed that the content of HCl decreased from 135 to 75 g/L, total iron increased from 44.5 g/L to about 87.6 g/L, and the liquid/solid mass ratio decreased to 5:1 with a two steps leaching process. The leaching product produced through a two steps leaching process shows a pure golden red with a high content of titanium (92.65 pct TiO2), a relatively low content of calcium (0.10 pct CaO) and magnesium (0.12 pct MgO), but high content of silicon (5.72 pct SiO2).

Physician and Staff Acceptance of Care Managers in Primary Care Offices.

PubMed

Malouin, Jean M; Malouin, Rebecca A; Sarinopoulos, Issidoros; Beisel, Marie; Bechel-Marriot, Diane; First, Amanda; Gamble, Ginger M; Tanner, Clare

2017-01-01

Embedded care managers are increasingly implemented as part of the care team within primary care practices, yet previous studies have indicated variability in acceptance by physicians and staff. This study assesses the acceptability of care managers among staff and physicians within the Michigan Primary Care Transformation (MiPCT) demonstration. Care manager acceptance was measured using a web-based survey distributed to practices participating in the MiPCT demonstration. Both physicians and staff reported high levels of care manager acceptance. Longer length of care manager employment at the practice, higher care manager FTE dedicated to care management, and care manager employed by practice were all significantly associated with care manager acceptance. The MiPCT demonstration found high care manager acceptance across all care team members. The high level of acceptance may be due to the structures and processes developed by MiPCT to support implementation of care managers and the length of the intervention period. The MiPCT demonstration confirms that following three years of implementation, embedded care managers are acceptable to both physicians and staff within primary care practices. Importantly, embeddedness, or the amount of time care managers are located within practices, is associated with increased acceptance. © Copyright 2017 by the American Board of Family Medicine.

Rationale and design of the IMPACT EU-trial: improve management of heart failure with procalcitonin biomarkers in cardiology (BIC)-18.

PubMed

Möckel, Martin; Slagman, Anna; Vollert, Jörn Ole; Ebmeyer, Stefan; Wiemer, Jan C; Searle, Julia; Giannitsis, Evangelos; Kellum, John A; Maisel, Alan

2018-02-01

To evaluate the effectiveness of procalcitonin (PCT)-guided antibiotic treatment compared to current treatment practice to reduce 90-day all-cause mortality in emergency patients with shortness of breath (SOB) and suspected acute heart failure (AHF). Concomitant AHF and lower respiratory tract (or other bacterial) infection in emergency patients with dyspnea are common and can be difficult to diagnose. Early and adequate initiation of antibiotic therapy (ABX) significantly improves patient outcome, but superfluous prescription of ABX maybe harmful. In a multicentre, prospective, randomized, controlled process trial with an open intervention, adult emergency patients with SOB and increased levels of natriuretic peptides will be randomized to either a standard care group or a PCT-guided group with respect to the initiation of antibiotic treatment. In the PCT-guided group, the initiation of antibiotic therapy is based on the results of acute PCT measurements at admission, using a cut-off of 0.2 ng/ml. A two-stage sample-size adaptive design is used; an interim analysis was done after completion of 50% of patients and the final sample size remained unchanged. Primary endpoint is 90-day all-cause mortality. The current study will provide evidence, whether the routine use of PCT in patients with suspected AHF improves outcome.

Application of Precipitate Free Zone Growth Kinetics to the β-Phase Depletion Behavior in a CoNiCrAlY Coating Alloy: An Analytical Approach

NASA Astrophysics Data System (ADS)

Chen, H.

2018-06-01

This paper concerns the β-phase depletion kinetics of a thermally sprayed free-standing CoNiCrAlY (Co-31.7 pct Ni-20.8 pct Cr-8.1 pct Al-0.5 pct Y, all in wt pct) coating alloy. An analytical β-phase depletion model based on the precipitate free zone growth kinetics was developed to calculate the β-phase depletion kinetics during isothermal oxidation. This approach, which accounts for the molar volume of the alloy, the interfacial energy of the γ/ β interface, and the Al concentration at γ/ γ + β boundary, requires the Al concentrations in the β-phase depletion zone as the input rather than the oxidation kinetics at the oxide/coating interface. The calculated β-phase depletion zones derived from the current model were compared with experimental results. It is shown that the calculated β-phase depletion zones using the current model are in reasonable agreement with those obtained experimentally. The constant compositional terms used in the model are likely to cause the discrepancies between the model predictions and experimental results. This analytical approach, which shows a reasonable correlation with experimental results, demonstrates a good reliability in the fast evaluation on lifetime prediction of MCrAlY coatings.

Differences in the effectiveness of serum biomarkers for the diagnosis of bacterial infections in adult and elderly patients admitted to the emergency department.

PubMed

Yilmaz, Hava; Duran, Latif; Yanik, Keramettin; Altuntaş, Mehmet; Sünbül, Mustafa

2015-01-01

This study aimed to evaluate the superiority of procalcitonin (PCT), C-reactive protein (CRP) levels, white blood cell (WBC) counts, and erythrocyte sedimentation rate (ESR) in discriminating among infection, systemic inflammatory response syndrome (SIRS), and sepsis, and their differences according to age groups. The patients were divided into an adult group and a geriatric group (over 65 years) and classified according to the presence of infection, SIRS, and sepsis. The patients' laboratory values (PCT, CRP, WBC, ESR), demographic characteristics, and vital signs were taken into consideration. When the laboratory parameters were evaluated, there were no significant differences in the PCT, WBC, and ESR values between the age groups (P > 0.05). CRP was significantly higher in the adult patient group compared to the geriatric group (P < 0.001). When the two groups were compared in terms of infection, there were no significant differences in the PCT levels and the WBC count (P > 0.05) in SIRS and sepsis. In addition, the CRP levels and the ESR were significantly higher in the adult sepsis patients when compared with the geriatric patients (P < 0.001). PCT levels do not distinguish among infection, SIRS, and sepsis in adult and geriatric age groups.

Application of Precipitate Free Zone Growth Kinetics to the β-Phase Depletion Behavior in a CoNiCrAlY Coating Alloy: An Analytical Approach

NASA Astrophysics Data System (ADS)

Chen, H.

2018-03-01

This paper concerns the β-phase depletion kinetics of a thermally sprayed free-standing CoNiCrAlY (Co-31.7 pct Ni-20.8 pct Cr-8.1 pct Al-0.5 pct Y, all in wt pct) coating alloy. An analytical β-phase depletion model based on the precipitate free zone growth kinetics was developed to calculate the β-phase depletion kinetics during isothermal oxidation. This approach, which accounts for the molar volume of the alloy, the interfacial energy of the γ/β interface, and the Al concentration at γ/γ + β boundary, requires the Al concentrations in the β-phase depletion zone as the input rather than the oxidation kinetics at the oxide/coating interface. The calculated β-phase depletion zones derived from the current model were compared with experimental results. It is shown that the calculated β-phase depletion zones using the current model are in reasonable agreement with those obtained experimentally. The constant compositional terms used in the model are likely to cause the discrepancies between the model predictions and experimental results. This analytical approach, which shows a reasonable correlation with experimental results, demonstrates a good reliability in the fast evaluation on lifetime prediction of MCrAlY coatings.

Physicochemical Properties of Industrial Aluminum Electrolytes Enriching Li and K: The Liquidus Temperature

NASA Astrophysics Data System (ADS)

Lv, Xiao-jun; Shuang, Ya-jing; Li, Jie; Chen, Shi-yue; Lai, Yan-qing; Zhang, Hong-liang; Liu, Ye-xiang

2017-04-01

The alumina contains plenty of Li2O and K2O as a result of using low-grade bauxite in China. Thus, LiF and KF will be enriched in the electrolytes with the operation of the cell, so that the composition and physicochemical properties of electrolytes have been changed. The effects of LiF, KF, and CR on the liquidus temperature of electrolytes based on the xNaF·AlF3-5 wt pct CaF2-2.5 wt pct Al2O3-0.5 wt pct MgF2 system have been investigated in this study. The results show that the liquidus temperature decreases by 5.13 K to 10.74 K (5.13 °C to 10.74 °C) per 1 wt pct addition of LiF and that the liquidus temperature decreases by 1.63 K to 3.8 K (1.63 °C to 3.8 °C) with per 1 wt pct addition of KF. When adding LiF and KF together, it has the interplay between LiF and KF. Under different electrolyte systems, the interplay between LiF and KF is complex. The effect of CR on liquidus temperature has been related to the concentration of LiF and KF.

Robust low-dose dynamic cerebral perfusion CT image restoration via coupled dictionary learning scheme.

PubMed

Tian, Xiumei; Zeng, Dong; Zhang, Shanli; Huang, Jing; Zhang, Hua; He, Ji; Lu, Lijun; Xi, Weiwen; Ma, Jianhua; Bian, Zhaoying

2016-11-22

Dynamic cerebral perfusion x-ray computed tomography (PCT) imaging has been advocated to quantitatively and qualitatively assess hemodynamic parameters in the diagnosis of acute stroke or chronic cerebrovascular diseases. However, the associated radiation dose is a significant concern to patients due to its dynamic scan protocol. To address this issue, in this paper we propose an image restoration method by utilizing coupled dictionary learning (CDL) scheme to yield clinically acceptable PCT images with low-dose data acquisition. Specifically, in the present CDL scheme, the 2D background information from the average of the baseline time frames of low-dose unenhanced CT images and the 3D enhancement information from normal-dose sequential cerebral PCT images are exploited to train the dictionary atoms respectively. After getting the two trained dictionaries, we couple them to represent the desired PCT images as spatio-temporal prior in objective function construction. Finally, the low-dose dynamic cerebral PCT images are restored by using a general DL image processing. To get a robust solution, the objective function is solved by using a modified dictionary learning based image restoration algorithm. The experimental results on clinical data show that the present method can yield more accurate kinetic enhanced details and diagnostic hemodynamic parameter maps than the state-of-the-art methods.

[Clinical characteristics and prognosis in patients with high plasma level of procalcitonin: an analysis in 188 patients].

PubMed

Pan, Chuli; Cui, Wei; Zhou, Feifei; Tu, Junwei; Lin, Xiuhui; Li, Libin; Zhang, Gensheng

2017-07-01

To investigate the clinical characteristics and prognosis of patients with high level of plasma procalcitonin (PCT > 100 μg/L), and to improve the clinician's understanding, diagnosis and treatment of this kind of patients. A retrospective study was conducted. The clinical data of patients with plasma PCT over 100 μg/L within 48 hours of admission admitted to Second Affiliated Hospital of Zhejiang University School of Medicine from February 2013 to December 2016 were collected, and the clinical characteristics were analyzed. The patients were divided into survival and death groups according to 28-day prognosis. The general data and laboratory parameters including vital signs, 24-hour urine output, routine blood test, blood biochemical tests, coagulation parameters, myocardial enzymes and arterial blood gas analysis were collected. The risk factors of mortality were analyzed using multi-logistic regression analysis. 188 patients with high level of plasma PCT were enrolled. There were 128 male patients (68.1%) with the average age of 62 (49, 75) years. Most patients were admitted in intensive care unit (ICU, 70.7%, 133/188). Major diagnosis was sepsis (91.0%), followed by multiple organ dysfunction syndrome (MODS, 57.4%), post large operation of thorax and abdomen (20.7%), trauma/burns (13.8%) and post-cardiopulmonary resuscitation (CPR, 6.4%). Of all the 188 patients, 115 patients survived and 73 died with a mortality of 38.8%. The parameters in the death group, including the percentages of MODS (84.9% vs. 40.0%), trauma/burns (26.0% vs. 6.1%), post-CPR (13.7% vs. 1.7%), ventilator support (82.2% vs. 40.9%) and shock (100.0% vs. 60.0%), the numbers of principal diagnosis [2.0 (2.0, 3.0) vs. 2.0 (1.0, 2.0)], acute physiology and chronic health evaluation II score [APACHE II score: 24 (19, 28) vs. 14 (10, 16)] and sequential organ failure assessment (SOFA) score [16.0 (12.5, 18.0) vs. 9.0 (6.0, 12.0)], as well as liver function, coagulation parameters, myocardial enzymes and lactic acid (Lac) levels were significantly higher than those in the survival group, but the platelet (PLT) count in the death group was significantly lower than that in the survival group [×10 9 /L: 62.00 (21.50, 111.00) vs. 93.00 (53.00, 136.00), all P < 0.05]. The parameters with statistical significance in the univariate analysis were enrolled in the multiple factor logistic regression analysis, which showed that patient with a high score of APACHE II [odds ratio (OR) = 1.290, 95% confidence interval (95%CI) = 1.121-1.484, P = 0.000] or the occurrence of MODS (OR = 7.264, 95%CI = 1.762-29.941, P = 0.006) at admission had a poor prognosis. The primary patients with high levels of plasma PCT (> 100 μg/L) were diagnosed with sepsis, MODS, trauma and post-CPR, complicated with respiratory and circulatory insufficiency. These factors of trauma, MODS and cardiac arrest, and some laboratory parameters including PLT, Lac, liver function, coagulation spectrum, and cardiac enzymes were correlated with the prognosis of the patients with high levels of plasma PCT. High APACHE II score and the incidence of MODS might be independent predictors of poor prognosis in the patients with high levels of plasma PCT.

Ultrasound-guided percutaneous tracheostomy in critically ill obese patients

PubMed Central

2012-01-01

Introduction The purpose of this study was to evaluate the feasibility of ultrasound (US)-guided percutaneous tracheostomy (PCT) and the incidence of complications in critically ill, obese patients. Methods Fifty consecutive patients were included in a prospective study in two surgical and critical care medicine departments. Obesity was defined as a body mass index (BMI) of at least 30 kg/m2. The feasibility of PCT and the incidence of complications were compared in obese patients (n = 26) and non-obese patients (n = 24). Results are expressed as the median (25th-75th percentile) or number (percentage). Results The median BMIs were 34 kg/m2 (32-38) in the obese patient group and 25 kg/m2 (24-28) in the non-obese group (p < 0.001). The median times for tracheostomy were 10 min (8-14) in non-obese patients and 9 min (5-10) in obese-patients (p = 0.1). The overall complication rate was similar in obese and non-obese patient groups (35% vs. 33%, p = 0.92). Most complications were minor (hypotension, desaturation, tracheal cuff puncture and minor bleeding), with no differences between obese and non-obese groups. Bronchoscopic inspection revealed two cases of granuloma (8%) in obese patients. One non-obese patient developed a peristomal skin infection, which was treated with intravenous antibiotics. Ultrasound-guided PCT was possible in all enrolled patients and there were no surgical conversions or deaths. Conclusions This study demonstrated that US-guided PCT is feasible in obese patients with a low complication rate. Obesity may not constitute a contra-indication for US-guided PCT. A US examination provides information on cervical anatomy and hence modifies and guides choice of the PCT puncture site. Trial registration ClinicalTrials.gov: NCT01502657. PMID:22390815

Ultrasound-guided percutaneous tracheostomy in critically ill obese patients.

PubMed

Guinot, Pierre-Grégoire; Zogheib, Elie; Petiot, Sandra; Marienne, Jean-Pierre; Guerin, Anne-Marie; Monet, Pauline; Zaatar, Rody; Dupont, Hervé

2012-12-12

The purpose of this study was to evaluate the feasibility of ultrasound (US)-guided percutaneous tracheostomy (PCT) and the incidence of complications in critically ill, obese patients. Fifty consecutive patients were included in a prospective study in two surgical and critical care medicine departments. Obesity was defined as a body mass index (BMI) of at least 30 kg/m². The feasibility of PCT and the incidence of complications were compared in obese patients (n = 26) and non-obese patients (n = 24). Results are expressed as the median (25th-75th percentile) or number (percentage). The median BMIs were 34 kg/m² (32-38) in the obese patient group and 25 kg/m² (24-28) in the non-obese group (p < 0.001). The median times for tracheostomy were 10 min (8-14) in non-obese patients and 9 min (5-10) in obese-patients (p = 0.1). The overall complication rate was similar in obese and non-obese patient groups (35% vs. 33%, p = 0.92). Most complications were minor (hypotension, desaturation, tracheal cuff puncture and minor bleeding), with no differences between obese and non-obese groups. Bronchoscopic inspection revealed two cases of granuloma (8%) in obese patients. One non-obese patient developed a peristomal skin infection, which was treated with intravenous antibiotics. Ultrasound-guided PCT was possible in all enrolled patients and there were no surgical conversions or deaths. This study demonstrated that US-guided PCT is feasible in obese patients with a low complication rate. Obesity may not constitute a contra-indication for US-guided PCT. A US examination provides information on cervical anatomy and hence modifies and guides choice of the PCT puncture site. ClinicalTrials.gov: NCT01502657.

Procalcitonin Levels in Gram-Positive, Gram-Negative, and Fungal Bloodstream Infections

PubMed Central

Ferranti, Marta; Moretti, Amedeo; Al Dhahab, Zainab Salim; Cenci, Elio; Mencacci, Antonella

2015-01-01

Procalcitonin (PCT) can discriminate bacterial from viral systemic infections and true bacteremia from contaminated blood cultures. The aim of this study was to evaluate PCT diagnostic accuracy in discriminating Gram-positive, Gram-negative, and fungal bloodstream infections. A total of 1,949 samples from patients with suspected bloodstream infections were included in the study. Median PCT value in Gram-negative (13.8 ng/mL, interquartile range (IQR) 3.4–44.1) bacteremias was significantly higher than in Gram-positive (2.1 ng/mL, IQR 0.6–7.6) or fungal (0.5 ng/mL, IQR 0.4–1) infections (P < 0.0001). Receiver operating characteristic analysis showed an area under the curve (AUC) for PCT of 0.765 (95% CI 0.725–0.805, P < 0.0001) in discriminating Gram-negatives from Gram-positives at the best cut-off value of 10.8 ng/mL and an AUC of 0.944 (95% CI 0.919–0.969, P < 0.0001) in discriminating Gram-negatives from fungi at the best cut-off of 1.6 ng/mL. Additional results showed a significant difference in median PCT values between Enterobacteriaceae and nonfermentative Gram-negative bacteria (17.1 ng/mL, IQR 5.9–48.5 versus 3.5 ng/mL, IQR 0.8–21.5; P < 0.0001). This study suggests that PCT may be of value to distinguish Gram-negative from Gram-positive and fungal bloodstream infections. Nevertheless, its utility to predict different microorganisms needs to be assessed in further studies. PMID:25852221

Usefulness of analytical parameters in the management of paediatric patients with suspicion of acute pyelonephritis. Is procalcitonin reliable?

PubMed

Bañuelos-Andrío, L; Espino-Hernández, M; Ruperez-Lucas, M; Villar-Del Campo, M C; Romero-Carrasco, C I; Rodríguez-Caravaca, G

To investigate the usefulness of procalcitonin (PCT) and other analytical parameters (white blood cell count [WBC], C-reactive protein [CRP]) as markers of acute renal damage in children after a first febrile or afebrile urinary tract infection (UTI). A retrospective study was conducted on children with a first episode of UTI admitted between January 2009 to December 2011, and in whom serum PCT, CRP and white blood cell count were measured, as well as assessing the acute renal damage with renal scintigraphy with 99m Tc-DMSA (DMSA) within the first 72h after referral. A descriptive study was performed and ROC curves were plotted, with optimal cut-off points calculated for each parameter. The 101 enrolled patients were divided into two groups according to DMSA scintigraphy results, with 64 patients being classified with acute pyelonephritis (APN), and 37 with UTI. The mean WBC, CRP and PCT values were significantly higher in patients with APN with respect to normal acute DMSA. The area under the ROC curve was 0.862 for PCR, 0.774 for WBC, and 0.731 for PCT. The optimum statistical cut-off value for PCT was 0.285ng/ml (sensitivity 71.4% and specificity 75%). Although the mean levels of fever, WBC, CRP, and PCT were significantly increased in patients with APN than in those who had UTI, the sensitivity and specificity of these analytical parameters are unable to predict the existence of acute renal damage, making the contribution by renal DMSA scintigraphy essential. Copyright © 2016 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

Diagnostic accuracy of procalcitonin in critically ill immunocompromised patients.

PubMed

Bele, Nicolas; Darmon, Michael; Coquet, Isaline; Feugeas, Jean-Paul; Legriel, Stéphane; Adaoui, Nadir; Schlemmer, Benoît; Azoulay, Elie

2011-08-24

Recognizing infection is crucial in immunocompromised patients with organ dysfunction. Our objective was to assess the diagnostic accuracy of procalcitonin (PCT) in critically ill immunocompromised patients. This prospective, observational study included patients with suspected sepsis. Patients were classified into one of three diagnostic groups: no infection, bacterial sepsis, and nonbacterial sepsis. We included 119 patients with a median age of 54 years (interquartile range [IQR], 42-68 years). The general severity (SAPSII) and organ dysfunction (LOD) scores on day 1 were 45 (35-62.7) and 4 (2-6), respectively, and overall hospital mortality was 32.8%. Causes of immunodepression were hematological disorders (64 patients, 53.8%), HIV infection (31 patients, 26%), and solid cancers (26 patients, 21.8%). Bacterial sepsis was diagnosed in 58 patients and nonbacterial infections in nine patients (7.6%); 52 patients (43.7%) had no infection. PCT concentrations on the first ICU day were higher in the group with bacterial sepsis (4.42 [1.60-22.14] vs. 0.26 [0.09-1.26] ng/ml in patients without bacterial infection, P < 0.0001). PCT concentrations on day 1 that were > 0.5 ng/ml had 100% sensitivity but only 63% specificity for diagnosing bacterial sepsis. The area under the receiver operating characteristic (ROC) curve was 0.851 (0.78-0.92). In multivariate analyses, PCT concentrations > 0.5 ng/ml on day 1 independently predicted bacterial sepsis (odds ratio, 8.6; 95% confidence interval, 2.53-29.3; P = 0.0006). PCT concentrations were not significantly correlated with hospital mortality. Despite limited specificity in critically ill immunocompromised patients, PCT concentrations may help to rule out bacterial infection.

Diagnostic accuracy of procalcitonin in critically ill immunocompromised patients

PubMed Central

2011-01-01

Background Recognizing infection is crucial in immunocompromised patients with organ dysfunction. Our objective was to assess the diagnostic accuracy of procalcitonin (PCT) in critically ill immunocompromised patients. Methods This prospective, observational study included patients with suspected sepsis. Patients were classified into one of three diagnostic groups: no infection, bacterial sepsis, and nonbacterial sepsis. Results We included 119 patients with a median age of 54 years (interquartile range [IQR], 42-68 years). The general severity (SAPSII) and organ dysfunction (LOD) scores on day 1 were 45 (35-62.7) and 4 (2-6), respectively, and overall hospital mortality was 32.8%. Causes of immunodepression were hematological disorders (64 patients, 53.8%), HIV infection (31 patients, 26%), and solid cancers (26 patients, 21.8%). Bacterial sepsis was diagnosed in 58 patients and nonbacterial infections in nine patients (7.6%); 52 patients (43.7%) had no infection. PCT concentrations on the first ICU day were higher in the group with bacterial sepsis (4.42 [1.60-22.14] vs. 0.26 [0.09-1.26] ng/ml in patients without bacterial infection, P < 0.0001). PCT concentrations on day 1 that were > 0.5 ng/ml had 100% sensitivity but only 63% specificity for diagnosing bacterial sepsis. The area under the receiver operating characteristic (ROC) curve was 0.851 (0.78-0.92). In multivariate analyses, PCT concentrations > 0.5 ng/ml on day 1 independently predicted bacterial sepsis (odds ratio, 8.6; 95% confidence interval, 2.53-29.3; P = 0.0006). PCT concentrations were not significantly correlated with hospital mortality. Conclusion Despite limited specificity in critically ill immunocompromised patients, PCT concentrations may help to rule out bacterial infection. PMID:21864380

Prognostic and diagnostic value of eosinopenia, C-reactive protein, procalcitonin, and circulating cell-free DNA in critically ill patients admitted with suspicion of sepsis.

PubMed

Garnacho-Montero, Jose; Huici-Moreno, María J; Gutiérrez-Pizarraya, Antonio; López, Isabel; Márquez-Vácaro, Juan Antonio; Macher, Hada; Guerrero, Juan Manuel; Puppo-Moreno, Antonio

2014-06-05

The aims of this study were to assess the reliability of circulating cell-free DNA (cf-DNA) concentrations, compared with C-reactive protein (CRP), procalcitonin (PCT) and eosinophil count, in the diagnosis of infections in patients with systemic inflammatory response syndrome (SIRS) and their prognostic values in a cohort of critically ill patients. We conducted a prospective cohort study in a medical-surgical intensive care unit of a university hospital. Eosinophil count and concentrations of cf-DNA, CRP, and PCT were measured in patients who fulfilled SIRS criteria at admission to the intensive care unit (ICU) and a second determination 24 hours later. DNA levels were determined by a PCR method using primers for the human beta-haemoglobin gene. One hundred and sixty consecutive patients were included: 43 SIRS without sepsis and 117 with sepsis. Levels of CRP and PCT, but not cf-DNA or eosinophil count, were significantly higher in patients with sepsis than in SIRS-no sepsis group on days 1 and 2. PCT on day 1 achieves the best area under the curve (AUC) for sepsis diagnosis (0.87; 95% confidence interval = 0.81-0.94). Levels of cf-DNA do not predict outcome and the accuracy of these biomarkers for mortality prediction was lower than that shown by APACHE II score. PCT decreases significantly from day 1 to day 2 in survivors in the entire cohort and in patients with sepsis without significant changes in the other biomarkers. Our data do not support the clinical utility of cf-DNA measurement in critical care patients with SIRS. PCT is of value especially for infection identification in patients with SIRS at admission to the ICU.

Relative cerebral blood volume as a marker of durable tissue-at-risk viability in hyperacute ischemic stroke.

PubMed

Cortijo, Elisa; Calleja, Ana Isabel; García-Bermejo, Pablo; Mulero, Patricia; Pérez-Fernández, Santiago; Reyes, Javier; Muñoz, Ma Fe; Martínez-Galdámez, Mario; Arenillas, Juan Francisco

2014-01-01

Selection of best responders to reperfusion therapies could be aided by predicting the duration of tissue-at-risk viability, which may be dependant on collateral circulation status. We aimed to identify the best predictor of good collateral circulation among perfusion computed tomography (PCT) parameters in middle cerebral artery (MCA) ischemic stroke and to analyze how early MCA response to intravenous thrombolysis and PCT-derived markers of good collaterals interact to determine stroke outcome. We prospectively studied patients with acute MCA ischemic stroke treated with intravenous thrombolysis who underwent PCT before treatment showing a target mismatch profile. Collateral status was assessed using a PCT source image-based score. PCT maps were quantitatively analyzed. Cerebral blood volume (CBV), cerebral blood flow, and Tmax were calculated within the hypoperfused volume and in the equivalent region of unaffected hemisphere. Occluded MCAs were monitored by transcranial Duplex to assess early recanalization. Main outcome variables were brain hypodensity volume and modified Rankin scale score at day 90. One hundred patients with MCA ischemic stroke imaged by PCT received intravenous thrombolysis, and 68 met all inclusion criteria. A relative CBV (rCBV) >0.93 emerged as the only predictor of good collaterals (odds ratio, 12.6; 95% confidence interval, 2.9-55.9; P=0.001). Early MCA recanalization was associated with better long-term outcome and lower infarct volume in patients with rCBV<0.93, but not in patients with high rCBV. None of the patients with rCBV<0.93 achieved good outcome in absence of early recanalization. High rCBV was the strongest marker of good collaterals and may characterize durable tissue-at-risk viability in hyperacute MCA ischemic stroke.

[Clinical data that are essential for the primary care clinical records: an experience of evaluation and improvement].

PubMed

López-Picazo Ferrer, J J; Agulló Roca, F; Villaescusa Pedemonte, M; Cerezo Corbalán, J M

2002-06-30

To evaluate and improve the presence of essential clinical data in the clinical records of a primary care management area (PCMA) by means of an intervention programme. Intervention study without a control, using evaluation and improvement-of-quality methods. We chose 4 criteria from the minimum technical standards: personal history (PH), family background (FB), allergies to medicines (AM) and list of problems (LP). We evaluated overall compliance and compliance per primary care team (PCT) through batch quality acceptance of samples (LQAS), designed an intervention to improve the situation, and then re-evaluated. PCMA of Murcia (45 PCTs). Participants. 42 PCTs (3 were excluded because they had poor coverage in their records). These lasted 12 months (October 1999-October 2000) and involved the following: graphic report per PCT; session with the PCT; discussion on results and strategies in the Area Management Council; and inclusion of an explicit objective, with incentives, in the management contracts. Significant improvement of the four criteria of the PCMA (improvements: FB, 48.1%; PH, 51.1%; AM, 55.4%; LP, 50.9%). LQAS analysis: we rejected 24 batches (14.3%) at the 1st evaluation and 15 (9.0%) at the second, with FB being the criterion most rejected in both instances. Defects appeared in 14 PCT (33.3%; 3 PCT accounted for 41.7%) at the 1st evaluation, and 7 PCT at the re-evaluation (16.7%; 2 reaching 46.7%). The presence of essential clinical data in clinical records has improved. LQAS proved to be a rapid and simple method for evaluating, improving and monitoring quality in primary care.

Production of Ultrafine, High-purity Ceramic Powders Using the US Bureau of Mines Developed Turbomill

NASA Technical Reports Server (NTRS)

Hoyer, Jesse L.

1993-01-01

Turbomilling, an innovative grinding technology developed by the U.S. Bureau of Mines in the early 1960's for delaminating filler-grade kaolinitic clays, has been expanded into the areas of particle size reduction, material mixing, and process reaction kinetics. The turbomill, originally called an attrition grinder, has been used for particle size reduction of many minerals, including natural and synthetic mica, pyrophyllite, talc, and marble. In recent years, an all-polymer version of the turbomill has been used to produce ultrafine, high-purity, advanced ceramic powders such as SiC, Si3N4, TiB2, and ZrO2. In addition to particle size reduction, the turbomill has been used to produce intimate mixtures of high surface area powders and whiskers. Raw materials, TiN, AlN, and Al2O3, used to produce a titanium nitride/aluminum oxynitride (TiN/AlON) composite, were mixed in the turbomill, resulting in strength increases over samples prepared by dry ball milling. Using the turbomill as a leach vessel, it was found that 90.4 pct of the copper was extracted from the chalcopyrite during a 4-hour leach test in ferric sulfate versus conventional processing which involves either roasting of the ore for Cu recovery or leaching of the ore for several days.

Ratcheting Behavior of a Titanium-Stabilized Interstitial Free Steel

NASA Astrophysics Data System (ADS)

De, P. S.; Chakraborti, P. C.; Bhattacharya, B.; Shome, M.; Bhattacharjee, D.

2013-05-01

Engineering stress-control ratcheting behavior of a titanium-stabilized interstitial free steel has been studied under different combinations of mean stress and stress amplitude at a stress rate of 250 MPa s-1. Tests have been done up to 29.80 pct true ratcheting strain evolution in the specimens at three maximum stress levels. It is observed that this amount of ratcheting strain is more than the uniform tensile strain at a strain rate of 10-3 s-1 and evolves without showing tensile instability of the specimens. In the process of ratcheting strain evolution at constant maximum stresses, the effect of increasing stress amplitude is found to be more than that of increasing the mean stress component. Further, the constant maximum stress ratcheting test results reveal that the number of cycles ( N) required for 29.80 pct. true ratcheting strain evolution exponentially increases with increase of stress ratio ( R). Post-ratcheting tensile test results showing increase of strength and linear decrease in ductility with increasing R at different constant maximum stresses indicate that stress parameters used during ratcheting tests influence the size of the dislocation cell structure of the steel even with the same amount of ratcheting strain evolution. It is postulated that during ratcheting fatigue, damage becomes greater with the increase of R for any fixed amount of ratcheting strain evolution at constant maximum stress.

Galvanizability of Advanced High-Strength Steels 1180TRIP and 1180CP

NASA Astrophysics Data System (ADS)

Kim, M. S.; Kwak, J. H.; Kim, J. S.; Liu, Y. H.; Gao, N.; Tang, N.-Y.

2009-08-01

In general, Si-bearing advanced high-strength steels (AHSS) possess excellent mechanical properties but poor galvanizability. The galvanizability of a transformation-induced plasticity (TRIP) steel 1180TRIP containing 2.2 pct Mn and 1.7 pct Si and a complex phase steel 1180CP containing 2.7 pct Mn and 0.2 pct Si was extensively studied using a galvanizing simulator. The steel coupons were annealed at fixed dew points in the simulator. The surface features of the as-annealed steel coupons, together with galvanized and galvannealed coatings, were carefully examined using a variety of advanced analysis techniques. It was found that various oxides formed on the surface of these steels, depending on the steel composition and on the dew point control. Coating quality was good at 0 °C dew point but deteriorated as the dew point decreased to -35 °C and -65 °C. Based on the findings, guidance was provided for improving galvanizability by adjusting the Mn:Si ratio in steel compositions according to the dew point.

Development of a unique laboratory standard: Indium gallium arsenide detector for the 500-1700 nm spectral region

NASA Technical Reports Server (NTRS)

1987-01-01

A planar (5 mm diameter) indium gallium arsenide detector having a high (greater than 50 pct) quantum efficiency from the visible into the infrared spectrum (500 to 1700 nm) was fabricated. Quantum efficiencies as high as 37 pct at 510 nm, 58 pct at 820 nm and 62 pct at 1300 nm and 1550 nm were measured. A planar InP/InGaAs detector structure was also fabricated using vapor phase epitaxy to grow device structures with 0, 0.2, 0.4 and 0.6 micrometer thick InP caps. Quantum efficiency was studied as a function of cap thickness. Conventional detector structures were also used by completely etching off the InP cap after zinc diffusion. Calibrated quantum efficiencies were measured. Best results were obtained with devices whose caps were completely removed by etching. Certain problems still remain with these detectors including non-uniform shunt resistance, reproducibility, contact resistance and narrow band anti-reflection coatings.

Strengthening Mechanisms in Thermomechanically Processed NbTi-Microalloyed Steel

NASA Astrophysics Data System (ADS)

Kostryzhev, Andrii G.; Marenych, Olexandra O.; Killmore, Chris R.; Pereloma, Elena V.

2015-08-01

The effect of deformation temperature on microstructure and mechanical properties was investigated for thermomechanically processed NbTi-microalloyed steel with ferrite-pearlite microstructure. With a decrease in the finish deformation temperature at 1348 K to 1098 K (1075 °C to 825 °C) temperature range, the ambient temperature yield stress did not vary significantly, work hardening rate decreased, ultimate tensile strength decreased, and elongation to failure increased. These variations in mechanical properties were correlated to the variations in microstructural parameters (such as ferrite grain size, solid solution concentrations, precipitate number density and dislocation density). Calculations based on the measured microstructural parameters suggested the grain refinement, solid solution strengthening, precipitation strengthening, and work hardening contributed up to 32 pct, up to 48 pct, up to 25 pct, and less than 3 pct to the yield stress, respectively. With a decrease in the finish deformation temperature, both the grain size strengthening and solid solution strengthening increased, the precipitation strengthening decreased, and the work hardening contribution did not vary significantly.

Study of dosimetric variation due to interfraction organ movement in High Dose Rate Interstital (MUPIT) brachytherapy for gynecologic malignancies

NASA Astrophysics Data System (ADS)

Velmurugan, Thanigaimalai; Sukumar, Prabakar; Krishnappan, Chokkalingam; Boopathy, Raghavendiran

2010-01-01

Ten patients with cancer of uterine cervix who underwent interstitial brachytherapy using MUPIT templates were CT scanned (CT1) using which bladder, rectum and CTV were delineated. The treatment plan PCT1 was generated and optimized geometrically on the volume. CT scan (CT2) was repeated before the second fraction of the treatment CTV and critical organs were delineated. The plan (PCT2) was created by reproducing the Plan PCT1 in the CT2 images and compared with PCT1. Bladder, Rectum and CTV percentage volume variation ranges from +28.6% to -34.3%, 38.4% to -14.9% and 8.5% to -15.2% respectively. Maximum dose variation in bladder was +17.1%, in rectum was up to +410% and in CTV was -13.0%. The dose to these structures varies independently with no strong correlation with the volume variation. Hence it is suggested that repeat CT and re-planning is mandatory before second fraction execution.

Combined biomarkers discriminate a low likelihood of bacterial infection among surgical intensive care unit patients with suspected sepsis

PubMed Central

Kelly, Brendan J.; Lautenbach, Ebbing; Nachamkin, Irving; Coffin, Susan E.; Gerber, Jeffrey S.; Fuchs, Barry D.; Garrigan, Charles; Han, Xiaoyan; Bilker, Warren B.; Wise, Jacqueleen; Tolomeo, Pam; Han, Jennifer H.

2016-01-01

Among surgical intensive care unit (SICU) patients, it is difficult to distinguish bacterial sepsis from other causes of systemic inflammatory response syndrome (SIRS). Biomarkers have proven useful to identify the presence of bacterial infection. We enrolled a prospective cohort of 69 SICU patients with suspected sepsis and assayed the concentrations of nine biomarkers (α-2 macroglobulin (A2M), C-reactive protein, ferritin, fibrinogen, haptoglobin, procalcitonin (PCT), serum amyloid A, serum amyloid P, and tissue plasminogen activator) at baseline, 24-, 48-, and 72-hours. 42 patients (61%) had bacterial sepsis by chart review. A2M concentrations were significantly lower and PCT concentrations significantly higher in subjects with bacterial sepsis at three of four timepoints. Using optimal cutoff values, the combination of baseline A2M and 72-hour PCT achieved a negative predictive value of 75% (95% CI, 54%–96%). The combination of A2M and PCT discriminated bacterial sepsis from other SIRS among SICU patients with suspected sepsis. PMID:26971636

Application of fluence field modulation to proton computed tomography for proton therapy imaging.

PubMed

Dedes, G; De Angelis, L; Rit, S; Hansen, D; Belka, C; Bashkirov, V; Johnson, R P; Coutrakon, G; Schubert, K E; Schulte, R W; Parodi, K; Landry, G

2017-07-12

This simulation study presents the application of fluence field modulated computed tomography, initially developed for x-ray CT, to proton computed tomography (pCT). By using pencil beam (PB) scanning, fluence modulated pCT (FMpCT) may achieve variable image quality in a pCT image and imaging dose reduction. Three virtual phantoms, a uniform cylinder and two patients, were studied using Monte Carlo simulations of an ideal list-mode pCT scanner. Regions of interest (ROI) were selected for high image quality and only PBs intercepting them preserved full fluence (FF). Image quality was investigated in terms of accuracy (mean) and noise (standard deviation) of the reconstructed proton relative stopping power compared to reference values. Dose calculation accuracy on FMpCT images was evaluated in terms of dose volume histograms (DVH), range difference (RD) for beam-eye-view (BEV) dose profiles and gamma evaluation. Pseudo FMpCT scans were created from broad beam experimental data acquired with a list-mode pCT prototype. FMpCT noise in ROIs was equivalent to FF images and accuracy better than  -1.3%(-0.7%) by using 1% of FF for the cylinder (patients). Integral imaging dose reduction of 37% and 56% was achieved for the two patients for that level of modulation. Corresponding DVHs from proton dose calculation on FMpCT images agreed to those from reference images and 96% of BEV profiles had RD below 2 mm, compared to only 1% for uniform 1% of FF. Gamma pass rates (2%, 2 mm) were 98% for FMpCT while for uniform 1% of FF they were as low as 59%. Applying FMpCT to preliminary experimental data showed that low noise levels and accuracy could be preserved in a ROI, down to 30% modulation. We have shown, using both virtual and experimental pCT scans, that FMpCT is potentially feasible and may allow a means of imaging dose reduction for a pCT scanner operating in PB scanning mode. This may be of particular importance to proton therapy given the low integral dose found outside the target.

Ability of procalcitonin to predict bacterial meningitis in the emergency department.

PubMed

Morales Casado, M I; Moreno Alonso, F; Juárez Belaunde, A L; Heredero Gálvez, E; Talavera Encinas, O; Julián-Jiménez, A

2016-01-01

The aim of this study was to analyse and compare procalcitonin (PCT) and C-reactive protein (CRP) as tools for detecting bacterial meningitis and predicting bacteraemia. Prospective, observational, and descriptive analytical study of 98 consecutive patients aged ≥15 years and diagnosed with acute meningitis in an emergency department between August 2009 and July 2013. We analysed 98 patients with AM (66 males [67%]); mean age was 44±21 years. The diagnosis was bacterial meningitis in 38 patients (20 with bacteraemia); viral meningitis in 33; probable viral meningitis in 15; and presumptively diagnosed partially treated acute meningitis in 12. PCT had the highest area under the ROC curve (AUC) (0.996; 95% CI, 0.987-1; p<0.001). With a cutoff of ≥ 0.74 ng/ml, PCT achieved 94.7% sensitivity, 100% specificity, negative predictive value (NPV) of 93.9%, and positive predictive value (PPV) of 100%. The mean levels for PCT were11.47±7.76 ng/ml in bacterial meningitis vs. 0.10±0.15 ng/ml in viral meningitis (p <0.001). The AUC for CRP was 0.916 and a cutoff of ≥ 90 mg/L achieved 67.5% sensitivity, 86.3% specificity, PPV of 89.2%, and NPV of 90.4%. As a predictor of bacteraemia in bacterial meningitis, only PCT delivered a significant difference (14.7±7.1 ng/mL vs. 4.68±3.54 ng/mL, p<0.001). A cutoff of ≥ 1.1 ng/mL achieved 94.6% sensitivity, 72.4% specificity, NPV of 95.4%, and PPV of 69.2%; the AUC was 0.965 (95% CI, 0.921-1; p<0.001). PCT has a high diagnostic power for acute meningitis in emergency department patients. PCT outperforms CRP in the detection of bacterial aetiology and is a good predictor of bacteraemia in bacterial meningitis. Copyright © 2014 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

Thermoelectric properties of hot pressed p-type SiGe alloys

NASA Technical Reports Server (NTRS)

Bajgar, Clara; Masters, Richard; Scoville, Nancy; Vandersande, Jan

1991-01-01

This paper presents the results of measurements of electrical resistivity, Seebeck coefficient, thermal conductivity, as well as Hall carrier concentration, and mobility, for hot pressed SiGe 80 at. pct Si-20 at. pct Ge (SiGe) thermoelectric materials containing 0.24-3.0 at. pct boron. The carrier concentration was varied by annealing and quenching at different high temperatures. Figure-of-merit, Z, was found to be 0.60 +/- 0.03 x 10 exp -3/K over a carrier concentration range from 1.8- 3.5 x 10 exp -20/cu cm. This result is very encouraging from a production standpoint, since the dopant concentration is not critical.

Department of Defense CHAMPUS Ambulatory Professional Services Summary Analysis, Fiscal Year 1991

DTIC Science & Technology

1991-11-21

CONTINUED) CPT4 TOTAL AD RET/ RET/DEC CODE CPT4 NAME (SHORT) PROC DEP PCT DEC PCT DEP PCT 97520 PROSTHETIC TRAINING 40 11 27.5% 8 20.0% 21 52.5% 93510...219 27.8% 491 62.2% 51726 COMPLEX CYSTOMETROGRAM 782 207 26.5% 146 18.7% 429 54.9% 25600 TREAT FRACTURE RADIUS/ULN 754 509 67.5% 25 3.3% 220 29.2...11701 SURGICAL CLEANSING OF NAI 483 19 3.9. 146 30.2% 318 65.8% 25605 TREAT FRACTURE RADIUS/ULN 482 254 52.7% 26 5.4% 202 41.9% 51720 TREATMENT OF

Noble gases released by vacuum crushing of EETA 79001 glass

NASA Technical Reports Server (NTRS)

Wiens, R. C.

1988-01-01

An EETA 79001 glass sample was crushed in a vacuum to observe the gases released. About 15 pct of the total gas concentrations were a mixture of a small amount of SPB-type gas with larger proportions of another air-like component. Less than 5 pct of the SPB gas was released by crushing, while 36-40 pct of the EETV (indigenous) gas was crush-released. The results are consistent with a siting of the EETV component in 10-100 micron vesicles seen in the glass. It is suggested that the SPB component is either in vesicles less than 6 microns in diameter or is primarily sited elsewhere.

78 FR 35637 - Prospective Grant of Exclusive License: Modulation of Poliovirus Replicative Fitness by...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-13

... Grant of Exclusive License: Modulation of Poliovirus Replicative Fitness by Deoptimization of Synonymous... Replicative Fitness by Deoptimization of Synonymous Codons''; PCT Application PCT/US05/036241, filed 10/7/ 2005, entitled ``Modulation of Poliovirus Replicative Fitness by Deoptimization of Synonymous Codons...

Long Range Plan, 1991-1994.

ERIC Educational Resources Information Center

Pennsylvania Coll. of Technology, Williamsport.

This long-range plan for the Pennsylvania College of Technology (PCT) is divided into three main sections. Part I provides an overview of planning at PCT, including a definition of long-range planning, the college philosophy, mission, and vision statements, major institutional initiatives for 1991-92, and accreditation agency recommendations…

Effect of Co Addition on the Microstructure, Martensitic Transformation and Shape Memory Behavior of Fe-Mn-Si Alloys

NASA Astrophysics Data System (ADS)

Maji, Bikas C.; Krishnan, Madangopal; Sujata, M.; Gouthama; Ray, Ranjit K.

2013-01-01

The effect of Co addition has been studied in Fe-30Mn-6Si- xCo ( x = 0 to 9 wt pct) shape memory alloys in terms of their microstructure, martensitic transformation and shape recovery. Microstructural investigations reveal that in Fe-Mn-Si-Co alloys, the microstructure remains single-phase austenite (γ) up to 5 pct Co and beyond that becomes two-phase comprising γ and off-stoichiometric (Fe,Co)5Mn3Si2 intermetallic π-phases. The forward γ-ɛ martensite transformation start temperature ( M S) decreases with the addition of Co up to 5 pct, and alloys containing more than 5 pct Co, show slightly higher M S possibly on account of two-phase microstructure. Unlike M S, the ɛ-γ reverse transformation start temperature ( A S) has been found to remain almost unaltered by Co addition. In general, addition of Co to Fe-Mn-Si alloys deteriorates shape recovery due to decreasing resistance to plastic yielding concomitant with the formation of stress induced ɛ martensite. However, there is an improvement in shape recovery beyond 5 pct Co addition, possibly due to the strengthening effect arising from the presence of (Fe,Co)5Mn3Si2 precipitates within the two-phase microstructure and due to higher amount of stress induced ɛ martensite.

Diagnostic accuracy of presepsin (sCD14-ST) as a biomarker of infection and sepsis in the emergency department.

PubMed

de Guadiana Romualdo, Luis García; Torrella, Patricia Esteban; Acebes, Sergio Rebollo; Otón, María Dolores Albaladejo; Sánchez, Roberto Jiménez; Holgado, Ana Hernando; Santos, Enrique Jiménez; Freire, Alejandro Ortín

2017-01-01

Presepsin is a promising biomarker for the diagnosis and prognosis of sepsis. However, results reported about its value to diagnose sepsis in an emergency department (ED) are controversial, probably due to differences in the design of the studies. We have evaluated the diagnostic accuracy of presepsin for infection and sepsis, compared with procalcitonin (PCT) and C-reactive protein (CRP), in patients presenting to the emergency department (ED) with suspected infection. 223 patients with suspected infection were enrolled for the study. Blood samples were collected on admission for measurement of biomarkers. Definitive diagnosis was obtained afterwards by analysis of digital medical records. Receiver operating characteristic (ROC) curve analysis was conducted to determine the diagnostic accuracy. Infection was confirmed in 200 patients, including 130 with non-complicated infection and 70 with sepsis. Median CRP, PCT and presepsin levels were significantly higher in patients with infection and sepsis. PCT was the biomarker with the highest performance for infection (ROC AUC: 0.910); for sepsis, PCT (ROC AUC: 0.815) and presepsin (ROC AUC: 0.775) shown a similar performance. Although presepsin is a valuable biomarker for diagnosis of infection and sepsis, its diagnostic accuracy in our study does not improve that of PCT. Its introduction in clinical practice is not justified. Copyright © 2016 Elsevier B.V. All rights reserved.

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

Wang, P; Cammin, J; Solberg, T

Purpose: Proton radiography and proton computed tomography (PCT) can be used to measure proton stopping power directly. However, practical and cost effective proton imaging detectors are not widely available. In this study, the authors investigated the feasibility of proton imaging using a silicon diode array. Methods: A one-dimensional silicon-diode detector array (1DSDA) was aligned with the central axis (CAX) of the proton beam. Polymethyl methacrylate (PMMA) slabs were used to find the correspondence between the water equivalent thickness (WET) and 1DSDA channel number. 2D proton radiographs (PR) were obtained by translation and rotation of a phantom relative to CAX whilemore » the proton nozzle and 1DSDA were kept stationary. A PCT image of one slice of the phantom was reconstructed using filtered backprojection. Results: PR and PCT images of the PMMA cube were successfully acquired using the 1DSDA. The WET of the phantom was measured using PR data with an accuracy of 4.2% or better. Structures down to 1 mm in size could be resolved. Reconstruction of a PCT image showed very good agreement with simulation. Limitations in spatial resolution are attributed to limited spatial sampling, beam collimation, and proton scatter. Conclusion: The results demonstrate the feasibility of using silicon diode arrays for proton imaging. Such a device can potentially offer fast image acquisition, high spatial and energy resolution for PR and PCT.« less

Paraequilibrium Carburization of Duplex and Ferritic Stainless Steels

NASA Astrophysics Data System (ADS)

Michal, G. M.; Gu, X.; Jennings, W. D.; Kahn, H.; Ernst, F.; Heuer, A. H.

2009-08-01

AISI 301 and E-BRITE stainless steels were subjected to low-temperature (743 K) carburization experiments using a commercial technology developed for carburization of 316 austenitic stainless steels. The AISI 301 steel contained ~40 vol pct ferrite before carburization but had a fully austenitic hardened case, ~20- μm thick, and a surface carbon concentration of ~8 at. pct after treatment; this “colossal” paraequilibrium carbon supersaturation caused an increase in lattice parameter of ~3 pct. The E-BRITE also developed a hardened case, 12- to 18- μm thick, but underwent a more modest (~0.3 pct) increase in lattice parameter; the surface carbon concentration was ~10 at. pct. While the hardened case on the AISI 301 stainless steel appeared to be single-phase austenite, evidence for carbide formation was apparent in X-ray diffractometer (XRD) scans of the E-BRITE. Paraequilibrium phase diagrams were calculated for both AISI 301 and E-BRITE stainless steels using a CALPHAD compound energy-based interstitial solid solution model. In the low-temperature regime of interest, and based upon measured paraequilibrium carbon solubilities, more negative Cr-carbon interaction parameters for austenite than those in the current CALPHAD data base may be appropriate. A sensitivity analysis involving Cr-carbon interaction parameters for ferrite found a strong dependence of carbon solubility on relatively small changes in the magnitude of these parameters.

Manufacture of a UO2-Based Nuclear Fuel with Improved Thermal Conductivity with the Addition of BeO

NASA Astrophysics Data System (ADS)

Garcia, Chad B.; Brito, Ryan A.; Ortega, Luis H.; Malone, James P.; McDeavitt, Sean M.

2017-12-01

The low thermal conductivity of oxide nuclear fuels is a performance-limiting parameter. Enhancing this property may provide a contribution toward establishing accident-tolerant fuel forms. In this study, the thermal conductivity of UO2 was increased through the fabrication of ceramic-ceramic composite forms with UO2 containing a continuous BeO matrix. Fuel with a higher thermal conductivity will have reduced thermal gradients and lower centerline temperatures in the fuel pin. Lower operational temperatures will reduce fission gas release and reduce fuel restructuring. Additions of BeO were made to UO2 fuel pellets in 2.5, 5, 7.5, and 10 vol pct concentrations with the goals of establishing reliable lab-scale processing procedures, minimizing porosity, and maximizing thermal conductivity. The microstructure was characterized with electron probe microanalysis, and the thermal properties were assessed by light flash analysis and differential scanning calorimetry. Reliable, high-density samples were prepared using compaction pressure between 200 and 225 MPa and sintering times between 4 and 6 hours. It was found that the thermal conductivity of UO2 improved approximately 10 pct for each 1 vol pct BeO added over the measured temperature range 298.15 K to 523.15 K (25 °C to 250 °C) with the maximum observed improvement being ˜ 100 pct, or doubled, at 10 vol pct BeO.

16 CFR 1615.4 - Test procedure.

Code of Federal Regulations, 2012 CFR

2012-01-01

...) Specimen holder. The specimen holder is designed to permit suspension of the specimen in a fixed vertical... series of loads for char length determinations. Suitable metal hooks consist of No. 19 gauge steel wire... least 8 h at 21±1.1 °C (70±2 °F) and 65±2 pct relative humidity. Shorter conditioning times may be used...

Structural Characteristics and In Vitro Biodegradation of a Novel Zn-Li Alloy Prepared by Induction Melting and Hot Rolling

NASA Astrophysics Data System (ADS)

Zhao, Shan; McNamara, Cameron T.; Bowen, Patrick K.; Verhun, Nicholas; Braykovich, Jacob P.; Goldman, Jeremy; Drelich, Jaroslaw W.

2017-03-01

Zinc shows great promise as a bioabsorbable metal; however, the low tensile strength of pure zinc limits its application for endovascular stent purposes. In this study, a new Zn- xLi alloy (with x = 2, 4, 6 at. pct) was prepared by induction melting in an argon atmosphere and processed through hot rolling. Structures of the formulated binary alloys were characterized by X-ray diffraction and optical microscopy. Mechanical testing showed that the incorporation of Li into Zn increased ultimate tensile strength from <120 MPa (pure Zn) to >560 MPa ( x = 6 at. pct). In vitro corrosion behavior was evaluated by immersion tests in simulated body fluid. The Zn-2Li and Zn-4Li corrosion study demonstrated that corrosion rates and products resemble those observed for pure Zn in vivo, and in addition, the Zn-4Li alloy exhibits higher resistance to corrosion as compared to Zn-2Li. The findings herein encourage further exploration of Zn-Li systems for structural use in biomedical vascular support applications with the ultimate goal of simplifying stent procedures, thereby reducing stent-related complications.

7 CFR 51.2954 - Tolerances for grade defects.

Code of Federal Regulations, 2012 CFR

2012-01-01

... grades as indicated. Terms in quotation marks refer to color classifications illustrated on the color chart. Tolerances for Grade Defects Grade External (shell) defects Internal (kernel) defects Color of... tolerance to reduce the required 70 pct of “light amber” kernels or the required 40 pct of “light” kernels...

7 CFR 51.2954 - Tolerances for grade defects.

Code of Federal Regulations, 2014 CFR

2014-01-01

... meet the requirements of the respective grades as indicated. Terms in quotation marks refer to color classifications illustrated on the color chart. Tolerances for Grade Defects Grade External (shell) defects Internal (kernel) defects Color of kernel U.S. No. 1. 10 pct, by count for splits. 5 pct. by count, for...

7 CFR 51.2954 - Tolerances for grade defects.

Code of Federal Regulations, 2013 CFR

2013-01-01

... meet the requirements of the respective grades as indicated. Terms in quotation marks refer to color classifications illustrated on the color chart. Tolerances for Grade Defects Grade External (shell) defects Internal (kernel) defects Color of kernel U.S. No. 1. 10 pct, by count for splits. 5 pct. by count, for...

Long Range Plan, 1997-2000.

ERIC Educational Resources Information Center

Pennsylvania Coll. of Technology, Williamsport. Office of Strategic Planning and Research.

At Pennsylvania College of Technology (PCT), long range planning is used to define institutional philosophy and mission and determine strategies to make the best use of available resources and implement actions to fulfill institutional mission. This document presents PCT's long-range plan for 1997-2000 in three parts. The first part describes long…

Cognitive-Behavioral Treatment of Panic Disorder in Adolescence

ERIC Educational Resources Information Center

Pincus, Donna B.; May, Jill Ehrenreich; Whitton, Sarah W.; Mattis, Sara G.; Barlow, David H.

2010-01-01

This investigation represents the first randomized controlled trial to evaluate the feasibility and efficacy of Panic Control Treatment for Adolescents (PCT-A). Thirteen adolescents, ages 14 to 17, were randomized to 11 weekly sessions of PCT-A treatment, whereas 13 were randomized to a self-monitoring control group. Results indicate that…

PCT funding. Beggars belief.

PubMed

Hacking, John

2003-04-10

At the pace of change set for implementing the new PCT funding formula over the next three years, it will take more than 20 years to achieve equity. If the minimum increases were set lower it would largely be achieved within five years. The current state of affairs perpetuates the north-south health divide.

Intraoperative Computed Tomography (CT) for Treating Giant Carotid Intracavernous Aneurysms

PubMed Central

Xue, Zhe; Wang, Fuyu; Sun, Zhenghui; Zhang, Hui; Wu, Chen; Kong, Dongsheng; Xu, Bainan

2017-01-01

Background Giant carotid intracavernous aneurysm refers to those lesions larger than 2.5 cm and derived from a cavernous segment, accounting for about 30% of all intracranial tumors. Dynamic CT perfusion imaging (PCT) is a common method recently employed to evaluate cerebral perfusion. This study investigated the efficacy and clinical application of intraoperative CT in the surgery for giant symptomatic carotid intracavernous aneurysm. Material/Methods A retrospective analysis was performed on 23 cases with giant symptomatic carotid intracavernous aneurysm. BTO testing was performed before surgery. Differential treatments were performed based on the condition of aneurysm, and some patients received intraoperative PCT. Postoperative anti-coagulation was given with DSA or CTA follow-up examinations at 3–6 months, 1 year, and 2 years after surgery. Results A total of 17 patients received aneurysm isolation coupled with high-flow bypass surgery. Among those, 9 developed early-onset neurological function after surgery, with gradual recover within 6 months. One coma patient died 25 months after discharge. One patient had aneurysm isolation with clapping of anterior communicating artery, and the other 5 cases received artery clapping only. In those patients, 4 had improvement at early phase, while 1 patient had numbness of the oculomotor nerve. Six patients received surgery in the CT room, including 5 cases with single proximal ligation of the internal carotid artery plus 1 aneurysm isolation combined with high-flow bypass surgery. Conclusions Intraoperative PCT can provide objective evidence and effective evaluation of cerebral perfusion. PMID:28640793

Chemical composition analysis and product consistency tests supporting refinement of the Nepheline model for the high aluminum Hanford Glass composition region

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

Fox, K. M.; Edwards, T. B.; Mcclane, D. L.

2016-02-17

In this report, SRNL provides chemical analyses and Product Consistency Test (PCT) results for a series of simulated HLW glasses fabricated by Pacific Northwest National Laboratory (PNNL) as part of an ongoing nepheline crystallization study. The results of these analyses will be used to improve the ability to predict crystallization of nepheline as a function of composition and heat treatment for glasses formulated at high alumina concentrations.

Chemical composition analysis and product consistency tests supporting refinement of the Nepheline Model for the high aluminum Hanford glass composition region

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

Fox, K. M.; Edwards, T. B.; Mcclane, D. L.

2016-03-01

In this report, Savannah River National Laboratory provides chemical analyses and Product Consistency Test (PCT) results for a series of simulated high level waste (HLW) glasses fabricated by Pacific Northwest National Laboratory (PNNL) as part of an ongoing nepheline crystallization study. The results of these analyses will be used to improve the ability to predict crystallization of nepheline as a function of composition and heat treatment for glasses formulated at high alumina concentrations.

Correlation Between Pre-annealing Temperature and {110}<001> Annealing Texture in C- and Al-Free Fe-3 Pct Si-0.1 Pct Mn-0.002 Pct S Electrical Steel

NASA Astrophysics Data System (ADS)

Oh, Eun Jee; Heo, Nam Hoe; Koo, Yang Mo

2017-06-01

In C- and Al-free electrical steel, the increase in primary grain size with increasing pre-annealing temperature causes the transition in annealing texture after final annealing from {110} + {100} to {110}. The strip pre-annealed at 1073 K (800 °C) shows a low magnetic induction B8(T) of 1.784 T after final annealing. The strip pre-annealed at 1223 K (950 °C) shows a sharp {110}<001> Goss texture, producing a high magnetic induction B8(T) of 1.914 T comparable to that of the conventional electrical steels.

A patch-based pseudo-CT approach for MRI-only radiotherapy in the pelvis

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

Andreasen, Daniel, E-mail: dana@dtu.dk

Purpose: In radiotherapy based only on magnetic resonance imaging (MRI), knowledge about tissue electron densities must be derived from the MRI. This can be achieved by converting the MRI scan to the so-called pseudo-computed tomography (pCT). An obstacle is that the voxel intensities in conventional MRI scans are not uniquely related to electron density. The authors previously demonstrated that a patch-based method could produce accurate pCTs of the brain using conventional T{sub 1}-weighted MRI scans. The method was driven mainly by local patch similarities and relied on simple affine registrations between an atlas database of the co-registered MRI/CT scan pairsmore » and the MRI scan to be converted. In this study, the authors investigate the applicability of the patch-based approach in the pelvis. This region is challenging for a method based on local similarities due to the greater inter-patient variation. The authors benchmark the method against a baseline pCT strategy where all voxels inside the body contour are assigned a water-equivalent bulk density. Furthermore, the authors implement a parallelized approximate patch search strategy to speed up the pCT generation time to a more clinically relevant level. Methods: The data consisted of CT and T{sub 1}-weighted MRI scans of 10 prostate patients. pCTs were generated using an approximate patch search algorithm in a leave-one-out fashion and compared with the CT using frequently described metrics such as the voxel-wise mean absolute error (MAE{sub vox}) and the deviation in water-equivalent path lengths. Furthermore, the dosimetric accuracy was tested for a volumetric modulated arc therapy plan using dose–volume histogram (DVH) point deviations and γ-index analysis. Results: The patch-based approach had an average MAE{sub vox} of 54 HU; median deviations of less than 0.4% in relevant DVH points and a γ-index pass rate of 0.97 using a 1%/1 mm criterion. The patch-based approach showed a significantly better performance than the baseline water pCT in almost all metrics. The approximate patch search strategy was 70x faster than a brute-force search, with an average prediction time of 20.8 min. Conclusions: The authors showed that a patch-based method based on affine registrations and T{sub 1}-weighted MRI could generate accurate pCTs of the pelvis. The main source of differences between pCT and CT was positional changes of air pockets and body outline.« less

75 FR 8981 - Prospective Grant of Exclusive License: Treatment of Glaucoma by Administration of Adenosine A3...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-26

... practice the inventions embodied in U.S. Provisional Patent Application 60/010,737, entitled... Patent Application 60/021,191, entitled ``Dihydropyridine, pyridine-, benzopyran one-, and... [HHS Ref. No. E-225-1995/1-US-1], PCT Application PCT/US97/01252, entitled ``Dihydropyridine, pyridine...

Person-Centered Therapy: A Philosophy to Support Early Childhood Education

ERIC Educational Resources Information Center

Boyer, Wanda

2016-01-01

Person-centered therapy (PCT) comes from the experiential and relationship-oriented therapy tradition. It is considered to be a third force in therapeutic engagement, along with the psychoanalytic and behavioral approaches. PCT is based on faith in and empowerment of human beings to be joyful, creative, self-fulfilled and willing and able to…

37 CFR 1.437 - The drawings.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false The drawings. 1.437 Section 1... Application § 1.437 The drawings. (a) Drawings are required when they are necessary for the understanding of the invention (PCT Art. 7). (b) The physical requirements for drawings are set forth in PCT Rule 11...

A Comparison of Alprazolam and Behavior Therapy in Treatment of Panic Disorder.

ERIC Educational Resources Information Center

Klosko, Janet S.; And Others

1990-01-01

Compared panic control treatment (PCT), behavior therapy for panic disorders, with alprazolam medication, placebo, and waiting-list control groups. Percentage of clients (N=57) completing study who were free of panic attacks following PCT was 87 percent, compared with 50 percent for alprazolam, 36 percent for placebo, and 33 percent for…

78 FR 40020 - Fenbuconazole; Pesticide Tolerances

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-03

... average PCT is less than one. In those cases, 1% is used as the average PCT and 2.5% is used as the... one of the following methods: Federal eRulemaking Portal: http://www.regulations.gov . Follow the... validity, completeness, and reliability as well as the relationship of the results of the studies to human...

75 FR 18825 - Advantage Electronic Product Development Incorporated/Utility Crew Safety LLC

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-13

... described in U.S. Patent Application No. 12/401,033, entitled ``Ground Potential Rise Monitor,'' and PCT/US10/26189, entitled ``Ground Potential Rise Monitor,'' in the United States and in foreign countries... embodied in U.S. Patent Application No. 12/401,033, entitled ``Ground Potential Rise Monitor'' and PCT...

Treating Comorbid Panic Disorder in Veterans With Posttraumatic Stress Disorder

ERIC Educational Resources Information Center

Teng, Ellen J.; Bailey, Sara D.; Chaison, Angelic D.; Petersen, Nancy J.; Hamilton, Joseph D.; Dunn, Nancy Jo

2008-01-01

This study compares the effectiveness of panic control treatment (PCT) with that of a psychoeducational supportive treatment (PE-SUP) in treating panic disorder among a veteran sample with a primary diagnosis of chronic posttraumatic stress disorder (PTSD). Thirty-five patients randomized to receive 10 individual sessions of either PCT or PE-SUP…

The effect of trace additions of Zn on the precipitation behavior of alloy 8090 during artificial aging

NASA Technical Reports Server (NTRS)

Kilmer, R. J.; Stoner, G. E.

1991-01-01

The effect(s) of trace additions of Zn to the artificial aging behavior of alloy 8090 (Al-Li-Cu-Mg-Zr) was investigated in the approximate composition range 0-1 wt-pct Zn. Trace Zn additions were found to delay aging and under equivalent aging treatments (100 hrs at 160 C) the alloy without Zn and the 1.07 wt-pct Zn alloy developed delta-prime-free zones along subgrain boundaries, while the alloys of 0.21 and 0.58 wt-pct Zn did not. DSC analysis indicated that Zn was being incorporated into the delta-prime, shifting it's exotherm to higher temperatures, while having little if any effect on its associated endotherm making it unlikely that it is an artifact of a solvus shift. In the 8090 + 1.07 wt-pct Zn alloy, coarse precipitates were found to reside on subgrain boundaries and EDS indicated that they were rich in Cu and Zn. It was also noted that in the Zn containing 8090 varients, the S prime precipitates were more coarse in size than the baseline 8090.

Space sickness predictors suggest fluid shift involvement and possible countermeasures

NASA Technical Reports Server (NTRS)

Simanonok, K. E.; Moseley, E. C.; Charles, J. B.

1992-01-01

Preflight data from 64 first time Shuttle crew members were examined retrospectively to predict space sickness severity (NONE, MILD, MODERATE, or SEVERE) by discriminant analysis. From 9 input variables relating to fluid, electrolyte, and cardiovascular status, 8 variables were chosen by discriminant analysis that correctly predicted space sickness severity with 59 pct. success by one method of cross validation on the original sample and 67 pct. by another method. The 8 variables in order of their importance for predicting space sickness severity are sitting systolic blood pressure, serum uric acid, calculated blood volume, serum phosphate, urine osmolality, environmental temperature at the launch site, red cell count, and serum chloride. These results suggest the presence of predisposing physiologic factors to space sickness that implicate a fluid shift etiology. Addition of a 10th input variable, hours spent in the Weightless Environment Training Facility (WETF), improved the prediction of space sickness severity to 66 pct. success by the first method of cross validation on the original sample and to 71 pct. by the second method. The data suggest that WETF training may reduce space sickness severity.

Phase Equilibria of Sn-Co-Cu Ternary System

NASA Astrophysics Data System (ADS)

Chen, Yu-Kai; Hsu, Chia-Ming; Chen, Sinn-Wen; Chen, Chih-Ming; Huang, Yu-Chih

2012-10-01

Sn-Co-Cu ternary alloys are promising lead-free solders, and isothermal sections of Sn-Co-Cu phase equilibria are fundamentally important for the alloys' development and applications. Sn-Co-Cu ternary alloys were prepared and equilibrated at 523 K, 1073 K, and 1273 K (250 °C, 800 °C, and 1000 °C), and the equilibrium phases were experimentally determined. In addition to the terminal solid solutions and binary intermetallic compounds, a new ternary compound, Sn3Co2Cu8, was found. The solubilities of Cu in the α-CoSn3 and CoSn2 phases at 523 K (250 °C) are 4.2 and 1.6 at. pct, respectively, while the Cu solubility in the α-Co3Sn2 phase is as high as 20.0 at. pct. The Cu solubility increases with temperature and is around 30.0 at. pct in the β-Co3Sn2 at 1073 K (800 °C). The Co solubility in the η-Cu6Sn5 phase is also significant and is 15.5 at. pct at 523 K (250 °C).

Dielectric, Impedance and Conduction Behavior of Double Perovskite Pr2CuTiO6 Ceramics

NASA Astrophysics Data System (ADS)

Mahato, Dev K.; Sinha, T. P.

2017-01-01

Polycrystalline Pr2CuTiO6 (PCT) ceramics exhibits dielectric, impedance and modulus characteristics as a possible material for microelectronic devices. PCT was synthesized through the standard solid-state reaction method. The dielectric permittivity, impedance and electric modulus of PCT have been studied in a wide frequency (100 Hz-1 MHz) and temperature (303-593 K) range. Structural analysis of the compound revealed a monoclinic phase at room temperature. Complex impedance Cole-Cole plots are used to interpret the relaxation mechanism, and grain boundary contributions towards conductivity have been estimated. From electrical modulus formalism polarization and conductivity relaxation behavior in PCT have been discussed. Normalization of the imaginary part of impedance ( Z″) and the normalized imaginary part of modulus ( M″) indicates contributions from both long-range and localized relaxation effects. The grain boundary resistance along with their relaxation frequencies are plotted in the form of an Arrhenius plot with activation energy 0.45 eV and 0.46 eV, respectively. The ac conductivity mechanism has been discussed.

Influence of Al on the Microstructural Evolution and Mechanical Behavior of Low-Carbon, Manganese Transformation-Induced-Plasticity Steel

NASA Astrophysics Data System (ADS)

Suh, Dong-Woo; Park, Seong-Jun; Lee, Tae-Ho; Oh, Chang-Seok; Kim, Sung-Joon

2010-02-01

Microstructural design with an Al addition is suggested for low-carbon, manganese transformation-induced-plasticity (Mn TRIP) steel for application in the continuous-annealing process. With an Al content of 1 mass pct, the competition between the recrystallization of the cold-rolled microstructure and the austenite formation cannot be avoided during intercritical annealing, and the recrystallization of the deformed matrix does not proceed effectively. The addition of 3 mass pct Al, however, allows nearly complete recrystallization of the deformed microstructure by providing a dual-phase cold-rolled structure consisting of ferrite and martensite and by suppressing excessive austenite formation at a higher annealing temperature. An optimized annealing condition results in the room-temperature stability of the intercritical austenite in Mn TRIP steel containing 3 mass pct Al, permitting persistent transformation to martensite during tensile deformation. The alloy presents an excellent strength-ductility balance combining a tensile strength of approximately 1 GPa with a total elongation over 25 pct, which is comparable to that of Mn TRIP steel subjected to batch-type annealing.

Design and Construction of Detector and Data Acquisition Elements for Proton Computed Tomography

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

Fermi Research Alliance; Northern Illinois University

2015-07-15

Proton computed tomography (pCT) offers an alternative to x-ray imaging with potential for three-dimensional imaging, reduced radiation exposure, and in-situ imaging. Northern Illinois University (NIU) is developing a second-generation proton computed tomography system with a goal of demonstrating the feasibility of three-dimensional imaging within clinically realistic imaging times. The second-generation pCT system is comprised of a tracking system, a calorimeter, data acquisition, a computing farm, and software algorithms. The proton beam encounters the upstream tracking detectors, the patient or phantom, the downstream tracking detectors, and a calorimeter. The schematic layout of the PCT system is shown. The data acquisition sendsmore » the proton scattering information to an offline computing farm. Major innovations of the second generation pCT project involve an increased data acquisition rate ( MHz range) and development of three-dimensional imaging algorithms. The Fermilab Particle Physics Division and Northern Illinois Center for Accelerator and Detector Development at Northern Illinois University worked together to design and construct the tracking detectors, calorimeter, readout electronics and detector mounting system.« less

Grain boundary character distribution in nanocrystalline metals produced by different processing routes

DOE PAGES

Bober, David B.; Kumar, Mukal; Rupert, Timothy J.; ...

2015-12-28

Nanocrystalline materials are defined by their fine grain size, but details of the grain boundary character distribution should also be important. Grain boundary character distributions are reported for ball-milled, sputter-deposited, and electrodeposited Ni and Ni-based alloys, all with average grain sizes of ~20 nm, to study the influence of processing route. The two deposited materials had nearly identical grain boundary character distributions, both marked by a Σ3 length percentage of 23 to 25 pct. In contrast, the ball-milled material had only 3 pct Σ3-type grain boundaries and a large fraction of low-angle boundaries (16 pct), with the remainder being predominantlymore » random high angle (73 pct). Furthermore, these grain boundary character measurements are connected to the physical events that control their respective processing routes. Consequences for material properties are also discussed with a focus on nanocrystalline corrosion. As a whole, the results presented here show that grain boundary character distribution, which has often been overlooked in nanocrystalline metals, can vary significantly and influence material properties in profound ways.« less

Health, energy vulnerability and climate change: a retrospective thematic analysis of primary care trust policies and practices.

PubMed

Richardson, J; Kagawa, F; Nichols, A

2009-12-01

To review publicly available documents produced by primary care trusts (PCTs) to assess the extent to which local activity and planning consider energy vulnerability, climate change and sustainability. Retrospective thematic content analysis of publicly available materials located on PCT websites. Thematic content analysis of publicly available materials was undertaken by two researchers over a 6-month period in 2008. These materials were obtained from the websites of 30 PCTs in England. Materials included annual reports, plans, policies and strategy documents. Of the 30 PCT websites studied, four were found to have an absence of content related to climate change, energy vulnerability and sustainability. Of the remaining 26 PCT websites, consistent themes were found: strategic initiatives, joint working with other agencies, promoting sustainable communities, and targeted actions. Evidence of good examples in sustainable development was predominantly limited to policy statements and strategic aims; evidence of action was limited. As champions of the public health agenda, PCT action on sustainability should be integral to all aspects of organizational governance.

The Solubility of Aluminum in Cryolite-Based Electrolyte-Containing KF

NASA Astrophysics Data System (ADS)

Zhang, Yu; Yu, Jiangyu; Gao, Bingliang; Liu, Yibai; Hu, Xianwei; Shi, Zhongning; Wang, Zhaowen

2016-04-01

The solubility of aluminum in NaF-AlF3-CaF2-KF-A12O3 electrolyte system at 1253 K (980 °C) has been measured by the analysis of quenched samples saturated with aluminum. The content of the dissolved metal in the quenched melt was determined by collecting the volume of hydrogen gas when a finely crushed sample is treated with HCl. Addition of 0 to 5 pct KF has no obvious effect on the solubility of aluminum in cryolite-based melts with molar ratio of NaF/AlF3 (cryolite ratio) ranging from 2.2 to 3.0. The solubility of aluminum increases from 0.015 to 0.026 wt pct with cryolite ratio increases from 2.2 to 4.0 in the NaF-AlF3-5 wt pct CaF2-3 wt pct A12O3 electrolyte at 1253 K (980 °C). Aluminum solubility was affected by both chemical replacement reaction of Al + 3NaF = AlF3 + 3Na and physical dissolution.

The Study of Two Psychotherapy Approaches (Rogers Self Theory and Ellis Rational Theory) in Improvement of Bowen Self-differentiation and Intimacy.

PubMed

Yousefi, Naser; Kiani, Mohammad Ali

2014-01-01

To compare the effectiveness of rational, behavioral and emotive therapy (REBT) and person-centered therapy (PCT) on self-differentiation and intimacy among divorce clients. In quasi-experimental study, 42 divorce clients (both males and females) who presented to the Counsling Center of Sanandaj, Iran were sampled. They were categorized into three groups of PCT, REBT, and control group (each group contained 14 subjects). The recovery indices (dependent variables) employed were the subject of self-differentiation and intimacy, which were measured twice before and after intervention of Differentiation of Self Inventory-2 (DSI-2) and intimacy. The therapy involved 8 one-hour sessions. It was held twice a week and therapeutic effects were traced after 8 months. The results showed that REBT and PCT were effective on self-differentiation scale and intimacy. Also they were influential in recovery self-differentiation scale and intimacy follow up stage. REBT and PCT were effective on self-differentiation and its subscales (Emotional reactivity, "I" position, Emotional cut off and Fusion with other) and general intimacy. None.

Combined biomarkers discriminate a low likelihood of bacterial infection among surgical intensive care unit patients with suspected sepsis.

PubMed

Kelly, Brendan J; Lautenbach, Ebbing; Nachamkin, Irving; Coffin, Susan E; Gerber, Jeffrey S; Fuchs, Barry D; Garrigan, Charles; Han, Xiaoyan; Bilker, Warren B; Wise, Jacqueleen; Tolomeo, Pam; Han, Jennifer H

2016-05-01

Among surgical intensive care unit (SICU) patients, it is difficult to distinguish bacterial sepsis from other causes of systemic inflammatory response syndrome (SIRS). Biomarkers have proven useful to identify the presence of bacterial infection. We enrolled a prospective cohort of 69 SICU patients with suspected sepsis and assayed the concentrations of 9 biomarkers (α-2 macroglobulin [A2M], C-reactive protein, ferritin, fibrinogen, haptoglobin, procalcitonin [PCT], serum amyloid A, serum amyloid P, and tissue plasminogen activator) at baseline, 24, 48, and 72hours. Forty-two patients (61%) had bacterial sepsis by chart review. A2M concentrations were significantly lower, and PCT concentrations were significantly higher in subjects with bacterial sepsis at 3 of 4 time points. Using optimal cutoff values, the combination of baseline A2M and 72-hour PCT achieved a negative predictive value of 75% (95% confidence interval, 54-96%). The combination of A2M and PCT discriminated bacterial sepsis from other SIRS among SICU patients with suspected sepsis. Copyright © 2016 Elsevier Inc. All rights reserved.

Results from a Prototype Proton-CT Head Scanner

NASA Astrophysics Data System (ADS)

Johnson, R. P.; Bashkirov, V. A.; Coutrakon, G.; Giacometti, V.; Karbasi, P.; Karonis, N. T.; Ordoñez, C. E.; Pankuch, M.; Sadrozinski, H. F.-W.; Schubert, K. E.; Schulte, R. W.

We are exploring low-dose proton radiography and computed tomography (pCT) as techniques to improve the accuracy of proton treatment planning and to provide artifact-free images for verification and adaptive therapy at the time of treatment. Here we report on comprehensive beam test results with our prototype pCT head scanner. The detector system and data acquisition attain a sustained rate of more than a million protons individually measured per second, allowing a full CT scan to be completed in six minutes or less of beam time. In order to assess the performance of the scanner for proton radiography as well as computed tomography, we have performed numerous scans of phantoms at the Northwestern Medicine Chicago Proton Center including a custom phantom designed to assess the spatial resolution, a phantom to assess the measurement of relative stopping power, and a dosimetry phantom. Some images, performance, and dosimetry results from those phantom scans are presented together with a description of the instrument, the data acquisition system, and the calibration methods.

A Review of Use of Enantiomers in Homeopathy

PubMed Central

Kuzeff, R. M.

2012-01-01

This paper reviews publications of laboratory experiments using pairs of enantiomers in homeopathy. Many molecules in nature have geometry which enables them to exist as nonsuperimposable mirror images or enantiomers. Modulation of toxicity of such molecules provides possibility for therapeutics, since they target multiple points in biochemical pathways. It was hypothesized that toxicity of a chemical agent could be counteracted by a homeopathic preparation of the enantiomer of the chemical agent (patents applied for: PCT/AU2003/000219-PCT/AU2008/001611). A diverse body of data, including controlled laboratory studies, supports the conclusion that toxicity of optical isomers may be inhibited by homeopathic enantiomer preparations. These data were obtained with minimal or no pretesting to determine optimal test solutions. Inhibition of the excitotoxic neurotransmitter L-glutamic acid with homeopathic preparations of D-glutamic acid indicates the latter may be of use for amelioration of symptoms of disturbances of mood. Similarly, homeopathic preparation of (+)-nicotine may be of use for inhibition of effects of nicotine in tobacco. PMID:23724294

Elevated temperature strengthening of a melt spun austenitic steel by TiB2

NASA Technical Reports Server (NTRS)

Michal, G. M.; Glasgow, T. K.; Moore, T. J.

1986-01-01

Mechanical properties of an iron-based alloy containing (by wt pct) 33Ni, 2Al, 6Ti, and 2B (resulting in an alloy containing 10 vol pct TiB2) were evaluated by hardness and tensile testing. The alloy was cast as a ribbon using a dual 'free-jet' variation of Jech et al. (1984) method of chill-block melt-spinning against a copper wheel; to simulate thermal cycles the alloy ribbon would experience during compaction into shapes, various segments of the ribbon were annealed under a vacuum at temperatures ranging from 500 to 1150 C. The results show that maximum strengths at 650 and 760 C were developed in ribbons annealed at 1100 C; in these ribbons an optimal combination of grain coarsening with minimum TiB2 particle growth was observed. However, the elevated-temperature strength of the TiB2-strengthened alloy under optimal annealing conditions was poorer than that of conventional iron-based superalloys strengthened by gamma-prime precipitates.

Effect of LiF as Sintering Agent on the Densification and Phase Formation in Al2O3-4 Wt Pct Nb2O5 Ceramic Compound

NASA Astrophysics Data System (ADS)

Santos, J. L.; Marçal, R. L. S. B.; Jesus, P. R. R.; Gomes, A. V.; Lima, E. P.; Monteiro, S. N.; de Campos, J. B.; Louro, L. H. L.

2017-10-01

Different amounts of LiF were added to an Al2O3-4 pct Nb2O5 basic ceramic, as sintering agent. Improved new ceramics were obtained with LiF concentrations varying from 0.25 to 1.50 wt pct and three sintering temperatures of 1573 K, 1623 K, and 1673 K (1300 °C, 1350 °C, and 1400 °C). The addition of 0.5 wt pct LiF yielded the highest densification, 94 pct of the theoretical density, in association with a sintering temperature of 1673 K (1400 °C). Based on X-ray diffraction (XRD), this improvement was due not only to the presence of transformed phases, more precisely Nb3O7F, but also to the absence of LiAl5O8. The preferential interaction of LiF with Nb2O5, instead of Al2O3, contributed to increase the alumina sintering ability by liquid phase formation. Scanning electron microscopy (SEM) results revealed well-connected grains and isolated pores, whereas the chemical composition analysis by energy dispersive energy (EDX) indicated a preferential interaction of fluorine with niobium, in agreement with the results of XRD. It was also observed from thermal analysis that the polyethylene glycol binder burnout temperature increased for all LiF concentrations. This may be related to the formation of hydrogen bridge bonds.

Evolution of cytokine profile during the treatment of cerebral toxoplasmosis in HIV-infected patients.

PubMed

Meira, Cristina da Silva; Pereira-Chioccola, Vera Lucia; Vidal, José Ernesto; Motoie, Gabriela; Costa-Silva, Thaís Alves da; Gava, Ricardo

2015-11-01

This study was to follow IFN-γ, TNF-α and IL-10 modulation of peripheral blood mononuclear cells (PBMC) from HIV/cerebral toxoplasmosis patients (CT) during specific treatment. The results were compared with two other groups: HIV patients that had CT at least one year before (P/CT) and individuals with chronic toxoplasmosis (CHR). Blood samples (63) collected from three groups were analyzed. CT, 15 patients (3 blood samples collected one day before Toxoplasma gondii treatment; 7 and 15days during the treatment). P/CT, 5 patients (one blood sample collected at least, one year after the treatment). CHR, 13 individuals with chronic toxoplasmosis (one blood sample). Cytokine levels were assessed by ELISA after PBMC stimulation with T. gondii antigen. CT patients had low IFN-γ; discrete increase at 7th and 15th days; and the levels were recovered in cured patients (P/CT). CT patients had high TNF-α in the beginning of the treatment. TNF-α levels decrease during the treatment (7th and 15th) and in those patients who were treated (P/CT). IL-10 levels were almost similar in CT and P/CT groups but low when compared with CHR individuals. The evolution of the infection was correlated to restoration of IFN-γ response and a decrease of the inflammation. The evaluation of the immune response can provide valuable information and better monitoring of patients during specific treatment. Copyright © 2015 Elsevier B.V. All rights reserved.

A randomized controlled trial of aspirin and exertional heat stress activation of platelets in firefighters during exertion in thermal protective clothing.

PubMed

Hostler, David; Suyama, Joe; Guyette, Francis X; Moore, Charity G; Pryor, Riana R; Khorana, Priya; McEntire, Serina J; Comer, Diane; Reis, Steven E

2014-01-01

Platelet aggregation is enhanced in firefighters following short bouts of work in thermal protective clothing (TPC). We sought to determine if aspirin therapy before and/or following exertion in TPC prevents platelet activation. In a double-blind, placebo-controlled study, 102 firefighters were randomized to receive daily therapy (81 mg aspirin or placebo) for 14 days before and a single dose (325 mg aspirin or placebo) following exercise in TPC resulting in four potential assignments: aspirin before and after exercise (AA), placebo before and after exercise (PP), aspirin before and placebo after exercise (AP), and placebo before and aspirin after exercise (PA). Platelet closure time (PCT) was measured with a platelet function analyzer before the 2-week treatment, after the 2 week treatment period, immediately after exercise, and 30, 60, and 90 minutes later. Baseline PCT did not differ between groups. PCT changed over time in all four groups (p < 0.001) rising to a median of >300 seconds [IQR 99, 300] in AA and >300 [92, 300] in AP prior to exercise. Following exercise, median PCT decreased to in all groups. Median PCT returned to >300 seconds 30 minutes later in AA and AP and rose to 300 seconds in PA 60 minutes after exercise. Daily aspirin therapy blunts platelet activation during exertional heat stress and single-dose aspirin therapy following exertional heat stress reduces platelet activation within 60 minutes.

Fostering clinical engagement and medical leadership and aligning cultural values: an evaluation of a general practice specialty trainee integrated training placement in a primary care trust.

PubMed

Ruston, Annmarie; Tavabie, Abdol

2010-01-01

To report on the extent to which a general practice specialty trainee integrated training placement (ITP) developed the leadership skills and knowledge of general practice specialty trainees (GPSTRs) and on the potential of the ITP to improve clinical engagement. A case study method was used in a Kent primary care trust (PCT). Sources of data included face-to-face and telephone interviews (three GPSTRs, three PCT clinical supervisors, three general practitioner (GP) clinical supervisors and three Deanery/PCT managers), reflective diaries, documentary sources and observation. Interview data were transcribed and analysed using the constant comparative method. All respondents were positive about the value and success of the ITP in developing the leadership skills of the GPSTRs covering three dimensions: leadership of self, leadership of teams and leadership of organisations within systems. The ITP had enabled GP trainees to understand the context for change, to develop skills to set the direction for change and to collect and apply evidence to decision making. The ITP was described as an effective means of breaking down cultural barriers between general practice and the PCT and as having the potential for improving clinical engagement. The ITP provided a model to enable the effective exchange of knowledge and understanding of differing cultures between GPSTRs, general practice and the PCT. It provided a sound basis for effective, dispersed clinical engagement and leadership.

Comparison of procalcitonin and high-sensitivity C-reactive protein for the diagnosis of sepsis and septic shock in the oldest old patients.

PubMed

Zhang, Hongmin; Wang, Xiaoting; Zhang, Qing; Xia, Ying; Liu, Dawei

2017-08-01

Although the role of serum procalcitonin (PCT) and high-sensitivity C-reactive protein (hs-CRP) in the diagnosis of sepsis and septic shock is well studied, it has not been investigated among oldest old patients. The aim of our study is to determine the role of PCT and hs-CRP in the assessment of sepsis and septic shock in this specific group of patients in the ICU. This is a prospective observational study. Patients >85 years of age admitted to the ICU from May 1st, 2016 to February 1st, 2017 were evaluated. Patients were divided into a sepsis and septic shock group(sepsis/SS) and a non-sepsis group. Serum levels of PCT, hs-CRP and the WBC were measured within 12 h of admission. A total of 70 patients aged 85 years and older were enrolled in this study. Fifty patients were labelled as sepsis/SS and the other 20 were labelled non-sepsis. A ROC analysis showed that the area under the curves (AUC) of hs-CRP and PCT for the discrimination of sepsis/SS patients were 0.825 (95% confidence interval[CI]: 0.73-0.92; P < 0.001) and 0.819 (95%CI:0.72-0.92; p < 0.001), respectively. In a subgroup analysis of the sepsis/SS group, 27 patients had sepsis, while the other 23 patients had septic shock. The ROC analysis showed that the AUCs of hs-CRP and PCT for the discrimination of septic shock patients from sepsis patients were 0.751 (95% CI: 0.62-0.88; P = 0.002) and 0.719 (95% CI:0.57-0.86; p = 0.007), respectively. For the oldest old patients, hs-CRP is not inferior to PCT in the diagnosis of sepsis and septic shock.

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

Zhang, J; Zhang, W; Lu, J

Purpose: To investigate the accuracy and feasibility of dose calculations using kilovoltage cone beam computed tomography in cervical cancer radiotherapy using a correction algorithm. Methods: The Hounsfield units (HU) and electron density (HU-density) curve was obtained for both planning CT (pCT) and kilovoltage cone beam CT (CBCT) using a CIRS-062 calibration phantom. The pCT and kV-CBCT images have different HU values, and if the HU-density curve of CBCT was directly used to calculate dose in CBCT images may have a deviation on dose distribution. It is necessary to normalize the different HU values between pCT and CBCT. A HU correctionmore » algorithm was used for CBCT images (cCBCT). Fifteen intensity-modulated radiation therapy (IMRT) plans of cervical cancer were chosen, and the plans were transferred to the pCT and cCBCT data sets without any changes for dose calculations. Phantom and patient studies were carried out. The dose differences and dose distributions were compared between cCBCT plan and pCT plan. Results: The HU number of CBCT was measured by several times, and the maximum change was less than 2%. To compare with pCT, the CBCT and cCBCT has a discrepancy, the dose differences in CBCT and cCBCT images were 2.48%±0.65% (range: 1.3%∼3.8%) and 0.48%±0.21% (range: 0.1%∼0.82%) for phantom study, respectively. For dose calculation in patient images, the dose differences were 2.25%±0.43% (range: 1.4%∼3.4%) and 0.63%±0.35% (range: 0.13%∼0.97%), respectively. And for the dose distributions, the passing rate of cCBCT was higher than the CBCTs. Conclusion: The CBCT image for dose calculation is feasible in cervical cancer radiotherapy, and the correction algorithm offers acceptable accuracy. It will become a useful tool for adaptive radiation therapy.« less

The influence of heat treatment on the structure and properties of a near-α titanium alloy

NASA Astrophysics Data System (ADS)

Sridhar, G.; Kutumbarao, V. V.; Sarma, D. S.

1987-06-01

The microstructure and tensile properties of a near-α titanium alloy, IMI-829 (Ti-6.1 wt pct Al-3.2 wt pct Zr-3.3 wt pct Sn-0.5 wt pct Mo-1 wt pct Nb-0.32 wt pct Si) have been studied after solutionizing (and no subsequent aging) at two different temperatures separately, one above the β transus (1050 °C) and another below the β transus (975 °C) followed by various cooling rates (furnace, air, oil, or water). While 1050 °C treatment resulted in coarse Widmanstätten structures on furnace or air cooling, fine Widmanstätten structure on oil quenching and martensitic structure on water quenching, 975 °C treatment produced duplex microstructures consisting of equiaxed alpha and partially transformed beta phases. Transmission electron microscopy studies revealed the morphology, size, and distribution of the α, β, and martensite phases and also the presence of small ellipsoidal suicide particles and an interface phase with fcc structure at almost all α-β interfaces. The oil quenched structure from 1050 °C has been found to be a mixture of fine Widmanstätten α coexisting with martensite laths and retained beta at the lath boundaries. Silicides with hcp structure of about 0.4 μm size were observed in specimens solution treated at 975 °C. The interface phase is seen in all slowly-cooled specimens. The YS and UTS are superior for 975 °C treatment compared to 1050 °C treatment after water quenching or oil quenching. The tensile ductility values are superior for any cooling rate after 975 °C solution treatment as compared to 1050 °C solution treatment. The specimens failed in tension diagonally by shear after 1050 °C treatment and by cup and cone fracture after 975 °C treatment. In all cases fracture has taken place by microvoid coalescence and in most cases, along the α-β boundaries.

On the nature of the Fe-bearing particles influencing hard anodizing behavior of AA 7075 extrusion products

NASA Astrophysics Data System (ADS)

Mukhopadhyay, A. K.

1998-03-01

The deleterious effects of Fe-bearing constituent particles on the fracture toughness of wrought A1 alloys have been known. Recent studies have shown that the presence of Fe-bearing, constituent particles is also determental to the nature and growth of the hard anodic oxide coating formed on such materials. The present study, using a combination of scanning electron microscopy (SEM), transmission electron microscopy (TEM), and electron probe microanalysis (EPMA), was made to examine the influence of the nature of the Fe-bearing particles on the hard anodizing behavior of AA 7075 extrusion products containing varying amounts of Si, Mn, and Fe impurities. It was found that, in the alloy containing 0.25 wt pct Si, 0.27 wt pct Mn, and 0.25 wt pct Fe, the Fe-bearing constituent particles are based on the Al12(FeMn)3Si phase (bcc with α=1.260 nm). These particles survive the hard anodizing treatment, add resistance to the electrical path, causing a rapid rise in the bath voltage with time, and cause a nonuniform growth of the anodic oxide film. In the materials containing 0.05 wt pct Si, 0.04 wt pct Mn, and 0.18 wt pct Fe, on the other hand, the formation of the Al12(FeMn)3Si-based phase is suppressed, and two different Fe-bearing phases, based on Al-Fe-Cu-Mn-based (simple cubic with a=1.265 nm) and Al7Cu2Fe, respectively form. Neither the Al-Fe-Cu-Mn-based phase nor the Al7Cu2Fe-based phase survive the hard anodizing treatment, and this results in a steady rise in the bath voltage with time and a relatively uniform growth of the anodic oxide film. Consideration of the size of the Fe-bearing, particles reveals that the smaller the particle, the more uniform the growth of the anodic oxide film.

Quantitative assessment of anatomical change using a virtual proton depth radiograph for adaptive head and neck proton therapy.

PubMed

Wang, Peng; Yin, Lingshu; Zhang, Yawei; Kirk, Maura; Song, Gang; Ahn, Peter H; Lin, Alexander; Gee, James; Dolney, Derek; Solberg, Timothy D; Maughan, Richard; McDonough, James; Teo, Boon-Keng Kevin

2016-03-08

The aim of this work is to demonstrate the feasibility of using water-equivalent thickness (WET) and virtual proton depth radiographs (PDRs) of intensity corrected cone-beam computed tomography (CBCT) to detect anatomical change and patient setup error to trigger adaptive head and neck proton therapy. The planning CT (pCT) and linear accelerator (linac) equipped CBCTs acquired weekly during treatment of a head and neck patient were used in this study. Deformable image registration (DIR) was used to register each CBCT with the pCT and map Hounsfield units (HUs) from the planning CT (pCT) onto the daily CBCT. The deformed pCT is referred as the corrected CBCT (cCBCT). Two dimensional virtual lateral PDRs were generated using a ray-tracing technique to project the cumulative WET from a virtual source through the cCBCT and the pCT onto a virtual plane. The PDRs were used to identify anatomic regions with large variations in the proton range between the cCBCT and pCT using a threshold of 3 mm relative difference of WET and 3 mm search radius criteria. The relationship between PDR differences and dose distribution is established. Due to weight change and tumor response during treatment, large variations in WETs were observed in the relative PDRs which corresponded spatially with an increase in the number of failing points within the GTV, especially in the pharynx area. Failing points were also evident near the posterior neck due to setup variations. Differences in PDRs correlated spatially to differences in the distal dose distribution in the beam's eye view. Virtual PDRs generated from volumetric data, such as pCTs or CBCTs, are potentially a useful quantitative tool in proton therapy. PDRs and WET analysis may be used to detect anatomical change from baseline during treatment and trigger further analysis in adaptive proton therapy.

Procalcitonin in cerebrospinal fluid in meningitis: a prospective diagnostic study.

PubMed

Alons, Imanda M E; Verheul, Rolf J; Kuipers, Irma; Jellema, Korné; Wermer, Marieke J H; Algra, Ale; Ponjee, Gabriëlle

2016-11-01

Bacterial meningitis is a severe but treatable condition. Clinical symptoms may be ambiguous and current diagnostics lack sensitivity and specificity, complicating diagnosis. Procalcitonin (PCT) is a protein that is elevated in serum in bacterial infection. We aimed to assess the value of PCT in cerebrospinal fluid (CSF) in the diagnosis of bacterial meningitis. We included patients with bacterial meningitis, both community acquired and post neurosurgery. We included two comparison groups: patients with viral meningitis and patients who underwent lumbar punctures for noninfectious indications. We calculated mean differences and 95% confidence intervals of procalcitonin in CSF and plasma in patients with and without bacterial meningitis. Average PCT concentrations in CSF were 0.60 ng mL -1 (95% CI: 0.29-0.92) in the bacterial meningitis group ( n  = 26), 0.81 (95% CI: 0.33-1.28) in community-acquired meningitis ( n  = 16) and 0.28 (95% CI: 0.10-0.45) in postneurosurgical meningitis ( n  = 10), 0.10 ng mL -1 (95% CI: 0.08-0.12) in the viral meningitis group ( n  = 14) and 0.08 ng mL -1 (95% CI: 0.06-0.09) in the noninfectious group ( n  = 14). Mean difference of PCT-CSF between patients with community-acquired bacterial meningitis and with viral meningitis was 0.71 ng mL -1 (95% CI: 0.17-1.25) and 0.73 ng mL -1 (95% CI: 0.19-1.27) for community-acquired bacterial meningitis versus the noninfectious group. The median PCT CSF: plasma ratio was 5.18 in postneurosurgical and 0.18 in community-acquired meningitis (IQR 4.69 vs. 0.28). Procalcitonin in CSF was significantly higher in patients with bacterial meningitis when compared with patients with viral or no meningitis. PCT in CSF may be a valuable marker in diagnosing bacterial meningitis, and could become especially useful in patients after neurosurgery.

Does psychosocial competency training for junior physicians working in pediatric medicine improve individual skills and perceived job stress.

PubMed

Bernburg, Monika; Baresi, Lisa; Groneberg, David; Mache, Stefanie

2016-12-01

Pediatricians' job performance, work engagement, and job satisfaction are essential for both the individual physician and quality of care for their little patients and parents. Therefore, it is important to maintain or possibly augment pediatricians' individual and professional competencies. In this study, we developed and implemented a psychosocial competency training (PCT) teaching different psychosocial competencies and stress coping techniques. We investigated (1) the influence of the PCT on work-related characteristics: stress perception, work engagement, job satisfaction and (2) explored pediatricians' outcomes and satisfaction with PCT. Fifty-four junior physicians working in pediatric hospital departments participated in the training and were randomized in an intervention (n = 26) or a control group (n = 28). In the beginning, at follow-up 1 and 2, both groups answered a self-rated questionnaire on perceived training outcomes and work-related factors. The intervention group showed that their job satisfaction significantly increased while perceived stress scores decreased after taking part in the PCT. No substantial changes were observed with regard to pediatricians' work engagement. Participating physicians evaluated PCT with high scores for training design, content, received outcome, and overall satisfaction with the training. Professional psychosocial competency training could improve junior pediatricians' professional skills, reduce stress perception, increase their job satisfaction, and psychosocial skills. In addition, this study indicates that the PCT is beneficial to be implemented as a group training program for junior pediatricians at work. What is Known: • Junior pediatricians often report experiencing high levels of job strain and little supervisory support. • High levels of job demands make pediatricians vulnerable for mental health problems and decreased work ability. What is New: • Development, implementation, and evaluation of a psychosocial competency training for junior pediatricians working in clinical settings • Psychosocial competency training has the potential to improve pediatricians' psychosocial skills and perceptions of perceived work-related stress and job satisfaction.

The neodymium-gold phase diagram

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

Saccone, A.; Maccio, D.; Delfino, S.

The Nd-Au phase diagram was studied in the 0 to 100 at. pct Au composition range by differential thermal analysis (DTA), X-ray diffraction (XRD), optical microscopy (LOM), scanning electron microscopy (SEM), and electron probe microanalysis (EPMA). Six intermetallic phases were identified, the crystallographic structures were determined or confirmed, and the melting behavior was determined, as follows: Nd{sub 2}Au, orthorhombic oP12-Co{sub 2}Si type, peritectic decomposition at 810 C; NdAu, R.T. form, orthorhombic oP8-FeB type, H.T. forms, orthorhombic oC8-CrB type and, at a higher temperature, cubic cP2-CsCl type, melting point 1470 C; Nd{sub 3}Au{sub 4}, trigonal hR42-Pu{sub 3}Pd{sub 4} type, peritectic decompositionmore » at 1250 C; Nd{sub 17}Au{sub 36}, tetragonal tP106-Nd{sub 17}Au{sub 36} type, melting point 1170 C; Nd{sub 14}Au{sub 51}, hexagonal hP65-Gd{sub 14}Ag{sub 51} type, melting point 1210 C; and NdAu{sub 6}, monoclinic mC28-PrAu{sub 6} type, peritectic decomposition at 875 C. Four eutectic reactions were found, respectively, at 19.0 at. pct Au and 655 C, at 63.0 at. pct Au and 1080 C, at 72.0 at. pct Au and 1050 C, and, finally, at 91.0 at. pct Au and 795 C. A catatectic decomposition of the ({beta}Nd) phase, at 825 C and {approx}1 at. pct Au, was also found. The results are briefly discussed and compared to those for the other rare earth-gold (R-Au) systems. A short discussion of the general alloying behavior of the coinage metals (Cu, Ag, and Au) with the rare-earth metals is finally presented.« less

Retinal Nerve Fiber Layer and Peripapillary Choroidal Thicknesses in Non-Glaucomatous Unilateral Optic Atrophy Compared with Unilateral Advanced Pseudoexfoliative Glaucoma.

PubMed

Kucukevcilioglu, Murat; Ayyildiz, Onder; Aykas, Seckin; Gokce, Gokcen; Koylu, Mehmet Talay; Ozgonul, Cem; Ozge, Gokhan; Mumcuoglu, Tarkan; Yumusak, Erhan

2017-02-01

To investigate retinal nerve fiber layer thickness (RNFL-T) and peripapillary choroidal thickness (PC-T) in non-glaucomatous optic atrophy (OA) patients in comparison with unaffected and control eyes, furthermore, to compare thickness profiles with unilateral pseudoexfoliative advanced glaucoma. Thirty-three eyes with OA (Group A), 33 unaffected fellow eyes (Group B), 25 right eyes of 25 control subjects (Group C), and 15 eyes with advanced glaucoma (Group D) were enrolled. RNFL-T was measured in six regions by spectral-domain optical coherence tomography. Enhanced depth imaging optical coherence tomography was obtained to evaluate PC-T in corresponding regions. RNFL-T was significantly lower in Group A than in Groups B and C globally and at all peripapillary regions (all p < 0.001). P-CT in Group A was significantly lower globally (p = 0.03) and in three regions (temporal, p = 0.001; temporal-superior, p = 0.01; and nasal-inferior, p = 0.037) versus Group C. However, it was significantly thinner than in Group B in all regions (temporal, p = 0.02; temporal-superior, p = 0.013; nasal-superior, p = 0.044; nasal, p = 0.02; nasal-inferior, p < 0.001; and temporal-inferior, p < 0.001) and globally (p < 0.001). In Group A RNFL-T (thicker superiorly and inferiorly; thinner temporally and nasally) and PC-T (superior > temporal > nasal > inferior) profiles were almost identical to that in unaffected fellow eyes and control eyes. However, Group D showed different patterns with less regional differences in RNFL-T, and the greatest value of PC-T in nasal quadrant. Besides retinal nerve fiber layer thinning, non-glaucomatous OA is associated with choroidal thinning. The RNFL-T and PC-T profiles in advanced glaucoma eyes differed from the common patterns seen among OA eyes, unaffected fellow eyes, and control eyes.

In honour of N. Yngve Öhrn: surveying proton cancer therapy reactions with Öhrn's electron nuclear dynamics method. Aqueous clusters radiolysis and DNA-base damage by proton collisions

NASA Astrophysics Data System (ADS)

Mclaurin, Patrick M.; Privett, Austin J.; Stopera, Christopher; Grimes, Thomas V.; Perera, Ajith; Morales, Jorge A.

2015-02-01

Proton cancer therapy (PCT) utilises high-energy H+ projectiles to cure cancer. PCT healing arises from its DNA damage in cancerous cells, which is mostly inflicted by the products from PCT water radiolysis reactions. While clinically established, a complete microscopic understanding of PCT remains elusive. To help in the microscopic elucidation of PCT, Professor Öhrn's simplest-level electron nuclear dynamics (SLEND) method is herein applied to H+ + (H2O)3-4 and H+ + DNA-bases at ELab = 1.0 keV. These are two types of computationally feasible prototypes to study water radiolysis reactions and H+-induced DNA damage, respectively. SLEND is a time-dependent, variational, non-adiabatic and direct-dynamics method that adopts a nuclear classical-mechanics description and an electronic single-determinantal wavefunction. Additionally, our SLEND + effective-core-potential method is herein employed to simulate some computationally demanding PCT reactions. Due to these attributes, SLEND proves appropriate for the simulation of various types of PCT reactions accurately and feasibly. H+ + (H2O)3-4 simulations reveal two main processes: H+ projectile scattering and the simultaneous formation of H and OH fragments; the latter process is quantified through total integrals cross sections. H+ + DNA-base simulations reveal atoms and groups displacements, ring openings and base-to-proton electron transfers as predominant damage processes. The authors warmly dedicate this SLEND investigation in honour of Professor N. Yngve Öhrn on the occasion of his 80th birthday celebration during the 54th Sanibel Symposium in St. Simons' Island, Georgia, on February 16-21, 2014. Associate Professor Jorge A. Morales was a former chemistry PhD student under the mentorship of Professor Öhrn and Dr Ajith Perera took various quantum chemistry courses taught by Professor Öhrn during his chemistry PhD studies. Both Jorge and Ajith look back to those great times of their scientific formation under Yngve's guidance during the 1990s with a strong sense of gratitude toward him (and even with a sense of nostalgia). The authors are pleased to present to Professor Öhrn this birthday gift of fully mature SLEND developments that now venture to treat systems of biochemical interest.

Diagnostic and prognostic value of presepsin in the management of sepsis in the emergency department: a multicenter prospective study.

PubMed

Ulla, Marco; Pizzolato, Elisa; Lucchiari, Manuela; Loiacono, Maria; Soardo, Flavia; Forno, Daniela; Morello, Fulvio; Lupia, Enrico; Moiraghi, Corrado; Mengozzi, Giulio; Battista, Stefania

2013-07-30

Sepsis, severe sepsis and septic shock are common conditions with high mortality. Their early diagnosis in the Emergency Department (ED) is one of the keys to improving survival. Procalcitonin (PCT) has been used as a biomarker in septic patients but has limited specificity and can be elevated in other scenarios of systemic inflammatory response syndrome (SIRS). Soluble CD14 (sCD14) or presepsin is the free fragment of a glycoprotein expressed on monocytes and macrophages. Preliminary reports suggest that levels of presepsin are significantly higher in septic patients than in healthy individuals. The aim of this study is to investigate the diagnostic and prognostic value of presepsin compared to PCT in people presenting at the ED with SIRS and suspected sepsis or septic shock. This study was conducted in two major hospitals in Turin, Italy. One hundred six patients presenting to the EDs with suspected sepsis or septic shock were included, and another eighty-three patients affected by SIRS, but with no clinical evidence of infection, were recruited as controls. Blood samples were collected at first medical evaluation and for some patients after 24 and 72 h. The samples were analyzed using the PATHFAST Presepsin assay for sCD14, and commercial kits were used for other determinations (for example, PCT). Definitive diagnosis and survival rates were obtained afterward by analysis of digital medical records. Elevated concentrations of presepsin at presentation were observed in septic patients compared to control patients. The same trend was observed for mean values of PCT. Higher values of presepsin were observed in septic patients at presentation (time 0). The diagnostic accuracy of PCT was generally higher, and areas under the curve (AUCs) were 0.875 for PCT and 0.701 for presepsin. Mean presepsin values were significantly higher in nonsurvivor septic patients (60-day mortality) than in survivors. No significant correlation was noted between PCT and survival. In our experience, presepsin was useful in the early diagnosis of infection in a complex population of patients with SIRS, sepsis, severe sepsis and septic shock who presented to the ED. Presepsin showed a significant prognostic value, and initial values were significantly correlated with in-hospital mortality of patients affected by sepsis, severe sepsis or septic shock.

Diagnostic and prognostic value of presepsin in the management of sepsis in the emergency department: a multicenter prospective study

PubMed Central

2013-01-01

Introduction Sepsis, severe sepsis and septic shock are common conditions with high mortality. Their early diagnosis in the Emergency Department (ED) is one of the keys to improving survival. Procalcitonin (PCT) has been used as a biomarker in septic patients but has limited specificity and can be elevated in other scenarios of systemic inflammatory response syndrome (SIRS). Soluble CD14 (sCD14) or presepsin is the free fragment of a glycoprotein expressed on monocytes and macrophages. Preliminary reports suggest that levels of presepsin are significantly higher in septic patients than in healthy individuals. The aim of this study is to investigate the diagnostic and prognostic value of presepsin compared to PCT in people presenting at the ED with SIRS and suspected sepsis or septic shock. Methods This study was conducted in two major hospitals in Turin, Italy. One hundred six patients presenting to the EDs with suspected sepsis or septic shock were included, and another eighty-three patients affected by SIRS, but with no clinical evidence of infection, were recruited as controls. Blood samples were collected at first medical evaluation and for some patients after 24 and 72 h. The samples were analyzed using the PATHFAST Presepsin assay for sCD14, and commercial kits were used for other determinations (for example, PCT). Definitive diagnosis and survival rates were obtained afterward by analysis of digital medical records. Results Elevated concentrations of presepsin at presentation were observed in septic patients compared to control patients. The same trend was observed for mean values of PCT. Higher values of presepsin were observed in septic patients at presentation (time 0). The diagnostic accuracy of PCT was generally higher, and areas under the curve (AUCs) were 0.875 for PCT and 0.701 for presepsin. Mean presepsin values were significantly higher in nonsurvivor septic patients (60-day mortality) than in survivors. No significant correlation was noted between PCT and survival. Conclusions In our experience, presepsin was useful in the early diagnosis of infection in a complex population of patients with SIRS, sepsis, severe sepsis and septic shock who presented to the ED. Presepsin showed a significant prognostic value, and initial values were significantly correlated with in-hospital mortality of patients affected by sepsis, severe sepsis or septic shock. PMID:23899120

Registration uncertainties between 3D cone beam computed tomography and different reference CT datasets in lung stereotactic body radiation therapy.

PubMed

Oechsner, Markus; Chizzali, Barbara; Devecka, Michal; Combs, Stephanie Elisabeth; Wilkens, Jan Jakob; Duma, Marciana Nona

2016-10-26

The aim of this study was to analyze differences in couch shifts (setup errors) resulting from image registration of different CT datasets with free breathing cone beam CTs (FB-CBCT). As well automatic as manual image registrations were performed and registration results were correlated to tumor characteristics. FB-CBCT image registration was performed for 49 patients with lung lesions using slow planning CT (PCT), average intensity projection (AIP), maximum intensity projection (MIP) and mid-ventilation CTs (MidV) as reference images. Both, automatic and manual image registrations were applied. Shift differences were evaluated between the registered CT datasets for automatic and manual registration, respectively. Furthermore, differences between automatic and manual registration were analyzed for the same CT datasets. The registration results were statistically analyzed and correlated to tumor characteristics (3D tumor motion, tumor volume, superior-inferior (SI) distance, tumor environment). Median 3D shift differences over all patients were between 0.5 mm (AIPvsMIP) and 1.9 mm (MIPvsPCT and MidVvsPCT) for the automatic registration and between 1.8 mm (AIPvsPCT) and 2.8 mm (MIPvsPCT and MidVvsPCT) for the manual registration. For some patients, large shift differences (>5.0 mm) were found (maximum 10.5 mm, automatic registration). Comparing automatic vs manual registrations for the same reference CTs, ∆AIP achieved the smallest (1.1 mm) and ∆MIP the largest (1.9 mm) median 3D shift differences. The standard deviation (variability) for the 3D shift differences was also the smallest for ∆AIP (1.1 mm). Significant correlations (p < 0.01) between 3D shift difference and 3D tumor motion (AIPvsMIP, MIPvsMidV) and SI distance (AIPvsMIP) (automatic) and also for 3D tumor motion (∆PCT, ∆MidV; automatic vs manual) were found. Using different CT datasets for image registration with FB-CBCTs can result in different 3D couch shifts. Manual registrations achieved partly different 3D shifts than automatic registrations. AIP CTs yielded the smallest shift differences and might be the most appropriate CT dataset for registration with 3D FB-CBCTs.

Ayahuasca enhances creative divergent thinking while decreasing conventional convergent thinking.

PubMed

Kuypers, K P C; Riba, J; de la Fuente Revenga, M; Barker, S; Theunissen, E L; Ramaekers, J G

2016-09-01

Ayahuasca is a South American psychotropic plant tea traditionally used in Amazonian shamanism. The tea contains the psychedelic 5-HT2A receptor agonist N,N-dimethyltryptamine (DMT), plus β-carboline alkaloids with monoamine oxidase-inhibiting properties. Increasing evidence from anecdotal reports and open-label studies indicates that ayahuasca may have therapeutic effects in treatment of substance use disorders and depression. A recent study on the psychological effects of ayahuasca found that the tea reduces judgmental processing and inner reactivity, classic goals of mindfulness psychotherapy. Another psychological facet that could potentially be targeted by ayahuasca is creative divergent thinking. This mode of thinking can enhance and strengthen psychological flexibility by allowing individuals to generate new and effective cognitive, emotional, and behavioral strategies. The present study aimed to assess the potential effects of ayahuasca on creative thinking. We visited two spiritual ayahuasca workshops and invited participants to conduct creativity tests before and during the acute effects of ayahuasca. In total, 26 participants consented. Creativity tests included the "pattern/line meanings test" (PLMT) and the "picture concept test" (PCT), both assessing divergent thinking and the latter also assessing convergent thinking. While no significant effects were found for the PLMT, ayahuasca intake significantly modified divergent and convergent thinking as measured by the PCT. While convergent thinking decreased after intake, divergent thinking increased. The present data indicate that ayahuasca enhances creative divergent thinking. They suggest that ayahuasca increases psychological flexibility, which may facilitate psychotherapeutic interventions and support clinical trial initiatives.

Effects of processing on the transverse fatigue properties of low-sulfur AISI 4140 steel

NASA Astrophysics Data System (ADS)

Collins, Sunniva R.; Michal, Gary M.

1993-12-01

The effects of inclusions due to steelmaking processes on the fatigue life of AISI 4140 have been investigated. The test matrix consisted of three commercially produced heats of AISI 4140 of comparable cleanliness: one was conventionally cast (CC), and two were inert gas-shielded/ bottom-poured (IGS). One of the IGS heats was calcium-treated to explore the effects of inclusion shape control (IGS/SC). All heats were hot-rolled and reduced over 95 pct to produce bar stock of 127 to 152 mm (5 to 6 in.) in diameter. Transverse axial specimens conforming to ASTM E466 were machined, quenched, and tempered to approximately 40 HRC, and they were fatigue tested in tension-tension cycling ( R = 0.1). Test results and statistical analyses of the stress-life data show that the IGS grade has several times the fatigue strength of the CC grade at 107 cycles. Lower-limit fatigue strengths calculated at a 99.9 pct probability were 518.5 MPa (75.2 ksi) for IGS vs 55.6 MPa (8.1 ksi) for the CC grade. The IGS/SC grade had the best performance at all stress and life levels. The results obtained indicate that fatigue performance can be improved by choosing a processing method that reduces the incidence of exogenous oxides and by controlling the shape of the sulfides.

TORC1 and class I HDAC inhibitors synergize to suppress mature B cell neoplasms.

PubMed

Simmons, John K; Patel, Jyoti; Michalowski, Aleksandra; Zhang, Shuling; Wei, Bih-Rong; Sullivan, Patrick; Gamache, Ben; Felsenstein, Kenneth; Kuehl, W Michael; Simpson, R Mark; Zingone, Adriana; Landgren, Ola; Mock, Beverly A

2014-03-01

Enhanced proliferative signaling and loss of cell cycle regulation are essential for cancer progression. Increased mitogenic signaling through activation of the mTOR pathway, coupled with deregulation of the Cyclin D/retinoblastoma (Rb) pathway is a common feature of lymphoid malignancies, including plasmacytoma (PCT), multiple myeloma (MM), Burkitt's lymphoma (BL), and mantle cell lymphoma (MCL). Here we evaluate the synergy of pharmacologically affecting both of these critical pathways using the mTOR inhibitor sirolimus and the histone deacetylase inhibitor entinostat. A dose-matrix screening approach found this combination to be highly active and synergistic in a panel of genetically diverse human MM cell lines. Synergy and activity was observed in mouse PCT and human BL and MCL cell lines tested in vitro, as well as in freshly isolated primary MM patient samples tested ex vivo. This combination had minimal effects on healthy donor cells and retained activity when tested in a co-culture system simulating the protective interaction of cancer cells with the tumor microenvironment. Combining sirolimus with entinostat enhanced cell cycle arrest and apoptosis. At the molecular level, entinostat increased the expression of cell cycle negative regulators including CDKN1A (p21) and CDKN2A (p16), while the combination decreased critical growth and survival effectors including Cyclin D, BCL-XL, BIRC5, and activated MAPK. Published by Elsevier B.V.

78 FR 7759 - Patent Cooperation Treaty

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-04

...) Concerning a Submission Under 35 U.S.C. 371 (PTO-1390) PCT/Model of Power of Attorney 15 minutes 4,829 1,207 PCT/Model of General Power of Attorney 15 minutes 483 121 Indications Relating to a Deposited...,508 Acceptance of an unintentionally delayed claim for priority (37 2 hours 294 588 CFR 1.78(a)(3...

77 FR 65699 - Prospective Grant of Exclusive License: Development of Chemopreventive Treatments for Head and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-30

... Exclusive License: Development of Chemopreventive Treatments for Head and Neck Squamous Cell Carcinoma... Neck Squamous Cell Carcinoma'' (HHS Ref. No. E-302-2008/0) and PCT Patent Application No. PCT/IL2010... head and neck squamous cell carcinoma (HNSCC), a cancer occurring mostly in the mouth, it is frequently...

Identifying Efficacious Treatment Components of Panic Control Treatment for Adolescents: A Preliminary Examination

ERIC Educational Resources Information Center

Micco, Jamie A.; Choate-Summers, Molly L.; Ehrenreich, Jill T.; Pincus, Donna B.; Mattis, Sara G.

2007-01-01

Panic Control Treatment for Adolescents (PCT-A) is a developmentally sensitive and efficacious treatment for adolescents with panic disorder. The present study is a preliminary examination of the relative efficacy of individual treatment components in PCT-A in a sample of treatment completers; the study identified when rapid improvements in panic…

A Comparison of Perceptions of Career and Technical Education Curriculum and Academic Core Curriculum

ERIC Educational Resources Information Center

Handy, Kimberly

2012-01-01

This study focused on identifying and categorizing the perceptions of teachers, counselors, and administrators related to career and technical education (CTE) and academic core (AC) curricula in a large school district. Control group actions' perceptual control theory (PCT) was used as the conceptual framework for the study. PCT is a model of…

Manganese Recovery by Silicothermic Reduction of MnO in BaO-MnO-MgO-CaF2 (-SiO2) Slags

NASA Astrophysics Data System (ADS)

Heo, Jung Ho; Park, Joo Hyun

2018-04-01

The effects of reducing agent, CaF2 content, and reaction temperature upon the silicothermic reduction of MnO in the BaO-MnO-MgO-CaF2 (-SiO2) slags were investigated. Mn recovery was proportional to Si activity in the molten alloy. Moreover, 90 pct yield of Mn recovery was obtained under 5 mass pct CaF2 content and 1873 K (1600 °C) reaction temperature. Increasing CaF2 content above 5 pct yielded little or no further increase in Mn recovery, because it was accompanied by increased slag viscosity owing to the precipitation of high melting point compounds such as Ba2SiO4.

On the practical efficiency of shape memory engines

NASA Astrophysics Data System (ADS)

McCormick, P. G.

1987-02-01

The effects of non-ideal behavior, i.e., thermal efficiencies less than perfect, on the efficiency of shape memory (SME) engines are analyzed. Account is taken of the temperature hysteresis between the forward and reverse transformation and the finite elastic compliance of the SM element and the engine. The temperature difference produced by a particular stress cycle and necessary to complete the cycle is quantified, along with the temperature penalty which arises from non-ideal behavior. The hysteresis, elastic compliance and low working strains in cycled materials are shown to yield low thermal efficiencies, e.g., 1.95 pct instead of 6.74 pct in the case of a 20 k hysteresis. Heat recycling can theoretically improve the efficiency to about 3.23 pct.

The effect of alumina in slag on manganese and silicon distributions in silicomanganese smelting

NASA Astrophysics Data System (ADS)

Swinbourne, D. R.; Rankin, W. J.; Eric, R. H.

1995-02-01

The distribution ratios of manganese and silicon between silicomanganese alloy and slag, in equilibrium with carbon, were investigated at 1500 °C. The alumina content of the slag was varied from about 9 to 32 pct. Both distribution ratios decreased as A12O3 increased to about 20 pct and, thereafter, remained constant. The value of the “apparent equilibrium constant” displayed a maximum at about 24 pct A12O3, mainly because of the variation in the values of the activity coefficients of SiO2 and MnO. It was concluded that the slag and silicomanganese alloy in a submerged arc furnace are at, or at least close to, equilibrium.

Patch-based generation of a pseudo CT from conventional MRI sequences for MRI-only radiotherapy of the brain

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

Andreasen, Daniel, E-mail: dana@dtu.dk; Van Leemput, Koen; Hansen, Rasmus H.

Purpose: In radiotherapy (RT) based on magnetic resonance imaging (MRI) as the only modality, the information on electron density must be derived from the MRI scan by creating a so-called pseudo computed tomography (pCT). This is a nontrivial task, since the voxel-intensities in an MRI scan are not uniquely related to electron density. To solve the task, voxel-based or atlas-based models have typically been used. The voxel-based models require a specialized dual ultrashort echo time MRI sequence for bone visualization and the atlas-based models require deformable registrations of conventional MRI scans. In this study, we investigate the potential of amore » patch-based method for creating a pCT based on conventional T{sub 1}-weighted MRI scans without using deformable registrations. We compare this method against two state-of-the-art methods within the voxel-based and atlas-based categories. Methods: The data consisted of CT and MRI scans of five cranial RT patients. To compare the performance of the different methods, a nested cross validation was done to find optimal model parameters for all the methods. Voxel-wise and geometric evaluations of the pCTs were done. Furthermore, a radiologic evaluation based on water equivalent path lengths was carried out, comparing the upper hemisphere of the head in the pCT and the real CT. Finally, the dosimetric accuracy was tested and compared for a photon treatment plan. Results: The pCTs produced with the patch-based method had the best voxel-wise, geometric, and radiologic agreement with the real CT, closely followed by the atlas-based method. In terms of the dosimetric accuracy, the patch-based method had average deviations of less than 0.5% in measures related to target coverage. Conclusions: We showed that a patch-based method could generate an accurate pCT based on conventional T{sub 1}-weighted MRI sequences and without deformable registrations. In our evaluations, the method performed better than existing voxel-based and atlas-based methods and showed a promising potential for RT of the brain based only on MRI.« less

SU-C-207A-01: A Novel Maximum Likelihood Method for High-Resolution Proton Radiography/proton CT

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

Collins-Fekete, C; Centre Hospitalier University de Quebec, Quebec, QC; Mass General Hospital

2016-06-15

Purpose: Multiple Coulomb scattering is the largest contributor to blurring in proton imaging. Here we tested a maximum likelihood least squares estimator (MLLSE) to improve the spatial resolution of proton radiography (pRad) and proton computed tomography (pCT). Methods: The object is discretized into voxels and the average relative stopping power through voxel columns defined from the source to the detector pixels is optimized such that it maximizes the likelihood of the proton energy loss. The length spent by individual protons in each column is calculated through an optimized cubic spline estimate. pRad images were first produced using Geant4 simulations. Anmore » anthropomorphic head phantom and the Catphan line-pair module for 3-D spatial resolution were studied and resulting images were analyzed. Both parallel and conical beam have been investigated for simulated pRad acquisition. Then, experimental data of a pediatric head phantom (CIRS) were acquired using a recently completed experimental pCT scanner. Specific filters were applied on proton angle and energy loss data to remove proton histories that underwent nuclear interactions. The MTF10% (lp/mm) was used to evaluate and compare spatial resolution. Results: Numerical simulations showed improvement in the pRad spatial resolution for the parallel (2.75 to 6.71 lp/cm) and conical beam (3.08 to 5.83 lp/cm) reconstructed with the MLLSE compared to averaging detector pixel signals. For full tomographic reconstruction, the improved pRad were used as input into a simultaneous algebraic reconstruction algorithm. The Catphan pCT reconstruction based on the MLLSE-enhanced projection showed spatial resolution improvement for the parallel (2.83 to 5.86 lp/cm) and conical beam (3.03 to 5.15 lp/cm). The anthropomorphic head pCT displayed important contrast gains in high-gradient regions. Experimental results also demonstrated significant improvement in spatial resolution of the pediatric head radiography. Conclusion: The proposed MLLSE shows promising potential to increase the spatial resolution (up to 244%) in proton imaging.« less

Microstructural Evaluation of Inductively Sintered Aluminum Matrix Nanocomposites Reinforced with Silicon Carbide and/or Graphene Nanoplatelets for Tribological Applications

NASA Astrophysics Data System (ADS)

Islam, Mohammad; Khalid, Yasir; Ahmad, Iftikhar; Almajid, Abdulhakim A.; Achour, Amine; Dunn, Theresa J.; Akram, Aftab; Anwar, Saqib

2018-04-01

Silicon carbide (SiC) nanoparticles (NP) and/or graphene nanoplatelets (GNP) were incorporated into the aluminum matrix through colloidal dispersion and mixing of the powders, followed by consolidation using a high-frequency induction heat sintering process. All the nanocomposite samples exhibited high densification (> 96 pct) with a maximum increase in Vickers microhardness by 92 pct relative to that of pure aluminum. The tribological properties of the samples were determined at the normal frictional forces of 10 and 50 N. At relatively low load of 10 N, the adhesive wear was found to be the predominant wear mechanism, whereas in the case of a 50 N normal load, there was significant contribution from abrasive wear possibly by hard SiC NP. From wear tests, the values for the coefficient of friction (COF) and the normalized wear rate were determined. The improvement in hardness and wear resistance may be attributed to multiple factors, including high relative density, uniform SiC and GNP dispersion in the aluminum matrix, grain refinement through GNP pinning, as well as inhibition of dislocation movement by SiC NP. The nanocomposite sample containing 10 SiC and 0.5 GNP (by wt pct) yielded the maximum wear resistance at 10 N normal load. Microstructural characterization of the nanocomposite surfaces and wear debris was performed using scanning electron microscope (SEM) and transmission electron microscope (TEM). The synergistic effect of the GNP and SiC nanostructures accounts for superior wear resistance in the aluminum matrix nanocomposites.

Microstructural Evaluation of Inductively Sintered Aluminum Matrix Nanocomposites Reinforced with Silicon Carbide and/or Graphene Nanoplatelets for Tribological Applications

NASA Astrophysics Data System (ADS)

Islam, Mohammad; Khalid, Yasir; Ahmad, Iftikhar; Almajid, Abdulhakim A.; Achour, Amine; Dunn, Theresa J.; Akram, Aftab; Anwar, Saqib

2018-07-01

Silicon carbide (SiC) nanoparticles (NP) and/or graphene nanoplatelets (GNP) were incorporated into the aluminum matrix through colloidal dispersion and mixing of the powders, followed by consolidation using a high-frequency induction heat sintering process. All the nanocomposite samples exhibited high densification (> 96 pct) with a maximum increase in Vickers microhardness by 92 pct relative to that of pure aluminum. The tribological properties of the samples were determined at the normal frictional forces of 10 and 50 N. At relatively low load of 10 N, the adhesive wear was found to be the predominant wear mechanism, whereas in the case of a 50 N normal load, there was significant contribution from abrasive wear possibly by hard SiC NP. From wear tests, the values for the coefficient of friction (COF) and the normalized wear rate were determined. The improvement in hardness and wear resistance may be attributed to multiple factors, including high relative density, uniform SiC and GNP dispersion in the aluminum matrix, grain refinement through GNP pinning, as well as inhibition of dislocation movement by SiC NP. The nanocomposite sample containing 10 SiC and 0.5 GNP (by wt pct) yielded the maximum wear resistance at 10 N normal load. Microstructural characterization of the nanocomposite surfaces and wear debris was performed using scanning electron microscope (SEM) and transmission electron microscope (TEM). The synergistic effect of the GNP and SiC nanostructures accounts for superior wear resistance in the aluminum matrix nanocomposites.

Plasma neutrophil gelatinase-associated lipocalin: a marker of acute pyelonephritis in children.

PubMed

Kim, Byung Kwan; Yim, Hyung Eun; Yoo, Kee Hwan

2017-03-01

This study was designed to compare the diagnostic accuracy of plasma neutrophil gelatinase-associated lipocalin (NGAL) with procalcitonin (PCT), C-reactive protein (CRP), and white blood cells (WBCs) for predicting acute pyelonephritis (APN) in children with febrile urinary tract infections (UTIs). In total, 138 children with febrile UTIs (APN 59, lower UTI 79) were reviewed retrospectively. Levels of NGAL, PCT, CRP, and WBCs in blood were measured on admission. The diagnostic accuracy of the biomarkers was investigated. Independent predictors of APN were identified by multivariate logistic regression analysis. Receiver operating curve (ROC) analyses showed good diagnostic profiles of NGAL, PCT, CRP, and WBCs for identifying APN [area under the curve (AUC) 0.893, 0.855, 0.879, and 0.654, respectively]. However, multivariate analysis revealed only plasma NGAL level was an independent predictor of APN (P = 0.006). At the best cutoff values of all examined biomarkers for identifying APN, sensitivity (86 %), specificity (85 %), positive predictive value (81 %), and negative predictive value (89 %) of plasma NGAL levels were the highest. The optimal NGAL cutoff value was 117 ng/ml. The positive likelihood ratio [odds ratio (OR) 5.69, 95 % confidence interval (CI) 3.56-8.78], and negative likelihood ratio (OR 0.16, 95 % CI 0.08-0.29) of plasma NGAL for APN diagnosis also showed it seemed to be more accurate than serum PCT, CRP, and WBCs. Plasma NGAL can be more useful than serum PCT, CRP, and WBC levels for identifying APN in children with febrile UTIs.

Time-series intervention analysis of pedestrian countdown timer effects.

PubMed

Huitema, Bradley E; Van Houten, Ron; Manal, Hana

2014-11-01

Pedestrians account for 40-50% of traffic fatalities in large cities. Several previous studies based on relatively small samples have concluded that Pedestrian Countdown Timers (PCT) may reduce pedestrian crashes at signalized intersections, but other studies report no reduction. The purposes of the present article are to (1) describe a new methodology to evaluate the effectiveness of introducing PCT signals and (2) to present results of applying this methodology to pedestrian crash data collected in a large study carried out in Detroit, Michigan. The study design incorporated within-unit as well as between-unit components. The main focus was on dynamic effects that occurred within the PCT unit of 362 treated sites during the 120 months of the study. An interrupted time-series analysis was developed to evaluate whether change in crash frequency depended upon of the degree to which the countdown timers penetrated the treatment unit. The between-unit component involved comparisons between the treatment unit and a control unit. The overall conclusion is that the introduction of PCT signals in Detroit reduced pedestrian crashes to approximately one-third of the preintervention level. The evidence for this reductionis strong and the change over time was shown to be a function of the extent to which the timers were introduced during the intervention period. There was no general drop-off in crash frequency throughout the baseline interval of over five years; only when the PCT signals were introduced in large numbers was consistent and convincing crash reduction observed. Correspondingly, there was little evidence of change in the control unit. Copyright © 2014. Published by Elsevier Ltd.

Tool Steel Heat Treatment Optimization Using Neural Network Modeling

NASA Astrophysics Data System (ADS)

Podgornik, Bojan; Belič, Igor; Leskovšek, Vojteh; Godec, Matjaz

2016-11-01

Optimization of tool steel properties and corresponding heat treatment is mainly based on trial and error approach, which requires tremendous experimental work and resources. Therefore, there is a huge need for tools allowing prediction of mechanical properties of tool steels as a function of composition and heat treatment process variables. The aim of the present work was to explore the potential and possibilities of artificial neural network-based modeling to select and optimize vacuum heat treatment conditions depending on the hot work tool steel composition and required properties. In the current case training of the feedforward neural network with error backpropagation training scheme and four layers of neurons (8-20-20-2) scheme was based on the experimentally obtained tempering diagrams for ten different hot work tool steel compositions and at least two austenitizing temperatures. Results show that this type of modeling can be successfully used for detailed and multifunctional analysis of different influential parameters as well as to optimize heat treatment process of hot work tool steels depending on the composition. In terms of composition, V was found as the most beneficial alloying element increasing hardness and fracture toughness of hot work tool steel; Si, Mn, and Cr increase hardness but lead to reduced fracture toughness, while Mo has the opposite effect. Optimum concentration providing high KIc/HRC ratios would include 0.75 pct Si, 0.4 pct Mn, 5.1 pct Cr, 1.5 pct Mo, and 0.5 pct V, with the optimum heat treatment performed at lower austenitizing and intermediate tempering temperatures.

Bragg peak prediction from quantitative proton computed tomography using different path estimates

PubMed Central

Wang, Dongxu; Mackie, T Rockwell

2015-01-01

This paper characterizes the performance of the straight-line path (SLP) and cubic spline path (CSP) as path estimates used in reconstruction of proton computed tomography (pCT). The GEANT4 Monte Carlo simulation toolkit is employed to simulate the imaging phantom and proton projections. SLP, CSP and the most-probable path (MPP) are constructed based on the entrance and exit information of each proton. The physical deviations of SLP, CSP and MPP from the real path are calculated. Using a conditional proton path probability map, the relative probability of SLP, CSP and MPP are calculated and compared. The depth dose and Bragg peak are predicted on the pCT images reconstructed using SLP, CSP, and MPP and compared with the simulation result. The root-mean-square physical deviations and the cumulative distribution of the physical deviations show that the performance of CSP is comparable to MPP while SLP is slightly inferior. About 90% of the SLP pixels and 99% of the CSP pixels lie in the 99% relative probability envelope of the MPP. Even at an imaging dose of ~0.1 mGy the proton Bragg peak for a given incoming energy can be predicted on the pCT image reconstructed using SLP, CSP, or MPP with 1 mm accuracy. This study shows that SLP and CSP, like MPP, are adequate path estimates for pCT reconstruction, and therefore can be chosen as the path estimation method for pCT reconstruction, which can aid the treatment planning and range prediction of proton radiation therapy. PMID:21212472

Relations of Platelet Indices with Endometrial Hyperplasia and Endometrial Cancer.

PubMed

Karateke, Atilla; Kaplanoglu, Mustafa; Baloglu, Ali

2015-01-01

Platelets are blood elements thought to play a role in the immune system and therefore tumor development and metastasis. Platelet activation parameters such as mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT) can be easily evaluated with the whole blood count and have been studied as markers of systemic inflammatory responses in various cancer types. Our aim in this study was to evaluate the correlation between endometrial pathologies and MPV, PDW and PCT. A total of 194 patients who presented to our clinic with abnormal vaginal bleeding were included in our study. The patients were divided into 3 groups (endometrial hyperplasia, endometrial cancer, control) according to their pathology results. The groups were compared for MPV, PDW, and PCT values obtained from the blood samples taken on endometrial biopsy day. The endometrial cancer patients were the oldest group (p=0.04). There was no significant difference between the three groups in terms of white blood cell count (WBC), platelet count (PC), and hemoglobin (Hb) level. The highest MPV (p<0.001), PDW (p=0.002), and PCT (p<0.001) levels were in the endometrial cancer group, and the lowest levels were in the control group. The easy evaluation of platelet parameters in patients who are suspected of having endometrial pathology is a significant advantage. We found MPV, PDW, and PCT to be correlated with the severity of endometrial pathology with the highest values in endometrial cancer. Studies to be conducted together with different laboratory parameters will further help evaluate the diagnosis and severity of endometrial cancer and precursor lesions.

[Role of plasma procalcitonin in the diagnosis of ventilator-associated pneumonia: systematic review and metaanalysis].

PubMed

Sotillo-Díaz, J C; Bermejo-López, E; García-Olivares, P; Peral-Gutiérrez, J A; Sancho-González, M; Guerrero-Sanz, J E

2014-01-01

To determine the role of plasma procalcitonin (PCT) levels in diagnosing ventilator-associated pneumonia. A systematic review of publications prospectively assessing the diagnostic role of PCT in ventilator-associated pneumonia was carried out. The search was performed using Medline, Embase, the Cochrane Collaboration and MEDION, with reviewing of the references of retrieved articles. We extracted data that allowed the calculation of sensitivity, specificity, likelihood ratios and diagnostic odds ratio. Intervention Metaregression was performed to determine whether exposure to previous antibiotic treatment, the time to occurrence of ventilator-associated pneumonia and the type of patients had an impact upon the diagnostic performance of procalcitonin. Seven studies were considered (373 patients, 434 episodes). We found no publication bias or threshold effect. High plasma PCT levels were associated to an increased risk of suffering ventilator-associated pneumonia (OR: 8.39; 95% CI: 5.4-12.6). The pooled data on sensitivity, specificity, positive and negative likelihood ratio, and diagnostic odds ratio found were 76% (69-82), 79% (74-84), 4.35 (2.48-7.62), 0.26 (0.15-0.46) and 17.9 (10.1-31.7), respectively. Diagnostic yield was modified by prior exposure to antibiotics (rDOR 0.11, 0.02-0.069), but not by the type of critically ill patient or the time to occurrence of ventilator-associated pneumonia. Our results suggest that PCT provides additional information on the risk of VAP. Inclusion of PCT in diagnostic algorithms could improve their effectiveness. Copyright © 2013 Elsevier España, S.L. and SEMICYUC. All rights reserved.

Computed tomography synthesis from magnetic resonance images in the pelvis using multiple random forests and auto-context features

NASA Astrophysics Data System (ADS)

Andreasen, Daniel; Edmund, Jens M.; Zografos, Vasileios; Menze, Bjoern H.; Van Leemput, Koen

2016-03-01

In radiotherapy treatment planning that is only based on magnetic resonance imaging (MRI), the electron density information usually obtained from computed tomography (CT) must be derived from the MRI by synthesizing a so-called pseudo CT (pCT). This is a non-trivial task since MRI intensities are neither uniquely nor quantitatively related to electron density. Typical approaches involve either a classification or regression model requiring specialized MRI sequences to solve intensity ambiguities, or an atlas-based model necessitating multiple registrations between atlases and subject scans. In this work, we explore a machine learning approach for creating a pCT of the pelvic region from conventional MRI sequences without using atlases. We use a random forest provided with information about local texture, edges and spatial features derived from the MRI. This helps to solve intensity ambiguities. Furthermore, we use the concept of auto-context by sequentially training a number of classification forests to create and improve context features, which are finally used to train a regression forest for pCT prediction. We evaluate the pCT quality in terms of the voxel-wise error and the radiologic accuracy as measured by water-equivalent path lengths. We compare the performance of our method against two baseline pCT strategies, which either set all MRI voxels in the subject equal to the CT value of water, or in addition transfer the bone volume from the real CT. We show an improved performance compared to both baseline pCTs suggesting that our method may be useful for MRI-only radiotherapy.

Urinary neutrophil gelatinase-associated lipocalin, a biomarker for systemic inflammatory response syndrome in patients with nephrolithiasis.

PubMed

Zhu, Wei; Liu, Min; Wang, Guang-Chun; Che, Jian-Ping; Xu, Yun-Fei; Peng, Bo; Zheng, Jun-Hua

2014-03-01

The objective of this study was to determine the diagnostic value of neutrophil gelatinase-associated lipocalin (NGAL), C-reactive protein (CRP), and procalcitonin (PCT) in the prognosis of patients presenting with the systemic inflammatory response syndrome (SIRS) with nephrolithiasis. Urine NGAL protein levels were measured by enzyme-linked immunosorbent assay in 87 patients presenting with nephrolithiasis who were diagnosed as SIRS. Additionally, 52 patients presenting with nephrolithiasis but without urinary tract infection and 30 healthy controls were also included in the study. Levels of serum CRP and PCT were also taken into consideration. Median urinary NGAL levels were significantly increased in the SIRS cohorts compared with nephrolithiasis without urinary tract infection patients (4.28 ng/mL versus 2.69 ng/mL, P < 0.001), and NGAL was markedly elevated even in the early stage of SIRS (3.23 ng/mL versus 2.69 ng/mL, P < 0.001). According to the receiver-operating characteristic analysis, NGAL demonstrated a high diagnostic value compared with either PCT or CRP. In the later stage of SIRS, NGAL remained a highly sensitive (76.8%) and specific (86.5%) diagnostic marker compared with either PCT or CRP. Moreover, the area under the curves of NGAL (0.822) were also superior to those seen in either PCT (0.657) or CRP (0.761). Urinary NGAL is a highly sensitive and specific predictor of SIRS for patients presenting with nephrolithiasis. Further study of NGAL as a reliable biomarker of SIRS is required. Copyright © 2014 Elsevier Inc. All rights reserved.

Serum soluble ST2 as diagnostic marker of systemic inflammatory reactive syndrome of bacterial etiology in children.

PubMed

Calò Carducci, Francesca Ippolita; Aufiero, Lelia Rotondi; Folgori, Laura; Vittucci, Anna Chiara; Amodio, Donato; De Luca, Maia; Li Pira, Giuseppina; Bergamini, Alberto; Pontrelli, Giuseppe; Finocchi, Andrea; D'Argenio, Patrizia

2014-02-01

Accurate and timely diagnosis of community-acquired bacterial versus viral infections in children with systemic inflammatory response syndrome (SIRS) remains challenging both for clinician and laboratory. In the quest of new biochemical markers to distinguish bacterial from viral infection, we have explored the possible role of the soluble secreted form of ST2 (sST2). This explorative prospective cohort study included children with SIRS who were suspected of having community-acquired infections. Plasma samples for sST2 measurement were obtained from 64 hospitalized children, 41 of whom had SIRS of bacterial etiology and 23 SIRS of viral etiology, and from 20 healthy, age- and sex-matched control children. sST2 measurement was carried out by enzyme-linked immunosorbent assay in parallel with standard measurements of procalcitonin (PCT) and C reactive protein (CRP). Our findings demonstrate that children with SIRS associated with bacterial infection present significantly increased levels of sST2, when compared with patients with SIRS of viral etiology and healthy children. More important, receiver operating characteristic curve analysis indicated that sST2 has a significant diagnostic performance with respect to early identification of SIRS of bacterial etiology, which was similar to that of PCT and greater than that of CRP. Finally, the combination of sST2 plus PCT and/or CRP, and PCT plus CRP increased their sensitivity and negative predictive value compared with sST2, PCT and CRP alone. In conclusion, sST2 level may prove useful in predicting bacterial etiology in children with SIRS.

Diagnostic value of lactate, procalcitonin, ferritin, serum-C-reactive protein, and other biomarkers in bacterial and viral meningitis: A cross-sectional study.

PubMed

Sanaei Dashti, Anahita; Alizadeh, Shekoofan; Karimi, Abdullah; Khalifeh, Masoomeh; Shoja, Seyed Abdolmajid

2017-09-01

There are many difficulties distinguishing bacterial from viral meningitis that could be reasonably solved using biomarkers. The aim of this study was to evaluate lactate, procalcitonin (PCT), ferritin, serum-CRP (C-reactive protein), and other known biomarkers in differentiating bacterial meningitis from viral meningitis in children.All children aged 28 days to 14 years with suspected meningitis who were admitted to Mofid Children's Hospital, Tehran, between October 2012 and November 2013, were enrolled in this prospective cross-sectional study. Children were divided into 2 groups of bacterial and viral meningitis, based on the results of cerebrospinal fluid (CSF) culture, polymerase chain reaction, and cytochemical profile. Diagnostic values of CSF parameters (ferritin, PCT, absolute neutrophil count [ANC], white blood cell count, and lactate) and serum parameters (PCT, ferritin, CRP, and erythrocyte sedimentation rate [ESR]) were evaluated.Among 50 patients with meningitis, 12 were diagnosed with bacterial meningitis. Concentrations of all markers were significantly different between bacterial and viral meningitis, except for serum (P = .389) and CSF (P = .136) PCT. The best rates of area under the receiver operating characteristic (ROC) curve (AUC) were achieved by lactate (AUC = 0.923) and serum-CRP (AUC = 0.889). The best negative predictive values (NPV) for bacterial meningitis were attained by ANC (100%) and lactate (97.1%).The results of our study suggest that ferritin and PCT are not strong predictive biomarkers. A combination of low CSF lactate, ANC, ESR, and serum-CRP could reasonably rule out the bacterial meningitis.

Diagnostic value of lactate, procalcitonin, ferritin, serum-C-reactive protein, and other biomarkers in bacterial and viral meningitis

PubMed Central

Sanaei Dashti, Anahita; Alizadeh, Shekoofan; Karimi, Abdullah; Khalifeh, Masoomeh; Shoja, Seyed Abdolmajid

2017-01-01

Abstract There are many difficulties distinguishing bacterial from viral meningitis that could be reasonably solved using biomarkers. The aim of this study was to evaluate lactate, procalcitonin (PCT), ferritin, serum-CRP (C-reactive protein), and other known biomarkers in differentiating bacterial meningitis from viral meningitis in children. All children aged 28 days to 14 years with suspected meningitis who were admitted to Mofid Children's Hospital, Tehran, between October 2012 and November 2013, were enrolled in this prospective cross-sectional study. Children were divided into 2 groups of bacterial and viral meningitis, based on the results of cerebrospinal fluid (CSF) culture, polymerase chain reaction, and cytochemical profile. Diagnostic values of CSF parameters (ferritin, PCT, absolute neutrophil count [ANC], white blood cell count, and lactate) and serum parameters (PCT, ferritin, CRP, and erythrocyte sedimentation rate [ESR]) were evaluated. Among 50 patients with meningitis, 12 were diagnosed with bacterial meningitis. Concentrations of all markers were significantly different between bacterial and viral meningitis, except for serum (P = .389) and CSF (P = .136) PCT. The best rates of area under the receiver operating characteristic (ROC) curve (AUC) were achieved by lactate (AUC = 0.923) and serum-CRP (AUC = 0.889). The best negative predictive values (NPV) for bacterial meningitis were attained by ANC (100%) and lactate (97.1%). The results of our study suggest that ferritin and PCT are not strong predictive biomarkers. A combination of low CSF lactate, ANC, ESR, and serum-CRP could reasonably rule out the bacterial meningitis. PMID:28858084

Remedial treatment of lodgepole pine infested with mountain pine beetle: efficacy of three insecticides

Treesearch

Paul E. Tilden

1985-01-01

Lindane is registered for remedial control of bark beetles; however, forestry uses are controversial and alternative chemicals are needed. Chlorpyrifos (Dursban 4E), carbaryl (Sevimol 4), and fenitrothion (Sumithion 8E) at 1, 2, and 4 pct active ingredient, and lindane at the registered dosage of 0.6 pct were sprayed on lodgepole pine (Pinus contorta...

Trends in ozone profile measurements

NASA Technical Reports Server (NTRS)

Johnston, H.; Aikin, A.; Barnes, R.; Chandra, S.; Cunnold, D.; Deluisi, J.; Gille, J. C.; Hudson, R.; Mccormick, M. P.; Mcmaster, L.

1989-01-01

From an examination of the agreements and differences between different satellite instruments, it is difficult to believe that existing satellite instruments determine upper stratospheric ozone much better than 4 pct.; by extension, it probably would require at least a 4 pct. change to be reliably detected as a change. The best estimates of the vertical profiles of ozone change in the upper stratosphere between 1979 and 1986 are judged to be those given by the two SAGE satellite instruments. SAGE-2 minus SAGE-1 gives a much lower ozone reduction than that given by the archived Solar Backscatter UV data. The average SAGE profiles of ozone changes between 20 and 50 degs north and between 20 and 50 degs south are given. The SAGE-1 and SAGE-2 comparison gives an ozone reduction of about 4 pct. at 25 km over temperate latitudes. Five ground based Umkehr stations between 36 and 52 degs north, corrected for the effects of volcanic aerosols, report an ozone reduction between 1979 and 1987 at Umkehr layer 8 of 9 + or - 5 pct. The central estimate of upper stratospheric ozone reduction given by SAGE at 40 km is less than the central value estimated by the Umkehr method at layer 8.

Analysis and Evaluation of Parameters Determining Maximum Efficiency of Fish Protection

NASA Astrophysics Data System (ADS)

Khetsuriani, E. D.; Kostyukov, V. P.; Khetsuriani, T. E.

2017-11-01

The article is concerned with experimental research findings. The efficiency of fish fry protection from entering water inlets is the main criterion of any fish protection facility or device. The research was aimed to determine an adequate mathematical model E = f(PCT, Vp, α), where PCT, Vp and α are controlled factors influencing the process of fish fry protection. The result of the processing of experimental data was an adequate regression model. We determined the maximum of fish protection Emax=94,21 and the minimum of optimization function Emin=44,41. As a result of the statistical processing of experimental data we obtained adequate dependences for determining an optimal rotational speed of tip and fish protection efficiency. The analysis of fish protection efficiency dependence E% = f(PCT, Vp, α) allowed the authors to recommend the following optimized operating modes for it: the maximum fish protection efficiency is achieved at the process pressure PCT=3 atm, stream velocity Vp=0,42 m/s and nozzle inclination angle α=47°49’. The stream velocity Vp has the most critical influence on fish protection efficiency. The maximum efficiency of fish protection is obtained at the tip rotational speed of 70.92 rpm.

The Study of Two Psychotherapy Approaches (Rogers Self Theory and Ellis Rational Theory) in Improvement of Bowen Self-differentiation and Intimacy

PubMed Central

Yousefi, Naser; Kiani, Mohammad Ali

2014-01-01

Objective: To compare the effectiveness of rational, behavioral and emotive therapy (REBT) and person-centered therapy (PCT) on self-differentiation and intimacy among divorce clients. Methods: In quasi-experimental study, 42 divorce clients (both males and females) who presented to the Counsling Center of Sanandaj, Iran were sampled. They were categorized into three groups of PCT, REBT, and control group (each group contained 14 subjects). The recovery indices (dependent variables) employed were the subject of self-differentiation and intimacy, which were measured twice before and after intervention of Differentiation of Self Inventory-2 (DSI-2) and intimacy. The therapy involved 8 one-hour sessions. It was held twice a week and therapeutic effects were traced after 8 months. Results: The results showed that REBT and PCT were effective on self-differentiation scale and intimacy. Also they were influential in recovery self-differentiation scale and intimacy follow up stage. Conclusion: REBT and PCT were effective on self-differentiation and its subscales (Emotional reactivity, “I” position, Emotional cut off and Fusion with other) and general intimacy. Declaration of interest: None. PMID:24995028

Improving Low-Dose Blood-Brain Barrier Permeability Quantification Using Sparse High-Dose Induced Prior for Patlak Model

PubMed Central

Fang, Ruogu; Karlsson, Kolbeinn; Chen, Tsuhan; Sanelli, Pina C.

2014-01-01

Blood-brain-barrier permeability (BBBP) measurements extracted from the perfusion computed tomography (PCT) using the Patlak model can be a valuable indicator to predict hemorrhagic transformation in patients with acute stroke. Unfortunately, the standard Patlak model based PCT requires excessive radiation exposure, which raised attention on radiation safety. Minimizing radiation dose is of high value in clinical practice but can degrade the image quality due to the introduced severe noise. The purpose of this work is to construct high quality BBBP maps from low-dose PCT data by using the brain structural similarity between different individuals and the relations between the high- and low-dose maps. The proposed sparse high-dose induced (shd-Patlak) model performs by building a high-dose induced prior for the Patlak model with a set of location adaptive dictionaries, followed by an optimized estimation of BBBP map with the prior regularized Patlak model. Evaluation with the simulated low-dose clinical brain PCT datasets clearly demonstrate that the shd-Patlak model can achieve more significant gains than the standard Patlak model with improved visual quality, higher fidelity to the gold standard and more accurate details for clinical analysis. PMID:24200529

Chemical composition analysis and product consistency tests to support Enhanced Hanford Waste Glass Models. Results for the Augusta and October 2014 LAW Glasses

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

Fox, K. M.; Edwards, T. B.; Best, D. R.

2015-07-07

In this report, the Savannah River National Laboratory provides chemical analyses and Product Consistency Test (PCT) results for several simulated low activity waste (LAW) glasses (designated as the August and October 2014 LAW glasses) fabricated by the Pacific Northwest National Laboratory. The results of these analyses will be used as part of efforts to revise or extend the validation regions of the current Hanford Waste Treatment and Immobilization Plant glass property models to cover a broader span of waste compositions.

Evolution of Microstructure and Stress Corrosion Cracking Behavior of AA2219 Plate to Ring Weld Joints in 3.5 Wt Pct NaCl Solution

NASA Astrophysics Data System (ADS)

Venugopal, A.; Narayanan, P. Ramesh; Sharma, S. C.

2016-04-01

AA2219 aluminum alloy plate (T87) and ring (T851) were joined by tungsten inert gas (TIG) welding using multi-pass welding. The mechanical properties and stress corrosion cracking (SCC) resistance of the above base metals (BMs) in different directions (L, LT, and ST) were examined. Similarly, the weld metal joined by plate to plate and plate to ring (PR) joints was evaluated. The results revealed that the mechanical properties of the ring were comparatively lower than the plate. This was found to be due to the extremely coarse grain size of the ring along with severe Cu-rich segregation along the grain boundaries when compared to the plate material. The SCC resistance of the base and weldments were found to be good and not susceptible to SCC. This was shown to be due to high values of SCC index (>0.9) and the typical ductile cracking morphology of the BM and the weld joints after SCC test in the environment (3.5 wt pct NaCl) when compared to test performed in the control environment (air). However, the corrosion resistance of the weld interface between the FZ and ring was inferior to the FZ-plate interface.

Information extraction from multivariate images

NASA Technical Reports Server (NTRS)

Park, S. K.; Kegley, K. A.; Schiess, J. R.

1986-01-01

An overview of several multivariate image processing techniques is presented, with emphasis on techniques based upon the principal component transformation (PCT). Multiimages in various formats have a multivariate pixel value, associated with each pixel location, which has been scaled and quantized into a gray level vector, and the bivariate of the extent to which two images are correlated. The PCT of a multiimage decorrelates the multiimage to reduce its dimensionality and reveal its intercomponent dependencies if some off-diagonal elements are not small, and for the purposes of display the principal component images must be postprocessed into multiimage format. The principal component analysis of a multiimage is a statistical analysis based upon the PCT whose primary application is to determine the intrinsic component dimensionality of the multiimage. Computational considerations are also discussed.

Value of soluble TREM-1, procalcitonin, and C-reactive protein serum levels as biomarkers for detecting bacteremia among sepsis patients with new fever in intensive care units: a prospective cohort study.

PubMed

Su, Longxiang; Han, Bingchao; Liu, Changting; Liang, Liling; Jiang, Zhaoxu; Deng, Jie; Yan, Peng; Jia, Yanhong; Feng, Dan; Xie, Lixin

2012-07-18

The purpose of this study was to explore the diagnostic value of soluble triggering receptor expressed on myeloid cells 1 (sTREM-1), procalcitonin (PCT), and C-reactive protein (CRP) serum levels for differentiating sepsis from SIRS, identifying new fever caused by bacteremia, and assessing prognosis when new fever occurred. We enrolled 144 intensive care unit (ICU) patients: 60 with systemic inflammatory response syndrome (SIRS) and 84 with sepsis complicated by new fever at more than 48 h after ICU admission. Serum sTREM-1, PCT, and CRP levels were measured on the day of admission and at the occurrence of new fever (>38.3°C) during hospitalization. Based on the blood culture results, the patients were divided into a blood culture-positive bacteremia group (33 patients) and blood culture-negative group (51 patients). Based on 28-day survival, all patients, both blood culture-positive and -negative, were further divided into survivor and nonsurvivor groups. On ICU day 1, the sepsis group had higher serum sTREM-1, PCT, and CRP levels compared with the SIRS group (P <0.05). The areas under the curve (AUC) for these indicators were 0.868 (95% CI, 0.798-0.938), 0.729 (95% CI, 0.637-0.821), and 0.679 (95% CI, 0.578-0.771), respectively. With 108.9 pg/ml as the cut-off point for serum sTREM-1, sensitivity was 0.83 and specificity was 0.81. There was no statistically significant difference in serum sTREM-1 or PCT levels between the blood culture-positive and -negative bacteremia groups with ICU-acquired new fever. However, the nonsurvivors in the blood culture-positive bacteremia group had higher levels of serum sTREM-1 and PCT (P <0.05), with a prognostic AUC for serum sTREM-1 of 0.868 (95% CI, 0.740-0.997). Serum sTREM-1, PCT, and CRP levels each have a role in the early diagnosis of sepsis. Serum sTREM-1, with the highest sensitivity and specificity of all indicators studied, is especially notable. sTREM-1, PCT, and CRP levels are of no use in determining new fever caused by bacteremia in ICU patients, but sTREM-1 levels reflect the prognosis of bacteremia. ClinicalTrial.gov identifier NCT01410578.

Phase Transformation Behavior of Medium Manganese Steels with 3 Wt Pct Aluminum and 3 Wt Pct Silicon During Intercritical Annealing

NASA Astrophysics Data System (ADS)

Sun, Binhan; Fazeli, Fateh; Scott, Colin; Yue, Stephen

2016-10-01

Medium manganese steels alloyed with sufficient aluminum and silicon amounts contain high fractions of retained austenite adjustable to various transformation-induced plasticity/twinning-induced plasticity effects, in addition to a reduced density suitable for lightweight vehicle body-in-white assemblies. Two hot rolled medium manganese steels containing 3 wt pct aluminum and 3 wt pct silicon were subjected to different annealing treatments in the present study. The evolution of the microstructure in terms of austenite transformation upon reheating and the subsequent austenite decomposition during quenching was investigated. Manganese content of the steels prevailed the microstructural response. The microstructure of the leaner alloy with 7 wt pct Mn (7Mn) was substantially influenced by the annealing temperature, including the variation of phase constituents, the morphology and composition of intercritical austenite, the Ms temperature and the retained austenite fraction. In contrast, the richer variant 10 wt pct Mn steel (10Mn) exhibited a substantially stable ferrite-austenite duplex phase microstructure containing a fixed amount of retained austenite which was found to be independent of the variations of intercritical annealing temperature. Austenite formation from hot band ferrite-pearlite/bainite mixtures was very rapid during annealing at 1273 K (1000 °C), regardless of Mn contents. Austenite growth was believed to be controlled at early stages by carbon diffusion following pearlite/bainite dissolution. The redistribution of Mn in ferrite and particularly in austenite at later stages was too subtle to result in a measureable change in austenite fraction. Further, the hot band microstructure of both steels contained a large fraction of coarse-grained δ-ferrite, which remained almost unchanged during intercritical annealing. A recently developed thermodynamic database was evaluated using the experimental data. The new database achieved a better agreement with the experimental results for the 7Mn steel compared with the existing commercial TCFE database; however, some discrepancy in the predicted phase fractions and compositions still existed. The phase transformation behavior of the two steels during annealing and its implication on the design of high aluminum-silicon medium manganese steels were discussed in detail.

SU-E-J-106: The Use of Deformable Image Registration with Cone-Beam CT for a Better Evaluation of Cumulative Dose to Organs

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

Fillion, O; Gingras, L; Archambault, L

2015-06-15

Purpose: The knowledge of dose accumulation in the patient tissues in radiotherapy helps in determining the treatment outcomes. This project aims at providing a workflow to map cumulative doses that takes into account interfraction organ motion without the need for manual re-contouring. Methods: Five prostate cancer patients were studied. Each patient had a planning CT (pCT) and 5 to 13 CBCT scans. On each series, a physician contoured the prostate, rectum, bladder, seminal vesicles and the intestine. First, a deformable image registration (DIR) of the pCTs onto the daily CBCTs yielded registered CTs (rCT) . This rCT combined the accuratemore » CT numbers of the pCT with the daily anatomy of the CBCT. Second, the original plans (220 cGy per fraction for 25 fractions) were copied on the rCT for dose re-calculation. Third, the DIR software Elastix was used to find the inverse transform from the rCT to the pCT. This transformation was then applied to the rCT dose grid to map the dose voxels back to their pCT location. Finally, the sum of these deformed dose grids for each patient was applied on the pCT to calculate the actual dose delivered to organs. Results: The discrepancy between the planned D98 and D2 and these indices re-calculated on the rCT, are, on average, of −1 ± 1 cGy and 1 ± 2 cGy per fraction, respectively. For fractions with large anatomical motion, the D98 discrepancy on the re-calculated dose grid mapped onto the pCT can raise to −17 ± 4 cGy. The obtained cumulative dose distributions illustrate the same behavior. Conclusion: This approach allowed the evaluation of cumulative doses to organs with the help of uncontoured daily CBCT scans. With this workflow, the easy evaluation of doses delivered for EBRT treatments could ultimately lead to a better follow-up of prostate cancer patients.« less

Platelet closure time in anesthetized Greyhounds with hemorrhagic shock treated with hydroxyethyl starch 130/0.4 or 0.9% sodium chloride infusions.

PubMed

McBride, Duana; Hosgood, Giselle; Raisis, Anthea; Smart, Lisa

2016-07-01

To measure platelet closure time (PCT) in dogs during controlled hemorrhagic shock and after fluid resuscitation with hydroxyethyl starch (HES) 130/0.4 or 0.9% sodium chloride. Experimental interventional study. University veterinary teaching hospital. Eleven healthy Greyhounds. Dogs were anesthetized and had 48 mL/kg of blood removed to induce hemorrhagic shock. Dogs received 20 mL/kg of HES 130/0.4 (n = 6) or 80 mL/kg of 0.9% sodium chloride (NaCl; n = 5) intravenously over 20 minutes. PCT was measured using the Platelet Function Analyzer-100 with collagen and adenosine-diphosphate cartridges at: T0 = 60 minutes after induction of anesthesia prior to hemorrhage, T1 = during hemorrhagic shock, and T2 = 40 minutes after completion of fluid bolus. Packed cell volume and platelet count were concurrently measured. Hemorrhagic shock did not significantly change PCT, with no difference between T0 and T1. Both the HES 130/0.4 and 0.9% NaCl group had a significantly increased mean PCT at T2 of 91.4 seconds (95% CI 69.3-113.4) and 95.5 seconds (95% CI 78.2-112.8), respectively, compared to T1. The magnitude of change was significantly greater for the 0.9% NaCl group than the HES 130/0.4 group. There was no difference in the magnitude of change in PCV and platelet count between the 2 groups. The PCV and platelet count were >25% and >100,000/μL, respectively, in all dogs, except for dogs in the HES 130/0.4 group at T2 where platelet counts were <100,000/μL. Controlled hemorrhagic shock in Greyhounds under anesthesia did not cause a significant change in PCT. Both HES 130/0.4 and 0.9% NaCl administration after induction of shock increased PCT. These results do not support that HES 130/0.4 causes relevant platelet dysfunction beyond hemodilution. © Veterinary Emergency and Critical Care Society 2016.

Thermodynamic properties of Na2O-SiO2-CaO melts at 1000 to 1100 °C

NASA Astrophysics Data System (ADS)

Neudorf, D. A.; Elliott, J. F.

1980-12-01

The thermodynamic properties of Na2O-SiO2 and Na2O-SiO2-CaO melts have been measured using the galvanic cellbegin{array}{*{20}c} {O_2 (g), (Na_2 O), Pt} \\ {Na_2 O - WO_3 liq} \\ left| begin{gathered} Na^ + \\ β - alumina \\ right| begin{array}{*{20}c} {Pt,(Na_2 O), O_2 (g)} \\ {Na_2 O - SiO_2 - CaO liq} \\ Activities of Na2O were calculated from the reversible emf of the cell. This is possible because the activity of Na2O in the Na2O-WO3 liquid is known from previous work. Data for the binary Na2O-SiO2 system were obtained between 1000 and 1100 °C and for compositions ranging from 25 wt pct to 40 wt pct Na2O. At 1050 °C, Loga_{Na_2 O} varied from approximately 10.2 at 25 wt pct Na2O to approximately -8.3 at 40 wt pct Na2O, the dependence with respect to composition being nearly linear. The Gibbs-Duhem equation was used to calculate the activities of SiO2(s), and the integral mixing properties, G M, HM, and S M, were derived. At the di-silicate composition, G M = -83 kJ/mol, H M = -41 kJ mol and S M = 33 J/mol K at 1000 °C. (Standard states are pure, liquid Na2O and pure, solid tridymite.) The activity data are interpreted in terms of the polymeric nature of silicate melts. Activities of Na2O in the Na2O-CaO-SiO2 system were measured for the 25, 30 and 35 wt pct Na2O binary compositions with up to 10 wt pct CaO added. The addition of CaO caused an increase in the activity of Na2O at constantN_{Na_2 O} /N_{SiO_2 } . The experimental data agree well with the behavior predicted by Richardson’s ternary mixing model.

Procalcitonin Biomarker Algorithm Reduces Antibiotic Prescriptions, Duration of Therapy, and Costs in Chronic Obstructive Pulmonary Disease: A Comparison in the Netherlands, Germany, and the United Kingdom.

PubMed

van der Maas, Marloes E; Mantjes, Gertjan; Steuten, Lotte M G

2017-04-01

Antibiotics are often recommended as treatment for patients with chronic obstructive pulmonary disease (COPD) exacerbations. However, not all COPD exacerbations are caused by bacterial infections and there is consequently considerable misuse and overuse of antibiotics among patients with COPD. This poses a severe burden on healthcare resources such as increased risk of developing antibiotic resistance. The biomarker procalcitonin (PCT) displays specificity to distinguish bacterial inflammations from nonbacterial inflammations and may therefore help to rationalize antibiotic prescriptions. We report in this study, a three-country comparison of the health and economic consequences of a PCT biomarker-guided prescription and clinical decision-making strategy compared to current practice in hospitalized patients with COPD exacerbations. A decision tree was developed, comparing the expected costs and effects of the PCT algorithm to current practice in the Netherlands, Germany, and the United Kingdom. The time horizon of the model captured the length of hospital stay and a societal perspective was also adopted. The primary health outcome was the duration of antibiotic therapy. The incremental cost-effectiveness ratio was defined as the incremental costs per antibiotic day avoided. The incremental cost savings per day on antibiotic therapy avoided were (in Euros) €90 in the Netherlands, €125 in Germany, and €52 in the United Kingdom. Probabilistic sensitivity analyses showed that in the majority of simulations, the PCT biomarker strategy was superior to current practice (the Netherlands: 58%, Germany: 58%, and the United Kingdom: 57%). In conclusion, the PCT biomarker algorithm to optimize antibiotic prescriptions in COPD is likely to be cost-effective compared to current practice. Both the percentage of patients who start with antibiotic treatment as well as the duration of antibiotic therapy are reduced with the PCT decision algorithm, leading to a decrease in total costs per patient. Economic analysis based on real-life data is recommended for further research. Biomarker-driven prescription algorithms are important instruments for personalized medicine in COPD. This also attests to the emerging convergence of biomarker innovations and the broader field of Health Technology Assessment (HTA).

Comparison of procalcitonin and different guidelines for first febrile urinary tract infection in children by imaging.

PubMed

Liao, Pei-Fen; Ku, Min-Sho; Tsai, Jeng-Dau; Choa, Yu-Hua; Hung, Tung-Wei; Lue, Ko-Huang; Sheu, Ji-Nan

2014-09-01

We examined the ability of a procalcitonin (PCT) protocol to detect vesicoureteral reflux (VUR) and renal scarring (RS), evaluated procedural costs and radiation burden, and compared four representative guidelines for children with their first febrile urinary tract infection (UTI). Children aged ≤2 years with their first febrile UTI who underwent renal ultrasonography (US), acute and late technetium-99m ((99m)Tc)-dimercaptosuccinic acid scan, and voiding cystourethrography were prospectively studied. The representative guidelines applied in a retrospective simulation included the American Academy of Pediatrics (AAP), National Institute of Clinical Excellence, top-down approach (TDA), and Italian Society of Pediatric Nephrology (ISPN). These were compared in terms of ability to detect abnormalities, procedural costs and radiation. Of 278 children analyzed, 172 (61.9%) had acute pyelonephritis. There was VUR in 101 (36.3%) children, including 73 (26.3%) with grades III-V VUR. RS was identified in 75 (27.0%) children. To detect VUR, TDA and PCT had the highest sensitivity for grades I-V VUR (80.2%) and III-V VUR (94.5%), respectively, whereas AAP had the highest specificity for I-V VUR (77.4%) and III-V VUR (78.0%), respectively. TDA and PCT had the highest sensitivity (100%) for detecting RS. The highest cost and radiation dose was associated with TDA, whereas AAP had the least expenditure and radiation exposure. By multivariate analysis, PCT and VUR, especially grades III-V, were independent predictors of RS. There is no perfect guideline for first febrile UTI children. The PCT protocol has good ability for detecting high-grade VUR and RS. If based on available imaging modalities and reducing cost and radiation burden, clinical suggestions in the AAP guidelines represent a considerable protocol.

Crystal structures of resorcin[4]arene and pyrogallol[4]arene complexes with proline: A model for proline recognition through Csbnd H···π interaction

NASA Astrophysics Data System (ADS)

Fujisawa, Ikuhide; Kitamura, Yuji; Kato, Ryo; Aoki, Katsuyuki

2018-07-01

Resorcin[4]arene (resorcinol cyclic tetramer, abbreviated as RCT) or pyrogallol[4]arene (pyrogallol cyclic tetramer, PCT) form host-guest 1:1 complexes with DL-proline (DL-Pro) or L-proline (L-Pro), [RCT·DL-Pro]·2MeOH·3.5H2O (1) and 2[PCT·L-Pro]·2EtOH·10H2O (2), whose crystal structures have been determined. In each complex, the proline ligand is incorporated into the bowl-shaped cavity of RCT or PCT host molecules through Csbnd H … π interactions between alkyl protons of the pyrrolidine ring of proline and π-rings of RCT or PCT, forming an [RCT/PCT·Pro] structural fragment. In the crystal lattice, two [RCT/PCT·Pro] fragments self-associate to form a ligand-mediated dimeric structure, [RCT·D-Pro·L-Pro·RCT] in 1 or [PCT·L-Pro·L-Pro·PCT] in 2. A 1H NMR solution study gave the host‒ligand binding constants of 10.0 ± 1.1 M-1 for the RCT-DL-Pro system and 17.3 ± 1.3 M-1 for the PCT-L-Pro system. These complexes provide a synthetic model for the recognition of the proline residue in proline-containing substrates or inhibitors by enzymes through Csbnd H … π interaction. The CSD survey revealed that the absolute value of the torsion angle N-Cα-Csbnd O1 (O1 is cis to N) about the carboxyl Cα-C bond of proline is significantly smaller than that of the Cβ-Cα-Csbnd O2 (O2 is cis to Cβ) torsion angle.

Cerebral perfusion computed tomography deconvolution via structure tensor total variation regularization

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

Zeng, Dong; Zhang, Xinyu; Bian, Zhaoying, E-mail: zybian@smu.edu.cn, E-mail: jhma@smu.edu.cn

Purpose: Cerebral perfusion computed tomography (PCT) imaging as an accurate and fast acute ischemic stroke examination has been widely used in clinic. Meanwhile, a major drawback of PCT imaging is the high radiation dose due to its dynamic scan protocol. The purpose of this work is to develop a robust perfusion deconvolution approach via structure tensor total variation (STV) regularization (PD-STV) for estimating an accurate residue function in PCT imaging with the low-milliampere-seconds (low-mAs) data acquisition. Methods: Besides modeling the spatio-temporal structure information of PCT data, the STV regularization of the present PD-STV approach can utilize the higher order derivativesmore » of the residue function to enhance denoising performance. To minimize the objective function, the authors propose an effective iterative algorithm with a shrinkage/thresholding scheme. A simulation study on a digital brain perfusion phantom and a clinical study on an old infarction patient were conducted to validate and evaluate the performance of the present PD-STV approach. Results: In the digital phantom study, visual inspection and quantitative metrics (i.e., the normalized mean square error, the peak signal-to-noise ratio, and the universal quality index) assessments demonstrated that the PD-STV approach outperformed other existing approaches in terms of the performance of noise-induced artifacts reduction and accurate perfusion hemodynamic maps (PHM) estimation. In the patient data study, the present PD-STV approach could yield accurate PHM estimation with several noticeable gains over other existing approaches in terms of visual inspection and correlation analysis. Conclusions: This study demonstrated the feasibility and efficacy of the present PD-STV approach in utilizing STV regularization to improve the accuracy of residue function estimation of cerebral PCT imaging in the case of low-mAs.« less

The risk stratification and prognostic evaluation of soluble programmed death-1 on patients with sepsis in emergency department.

PubMed

Zhao, Yongzhen; Jia, Yumei; Li, Chunsheng; Fang, Yingying; Shao, Rui

2018-01-01

To evaluate the efficacy of soluble programmed death-1 (sPD-1) for risk stratification and prediction of 28-day mortality in patients with sepsis, we compared serum sPD-1 with procalcitonin (PCT), C-reactive protein (CRP), and the Mortality in Emergency Department Sepsis (MEDS) score. A total of 60 healthy volunteers and 595 emergency department (ED) patients were recruited for this prospective cohort study. According to the severity of their condition on ED arrival, the patients were allocated to the systemic inflammatory response syndrome group (130 cases), sepsis group (276 cases), severe sepsis group (121 cases), and septic shock group (68 cases). In addition, all patients with sepsis were also divided into the survivor group (349 cases) and nonsurvivor group (116 cases) according to the 28-day outcomes. When the severity of sepsis increased, the levels of sPD-1 gradually increased. The levels of sPD-1, PCT, CRP and the MEDS score were also higher in the nonsurvivor group compared to the survivor group. Logistic regression suggested that sPD-1, PCT, and the MEDS score were independent risk factors for 28-day mortality of patients with sepsis. Area under the curve (AUC) of sPD-1, PCT and the MEDS score for 28-day mortality was 0.725, 0.693, and 0.767, respectively, and the AUC was improved when all 3 factors were combined (0.843). Serum sPD-1 is positively correlated with the severity of sepsis, and it is valuable for risk stratification of patients and prediction of 28-day mortality. Combining sPD-1 with PCT and the MEDS score improves the prognostic evaluation. Copyright © 2017 Elsevier Inc. All rights reserved.

Adjunctive role of preoperative liver magnetic resonance imaging for potentially resectable pancreatic cancer.

PubMed

Kim, Hyoung Woo; Lee, Jong-Chan; Paik, Kyu-Hyun; Kang, Jingu; Kim, Young Hoon; Yoon, Yoo-Seok; Han, Ho-Seong; Kim, Jaihwan; Hwang, Jin-Hyeok

2017-06-01

The adjunctive role of magnetic resonance imaging of the liver before pancreatic ductal adenocarcinoma has been unclear. We evaluated whether the combination of hepatic magnetic resonance imaging with multidetector computed tomography using a pancreatic protocol (pCT) could help surgeons select appropriate candidates and decrease the risk of early recurrence. We retrospectively enrolled 167 patients in whom complete resection was achieved without grossly visible residual tumor; 102 patients underwent pCT alone (CT group) and 65 underwent both hepatic magnetic resonance imaging and pCT (magnetic resonance imaging group). By adding hepatic magnetic resonance imaging during preoperative evaluation, hepatic metastases were newly discovered in 3 of 58 patients (5%) without hepatic lesions on pCT and 17 of 53 patients (32%) with indeterminate hepatic lesions on pCT. Patients with borderline resectability, a tumor size >3 cm, or preoperative carbohydrate antigen 19-9 level >1,000 U/mL had a greater rate of hepatic metastasis on subsequent hepatic magnetic resonance imaging. Among 167 patients in whom R0/R1 resection was achieved, the median overall survival was 18.2 vs 24.7 months (P = .020) and the disease-free survival was 8.5 vs 10.0 months (P = .016) in the CT and magnetic resonance imaging groups, respectively (median follow-up, 18.3 months). Recurrence developed in 82 (80%) and 43 (66%) patients in the CT and magnetic resonance imaging groups, respectively. The cumulative hepatic recurrence rate was greater in the CT group than in the magnetic resonance imaging group (P < .001). Preoperative hepatic magnetic resonance imaging should be considered in patients with potentially resectable pancreatic ductal adenocarcinoma, especially those with high tumor burden. Copyright © 2017 Elsevier Inc. All rights reserved.

The effect of grain boundary chemistry on Intergranular stress corrosion cracking of Ni-Cr-Fe alloys in 50 Pct NaOH at 140 °C

NASA Astrophysics Data System (ADS)

Sung, J. K.; Koch, J.; Angeliu, T.; Was, G. S.

1992-10-01

The role of chromium, carbon, chromium carbides, and phosphorus on the intergranular stress corrosion cracking (IGSCC) resistance of Ni-Cr-Fe alloys in 50 pct NaOH at 140 °C is studied using controlled-purity alloys. The effect of carbon is studied using heats in which the carbon level is varied between 0.002 and 0.063 wt pct while the Cr level is fixed at 16.8 wt pct. The effect of Cr is studied using alloys with Cr concentrations between 5 and 30 wt pct. The effect of grain boundary Cr and C together is studied by heat-treating the nominal alloy composition of Ni-16Cr-9Fe-0.035C, and the effect of P is studied using a high-purity, P-doped alloy and a carbon-containing, P-doped alloy. Constant extension rate tensile (CERT) results show that the crack depth increases with decreasing alloy Cr content and increasing alloy C content. Crack- ing severity also correlates inversely with thermal treatment time at 700 °C, during which the grain boundary Cr content rises and the grain boundary C content falls. Phosphorus is found to have a slightly beneficial effect on IG cracking susceptibility. Potentiodynamic polarization and potentiostatic current decay experiments confirm that Cr depletion or grain boundary C enhances the dissolution at the grain boundary. Results support a film rupture-anodic dissolution model in which Cr depletion or grain boundary C (independently or additively) enhances dissolution of nickel from the grain boundary region and leads to increased IG cracking.

Application of rotatable central composite design in the preparation and optimization of poly(lactic-co-glycolic acid) nanoparticles for controlled delivery of paclitaxel.

PubMed

Kollipara, Sivacharan; Bende, Girish; Movva, Snehalatha; Saha, Ranendra

2010-11-01

Polymeric carrier systems of paclitaxel (PCT) offer advantages over only available formulation Taxol® in terms of enhancing therapeutic efficacy and eliminating adverse effects. The objective of the present study was to prepare poly (lactic-co-glycolic acid) nanoparticles containing PCT using emulsion solvent evaporation technique. Critical factors involved in the processing method were identified and optimized by scientific, efficient rotatable central composite design aiming at low mean particle size and high entrapment efficiency. Twenty different experiments were designed and each formulation was evaluated for mean particle size and entrapment efficiency. The optimized formulation was evaluated for in vitro drug release, and absorption characteristics were studied using in situ rat intestinal permeability study. Amount of polymer and duration of ultrasonication were found to have significant effect on mean particle size and entrapment efficiency. First-order interactions of amount of miglyol with amount of polymer were significant in case of mean particle size, whereas second-order interactions of polymer were significant in mean particle size and entrapment efficiency. The developed quadratic model showed high correlation (R(2) > 0.85) between predicted response and studied factors. The optimized formulation had low mean particle size (231.68 nm) and high entrapment efficiency (95.18%) with 4.88% drug content. The optimized formulation showed controlled release of PCT for more than 72 hours. In situ absorption study showed faster and enhanced extent of absorption of PCT from nanoparticles compared to pure drug. The poly (lactic-co-glycolic acid) nanoparticles containing PCT may be of clinical importance in enhancing its oral bioavailability.

Hepatitis C virus core protein triggers abnormal porphyrin metabolism in human hepatocellular carcinoma cells.

PubMed

Nakano, Takafumi; Moriya, Kyoji; Koike, Kazuhiko; Horie, Toshiharu

2018-01-01

Porphyria cutanea tarda (PCT), the most common of the human porphyrias, arises from a deficiency of uroporphyrinogen decarboxylase. Studies have shown a high prevalence of hepatitis C virus (HCV) infection in patients with PCT. While these observations implicate HCV infection as a risk factor for PCT pathogenesis, the mechanism of interaction between the virus and porphyrin metabolism is unknown. This study aimed to assess the effect of HCV core protein on intracellular porphyrin metabolism to elucidate the link between HCV infection and PCT. The accumulation and excretion of porphyrins after treatment with 5-aminolevulinic acid, a porphyrin precursor, were compared between cells stably expressing HCV core protein and controls. Cells expressing HCV core protein had lower amounts of intracellular protoporphyrin IX and heme and had higher amounts of excreted coproporphyrin III, the oxidized form of coproporphyrinogen III, compared with controls. These observations suggest that HCV core protein affects porphyrin metabolism and facilitates the export of excess coproporphyrinogen III and/or coproporphyrin III, possibly via porphyrin transporters. Real-time PCR analysis revealed that the presence of HCV core protein increased the mRNA expression of porphyrin exporters ABCG2 and FLVCR1. Western blot analysis showed a higher expression level of FLVCR1, but not ABCG2, as well as a higher expression level of mature ALAS1, which is the rate-limiting enzyme in the heme synthesis pathway, in HCV core protein-expressing cells compared with controls. The data indicate that HCV core protein induced abnormal intracellular porphyrin metabolism, with an over-excretion of coproporphyrin III. These findings may partially account for the susceptibility of HCV-infected individuals to PCT development.

[Cord blood procalcitonin in the assessment of early-onset neonatal sepsis].

PubMed

Oria de Rueda Salguero, Olivia; Beceiro Mosquera, José; Barrionuevo González, Marta; Ripalda Crespo, María Jesús; Olivas López de Soria, Cristina

2017-08-01

Early diagnosis of early-onset neonatal sepsis (EONS) is essential to reduce morbidity and mortality. Procalcitonin (PCT) in cord blood could provide a diagnosis of infected patients from birth. To study the usefulness and safety of a procedure for the evaluation of newborns at risk of EONS, based on the determination of PCT in cord blood. Neonates with infectious risk factors, born in our hospital from October 2013 to January 2015 were included. They were processed according to an algorithm based on the values of cord blood procalcitonin (< 0.6ng/ml versus ≥0.6ng/ml). They were later classified as proved infection, probable, or no infection. Of the 2,519 infants born in the study period, 136 met inclusion criteria. None of 120 cases with PCT<0.6ng/ml in cord blood developed EONS (100% negative predictive value). On the other hand, of the 16 cases with PCT ≥0.6ng/ml, 10 were proven or probably infected (62.5% positive predictive value). The sensitivity of the PCT against infection was 100%, with a specificity of 95.2% (area under the receiver operator curve 0.969). The incidence of infection in the study group was 7.4%, and 26.1% in cases with maternal chorioamnionitis. 21 newborn (15.4%) received antibiotic therapy. The studied protocol has shown to be effective and safe to differentiate between patients with increased risk of developing an EONS, in those where the diagnostic and therapeutic approach was more interventionist, versus those with less likelihood of sepsis, who would benefit from a more conservative management. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

A scattering-based over-land rainfall retrieval algorithm for South Korea using GCOM-W1/AMSR-2 data

NASA Astrophysics Data System (ADS)

Kwon, Young-Joo; Shin, Hayan; Ban, Hyunju; Lee, Yang-Won; Park, Kyung-Ae; Cho, Jaeil; Park, No-Wook; Hong, Sungwook

2017-08-01

Heavy summer rainfall is a primary natural disaster affecting lives and properties in the Korean Peninsula. This study presents a satellite-based rainfall rate retrieval algorithm for the South Korea combining polarization-corrected temperature ( PCT) and scattering index ( SI) data from the 36.5 and 89.0 GHz channels of the Advanced microwave Scanning Radiometer 2 (AMSR-2) onboard the Global Change Observation Mission (GCOM)-W1 satellite. The coefficients for the algorithm were obtained from spatial and temporal collocation data from the AMSR-2 and groundbased automatic weather station rain gauges from 1 July - 30 August during the years, 2012-2015. There were time delays of about 25 minutes between the AMSR-2 observations and the ground raingauge measurements. A new linearly-combined rainfall retrieval algorithm focused on heavy rain for the PCT and SI was validated using ground-based rainfall observations for the South Korea from 1 July - 30 August, 2016. The validation presented PCT and SI methods showed slightly improved results for rainfall > 5 mm h-1 compared to the current ASMR-2 level 2 data. The best bias and root mean square error (RMSE) for the PCT method at AMSR-2 36.5 GHz were 2.09 mm h-1 and 7.29 mm h-1, respectively, while the current official AMSR-2 rainfall rates show a larger bias and RMSE (4.80 mm h-1 and 9.35 mm h-1, respectively). This study provides a scatteringbased over-land rainfall retrieval algorithm for South Korea affected by stationary front rain and typhoons with the advantages of the previous PCT and SI methods to be applied to a variety of spaceborne passive microwave radiometers.

Effect of Alloying Elements, Water Vapor Content, and Temperature on the Oxidation of Interstitial-Free Steels

NASA Astrophysics Data System (ADS)

Zhang, Z. T.; Sohn, I. R.; Pettit, F. S.; Meier, G. H.; Sridhar, S.

2009-08-01

The present study is an investigation of the surface and subsurface oxidation of Mn solid-solution-strengthened interstitial-free (IF) steels with the objective of elucidating the surface evolution before coating. Thermogravimetric (TG) analysis was carried out under 95 vol pct Ar + 5 vol pct (H2 + H2O) atmospheres with P_{{{text{H}}2 {text{O}}}} /P_{{{text{H}}2 }} ranging from 0.01 to 0.13 and temperatures ranging from 800 °C to 843 °C. Post-exposure characterization was carried out through scanning electron microscopy (SEM)/energy-dispersive spectroscopy (EDS), X-ray photoelectron spectroscopy (XPS), and glancing-angle X-ray diffraction (XRD) to study the external and internal oxide evolution. The oxidation proceeds as a combination of the internal and external formation of Mn oxides. Decreasing the P_{{{text{H}}2 {text{O}}}} /P_{{{text{H}}2 }} ratios or temperature has the effect of decreasing the amount of oxidation, which is a combination of internal and external oxidation controlled by solid-state oxygen and manganese diffusion, respectively. External oxides are not continuous; they are instead concentrated near the intersection of alloy grain boundaries with the external surface. Internal oxides are concentrated along the grain boundaries. The effects of Sb (0.03 wt pct), B (10 ppm), P (0.04 and 0.08 wt pct), and Si (0.06 to 1.5 wt pct) on the oxidation were investigated. It is found that small amounts of Sb and B have a significant effect on decreasing both the external and internal oxidation, whereas Si and P increase the external and internal oxidation.

Procalcitonin, interleukin 6 and systemic inflammatory response syndrome (SIRS): early markers of postoperative sepsis after major surgery.

PubMed

Mokart, D; Merlin, M; Sannini, A; Brun, J P; Delpero, J R; Houvenaeghel, G; Moutardier, V; Blache, J L

2005-06-01

Patients who undergo major surgery for cancer are at high risk of postoperative sepsis. Early markers of septic complications would be useful for diagnosis and therapeutic management in patients with postoperative sepsis. The aim of this study was to investigate the association between early (first postoperative day) changes in interleukin 6 (IL-6), procalcitonin (PCT) and C-reactive protein (CRP) serum concentrations and the occurrence of subsequent septic complications after major surgery. Serial blood samples were collected from 50 consecutive patients for determination of IL-6, PCT and CRP serum levels. Blood samples were obtained on the morning of surgery and on the morning of the first postoperative day. Sixteen patients developed septic complications during the first five postoperative days (group 1), and 34 patients developed no septic complications (group 2). On day 1, PCT and IL-6 levels were significantly higher in group 1 (P-values of 0.003 and 0.006, respectively) but CRP levels were similar. An IL-6 cut-off point set at 310 pg ml(-1) yielded a sensitivity of 90% and a specificity of 58% to differentiate group 1 patients from group 2 patients. When associated with the occurrence of SIRS on day 1 these values reached 100% and 79%, respectively. A PCT cut-off point set at 1.1 ng ml(-1) yielded a sensitivity of 81% and a specificity of 72%. When associated with the occurrence of SIRS on day 1, these values reached 100% and 86%, respectively. PCT and IL-6 appear to be early markers of subsequent postoperative sepsis in patients undergoing major surgery for cancer. These findings could allow identification of postoperative septic complications.

Diagnostic and prognostic value of sCD14-ST--presepsin for patients admitted to hospital intensive care unit (ICU).

PubMed

Godnic, Matej; Stubljar, David; Stubjar, David; Skvarc, Miha; Jukic, Tomislav

2015-07-01

Sepsis is a serious problem in intensive care units all over the world. Biomarkers could be useful to identify patients at risk. We focused especially on the performance of presepsin (sCD14-ST), compared to C-reactive protein (CRP), procalcitonin (PCT) and CD64, to determine its diagnostic and prognostic indications. The study was conducted on 47 hospitalized patients after procedures, who were divided into three groups; systemic inflammatory response (SIRS), sepsis and septic shock. Expression of CD64 on neutrophils presented as CD64 index, sCD14-ST, CRP and PCT were measured in whole blood or plasma samples. All patients had standard samples like urine, respiratory tract samples etc. taken for culturing. Blood cultures were drawn to confirm bloodstream infection. Forty (85 %) patients had SIRS with bacterial infection and seven (15 %) patients had SIRS with no infection. All infections were confirmed with blood cultures. Biomarkers were evaluated in all patients. In patients with confirmed infection the values were high. The patients with bacterial infection showed statistical significance with CD64 index (p = 0.003), CRP (p = 0.049) and sCD14-ST (p = 0.026), but not with PCT (p = 1.000). The severity of diagnosed SIRS was significant only with PCT (p < 0.001). CD64 index, CRP and sCD14-ST served as good parameters to determine possible infection in patients that needed intensive care after major procedures. Values of PCT were the only ones to predict SIRS severity and could distinguish between sepsis and severe sepsis or septic shock.

Serum Concentrations of Interleukin-6, Procalcitonin, and C-Reactive Protein: Discrimination of Septical Complications and Systemic Inflammatory Response Syndrome after Pediatric Surgery.

PubMed

Neunhoeffer, Felix; Plinke, Swantje; Renk, Hanna; Hofbeck, Michael; Fuchs, Jörg; Kumpf, Matthias; Zundel, Sabine; Seitz, Guido

2016-04-01

Early differentiation between sepsis and systemic inflammatory response syndrome (SIRS) is useful for therapeutic management in neonates and infants after surgery. To compare the early (first 2 days) diagnostic value of interleukin-6 (IL-6), procalcitonin (PCT), and C-reactive protein (CRP) after surgery in the differentiation of subsequent SIRS and septic complications. IL-6, PCT, and CRP were measured 0, 24, and 48 hours after surgery in neonates and infants with clinical suspicion of postoperative sepsis. Sensitivity, specificity, and predictive values for SIRS/septic complications were calculated. A total of 31 out of 205 neonates and infants showed clinical signs for postoperative sepsis and underwent sepsis work-up. Nine patients developed septic complications, sixteen patients met criteria for SIRS, and six patients showed an uneventful postoperative course during the first five postoperative days. IL-6, PCT, and CRP levels increased in all subgroups after surgery and were significantly higher in the sepsis group (p < 0.05). IL-6 peaked immediately, CRP at 24 to 48 hours, and PCT at 24 hours after surgery. Sensitivity and specificity (area under the curve) for IL-6 (cutoff 673 ng/dL) were 94.4 and 75% (86.2%), for CRP (cutoff 1.48 mg/dL) 76.2 and 75.0% (88.1%), and for PCT (cutoff 16.1 mg/L) 66.7 and 57.1% (65.6%). IL-6 appears to be an early marker for severe bacterial infections with high sensitivity. IL-6 and CRP were the most reliable markers for the discrimination between SIRS and sepsis within the postoperative period. Georg Thieme Verlag KG Stuttgart · New York.