Chronomodulated drug delivery system of urapidil for the treatment of hypertension

PubMed Central

Chaudhary, Sona S.; Patel, Hetal K.; Parejiya, Punit B.; Shelat, Pragna K.

2015-01-01

Introduction: Hypertension is a disease which shows circadian rhythm in the pattern of two peaks, one in the evening at about 7pm and other in the early morning between 4 am to 8 am. Conventional therapies are incapable to target those time points when actually the symptoms get worsened. To achieve drug release at two time points, chronomodulated delivery system may offer greater benefits. Materials and methods: The chronomodulated system comprised of dual approach; immediate release granules (IRG) and pulsatile release mini-tablets (PRM) filled in the hard gelatin capsule. The mini-tablets were coated using Eudragit S-100 which provided the lag time. To achieve the desired release, various parameters like coating duration and coat thickness were studied. The immediate release granules were evaluated for micromeritical properties and drug release, while mini-tablets were evaluated for various parameters such as hardness, thickness, friability, weight variation, drug content, and disintegration time and in-vitro drug release. Compatibility of drug-excipient was checked by fourier transform infrared spectroscopy and Differential scanning calorimetry studies and pellets morphology was done by Scanning electron microscopy studies. Results: The in-vitro release profile suggested that immediate release granules gives drug release within 20 min at the time of evening attack while the programmed pulsatile release was achieved from coated mini-tablets after a lag time of 9hrs, which was consistent with the demand of drug during early morning hour attack. Pellets found to be spherical in shape with smooth surface. Moreover compatibility studies illustrated no deleterious reaction between drug and polymers used in the study. Conclusions: The dual approach of developed chronomodulated formulation found to be satisfactory in the treatment of hypertension. PMID:25838996

Effects of exercise-induced fatigue on postural balance: a comparison of treadmill versus cycle fatiguing protocols.

PubMed

Wright, Katherine E; Lyons, Thomas S; Navalta, James W

2013-05-01

The authors of this study examined the effects of muscle fatigue on balance indices and recovery time in recreationally trained individuals after incremental tests on a treadmill and a cycle ergometer. Sixteen participants (male N = 11, female N = 5) (mean age = 21.2 ± 2 years) completed this study. Balance measures were performed on a Biodex Balance System via the Dynamic Balance Test. Balance was measured pre-exercise, immediately post-exercise, and at 3-, 6-, 9-, 12-, 15-, 18-, and 21-min post-exercise. Immediately following the fatiguing treadmill test, balance increased significantly in the overall stability index (SI) (from 4.38 ± 2.48 to 6.09 ± 1.80) and the anterior/posterior index (API) (from 3.49 ± 2.18 to 5.28 ± 1.81) (p < 0.01). Immediately following the fatiguing cycle test, balance was not altered significantly in SI or API. Balance was not altered significantly for the medial/lateral index for either exercise test at any time point. Additionally, there were no significant differences in time to recovery. At 12-min post-exercise, all indices were below pre-exercise values, indicating that fatiguing exercise has a positive effect on balance over time. These results are consistent with previous research, suggesting that any effects of fatigue on balance are seen immediately and are diminished as time after exercise increases.

Human self-control and the density of reinforcement

PubMed Central

Flora, Stephen R.; Pavlik, William B.

1992-01-01

Choice responding in adult humans on a discrete-trial button-pressing task was examined as a function of amount, delay, and overall density (points per unit time) of reinforcement. Reinforcement consisted of points that were exchangeable for money. In T 0 conditions, an impulsive response produced 4 points immediately and a self-control response produced 10 points after a delay of 15 s. In T 15 conditions, a constant delay of 15 s was added to both prereinforcer delays. Postreinforcer delays, which consisted of 15 s added to the end of each impulsive trial, equated trial durations regardless of choice, and was manipulated in both T 0 and T 15 conditions. In all conditions, choice was predicted directly from the relative reinforcement densities of the alternatives. Self-control was observed in all conditions except T 0 without postreinforcer delays, where the impulsive choices produced the higher reinforcement density. These results support previous studies showing that choice is a direct function of the relative reinforcement densities when conditioned (point) reinforcers are used. In contrast, where responding produces intrinsic (immediately consumable) reinforcers, immediacy of reinforcement appears to account for preference when density does not. PMID:16812652

Feedback in the OSCE: What Do Residents Remember?

PubMed

Humphrey-Murto, Susan; Mihok, Marika; Pugh, Debra; Touchie, Claire; Halman, Samantha; Wood, Timothy J

2016-01-01

The move to competency-based education has heightened the importance of direct observation of clinical skills and effective feedback. The Objective Structured Clinical Examination (OSCE) is widely used for assessment and affords an opportunity for both direct observation and feedback to occur simultaneously. For feedback to be effective, it should include direct observation, assessment of performance, provision of feedback, reflection, decision making, and use of feedback for learning and change. If one of the goals of feedback is to engage students to think about their performance (i.e., reflection), it would seem imperative that they can recall this feedback both immediately and into the future. This study explores recall of feedback in the context of an OSCE. Specifically, the purpose of this study was to (a) determine the amount and the accuracy of feedback that trainees remember immediately after an OSCE, as well as 1 month later, and (b) assess whether prompting immediate recall improved delayed recall. Internal medicine residents received 2 minutes of verbal feedback from physician examiners in the context of an OSCE. The feedback was audio-recorded and later transcribed. Residents were randomly allocated to the immediate recall group (immediate-RG; n = 10) or the delayed recall group (delayed-RG; n = 8). The immediate-RG completed a questionnaire prompting recall of feedback received immediately after the OSCE, and then again 1 month later. The delayed-RG completed a questionnaire only 1 month after the OSCE. The total number and accuracy of feedback points provided by examiners were compared to the points recalled by residents. Results comparing recall at 1 month between the immediate-RG and the delayed-RG were also studied. Physician examiners provided considerably more feedback points (M = 16.3) than the residents recalled immediately after the OSCE (M = 2.61, p < .001). There was no significant difference between the number of feedback points recalled upon completion of the OSCE (2.61) compared to 1 month later (M = 1.96, p = .06, Cohen's d = .70). Prompting immediate recall did not improve later recall. The mean accuracy score for feedback recall immediately after the OSCE was 4.3/9 or "somewhat representative," and at 1 month the score dropped to 3.5/9 or "not representative" (ns). Residents recall very few feedback points immediately after the OSCE and 1 month later. The feedback points that are recalled are neither very accurate nor representative of the feedback actually provided.

Predictors and patterns of fear of cancer recurrence in breast cancer survivors.

PubMed

McGinty, Heather L; Small, Brent J; Laronga, Christine; Jacobsen, Paul B

2016-01-01

This prospective, longitudinal study examined fear of cancer recurrence (FCR) among breast cancer survivors having mammograms. FCR was hypothesized to increase prior to the mammogram, decrease from immediately pre- to immediately post-mammogram with negative results, and then increase following the mammogram. The possible presence of different trajectories of FCR was also examined. Based on the cognitive-behavioral model (CBM) of health anxiety, greater perceived risk of recurrence, worse perceived consequences of recurrence, lower treatment efficacy beliefs, lower coping self-efficacy, and more engagement in reassurance-seeking behaviors were hypothesized to be associated with greater FCR across all study time points. Following treatment completion for Stage 0-IIIA breast cancer, 161 women completed the following measures: perceived risk and perceived consequences of recurrence, treatment efficacy beliefs, coping self-efficacy, and reassurance-seeking behaviors. Participants reported FCR at 3 time points before and 3 after the mammogram. Growth curve analysis was used to test for changes in FCR over time and growth mixture modeling examined different trajectories in FCR and the ability of the CBM to predict these trajectories. As hypothesized, FCR significantly changed over time; scores increased prior to the mammogram, decreased immediately following receipt of negative mammography results, and increased during the month following the mammogram. Growth mixture models revealed 2 classes, higher-FCR and lower-FCR, which were predicted by the CBM. These study findings support the use of the CBM in predicting which cancer survivors experience greater FCR and indicates that CBM-driven interventions may prove beneficial for reducing distressing FCR. (c) 2015 APA, all rights reserved).

Post-harvest and post-milling changes in wheat grain and flour quality characteristics

USDA-ARS?s Scientific Manuscript database

Soft red winter (SRW) wheat grain immediately after harvest and flour after milling were stored for 26 weeks and analyzed for comprehensive milling and baking quality characteristics at different time points to examine the consistency of the quality test results. Increases in falling number (FN) of ...

Predicting Family Burden Following Childhood Traumatic Brain Injury: A Cumulative Risk Approach

PubMed Central

Josie, Katherine Leigh; Peterson, Catherine Cant; Burant, Christopher; Drotar, Dennis; Stancin, Terry; Wade, Shari L.; Yeates, Keith; Taylor, H. Gerry

2015-01-01

Objective To examine the utility of a cumulative risk index (CRI) in predicting the family burden of injury (FBI) over time in families of children with traumatic brain injury (TBI). Participants One hundred eight children with severe or moderate TBI and their families participated in the study. Measures The measures used in the study include the Socioeconomic Composite Index, Life Stressors and Social Resources Inventory—Adult Form, Vineland Adaptive Behavior Scales, Child Behavior Checklist, Children’s Depression Inventory, McMaster Family Assessment Device, Brief Symptom Inventory, and Family Burden of Injury Interview. In addition, information on injury-related risk was obtained via medical charts. Methods Participants were assessed immediately, 6, and 12 months postinjury and at a 4-year extended follow-up. Results Risk variables were dichotomized (ie, high- or low-risk) and summed to create a CRI for each child. The CRI predicted the FBI at all assessments, even after accounting for autocorrelations across repeated assessments. Path coefficients between the outcome measures at each time point were significant, as were all path coefficients from the CRI to family burden at each time point. In addition, all fit indices were above the recommended guidelines, and the χ2 statistic indicated a good fit to the data. Conclusions The current study provides initial support for the utility of a CRI (ie, an index of accumulated risk factors) in predicting family outcomes over time for children with TBI. The time period immediately after injury best predicts the future levels of FBI; however, cumulative risk continues to influence the change across successive postinjury assessments. These results suggest that clinical interventions could be proactive or preventive by intervening with identified “at-risk” subgroups immediately following injury. PMID:19033828

Dissociated time course of recovery between genders after resistance exercise.

PubMed

Flores, Débora F; Gentil, Paulo; Brown, Lee E; Pinto, Ronei S; Carregaro, Rodrigo L; Bottaro, Martim

2011-11-01

Comparisons between men and women of time course responses of strength, delayed-onset muscle soreness (DOMS), and muscle swelling after a resistance training session are still controversial. Therefore, this study examined gender differences in strength loss, muscle thickness (MT), and DOMS between young men and women. Thirty apparently healthy, untrained volunteers (14 women and 16 men) participated in the study protocol. The resistance exercise session consisted of 8 sets at 10 repetition maximum load of the elbow flexor muscles of their dominant arm. Maximum isokinetic peak torque (PT), MT, and DOMS were recorded at baseline (TB), immediately after exercise (T0), and at 1 (T1), 2 (T2), 3 (T3), and 4 (T4) days after exercise. Baseline strength was expressed as 100%. There were no significant differences between the sexes for relative PT loss immediately after exercise (T0 = 74.31 ± 8.26% for men and 76.00 ± 6.31% for women). Also, PT was still significantly less than baseline from T1 to T4 for both genders. In contrast, recovery from PT was longer in women when compared with that in men. Muscle thickness responded similarly to PT in both genders. However, there was no significant difference between genders for DOMS at any time point. The time point that showed the greatest degree of mean soreness was T2 (4.94 ± 2.38 mm for men and 4.45 ± 2.07 mm for women). Our data suggest that after resistance exercise, women and men experience similar immediate strength loss; however they have dissimilar strength recovery across 4 days of recovery. Likewise, both genders experience a different time course of MT response after a traditional resistance exercise protocol. In contrast, men and women develop and dissipate muscle soreness in a similar manner.

Immediate extinction promotes the return of fear.

PubMed

Merz, Christian J; Hamacher-Dang, Tanja C; Wolf, Oliver T

2016-05-01

Accumulating evidence indicates that immediate extinction is less effective than delayed extinction in attenuating the return of fear. This line of fear conditioning research impacts the proposed onset of psychological interventions after threatening situations. In the present study, forty healthy men were investigated in a differential fear conditioning paradigm with fear acquisition in context A, extinction in context B, followed by retrieval testing in both contexts 24h later to test fear renewal. Differently coloured lights served as conditioned stimuli (CS): two CS (CS+) were paired with an electrical stimulation that served as unconditioned stimulus, the third CS was never paired (CS-). Extinction took place immediately after fear acquisition or 24h later. One CS+ was extinguished whereas the second CS+ remained unextinguished to control for different time intervals between fear acquisition and retrieval testing. Immediate extinction led to larger skin conductance responses during fear retrieval to both the extinguished and unextinguished CS relative to the CS-, indicating a stronger return of fear compared to delayed extinction. Taken together, immediate extinction is less potent than delayed extinction and is associated with a stronger renewal effect. Thus, the time-point of psychological interventions relative to the offset of threatening situations needs to be carefully considered to prevent relapses. Copyright © 2016 Elsevier Inc. All rights reserved.

The Immediate Effects on Inter-rectus Distance of Abdominal Crunch and Drawing-in Exercises During Pregnancy and the Postpartum Period.

PubMed

Mota, Patrícia; Pascoal, Augusto Gil; Carita, Ana Isabel; Bø, Kari

2015-10-01

Longitudinal descriptive exploratory study. To evaluate in primigravid women the immediate effect of drawing-in and abdominal crunch exercises on inter-rectus distance (IRD), measured at 4 time points during pregnancy and in the postpartum period. There is scant knowledge of the effect of different abdominal exercises on IRD in pregnant and postpartum women. The study included 84 primiparous participants. Ultrasound images were recorded with a 12-MHz linear transducer, at rest and during abdominal drawing-in and abdominal crunch exercises, at 3 locations on the linea alba. The IRD was measured at 4 time points: gestational weeks 35 to 41, 6 to 8 weeks postpartum, 12 to 14 weeks postpartum, and 24 to 26 weeks postpartum. Separate 2-way, repeated-measures analyses of variance (ANOVAs) were performed for each exercise (drawing-in and abdominal crunch) and each measurement location to evaluate the immediate effects of exercises on IRD at each of the 4 time points. Similarly, 2-way ANOVAs were used to contrast the effects of the 2 exercises on IRD. Performing the drawing-in exercise caused a significant change in width of the IRD at 2 cm below the umbilicus, narrowing the IRD by a mean of 3.8 mm (95% confidence interval [CI]: 1.2, 6.4 mm) at gestational weeks 35 to 41, and widening the IRD by 3.0 mm (95% CI: 1.4, 4.6 mm) at 6 to 8 weeks postpartum, by 1.8 mm (95% CI: 0.6, 3.1 mm) at 12 to 14 weeks postpartum, and by 2.5 mm (95% CI: 1.4, 3.6 mm) at 24 to 26 weeks postpartum (P<.01). Performing the abdominal crunch exercise led to a significant narrowing of the IRD (P<.01) in all 3 locations at all 4 time points, with the exception of 2 cm below the umbilicus at postpartum weeks 24 to 26. The average amount of narrowing varied from 1.6 to 20.9 mm, based on time and location. Overall, there was a contrasting effect of the 2 exercises, with the abdominal crunch exercise consistently producing a significant narrowing of the IRD. In contrast, the drawing-in exercise generally led to a small widening of the IRD.

The near real time image navigation of pictures returned by Voyager 2 at Neptune

NASA Technical Reports Server (NTRS)

Underwood, Ian M.; Bachman, Nathaniel J.; Taber, William L.; Wang, Tseng-Chan; Acton, Charles H.

1990-01-01

The development of a process for performing image navigation in near real time is described. The process was used to accurately determine the camera pointing for pictures returned by the Voyager 2 spacecraft at Neptune Encounter. Image navigation improves knowledge of the pointing of an imaging instrument at a particular epoch by correlating the spacecraft-relative locations of target bodies in inertial space with the locations of their images in a picture taken at that epoch. More than 8,500 pictures returned by Voyager 2 at Neptune were processed in near real time. The results were used in several applications, including improving pointing knowledge for nonimaging instruments ('C-smithing'), making 'Neptune, the Movie', and providing immediate access to geometrical quantities similar to those traditionally supplied in the Supplementary Experiment Data Record.

Peritraumatic startle response predicts the vulnerability to develop PTSD-like behaviors in rats: a model for peritraumatic dissociation

PubMed Central

Dong, Xinwen; Li, Yonghui

2014-01-01

Peritraumatic dissociation, a state characterized by alteration in perception and reduced awareness of surroundings, is considered to be a risk factor for the development of post-traumatic stress disorder (PTSD). However, the predictive ability of peritraumatic dissociation is questioned for the inconsistent results in different time points of assessment. The startle reflex is an objective behavioral measurement of defensive response to abrupt and intense sensory stimulus of surroundings, with potential to be used as an assessment on the dissociative status in both humans and rodents. The present study examined the predictive effect of acoustic startle response (ASR) in different time points around the traumatic event in an animal model of PTSD. The PTSD-like symptoms, including hyperarousal, avoidance, and contextual fear, were assessed 2–3 weeks post-trauma. The results showed that (1) the startle amplitude attenuated immediate after intense footshock in almost half of the stress animals, and (2) the attenuated startle responses at 1 h but not 24 h after stress predicted the development of severe PTSD-like symptoms. These data indicate that the startle alteration at the immediate period after trauma, including 1 h, is more important in PTSD prediction than 24 h after trauma. Our study also suggests that the startle attenuation immediate after intense stress may serve as an objective measurement of peritraumatic dissociation in rats. PMID:24478660

Simple reaction time to the onset of time-varying sounds.

PubMed

Schlittenlacher, Josef; Ellermeier, Wolfgang

2015-10-01

Although auditory simple reaction time (RT) is usually defined as the time elapsing between the onset of a stimulus and a recorded reaction, a sound cannot be specified by a single point in time. Therefore, the present work investigates how the period of time immediately after onset affects RT. By varying the stimulus duration between 10 and 500 msec, this critical duration was determined to fall between 32 and 40 milliseconds for a 1-kHz pure tone at 70 dB SPL. In a second experiment, the role of the buildup was further investigated by varying the rise time and its shape. The increment in RT for extending the rise time by a factor of ten was about 7 to 8 msec. There was no statistically significant difference in RT between a Gaussian and linear rise shape. A third experiment varied the modulation frequency and point of onset of amplitude-modulated tones, producing onsets at different initial levels with differently rapid increase or decrease immediately afterwards. The results of all three experiments results were explained very well by a straightforward extension of the parallel grains model (Miller and Ulrich Cogn. Psychol. 46, 101-151, 2003), a probabilistic race model employing many parallel channels. The extension of the model to time-varying sounds made the activation of such a grain depend on intensity as a function of time rather than a constant level. A second approach by mechanisms known from loudness produced less accurate predictions.

Statistical Considerations Concerning Dissimilar Regulatory Requirements for Dissolution Similarity Assessment. The Example of Immediate-Release Dosage Forms.

PubMed

Jasińska-Stroschein, Magdalena; Kurczewska, Urszula; Orszulak-Michalak, Daria

2017-05-01

When performing in vitro dissolution testing, especially in the area of biowaivers, it is necessary to follow regulatory guidelines to minimize the risk of an unsafe or ineffective product being approved. The present study examines model-independent and model-dependent methods of comparing dissolution profiles based on various compared and contrasted international guidelines. Dissolution profiles for immediate release solid oral dosage forms were generated. The test material comprised tablets containing several substances, with at least 85% of the labeled amount dissolved within 15 min, 20-30 min, or 45 min. Dissolution profile similarity can vary with regard to the following criteria: time point selection (including the last time point), coefficient of variation, and statistical method selection. Variation between regulatory guidance and statistical methods can raise methodological questions and result potentially in a different outcome when reporting dissolution profile testing. The harmonization of existing guidelines would address existing problems concerning the interpretation of regulatory recommendations and research findings. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Pointing with the Left and Right Hands in Congenitally Blind Children

ERIC Educational Resources Information Center

Ittyerah, Miriam; Gaunet, Florence; Rossetti, Yves

2007-01-01

Congenitally blind and blindfolded sighted children at ages of 6, 8, 10 and 12 years performed a pointing task with their left and right index fingers at an array of three targets on a touch screen to immediate (0 s) and delayed (4 s) instructions. Accuracy was greater for immediate than delayed pointing and there was an effect of delay for the…

Serial Changes in 3-Dimensional Supraspinatus Muscle Volume After Rotator Cuff Repair.

PubMed

Chung, Seok Won; Oh, Kyung-Soo; Moon, Sung Gyu; Kim, Na Ra; Lee, Ji Whan; Shim, Eungjune; Park, Sehyung; Kim, Youngjun

2017-08-01

There is considerable debate on the recovery of rotator cuff muscle atrophy after rotator cuff repair. To evaluate the serial changes in supraspinatus muscle volume after rotator cuff repair by using semiautomatic segmentation software and to determine the relationship with functional outcomes. Case series; Level of evidence, 4. Seventy-four patients (mean age, 62.8 ± 8.8 years) who underwent arthroscopic rotator cuff repair and obtained 3 consecutive (preoperatively, immediately postoperatively, and later postoperatively [≥1 year postoperatively]) magnetic resonance imaging (MRI) scans having complete Y-views were included. We generated a 3-dimensional (3D) reconstructed model of the supraspinatus muscle by using in-house semiautomatic segmentation software (ITK-SNAP) and calculated both the 2-dimensional (2D) cross-sectional area and 3D volume of the muscle in 3 different views (Y-view, 1 cm medial to the Y-view [Y+1 view], and 2 cm medial to the Y-view [Y+2 view]) at the 3 time points. The area and volume changes at each time point were evaluated according to repair integrity. Later postoperative volumes were compared with immediately postoperative volumes, and their relationship with various clinical factors and the effect of higher volume increases on range of motion, muscle power, and visual analog scale pain and American Shoulder and Elbow Surgeons scores were evaluated. The interrater reliabilities were excellent for all measurements. Areas and volumes increased immediately postoperatively as compared with preoperatively; however, only volumes on the Y+1 view and Y+2 view significantly increased later postoperatively as compared with immediately postoperatively ( P < .05). There were 9 patients with healing failure, and area and volume changes were significantly less later postoperatively compared with immediately postoperatively at all measurement points in these patients ( P < .05). After omitting the patients with healing failure, volume increases later postoperatively became more prominent ( P < .05) in the order of the Y+2 view, Y+1 view, and Y-view. Volume increases were higher in patients who healed successfully with larger tears ( P = .040). Higher volume increases were associated only with an increase in abduction power ( P = .029) and not with other outcomes. The supraspinatus muscle volume increased immediately postoperatively and continuously for at least 1 year after surgery. The increase was evident in patients who had larger tears and healed successfully and when measured toward the more medial portion of the supraspinatus muscle. The volume increases were associated with an increase in shoulder abduction power.

The Odyssey of Episodic Memories: Identifying the Paths and Processes Through Which They Contribute to Well-Being.

PubMed

Philippe, Frederick L; Bernard-Desrosiers, Léa

2017-08-01

This research highlights the processes through which lasting episodic memories and their characterized level of need satisfaction (autonomy, competence, and relatedness) can impact well-being, both at the situational level and over time. Study 1 (N = 92, M age  = 42.07 years, 72% female) investigated the effect of the unconscious activation of a personal episodic memory on situational well-being using a subliminal priming procedure. Study 2 (N = 275, M age  = 22.45 years, 84% female) followed the odyssey of an episodic memory by examining at various points over time its abstraction into perceptions of general need satisfaction and its long-term effect on well-being. Study 1 revealed that the activation of a need-satisfying memory produced an immediate increase in well-being, whereas the triggering of a need-thwarting memory led to an immediate decrease in well-being compared to controls. Study 2 revealed little influence of individual differences, but need satisfaction in episodic memories had a significant cumulative impact on well-being at different points in time over months and was abstracted into greater perceptions of general need satisfaction over time. Results provide convincing evidence for the directive function of memories on well-being, both at the situational level and over time. © 2016 Wiley Periodicals, Inc.

[Effect of hydroxyethyl starch 130/0.4 on S100B protein level and cerebral oxygen metabolism in open cardiac surgery under cardiopulmonary bypass].

PubMed

Pi, Zhi-bing; Tan, Guan-xian; Wang, Jun-lu

2007-07-17

To observe the effect of hydroxyethyl starch (HES) 130/0.4 on S100B protein level and cerebral metabolism of oxygen in open cardiac surgery under cardiopulmonary bypass (CPB) and to explore whether it has the protective effect of 6%HES130/0.4 as priming solution on cerebral injury during CPB and explore the probable mechanism. Forty patients with atrioseptal defect or ventricular septal defect scheduled for elective surgical repair under CPB with moderate hypothermia were randomly divided into two equal groups: HES 130/0.4 group (HES group) in which HES 130/0.4 (voluven) was used as priming solution and gelatin group (GRL group) in which gelofusine (succinylated gelatin) was used as priming solution. ECG, heart rate (HR), blood pressure (BP), mean arterial pressure (MAP), central venous pressure (CVP), arterial partial pressure of oxygen (P(a)O(2),), arterial partial pressure of carbon dioxide (P(et)CO(2)) and body temperature (naso-pharyngeal and rectal) were continuously monitored during the operation. Blood samples were obtained from the central vein for determination of blood concentrations of S100B protein at the following time points: before CPB (T(0)), 20 minutes after the beginning of CPB (T(1)), immediately after the termination of CPB (T(2)), 60 minutes after the termination of CPB (T(3)), and 24 hours after the termination of CPB (T(4)). The serum S100B protein levels were measured by ELISA. At the same time points blood samples were obtained from the jugular vein and radial artery to undergo blood gas analysis and measurement of blood glucose, based on which the cerebral oxygen metabolic rate/cerebral metabolic rate of glucose (CMRO(2)/CMR(GLU)) was calculated. Compared with the time point of immediately before CPB (T(0)), The S100B protein level of the 2 groups began to increase since the time point T(1), peaked at the time point T(2), began to decrease gradually since the time point T(3), and were still significantly higher than those before CPB at the time point T(4) (all P < 0.01), and the S100B protein levels at different time points of the HES group were all significantly lower than those of the GEL group (all P < 0.01). The S(jv)O(2) and CMRO(2)/CMR(GLU) levels of both groups increased at the time point T(1), decreased at the time points T(2) and T(3), and then restored to normal at the time points T(4). In the GEL group there were no significant differences in the levels between any 2 different time points, however, in the HES group S(jv)O(2) and CMRO(2)/CMR(GLU) levels at T(1) was significantly higher than those at the other time points (P < 0.05 or P < 0.01). S100B protein increases significantly in open cardiac surgery under CPB. HES130/0.4 lowers the S100B protein levels from the beginning of CPB to one hour after the termination of CPB with the probable mechanism of improving the cerebral metabolism of oxygen. 6%HES130/0.4 as priming solution may play a protective role in reduction of cerebral injury during CPB and open cardiac surgery.

The Time-Course of Lexical Activation During Sentence Comprehension in People With Aphasia

PubMed Central

Ferrill, Michelle; Love, Tracy; Walenski, Matthew; Shapiro, Lewis P.

2012-01-01

Purpose To investigate the time-course of processing of lexical items in auditorily presented canonical (subject–verb–object) constructions in young, neurologically unimpaired control participants and participants with left-hemisphere damage and agrammatic aphasia. Method A cross modal picture priming (CMPP) paradigm was used to test 114 control participants and 8 participants with agrammatic aphasia for priming of a lexical item (direct object noun) immediately after it is initially encountered in the ongoing auditory stream and at 3 additional time points at 400-ms intervals. Results The control participants demonstrated immediate activation of the lexical item, followed by a rapid loss (decay). The participants with aphasia demonstrated delayed activation of the lexical item. Conclusion This evidence supports the hypothesis of a delay in lexical activation in people with agrammatic aphasia. The delay in lexical activation feeds syntactic processing too slowly, contributing to comprehension deficits in people with agrammatic aphasia. PMID:22355007

Infusing pleasure: Mood effects of the consumption of a single cup of tea.

PubMed

Einöther, Suzanne J L; Rowson, Matthew; Ramaekers, Johannes G; Giesbrecht, Timo

2016-08-01

Tea has historically been associated with mood benefits. Nevertheless, few studies have empirically investigated mood changes after tea consumption. We explored immediate effects of a single cup of tea up to an hour post-consumption on self-reported valence, arousal, discrete emotions, and implicit measures of mood. In a parallel group design, 153 participants received a cup of tea or placebo tea, or a glass of water. Immediately (i.e. 5 min) after consumption, tea increased valence but reduced arousal, as compared to the placebo. There were no differences at later time points. Discrete emotions did not differ significantly between conditions, immediately or over time. Water consumption increased implicit positivity as compared to placebo. Finally, consumption of tea and water resulted in higher interest in activities overall and in specific activity types compared to placebo. The present study shows that effects of a single cup of tea may be limited to an immediate increase in pleasure and decrease in arousal, which can increase interest in activities. Differences between tea and water were not significant, while differences between water and placebo on implicit measures were unexpected. More servings over a longer time may be required to evoke tea's arousing effects and appropriate tea consumption settings may evoke more enduring valence effects. Copyright © 2016 Elsevier Ltd. All rights reserved.

Oxidative lung injury correlates with one-lung ventilation time during pulmonary lobectomy: a study of exhaled breath condensate and blood.

PubMed

García-de-la-Asunción, José; García-del-Olmo, Eva; Perez-Griera, Jaume; Martí, Francisco; Galan, Genaro; Morcillo, Alfonso; Wins, Richard; Guijarro, Ricardo; Arnau, Antonio; Sarriá, Benjamín; García-Raimundo, Miguel; Belda, Javier

2015-09-01

During lung lobectomy, the operated lung is collapsed and hypoperfused; oxygen deprivation is accompanied by reactive hypoxic pulmonary vasoconstriction. After lung lobectomy, ischaemia present in the collapsed state is followed by expansion-reperfusion and lung injury attributed to the production of reactive oxygen species. The primary objective of this study was to investigate the time course of several markers of oxidative stress simultaneously in exhaled breath condensate and blood and to determine the relationship between oxidative stress and one-lung ventilation time in patients undergoing lung lobectomy. This single-centre, observational, prospective study included 28 patients with non-small-cell lung cancer who underwent lung lobectomy. We measured the levels of hydrogen peroxide, 8-iso-PGF2α, nitrites plus nitrates and pH in exhaled breath condensate (n = 25). The levels of 8-iso-PGF2α and nitrites plus nitrates were also measured in blood (n = 28). Blood samples and exhaled breath condensate samples were collected from all patients at five time points: preoperatively; during one-lung ventilation, immediately before resuming two-lung ventilation; immediately after resuming two-lung ventilation; 60 min after resuming two-lung ventilation and 180 min after resuming two-lung ventilation. Both exhaled breath condensate and blood exhibited significant and simultaneous increases in oxidative-stress markers immediately before two-lung ventilation was resumed. However, all these values underwent larger increases immediately after resuming two-lung ventilation. In both exhaled breath condensate and blood, marker levels significantly and directly correlated with the duration of one-lung ventilation immediately before resuming two-lung ventilation and immediately after resuming two-lung ventilation. Although pH significantly decreased in exhaled breath condensate immediately after resuming two-lung ventilation, these pH values were inversely correlated with the duration of one-lung ventilation. During lung lobectomy, the operated lung is collapsed and oxidative injury occurs, with the levels of markers of oxidative stress increasing simultaneously in exhaled breath condensate and blood during one-lung ventilation. These increases were larger after resuming two-lung ventilation. Increases immediately before resuming two-lung ventilation and immediately after resuming two-lung ventilation were directly correlated with the duration of one-lung ventilation. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Victimization, Friendship and Resilience: Crossing the Land In-Between

ERIC Educational Resources Information Center

Moore, Stephen; MacLean, Rachel

2012-01-01

This article explores the victimization of young people immediately before and after the school day. This is a unique time when most young people of secondary school age, from a range of backgrounds, with different interests and standards of behaviour, are constrained to mix at some point on the journey to school. For most young people this a…

Temporal heating profile influence on the immediate bond strength following laser tissue soldering.

PubMed

Rabi, Yaron; Katzir, Abraham

2010-07-01

Bonding of tissues by laser heating is considered as a future alternative to sutures and staples. Increasing the post-operative bond strength remains a challenging issue for laser tissue bonding, especially in organs that have to sustain considerable tension or pressure. In this study, we investigated the influence of different temporal heating profiles on the strength of soldered incisions. The thermal damage following each heating procedure was quantified, in order to assess the effect of each heating profile on the thermal damage. Incisions in porcine bowel tissue strips (1 cmx4 cm) were soldered, using a 44% liquid albumin mixed with indocyanine green and a temperature controlled laser (830 nm) tissue bonding system. Heating was done either with a linear or a step temporal heating profile. The incisions were bonded by soldering at three points, separated by 2 mm. Set-point temperatures of T(set) = 60, 70, 80, 90, 100, 110, 150 degrees C and dwell times of t(d) = 10, 20, 30, 40 seconds were investigated. The bond strength was measured immediately following each soldering by applying a gradually increased tension on the tissue edges until the bond break. Bonds formed by linear heating were stronger than the ones formed by step heating: at T(set) = 80 degrees C the bonds were 40% stronger and at T(set) = 90 degrees C the bonds strength was nearly doubled. The bond strength difference between the heating methods was larger as T(set) increased. Linear heating produced stronger bonds than step heating. The difference in the bond strength was more pronounced at high set-point temperatures and short dwell times. The bond strength could be increased with either higher set-point temperature or a longer dwell time.

Balance and gait analysis of senior tumble-prone patients with cerebrovascular disease.

PubMed

Fang, Hong

2017-05-01

This study aims to observe the tumble status for senior patients with cerebrovascular disease, and to analyze the balance and gait condition in order to provide the basis for clinical prevention and nursing care. A total of 48 senior patients with cerebrovascular disease were investigated with the Tinetti balance and gait evaluation, and the relation between tumble occurrence and balance ability was interrogated. The total score of balance evaluation value and gait value for 89.1% of the senior patients with cerebrovascular disease was fewer than 19 points, which indicated a risk of tumble. The majority of patients could not complete the immediate standing balance well, turning stand balance, mild chest-pushed balance and eyes-closed standing balance. The occurrence of immediate standing balance and turning stand balance fewer than three times was less frequent than the occurrence of tumble for one time, which had significant difference (P<0.05). The senior patients with cerebrovascular disease and immediate standing balance and turning stand balance could easily tumble many times, which was crucial for the nursing staff to carry out preventive strategies. Detailed observations of balance and gait function for senior patients were described, which provided a promising basis for designing appropriate nursing measures.

Distant memories: a prospective study of vantage point of trauma memories.

PubMed

Kenny, Lucy M; Bryant, Richard A; Silove, Derrick; Creamer, Mark; O'Donnell, Meaghan; McFarlane, Alexander C

2009-09-01

Adopting an observer perspective to recall trauma memories may function as a form of avoidance that maintains posttraumatic stress disorder (PTSD). We conducted a prospective study to analyze the relationship between memory vantage point and PTSD symptoms. Participants (N= 947) identified the vantage point of their trauma memory and reported PTSD symptoms within 4 weeks of the trauma; 730 participants repeated this process 12 months later. Initially recalling the trauma from an observer vantage point was related to more severe PTSD symptoms at that time and 12 months later. Shifting from a field to an observer perspective a year after trauma was associated with greater PTSD severity at 12 months. These results suggest that remembering trauma from an observer vantage point is related to both immediate and ongoing PTSD symptoms.

Changes in infant disposable diaper weights at selected intervals post-wetting.

PubMed

Carlisle, Joan; Moore, Amanda; Cooper, Alyssa; Henderson, Terri; Mayfield, Debbie; Taylor, Randa; Thomas, Jennifer; Van Fleet, Laduska; Askanazi, David; Fineberg, Naomi; Sun, Yanhui

2012-01-01

Pediatric acute care nurses questioned the practice of weighing disposable infant diapers immediately after voiding. This study asked the research question, "Does volume of saline, diaper configuration, and/or size of diaper statistically effect changes in diaper weights over time?" The method was an experimental, laboratory model. Pre-set volumes of saline were added to disposable diapers that were then left folded or unfolded. Each diaper was weighed immediately post-wetting and re-weighed at hourly intervals for seven hours. Data were analyzed using a repeated measures analysis of variance (RMANOVA) with balanced data (F-test). Diaper weight changes over time were statistically significant for all time points and for all volumes regardless of diaper size; however, the changes in weight were small and without clinical significance. It is appropriate to weigh diapers at the end of eight hours without risk of altering subsequent fluid management of patients in open-air, non-humidified environments. This practice has led to more efficient use of nurses' time with fewer interruptions for patients and families.

Landing Technique Improvements After an Aquatic-Based Neuromuscular Training Program in Physically Active Women.

PubMed

Scarneo, Samantha E; Root, Hayley J; Martinez, Jessica C; Denegar, Craig; Casa, Douglas J; Mazerolle, Stephanie M; Dann, Catie L; Aerni, Giselle A; DiStefano, Lindsay J

2017-01-01

Neuromuscular training programs (NTPs) improve landing technique and decrease vertical ground-reaction forces (VGRFs), resulting in injury-risk reduction. NTPs in an aquatic environment may elicit the same improvements as land-based programs with reduced joint stress. To examine the effects of an aquatic NTP on landing technique as measured by the Landing Error Scoring System (LESS) and VGRFs, immediately and 4 mo after the intervention. Repeated measures, pool and laboratory. Fifteen healthy, recreationally active women (age 21 ± 2 y, mass 62.02 ± 8.18 kg, height 164.74 ± 5.97 cm) who demonstrated poor landing technique (LESS-Real Time > 4). All participants completed an aquatic NTP 3 times/wk for 6 wk. Participants' landing technique was evaluated using a jump-landing task immediately before (PRE), immediately after (POST), and 4 mo after (RET) the intervention period. A single rater, blinded to time point, graded all videos using the LESS, which is a valid and reliable movement-screening tool. Peak VGRFs were measured during the stance phase of the jump-landing test. Repeated-measure analyses of variance with planned comparisons were performed to explore differences between time points. LESS scores were lower at POST (4.46 ± 1.69 errors) and at RET (4.2 ± 1.72 errors) than at PRE (6.30 ± 1.78 errors) (P < .01). No significant differences were observed between POST and RET (P > .05). Participants also landed with significantly lower peak VGRFs (P < .01) from PRE (2.69 ± .72 N) to POST (2.23 ± .66 N). The findings introduce evidence that an aquatic NTP improves landing technique and suggest that improvements are retained over time. These results show promise of using an aquatic NTP when there is a desire to reduce joint loading, such as early stages of rehabilitation, to improve biomechanics and reduce injury risk.

High energy focused shock wave therapy accelerates bone healing. A blinded, prospective, randomized canine clinical trial.

PubMed

Kieves, N R; MacKay, C S; Adducci, K; Rao, S; Goh, C; Palmer, R H; Duerr, F M

2015-01-01

To evaluate the influence of shock wave therapy (SWT) on radiographic evidence of bone healing after tibial plateau leveling osteotomy (TPLO). Healthy dogs between two to nine years of age that underwent TPLO were randomly assigned to receive either electro-hydraulic SWT (1,000 shocks) or sham treatment (SHAM). Treatment or SHAM was administered to the osteotomy site immediately postoperatively and two weeks postoperatively. Three blinded radiologists evaluated orthogonal radiographs performed eight weeks postoperatively with both a 5-point and a 10-point bone healing scale. Linear regression analysis was used to compare median healing scores between groups. Forty-two dogs (50 stifles) were included in the statistical analysis. No major complications were observed and all osteotomies healed uneventfully. The median healing scores were significantly higher at eight weeks postoperatively for the SWT group compared to the SHAM group for the 10-point (p <0.0002) and 5-point scoring systems (p <0.0001). Shock wave therapy applied immediately and two weeks postoperatively led to more advanced bone healing at the eight week time point in this study population. The results of this study support the use of electro-hydraulic SWT as a means of accelerating acute bone healing of canine osteotomies. Additional studies are needed to evaluate its use for acceleration of bone healing following fracture, or with delayed union.

The effect of session order on the physiological, neuromuscular, and endocrine responses to maximal speed and weight training sessions over a 24-h period.

PubMed

Johnston, Michael; Johnston, Julia; Cook, Christian J; Costley, Lisa; Kilgallon, Mark; Kilduff, Liam P

2017-05-01

Athletes are often required to undertake multiple training sessions on the same day with these sessions needing to be sequenced correctly to allow the athlete to maximize the responses of each session. We examined the acute effect of strength and speed training sequence on neuromuscular, endocrine, and physiological responses over 24h. 15 academy rugby union players completed this randomized crossover study. Players performed a weight training session followed 2h later by a speed training session (weights speed) and on a separate day reversed the order (speed weights). Countermovement jumps, perceived muscle soreness, and blood samples were collected immediately prior, immediately post, and 24h post-sessions one and two respectively. Jumps were analyzed for power, jump height, rate of force development, and velocity. Blood was analyzed for testosterone, cortisol, lactate and creatine kinase. There were no differences between countermovement jump variables at any of the post-training time points (p>0.05). Likewise, creatine kinase, testosterone, cortisol, and muscle soreness were unaffected by session order (p>0.05). However, 10m sprint time was significantly faster (mean±standard deviation; speed weights 1.80±0.11s versus weights speed 1.76±0.08s; p>0.05) when speed was sequenced second. Lactate levels were significantly higher immediately post-speed sessions versus weight training sessions at both time points (p<0.05). The sequencing of strength and speed training does not affect the neuromuscular, endocrine, and physiological recovery over 24h. However, speed may be enhanced when performed as the second session. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Effect of post-thaw addition of seminal plasma on motility, viability and chromatin integrity of cryopreserved donkey jack (Equus asinus) spermatozoa.

PubMed

Sabatini, C; Mari, G; Mislei, B; Love, Cc; Panzani, D; Camillo, F; Rota, A

2014-12-01

Pregnancy rates in donkeys after artificial insemination with cryopreserved semen are still low, compared to the horse species. Addition of autologous seminal plasma to frozen-thawed semen appeared to improve pregnancy rates. The aims of this study were to evaluate (1) sperm motility and plasma membrane integrity after thawing (T0) and after one and 2 h (T1 and T2) of post-thaw incubation in either 0% (SP0) or 70% (SP70) autologous seminal plasma and (2) sperm motility, plasma membrane integrity and DNA quality (%COMP-αt) after thawing (T0) and after 2 and 4 h (T2 and T4) of post-thaw incubation in either 0% (SP0), 5% (SP5) or 20% (SP20) homologous seminal plasma. In experiment 1, seminal plasma decreased total and progressive sperm motility and plasma membrane intact spermatozoa immediately after dilution and at all following time points (p < 0.05). In experiment 2, total and progressive motility did not differ between treatments immediately after dilution and between SP0 and SP5 at T2, while they were lower in both SP5 and SP20 than in SP0 at T4. Plasma membrane intact sperm cells did not differ between SP0 and SP5 and were lower in SP20 at all time points. DNA quality was not affected by treatment immediately after dilution and was significantly worse for SP20 after 4 h of incubation (p < 0.05). The post-thaw addition of seminal plasma at the tested concentrations did not improve donkey frozen semen characteristics in vitro over time. © 2014 Blackwell Verlag GmbH.

Experimental hydrophilic vinyl polysiloxane (VPS) impression materials incorporating a novel surfactant compared with commercial VPS.

PubMed

Ud Din, Shahab; Parker, Sandra; Braden, Michael; Tomlins, Pete; Patel, Mangala

2017-08-01

To formulate experimental hydrophilic (Exp) VPS impression materials incorporating a novel surfactant (Rhodasurf CET-2), and to compare their contact angles (CAs) with commercial materials, before/after disinfection. CAs were measured immediately after setting and after disinfection (1% NaOCl; 30min and 24h), together with their change whilst a droplet remained on the materials surface (over 10, 20, 30 60 and 120s), on three commercial (Aquasil Ultra-Monophase [Aq M], Elite HD-Monophase [Elt M], Extrude Medium-bodied [Extr M]) and four experimental (Exp I-IV) materials, using the Drop Shape Analysis 100 technique. The results were compared statistically. CAs of all experimental materials were within the range of those obtained for the commercial materials, with the exception of Exp-IV, which presented with the lowest CAs at the three time points. The control Exp-I was hydrophobic at all three time points (CAs ∼100+), as was Elite. Immediately after setting, Aq M had low CAs but these increased significantly after 30min of disinfection. After twenty four hours' disinfection CAs of all Exp/commercial VPS increased significantly compared to immediately after setting. The CAs of droplets left on the material (120s) decreased with time, even after disinfection, except for Exp-I. The novel surfactant Rhodasurf CET-2 in Exp-III and IV, is an effective surfactant, retaining a low CA after disinfection, compared with Igepal CO-530 in Aq M. Disinfecting VPS impression materials for more than 30min increases their surface CAs, and therefore prolonged disinfection periods should be avoided. Copyright © 2017 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Central vasopressin V1a receptor activation is independently necessary for both partner preference formation and expression in socially monogamous male prairie voles.

PubMed

Donaldson, Zoe R; Spiegel, Lauren; Young, Larry J

2010-02-01

The neuropeptide arginine vasopressin (AVP) modulates a variety of species-specific social behaviors. In socially monogamous male prairie voles, AVP acts centrally via vasopressin V1a receptor (V1aR) to facilitate mating induced partner preferences. The display of a partner preference requires at least 2 temporally distinct processes: social bond formation as well as its recall, or expression. Studies to date have not determined in which of these processes V1aR acts to promote partner preferences. Here, male prairie voles were administered intracerebroventricularly a V1aR antagonist (AVPA) at different time points to investigate the role of V1aR in social bond formation and expression. Animals receiving AVPA prior to cohabitation with mating or immediately prior to partner preference testing failed to display a partner preference, while animals receiving AVPA immediately after cohabitation with mating and control animals receiving vehicle at all 3 time points displayed partner preferences. These results suggest that V1aR signaling is necessary for both the formation and expression of partner preferences and that these processes are dissociable. (c) 2009 APA, all rights reserved.

Emotional stress as a cause of syncope and torsade de pointes in patients with long QT syndrome.

PubMed

Vukmirović, Mihailo; Vukmirović, Irena Tomašević; Angelkov, Lazar; Vukmirović, Filip

2015-02-01

Long QT syndrome (LQTS) is a disorder of myocardial repolarization characterized by the prolongation of QT interval and high risk propensity of torsade de pointes (TdP) that can lead to syncope, cardiac arrest and sudden death. Episodes may be provoked by various stimuli depending on the type of the condition. A 25-year-old famele patient was hospitalized due to syncope that occurred immediately after her solo concert, first time in her life. The patient studied solo singing and after intensive preparations the first solo concert was organized. Electrocardiography (ECG) on admission registered frequent ventricular premature beats (VES), followed by polymorphic ventricular tachycardia--TdP that degenerated into ventricular fibrilation (VF). After immediate cardioversion magnesium and beta-blockers were administered. TdP was registered again several times preceded by VES. The corrected QT interval (QTc) was 516 msec. For secondary prevention of sudden cardiac death, a cardioverter defibrillator was implanted, and beta-blockers continued. After a 1-year follow-up there were no recurrent episodes of TdP, and measured QTc was reduced to 484 msec. Patients with syncope following intensive emotional stress should be evaluated for malignant arrhythmias in the context of LQTS.

Temporal orientation.

PubMed

Maglio, Sam J; Trope, Yaacov

2018-05-18

Time in the mind orients people in one of two directions. An inward orientation points to the present, contracting the scope of thought to immediate concerns. An outward orientation, in contrast, points away from the present to the past or the future, expanding the scope of thought to a wider consideration set. These oriented arrows need not solely be used for mental time travel, as a similar inward/outward orientation can apply to social distance, spatial distance, and probability. We review recent findings illuminated by this broad form distancing, as illustrated in how people learn from and compare themselves to others, before concluding with a discussion of how change necessarily transpires over time, providing opportunities for future research at the intersection of future thought and present behavior. Copyright © 2018 Elsevier Ltd. All rights reserved.

Reliability of Interaural Time Difference-Based Localization Training in Elderly Individuals with Speech-in-Noise Perception Disorder.

PubMed

Delphi, Maryam; Lotfi, M-Yones; Moossavi, Abdollah; Bakhshi, Enayatollah; Banimostafa, Maryam

2017-09-01

Previous studies have shown that interaural-time-difference (ITD) training can improve localization ability. Surprisingly little is, however, known about localization training vis-à-vis speech perception in noise based on interaural time difference in the envelope (ITD ENV). We sought to investigate the reliability of an ITD ENV-based training program in speech-in-noise perception among elderly individuals with normal hearing and speech-in-noise disorder. The present interventional study was performed during 2016. Sixteen elderly men between 55 and 65 years of age with the clinical diagnosis of normal hearing up to 2000 Hz and speech-in-noise perception disorder participated in this study. The training localization program was based on changes in ITD ENV. In order to evaluate the reliability of the training program, we performed speech-in-noise tests before the training program, immediately afterward, and then at 2 months' follow-up. The reliability of the training program was analyzed using the Friedman test and the SPSS software. Significant statistical differences were shown in the mean scores of speech-in-noise perception between the 3 time points (P=0.001). The results also indicated no difference in the mean scores of speech-in-noise perception between the 2 time points of immediately after the training program and 2 months' follow-up (P=0.212). The present study showed the reliability of an ITD ENV-based localization training in elderly individuals with speech-in-noise perception disorder.

Educating anesthesia residents to obtain and document informed consent for epidural labor analgesia: does simulation play a role?

PubMed

Antoniou, A; Marmai, K; Qasem, F; Cherry, R; Jones, P M; Singh, S

2018-05-01

Informed consent is required before placing an epidural. At our hospital, teaching of residents about this is done informally at the bedside. This study aimed to assess the ability of anesthesia residents to acquire and retain knowledge required when seeking informed consent for epidural labor analgesia. It assessed how well this knowledge was translated to clinical ability, by assessing the verbal consent process during an interaction with a standardized patient. Twenty anesthesia residents were randomized to a 'didactic group' or a 'simulation group'. Each resident was presented with a written scenario and asked to document the informed consent process, as they normally would do (pre-test). The didactic group then had a presentation about informed consent, while the simulation group members interviewed a simulated patient, the scenarios focusing on different aspects of consent. All residents then read a scenario and documented their informed consent process (post-test). Six weeks later all residents interviewed a standardized patient in labor and documented the consent from this interaction (six-week test). There was no significant difference in the baseline performance of the two groups. Both groups showed significant improvement in their written consent documentation at the immediate time point, the improvement in the didactic group being greater. The didactic group performed better at both the immediate time point and the six-week time point. In this small study, a didactic teaching method proved better than simulation-based teaching in helping residents to gain knowledge needed to obtain informed consent for epidural labor analgesia. Copyright © 2017 Elsevier Ltd. All rights reserved.

Influence of surgical and prosthetic techniques on marginal bone loss around titanium implants. Part I: immediate loading in fresh extraction sockets.

PubMed

Berberi, Antoine N; Tehini, Georges E; Noujeim, Ziad F; Khairallah, Alexandre A; Abousehlib, Moustafa N; Salameh, Ziad A

2014-10-01

Delayed placement of implant abutments has been associated with peri-implant marginal bone loss; however, long-term results obtained by modifying surgical and prosthetic techniques after implant placement are still lacking. This study aimed to evaluate the marginal bone loss around titanium implants placed in fresh extraction sockets using two loading protocols after a 5-year follow-up period. A total of 36 patients received 40 titanium implants (Astra Tech) intended for single-tooth replacement. Implants were immediately placed into fresh extraction sockets using either a one-stage (immediate loading by placing an interim prosthesis into functional occlusion) or a two-stage prosthetic loading protocol (insertion of abutments after 8 weeks of healing time). Marginal bone levels relative to the implant reference point were evaluated at four time intervals using intraoral radiographs: at time of implant placement, and 1, 3, and 5 years after implant placement. Measurements were obtained from mesial and distal surfaces of each implant (α = 0.05). One-stage immediate implant placement into fresh extraction sockets resulted in a significant reduction in marginal bone loss (p < 0.002) compared to the traditional two-stage technique. Whereas mesial surfaces remained stable for the 5-year observation period, significant marginal bone loss was observed on distal surfaces of implants after cementation of interim prostheses (p < 0.007) and after 12 months (p < 0.034). Within the limitations of this study, immediate loading of implants placed into fresh extraction sockets reduced marginal bone loss and did not compromise the success rate of the restorations. © 2014 by the American College of Prosthodontists.

No neurocognitive advantage for immediate antiretroviral treatment in adults with greater than 500 CD4+ T-cell counts.

PubMed

Wright, Edwina J; Grund, Birgit; Robertson, Kevin R; Cysique, Lucette; Brew, Bruce J; Collins, Gary L; Poehlman-Roediger, Mollie; Vjecha, Michael J; Penalva de Oliveira, Augusto César; Standridge, Barbara; Carey, Cate; Avihingsanon, Anchalee; Florence, Eric; Lundgren, Jens D; Arenas-Pinto, Alejandro; Mueller, Nicolas J; Winston, Alan; Nsubuga, Moses S; Lal, Luxshimi; Price, Richard W

2018-05-15

To compare the effect of immediate versus deferred antiretroviral treatment (ART) on neuropsychological test performance in treatment-naive HIV-positive adults with more than 500 CD4 cells/μl. Randomized trial. The START parent study randomized participants to commence immediate versus deferred ART until CD4 less than 350 cells/μl. The START Neurology substudy used eight neuropsychological tests, at baseline, months 4, 8, 12 and annually, to compare groups for changes in test performance. Test results were internally standardized to z-scores. The primary outcome was the average of the eight test z-scores (QNPZ-8). Mean changes in QNPZ-8 from baseline were compared by intent-to-treat using longitudinal mixed models. Changes from baseline to specific time points were compared using ANCOVA models. The 592 participants had a median age of 34 years; median baseline CD4 count was 629 cells/μl; the mean follow-up was 3.4 years. ART was used for 94 and 32% of accrued person-years in the immediate and deferred groups, respectively. There was no difference between the immediate and deferred ART groups in QNPZ-8 change through follow-up [-0.018 (95% CI -0.062 to 0.027, P = 0.44)], or at any visit. However, QNPZ-8 scores increased in both arms during the first year, by 0.22 and 0.24, respectively (P < 0.001 for increase from baseline). We observed substantial improvement in neurocognitive test performance during the first year in both study arms, underlining the importance of using a control group in studies assessing neurocognitive performance over time. Immediate ART neither benefitted nor harmed neurocognitive performance in individuals with CD4 cell counts above 500 cells/μl.

Another Look at the Great Area-Coverage Controversy of the 1950's

NASA Astrophysics Data System (ADS)

Blanchard, Walter

2005-09-01

In the immediate aftermath of WW2 there sprang up an international argument over the relative merits for aerial navigation of area-coverage radio navaids versus point-source systems. The United States was in favour of point-source whereas the UK proposed area-coverage, systems for which had successfully been demonstrated under very adverse conditions during the war. It rumbled on for many years, not being finally settled until the ICAO Montreal Conference of 1959 decided for point-source. Since then, VOR/DME/ADF/ILS have been the standard aviation radio navaids and there seems little likelihood of any change in the near future, GNSS notwithstanding, if one discounts the phasing-out of ADF. It now seems sufficiently in the past to perhaps allow a dispassionate evaluation of the technical arguments used at the time the political ones can be left to another place and time.

Portal Surveys of Time-Out Drinking Locations: A Tool for Studying Binge Drinking and AOD Use

ERIC Educational Resources Information Center

Voas, Robert B.; Furr-Holden, Debra; Lauer, Elizabeth; Bright, Kristin; Johnson, Mark B.; Miller, Brenda

2006-01-01

Portal surveys, defined as assessments occurring proximal to the entry point to a high-risk locale and immediately on exit, can be used in different settings to measure characteristics and behavior of attendees at an event of interest. This methodology has been developed to assess alcohol and other drug (AOD) use at specific events and has…

Measuring Cognitive Load with Subjective Rating Scales during Problem Solving: Differences between Immediate and Delayed Ratings

ERIC Educational Resources Information Center

Schmeck, Annett; Opfermann, Maria; van Gog, Tamara; Paas, Fred; Leutner, Detlev

2015-01-01

Subjective cognitive load (CL) rating scales are widely used in educational research. However, there are still some open questions regarding the point of time at which such scales should be applied. Whereas some studies apply rating scales directly after each step or task and use an average of these ratings, others assess CL only once after the…

Weak shock propagation through a turbulent atmosphere

NASA Technical Reports Server (NTRS)

Pierce, Allan D.; Sparrow, Victor W.

1990-01-01

Consideration is given to the propagation through turbulence of transient pressure waveforms whose initial onset at any given point is an abrupt shock. The work is motivated by the desire to eventually develop a mathematical model for predicting statistical features, such as peak overpressures and spike widths, of sonic booms generated by supersonic aircraft. It is argued that the transient waveform received at points where x greater than 0 will begin with a pressure jump and a formulation is developed for predicting the amount of this jump and the time derivatives of the pressure waveform immediately following the jump.

Delayed benefit of naps on motor learning in preschool children.

PubMed

Desrochers, Phillip C; Kurdziel, Laura B F; Spencer, Rebecca M C

2016-03-01

Sleep benefits memory consolidation across a variety of domains in young adults. However, while declarative memories benefit from sleep in young children, such improvements are not consistently seen for procedural skill learning. Here we examined whether performance improvements on a procedural task, although not immediately observed, are evident after a longer delay when augmented by overnight sleep (24 h after learning). We trained 47 children, aged 33-71 months, on a serial reaction time task and, using a within-subject design, evaluated performance at three time points: immediately after learning, after a daytime nap (nap condition) or equivalent wake opportunity (wake condition), and 24 h after learning. Consistent with previous studies, performance improvements following the nap did not differ from performance improvements following an equivalent interval spent awake. However, significant benefits of the nap were found when performance was assessed 24 h after learning. This research demonstrates that motor skill learning is benefited by sleep, but that this benefit is only evident after an extended period of time.

Mental Transformation Skill in Young Children: The Role of Concrete and Abstract Motor Training.

PubMed

Levine, Susan C; Goldin-Meadow, Susan; Carlson, Matthew T; Hemani-Lopez, Naureen

2018-05-01

We examined the effects of three different training conditions, all of which involve the motor system, on kindergarteners' mental transformation skill. We focused on three main questions. First, we asked whether training that involves making a motor movement that is relevant to the mental transformation-either concretely through action (action training) or more abstractly through gestural movements that represent the action (move-gesture training)-resulted in greater gains than training using motor movements irrelevant to the mental transformation (point-gesture training). We tested children prior to training, immediately after training (posttest), and 1 week after training (retest), and we found greater improvement in mental transformation skill in both the action and move-gesture training conditions than in the point-gesture condition, at both posttest and retest. Second, we asked whether the total gain made by retest differed depending on the abstractness of the movement-relevant training (action vs. move-gesture), and we found that it did not. Finally, we asked whether the time course of improvement differed for the two movement-relevant conditions, and we found that it did-gains in the action condition were realized immediately at posttest, with no further gains at retest; gains in the move-gesture condition were realized throughout, with comparable gains from pretest-to-posttest and from posttest-to-retest. Training that involves movement, whether concrete or abstract, can thus benefit children's mental transformation skill. However, the benefits unfold differently over time-the benefits of concrete training unfold immediately after training (online learning); the benefits of more abstract training unfold in equal steps immediately after training (online learning) and during the intervening week with no additional training (offline learning). These findings have implications for the kinds of instruction that can best support spatial learning. Copyright © 2018 Cognitive Science Society, Inc.

Effect of a preoperative self-catheterization video on anxiety: a randomized controlled trial.

PubMed

Oliphant, Sallie S; Lowder, Jerry L; Ghetti, Chiara; Zyczynski, Halina M

2013-03-01

The purpose of this study was to determine if a clean intermittent self-catheterization (CISC) instructional video could improve anxiety in women undergoing prolapse and/or incontinence surgery. A total of 199 women were randomized to preoperative CISC video or routine counseling prior to prolapse/incontinence surgery. Patient anxiety, satisfaction, and concerns about CISC were evaluated using the State-Trait Anxiety Inventory-State (STAI-S) and study-specific visual analog scale (VAS) questions at four perioperative time points. STAI-S and VAS anxiety measures were similar at baseline between groups; no significant differences were seen by group at any time point. STAI-S scores varied considerably over time, with highest scores at voiding trial failure and lowest scores at postoperative visit. Women in the video group had improved STAI-S scores and reported less worry and more comfort with CISC immediately following video viewing. Women with anxiety/depression had higher STAI-S scores at voiding trial failure and discharge and reported less anxiety reduction following video viewing compared to non-anxious/non-depressed peers. Women undergoing prolapse/incontinence surgery have significant perioperative anxiety, which is exacerbated by voiding trial failure. Preoperative CISC video viewing decreases anxiety scores immediately following viewing, but this effect is not sustained at voiding trial failure. Women with baseline anxiety/depression exhibit less anxiety score improvement after video viewing and have overall higher anxiety scores perioperatively.

Software for Verifying Image-Correlation Tie Points

NASA Technical Reports Server (NTRS)

Klimeck, Gerhard; Yagi, Gary

2008-01-01

A computer program enables assessment of the quality of tie points in the image-correlation processes of the software described in the immediately preceding article. Tie points are computed in mappings between corresponding pixels in the left and right images of a stereoscopic pair. The mappings are sometimes not perfect because image data can be noisy and parallax can cause some points to appear in one image but not the other. The present computer program relies on the availability of a left- right correlation map in addition to the usual right left correlation map. The additional map must be generated, which doubles the processing time. Such increased time can now be afforded in the data-processing pipeline, since the time for map generation is now reduced from about 60 to 3 minutes by the parallelization discussed in the previous article. Parallel cluster processing time, therefore, enabled this better science result. The first mapping is typically from a point (denoted by coordinates x,y) in the left image to a point (x',y') in the right image. The second mapping is from (x',y') in the right image to some point (x",y") in the left image. If (x,y) and(x",y") are identical, then the mapping is considered perfect. The perfect-match criterion can be relaxed by introducing an error window that admits of round-off error and a small amount of noise. The mapping procedure can be repeated until all points in each image not connected to points in the other image are eliminated, so that what remains are verified correlation data.

Examination of local and systemic in vivo responses to electrical injury using an electrical burn delivery system.

PubMed

Shupp, Jeffrey W; Moffatt, Lauren T; Nguyen, Thu; Ramella-Roman, Jessica C; Hammamieh, Rasha; Miller, Stacy-Ann; Leto, Ellen J; Jo, Daniel Y; Randad, Pranay R; Jett, Marti; Jeng, James C; Jordan, Marion H

2012-01-01

Electrical injuries are devastating and are difficult to manage due to the complexity of the tissue damage and physiological impacts. A paucity of literature exists which describes models for electrical injury. To date, those models have been used primarily to demonstrate thermal and morphological effects at the points of contact. Creating a more representative model for human injury and further elucidating the physics and pathophysiology of this unique form of tissue injury could be helpful in designing stage-appropriate therapy and improving limb salvage. An electrical burn delivery system was developed to accurately and reliably deliver electrical current at varying exposure times. A series of Sprague-Dawley rats were anesthetized and subjected to injury with 1000 V of direct current at incremental exposure times (2-20 seconds). Whole blood and plasma were obtained immediately before shock, immediately postinjury, and then hourly for 3 hours. Laser Doppler images of tissue adjacent to the entrance and exit wounds were obtained at the outlined time points to provide information on tissue perfusion. The electrical exposure was nonlethal in all animals. The size and the depth of contact injury increased in proportion to the exposure times and were reproducible. Skin adjacent to injury (both entrance and exit sites) exhibited marked edema within 30 minutes. In adjacent skin of upper extremity wounds, mean perfusion units increased immediately postinjury and then gradually decreased in proportion to the severity of the injuries. In the lower extremity, this phenomenon was only observed for short contact times, while longer contact times had marked malperfusion throughout. In the plasma, interleukin-10 and vascular endothelial growth factor levels were found to be augmented by injury. Systemic transcriptome analysis revealed promising information about signal networks involved in dermatological, connective tissue, and neurological pathophysiological processes. A reliable and reproducible in vivo model has been developed for characterizing the pathophysiology of high-tension electrical injury. Changes in perfusion were observed near and between entrance and exit wounds that appear consistent with injury severity. Further studies are underway to correlate differential mRNA expression with injury severity.

A Study of Platelet Inhibition, Using a 'Point of Care' Platelet Function Test, following Primary Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction [PINPOINT-PPCI].

PubMed

Johnson, Thomas W; Mumford, Andrew D; Scott, Lauren J; Mundell, Stuart; Butler, Mark; Strange, Julian W; Rogers, Chris A; Reeves, Barnaby C; Baumbach, Andreas

2015-01-01

Rapid coronary recanalization following ST-elevation myocardial infarction (STEMI) requires effective anti-platelet and anti-thrombotic therapies. This study tested the impact of door to end of procedure ('door-to-end') time and baseline platelet activity on platelet inhibition within 24hours post-STEMI. 108 patients, treated with prasugrel and procedural bivalirudin, underwent Multiplate® platelet function testing at baseline, 0, 1, 2 and 24hours post-procedure. Major adverse cardiac events (MACE), bleeding and stent thrombosis (ST) were recorded. Baseline ADP activity was high (88.3U [71.8-109.0]), procedural time and consequently bivalirudin infusion duration were short (median door-to-end time 55minutes [40-70] and infusion duration 30minutes [20-42]). Baseline ADP was observed to influence all subsequent measurements of ADP activity, whereas door-to-end time only influenced ADP immediately post-procedure. High residual platelet reactivity (HRPR ADP>46.8U) was observed in 75% of patients immediately post-procedure and persisted in 24% of patients at 2hours. Five patients suffered in-hospital MACE (4.6%). Acute ST occurred in 4 patients, all were <120mins post-procedure and had HRPR. No significant bleeding was observed. In a post-hoc analysis, pre-procedural morphine use was associated with significantly higher ADP activity following intervention. Baseline platelet function, time to STEMI treatment and opiate use all significantly influence immediate post-procedural platelet activity.

The beneficial effect of testing: an event-related potential study

PubMed Central

Bai, Cheng-Hua; Bridger, Emma K.; Zimmer, Hubert D.; Mecklinger, Axel

2015-01-01

The enhanced memory performance for items that are tested as compared to being restudied (the testing effect) is a frequently reported memory phenomenon. According to the episodic context account of the testing effect, this beneficial effect of testing is related to a process which reinstates the previously learnt episodic information. Few studies have explored the neural correlates of this effect at the time point when testing takes place, however. In this study, we utilized the ERP correlates of successful memory encoding to address this issue, hypothesizing that if the benefit of testing is due to retrieval-related processes at test then subsequent memory effects (SMEs) should resemble the ERP correlates of retrieval-based processing in their temporal and spatial characteristics. Participants were asked to learn Swahili-German word pairs before items were presented in either a testing or a restudy condition. Memory performance was assessed immediately and 1-day later with a cued recall task. Successfully recalling items at test increased the likelihood that items were remembered over time compared to items which were only restudied. An ERP subsequent memory contrast (later remembered vs. later forgotten tested items), which reflects the engagement of processes that ensure items are recallable the next day were topographically comparable with the ERP correlate of immediate recollection (immediately remembered vs. immediately forgotten tested items). This result shows that the processes which allow items to be more memorable over time share qualitatively similar neural correlates with the processes that relate to successful retrieval at test. This finding supports the notion that testing is more beneficial than restudying on memory performance over time because of its engagement of retrieval processes, such as the re-encoding of actively retrieved memory representations. PMID:26441577

Earth-Moon Libration Point Orbit Stationkeeping: Theory, Modeling and Operations

NASA Technical Reports Server (NTRS)

Folta, David C.; Pavlak, Thomas A.; Haapala, Amanda F.; Howell, Kathleen C.; Woodard, Mark A.

2013-01-01

Collinear Earth-Moon libration points have emerged as locations with immediate applications. These libration point orbits are inherently unstable and must be maintained regularly which constrains operations and maneuver locations. Stationkeeping is challenging due to relatively short time scales for divergence effects of large orbital eccentricity of the secondary body, and third-body perturbations. Using the Acceleration Reconnection and Turbulence and Electrodynamics of the Moon's Interaction with the Sun (ARTEMIS) mission orbit as a platform, the fundamental behavior of the trajectories is explored using Poincare maps in the circular restricted three-body problem. Operational stationkeeping results obtained using the Optimal Continuation Strategy are presented and compared to orbit stability information generated from mode analysis based in dynamical systems theory.

Sex differences in the inference and perception of causal relations within a video game

PubMed Central

Young, Michael E.

2014-01-01

The learning of immediate causation within a dynamic environment was examined. Participants encountered seven decision points in which they needed to choose, which of three possible candidates was the cause of explosions in the environment. Each candidate was firing a weapon at random every few seconds, but only one of them produced an immediate effect. Some participants showed little learning, but most demonstrated increases in accuracy across time. On average, men showed higher accuracy and shorter latencies that were not explained by differences in self-reported prior video game experience. This result suggests that prior reports of sex differences in causal choice in the game are not specific to situations involving delayed or probabilistic causal relations. PMID:25202293

Fertility after natural disaster: Hurricane Mitch in Nicaragua

PubMed Central

Davis, Jason

2017-01-01

This investigation evaluates the effect of Hurricane Mitch on women’s reproductive outcomes throughout Nicaragua. This research aim is achieved by analyzing a unique Nicaraguan Living Standards Measurement Study panel dataset that tracks women’s fertility immediately before and at two time points after Hurricane Mitch, combined with satellite-derived municipality-level precipitation data for the 10-day storm period. Results show higher odds of post-disaster fertility in municipalities receiving higher precipitation levels in the immediate post-Hurricane Mitch period. However, fertility normalizes between disaster and non-disaster areas four to six years after the storm. These findings suggest that the disruptive effects of a natural disaster such as Hurricane Mitch can have an initial stimulative effect on fertility but the effect is ephemeral. PMID:28694556

Sex differences in the inference and perception of causal relations within a video game.

PubMed

Young, Michael E

2014-01-01

The learning of immediate causation within a dynamic environment was examined. Participants encountered seven decision points in which they needed to choose, which of three possible candidates was the cause of explosions in the environment. Each candidate was firing a weapon at random every few seconds, but only one of them produced an immediate effect. Some participants showed little learning, but most demonstrated increases in accuracy across time. On average, men showed higher accuracy and shorter latencies that were not explained by differences in self-reported prior video game experience. This result suggests that prior reports of sex differences in causal choice in the game are not specific to situations involving delayed or probabilistic causal relations.

Nondiscrimination on the basis of handicap--Office of the Secretary, HHS. Interim final rule.

PubMed

1983-03-07

The interim final rule modifies existing regulations to meet the exigent needs that can arise when a handicapped infant is discriminatorily denied food or other medical care. Three current regulatory provisions are modified to allow timely reporting of violations, expeditious investigation, and immediate enforcement action when necessary to protect a handicapped infant whose life is endangered by discrimination in a program or activity receiving federal financial assistance. Recipients that provide health care to infants will be required to post a conspicuous notice in locations that provide such care. The notice will describe the protections under federal law against discrimination toward the handicapped, and will provide a contact point in the Department of HHS for reporting violations immediately by telephone.

Effects of exercise training and detraining in patients with fibromyalgia syndrome: a 3-yr longitudinal study.

PubMed

Sañudo, Borja; Carrasco, Luis; de Hoyo, Moisés; McVeigh, Joseph G

2012-07-01

This study aimed to evaluate the immediate effects of a 6-mo combined exercise program on quality-of-life, physical function, depression, and aerobic capacity in women with fibromyalgia syndrome and to determine the impact of repeated delivery of the intervention. Forty-one women with fibromyalgia were randomly assigned to a training group (EG; n = 21) and a control group (CG; n = 20). Quality-of-life and physical function were assessed using the 36-item Short-Form Health Survey (SF-36) and the Fibromyalgia Impact Questionnaire, and depression was measured using the Beck Depression Inventory. Physical fitness was measured using the 6-min Walk Test. Outcomes were assessed at baseline and after each 6-mo intervention, which was delivered over 30 mos (6 mos of training and 6 mos of detraining). After a 6-mo combined exercise program, there was a significant improvement in the Fibromyalgia Impact Questionnaire (P < 0.0005) for the training group over the control group. Repeated-measures analysis of variance across all time points demonstrated significant main effects for time for the Fibromyalgia Impact Questionnaire, SF-36, Beck Depression Inventory and the 6-min Walk Test, but there were no between-group interaction effects. For the EG, there were significant within-group changes in the Fibromyalgia Impact Questionnaire, SF-36, and Beck Depression Inventory at the final time point; however, there were no within-group changes for the control group. Improvement achieved for the training group were maintained during the detraining period. A long-term exercise program can produce immediate improvements in key health domains in women with fibromyalgia. The benefits achieved with regular training can be maintained for 30 mos. The lack of difference between groups over time may be caused by attrition and consequent lack of power at the final time point.

Investigation of abort procedures for space shuttle-type vehicles

NASA Technical Reports Server (NTRS)

Powell, R. W.; Eide, D. G.

1974-01-01

An investigation has been made of abort procedures for space shuttle-type vehicles using a point mass trajectory optimization program known as POST. This study determined the minimum time gap between immediate and once-around safe return to the launch site from a baseline due-East launch trajectory for an alternate space shuttle concept which experiences an instantaneous loss of 25 percent of the total main engine thrust.

Evaluation of an intra-articular synthetic ligament for treatment of cranial cruciate ligament disease in dogs: a six-month prospective clinical trial.

PubMed

Barnhart, Matthew D; Maritato, Karl; Schankereli, Kemal; Wotton, Harry; Naber, Steven

2016-11-23

Evaluate the short-term outcomes of a novel synthetic ligament for treatment of naturally occurring canine cranial cruciate ligament disease. Prospective clinical study. Dogs with unilateral cranial cruciate ligament disease (n = 50). Patient parameters evaluated included a five-point lameness score, evaluation of craniocaudal stifle instability, and radiographic findings over 24 weeks. Any postoperative complications were recorded. Thirty-four out of 42 dogs experienced significant improvements in lameness between the preoperative and 24 week time points. Lameness scores in those dogs improved significantly at all measured time intervals after postoperative week 2. Recurrence of stifle instability increased significantly over the study period from immediate postoperative measurements. Cranial drawer recurred in seven out of 42 of dogs by week 4 and 18/42 by week 24. Implant changes were not noted between the immediate and six-month postoperative radiographs except where complications occurred. Overall, 25 dogs experienced a total of 32 complications (22 major and 10 minor). Sixteen dogs had major complications, and nine had minor complications. The procedure was generally effective at improving lameness scores, but did not consistently maintain postoperative stifle stability and had an unacceptably high complication rate. This synthetic ligament procedure cannot be recommended for use in its current form.

Evidence for opponent-process actions of intravenous cocaine.

PubMed

Ettenberg, A; Raven, M A; Danluck, D A; Necessary, B D

1999-11-01

The present experiment was devised to test a prediction of the Opponent-Process Theory of drug action. This theory presumes that the initial affective experience of a subject treated with cocaine would be diametrically different immediately after administration compared to some point later in time when the positive impact of the drug had subsided. A conditioned place-preference procedure was employed in which a novel environment was paired with the effects of cocaine either immediately after, 5 min after, or 15 min after an intravenous injection of 0.75 mg/kg cocaine. It was hypothesized that animals would come to prefer environments associated with the immediate positive effects of cocaine and avoid environments associated with the drug's subsequent negative effects. The results confirmed this hypothesis. While the 0-min delay and 5-min delay groups exhibited conditioned preferences for the cocaine-paired environment, the 15-min delay group came to avoid the side of the preference apparatus paired with cocaine. These data, therefore, serve as additional support for an Opponent-Process account of cocaine's actions.

Anisomycin administered in the olfactory bulb and dorsal hippocampus impaired social recognition memory consolidation in different time-points.

PubMed

Pena, R R; Pereira-Caixeta, A R; Moraes, M F D; Pereira, G S

2014-10-01

To identify an individual as familiar, rodents form a specific type of memory named social recognition memory. The olfactory bulb (OB) is an important structure for social recognition memory, while the hippocampus recruitment is still controversial. The present study was designed to elucidate the OB and the dorsal hippocampus contribution to the consolidation of social memory. For that purpose, we tested the effect of anisomycin (ANI), which one of the effects is the inhibition of protein synthesis, on the consolidation of social recognition memory. Swiss adult mice with cannulae implanted into the CA1 region of the dorsal hippocampus or into the OB were exposed to a juvenile during 5 min (training session; TR), and once again 1.5 h or 24 h later to test social short-term memory (S-STM) or social long-term memory (S-LTM), respectively. To study S-LTM consolidation, mice received intra-OB or intra-CA1 infusion of saline or ANI immediately, 3, 6 or 18 h after TR. ANI impaired S-LTM consolidation in the OB, when administered immediately or 6h after TR. In the dorsal hippocampus, ANI was amnesic only if administered 3 h after TR. Furthermore, the infusion of ANI in either OB or CA1, immediately after training, did not affect S-STM. Moreover, ANI administered into the OB did not alter the animal's performance in the buried food-finding task. Altogether, our results suggest the consolidation of S-LTM requires both OB and hippocampus participation, although in different time points. This study may help shedding light on the specific roles of the OB and dorsal hippocampus in social recognition memory. Copyright © 2014 Elsevier Inc. All rights reserved.

Testing the Predictive Validity of the Hendrich II Fall Risk Model.

PubMed

Jung, Hyesil; Park, Hyeoun-Ae

2018-03-01

Cumulative data on patient fall risk have been compiled in electronic medical records systems, and it is possible to test the validity of fall-risk assessment tools using these data between the times of admission and occurrence of a fall. The Hendrich II Fall Risk Model scores assessed during three time points of hospital stays were extracted and used for testing the predictive validity: (a) upon admission, (b) when the maximum fall-risk score from admission to falling or discharge, and (c) immediately before falling or discharge. Predictive validity was examined using seven predictive indicators. In addition, logistic regression analysis was used to identify factors that significantly affect the occurrence of a fall. Among the different time points, the maximum fall-risk score assessed between admission and falling or discharge showed the best predictive performance. Confusion or disorientation and having a poor ability to rise from a sitting position were significant risk factors for a fall.

Puberty and the Education of Girls*

PubMed Central

CAVANAGH, SHANNON E.; RIEGLE-CRUMB, CATHERINE; CROSNOE, ROBERT

2010-01-01

This study extends previous research on the social psychological implications of pubertal timing to education by applying a life course framework to data from the National Longitudinal Study of Adolescent Health and from the Adolescent Health and Academic Achievement Study. Early pubertal timing, which has previously been associated with major social psychological changes in girls' lives during middle school, predicted girls' grade point average and probability of course failure at the start of high school. Because of this initial failure during the high school transition, it also predicted their probability of dropping out of high school, and, among those who graduated, their grade point average at the end of high school. Such research demonstrates one way in which the immediate social psychological risk of early pubertal timing, measured as the age at menarche, translates into long-term disadvantage for girls, thereby opening up new avenues of research for social psychologists interested in youth development, health, and education. PMID:20216926

A longitudinal study on the effects of team building for university baseball team in Japan: from the view point of team-vitalization.

PubMed

Hochi, Yasuyuki; Mizuno, Motoki; Nakayama, Takahiro; Kitamura, Kaoru

2012-01-01

The purpose of this study was to examine the effect in the experience of TB among university baseball team from the view point of team-vitalization. We carry out one university baseball team (102 males, 6 female). The average age of the participants was 19.99 years (SD = 1.41). Then, using Check List of Team- Vitalization that was developed by consulting firm in Japan, we examined the degrees of team-vitalization. The answers of this investigation were collected from the participants at fifth times (before intervention of TB, immediately after TB, after three months of TB, before intervention of follow-up training of TB, and immediately after follow-up training of TB). This study for eight months provided the following three conclusions; 1) University baseball team was vitalized through the experience of TB. 2) Team-vitalization was higher than before TB experience, but this effect of the TB did not seem to be permanent. 3) To keep intervention of TB was very important.

Evaluation of cortical plasticity in children with cerebral palsy undergoing constraint-induced movement therapy based on functional near-infrared spectroscopy

NASA Astrophysics Data System (ADS)

Cao, Jianwei; Khan, Bilal; Hervey, Nathan; Tian, Fenghua; Delgado, Mauricio R.; Clegg, Nancy J.; Smith, Linsley; Roberts, Heather; Tulchin-Francis, Kirsten; Shierk, Angela; Shagman, Laura; MacFarlane, Duncan; Liu, Hanli; Alexandrakis, George

2015-04-01

Sensorimotor cortex plasticity induced by constraint-induced movement therapy (CIMT) in six children (10.2±2.1 years old) with hemiplegic cerebral palsy was assessed by functional near-infrared spectroscopy (fNIRS). The activation laterality index and time-to-peak/duration during a finger-tapping task and the resting-state functional connectivity were quantified before, immediately after, and 6 months after CIMT. These fNIRS-based metrics were used to help explain changes in clinical scores of manual performance obtained concurrently with imaging time points. Five age-matched healthy children (9.8±1.3 years old) were also imaged to provide comparative activation metrics for normal controls. Interestingly, the activation time-to-peak/duration for all sensorimotor centers displayed significant normalization immediately after CIMT that persisted 6 months later. In contrast to this improved localized activation response, the laterality index and resting-state connectivity metrics that depended on communication between sensorimotor centers improved immediately after CIMT, but relapsed 6 months later. In addition, for the subjects measured in this work, there was either a trade-off between improving unimanual versus bimanual performance when sensorimotor activation patterns normalized after CIMT, or an improvement occurred in both unimanual and bimanual performance but at the cost of very abnormal plastic changes in sensorimotor activity.

The Effect of Exercise Intensity on Total PYY and GLP-1 in Healthy Females: A Pilot Study.

PubMed

Hallworth, Jillian R; Copeland, Jennifer L; Doan, Jon; Hazell, Tom J

2017-01-01

We compared the acute response of anorexigenic signals (total PYY and GLP-1) in response to submaximal and supramaximal exercise. Nine females completed three sessions: (1) moderate-intensity continuous training (MICT; 30 min; 65%  VO 2max ); (2) sprint interval training (SIT; 6 × 30 sec "all-out" cycling sprints with 4 min recovery); or (3) control (CTRL; no exercise). PYY and GLP-1 were measured via blood samples drawn before, immediately after, and 90 min after exercise. Perceptions of hunger were rated using a visual analogue scale at all blood sampling time points. There was a session × time interaction for GLP-1 ( p = 0.004) where SIT and MICT ( p < 0.015 and p < 0.001) were higher compared to CTRL both immediately and 90 min after exercise. There was a main effect of time for PYY where 90 min after exercise it was decreased versus before and immediately after exercise. There was a session × time interaction for hunger with lower ratings following SIT versus MICT ( p = 0.027) and CTRL ( p = 0.031) 90 min after exercise. These results suggest that though GLP-1 is elevated after exercise in women, it is not affected by exercise intensity though hunger was lower 90 min after exercise with SIT. As the sample size is small further study is needed to confirm these findings.

Early Diagnosis, Treatment, and Care of Cancer Patients

DTIC Science & Technology

2010-09-01

14 and Day 56 time points. In these studies, we examined the distortion product otoacoustic emissions (DPOAE) as an indicator of cochlear function...5-FU did not cause any changes in cochlear function as indicated by DPOAE test results. Our studies on EPO-mediated protection demonstrated that...temperature in the dark for 15 mins. Cells were then diluted with 200 µL of Annexin binding buffer and analyzed immediately by flow cytometry

Clinical Outcome After 8 to 10 Years of Immediately Restored Single Implants Placed in Extraction Sockets and Healed Ridges.

PubMed

Raes, Stefanie; Cosyn, Jan; Noyelle, Anabel; Raes, Filiep; De Bruyn, Hugo

Recent systematic reviews point to the scarcity of single implants followed up longer than 5 years, and the incidence of biologic/technical complications is underreported. This prospective follow-up study documents 8- to 10-year clinical outcomes of immediately restored single implants in extraction sockets (immediate implant treatment [IIT]) and healed bone (conventional implant treatment [CIT]). Patients received a single, chemically modified, moderately rough titanium implant and a provisional crown on the day of surgery in the anterior maxilla (second premolar to second premolar). Provisional crowns were replaced by permanent crowns after 10 weeks. Implant survival, complications, crestal bone changes, plaque score, probing depth, and bleeding on probing were regularly recorded up to 10 years of follow-up. Of 16 patients who underwent IIT, 11 could be evaluated after 8 years. Of the 23 patients who received an implant in healed bone, 18 were finally evaluated. One implant failed in the IIT group at 12 weeks; all implants survived in the CIT group; 38% of the patients experienced at least one complication; 10% had one or more biologic complications, whereas 31% experienced one or more technical complications. There were no significant changes in crestal bone level from 1 to ≥ 8 years of follow-up for either group or between IIT and CIT at any time point (P ≥ .129). Only 6.9% (2 of 29) implants demonstrated progressive bone loss > 2 mm combined with pockets ≥ 6 mm. Immediately restored single implants in extraction sockets and healed ridges demonstrate good long-term outcomes in terms of implant survival, crestal bone loss, and peri-implant health. However, biologic and especially technical complications are common.

Quench in the 1D Bose-Hubbard model: Topological defects and excitations from the Kosterlitz-Thouless phase transition dynamics

PubMed Central

Dziarmaga, Jacek; Zurek, Wojciech H.

2014-01-01

Kibble-Zurek mechanism (KZM) uses critical scaling to predict density of topological defects and other excitations created in second order phase transitions. We point out that simply inserting asymptotic critical exponents deduced from the immediate vicinity of the critical point to obtain predictions can lead to results that are inconsistent with a more careful KZM analysis based on causality – on the comparison of the relaxation time of the order parameter with the “time distance” from the critical point. As a result, scaling of quench-generated excitations with quench rates can exhibit behavior that is locally (i.e., in the neighborhood of any given quench rate) well approximated by the power law, but with exponents that depend on that rate, and that are quite different from the naive prediction based on the critical exponents relevant for asymptotically long quench times. Kosterlitz-Thouless scaling (that governs e.g. Mott insulator to superfluid transition in the Bose-Hubbard model in one dimension) is investigated as an example of this phenomenon. PMID:25091996

The immediate reduction in low back pain intensity following lumbar joint mobilization and prone press-ups is associated with increased diffusion of water in the L5-S1 intervertebral disc.

PubMed

Beattie, Paul F; Arnot, Cathy F; Donley, Jonathan W; Noda, Harmony; Bailey, Lane

2010-05-01

Single-group, prospective, repeated-measures design. To determine differences in the changes of diffusion of water in the L5-S1 intervertebral disc between subjects with nonspecific low back pain (LBP) who reported an immediate reduction in pain intensity of 2 or greater on an 11-point (0-10) numeric rating scale after a 10-minute session of lumbar joint mobilization, followed by prone press-up exercises, compared to those who did not report an immediate reduction in pain intensity of 2 or greater on the pain scale. Combining lumbar joint mobilization and prone press-up exercises is a common intervention for patients with LBP; however, there is conflicting evidence regarding the effectiveness and efficacy of this approach. Increased knowledge of the physiologic effects of the combined use of these treatments, and the relationship to pain reports, can lead to refinement of their clinical application. Twenty adults, aged 22 to 54, participated in this study. All subjects reported LBP of at least 2 on an 11-point (0-10) verbally administered numeric rating scale at the time of enrollment in the study and were classified as being candidates for the combination of joint mobilization and prone press-ups. Subjects underwent T2- and diffusion-weighted lumbar magnetic resonance imaging scans before and immediately after receiving a 10-minute session of lumbar pressures in a posterior-to-anterior direction and prone press-up exercises. Subjects who reported a decrease in current pain intensity of 2 or greater immediately following treatment were classified as immediate responders, while the remainder were classified as not-immediate responders. The apparent diffusion coefficient, representing the diffusion of water in the nucleus pulposis, was calculated from the midsagittal diffusion-weighted images. Following treatment, immediate responders (n = 10) had a mean increase in the apparent diffusion coefficient in the middle portion of the L5-S1 intervertebral disc of 4.2% compared to a mean decrease of 1.6% for the not-immediate responders (P<.005). In a group of subjects with LBP, who were classified as being candidates for extension-based treatment, the report of an immediate reduction in pain intensity of 2/10 of greater after a treatment of posterior-to-anterior-directed pressures, followed by prone press-up exercises, was associated with an increase in diffusion of water in the nuclear region of the L5-S1 intervertebral disc. Subjects who did not report a pain reduction of at least 2/10 did not have a change in diffusion. J Orthop Sports Phys Ther 2010;40(5):256-264, Epub 12 March 2010. doi:10.2519/jospt.2010.3284.

The association between body mass index, weight loss and physical function in the year following a hip fracture.

PubMed

Reider, L; Hawkes, W; Hebel, J R; D'Adamo, C; Magaziner, J; Miller, R; Orwig, D; Alley, D E

2013-01-01

To determine whether body mass index (BMI) at the time of hospitalization or weight change in the period immediately following hospitalization predict physical function in the year after hip fracture. Prospective observational study. Two hospitals in Baltimore, Maryland. Female hip fracture patients age 65 years or older (N=136 for BMI analysis, N=41 for analysis of weight change). Body mass index was calculated based on weight and height from the medical chart. Weight change was based on DXA scans at 3 and 10 days post fracture. Physical function was assessed at 2, 6 and 12 months following fracture using the lower extremity gain scale (LEGS), walking speed and grip strength. LEGS score and walking speed did not differ across BMI tertiles. However, grip strength differed significantly across BMI tertiles (p=0.029), with underweight women having lower grip strength than normal weight women at all time points. Women experiencing the most weight loss (>4.8%) had significantly lower LEGS scores at all time points, slower walking speed at 6 months, and weaker grip strength at 12 months post-fracture relative to women with more modest weight loss. In adjusted models, overall differences in function and functional change across all time points were not significant. However, at 12 months post fracture,women with the most weight loss had an average grip strength 7.0 kg lower than women with modest weight loss (p=0.030). Adjustment for confounders accounts for much of the relationships between BMI and function and weight change and function in the year after fracture. However, weight loss is associated with weakness during hip fracture recovery. Weight loss during and immediately after hospitalization appears to identify women at risk of poor function and may represent an important target for future interventions.

Graft dysfunction immediately after reperfusion predicts short-term outcomes in living-donor lobar lung transplantation but not in cadaveric lung transplantation

PubMed Central

Mizota, Toshiyuki; Miyao, Mariko; Yamada, Tetsu; Sato, Masaaki; Aoyama, Akihiro; Chen, Fengshi; Date, Hiroshi; Fukuda, Kazuhiko

2016-01-01

OBJECTIVES Primary graft dysfunction (PGD) is a major cause of early morbidity and mortality after cadaveric lung transplantation (CLT). This study examined the incidence, time course and predictive value of PGD after living-donor lobar lung transplantation (LDLLT). METHODS We retrospectively investigated 75 patients (42 with LDLLT and 33 with CLT) who underwent lung transplantation from January 2008 to December 2013. Patients were assigned PGD grades at six time points, as defined by the International Society for Heart and Lung Transplantation: immediately after final reperfusion, upon arrival at the intensive care unit (ICU), and 12, 24, 48 and 72 h after ICU admission. RESULTS The incidence of severe (Grade 3) PGD at 48 or 72 h after ICU admission was similar for LDLLT and CLT patients (16.7 vs 12.1%; P = 0.581). The majority of the LDLLT patients having severe PGD first developed PGD immediately after reperfusion, whereas more than half of the CLT patients first developed severe PGD upon ICU arrival or later. In LDLLT patients, severe PGD immediately after reperfusion was significantly associated with fewer ventilator-free days during the first 28 postoperative days [median (interquartile range) of 0 (0–10) vs 21 (13–25) days, P = 0.001], prolonged postoperative ICU stay [median (interquartile range) of 20 (16–27) vs 12 (8–14) days, P = 0.005] and increased hospital mortality (27.3 vs 3.2%, P = 0.02). Severe PGD immediately after reperfusion was not associated with ventilator-free days during the first 28 postoperative days, time to discharge from ICU or hospital, or hospital mortality in CLT patients. CONCLUSIONS Postoperative incidence of severe PGD was not significantly different between LDLLT and CLT patients. In LDLLT patients, the onset of severe PGD tended to be earlier than that in CLT patients. Severe PGD immediately after reperfusion was a significant predictor of postoperative morbidity and mortality in LDLLT patients but not in CLT patients. PMID:26705301

Graft dysfunction immediately after reperfusion predicts short-term outcomes in living-donor lobar lung transplantation but not in cadaveric lung transplantation.

PubMed

Mizota, Toshiyuki; Miyao, Mariko; Yamada, Tetsu; Sato, Masaaki; Aoyama, Akihiro; Chen, Fengshi; Date, Hiroshi; Fukuda, Kazuhiko

2016-03-01

Primary graft dysfunction (PGD) is a major cause of early morbidity and mortality after cadaveric lung transplantation (CLT). This study examined the incidence, time course and predictive value of PGD after living-donor lobar lung transplantation (LDLLT). We retrospectively investigated 75 patients (42 with LDLLT and 33 with CLT) who underwent lung transplantation from January 2008 to December 2013. Patients were assigned PGD grades at six time points, as defined by the International Society for Heart and Lung Transplantation: immediately after final reperfusion, upon arrival at the intensive care unit (ICU), and 12, 24, 48 and 72 h after ICU admission. The incidence of severe (Grade 3) PGD at 48 or 72 h after ICU admission was similar for LDLLT and CLT patients (16.7 vs 12.1%; P = 0.581). The majority of the LDLLT patients having severe PGD first developed PGD immediately after reperfusion, whereas more than half of the CLT patients first developed severe PGD upon ICU arrival or later. In LDLLT patients, severe PGD immediately after reperfusion was significantly associated with fewer ventilator-free days during the first 28 postoperative days [median (interquartile range) of 0 (0-10) vs 21 (13-25) days, P = 0.001], prolonged postoperative ICU stay [median (interquartile range) of 20 (16-27) vs 12 (8-14) days, P = 0.005] and increased hospital mortality (27.3 vs 3.2%, P = 0.02). Severe PGD immediately after reperfusion was not associated with ventilator-free days during the first 28 postoperative days, time to discharge from ICU or hospital, or hospital mortality in CLT patients. Postoperative incidence of severe PGD was not significantly different between LDLLT and CLT patients. In LDLLT patients, the onset of severe PGD tended to be earlier than that in CLT patients. Severe PGD immediately after reperfusion was a significant predictor of postoperative morbidity and mortality in LDLLT patients but not in CLT patients. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Fire effects on the Point Reyes Mountain Beaver at Point Reyes National Seashore, California

USGS Publications Warehouse

Fellers, Gary M.; Pratt, David; Griffin, Jennifer L.

2004-01-01

In October 1995, a wildlands fire burned 5,000 ha on the Point Reyes peninsula, California, USA. In most of the nonforested areas, the fire effectively cleared the ground of litter and vegetation and revealed thousands of Point Reyes mountain beaver (Aplodontia rufa phaea) burrow openings. In the first 6 months after the fire, we surveyed burned coastal scrub and riparian habitat to (1) count the number of burrow openings that existed at the time of the fire, and (2) evaluate whether signs of post-fire mountain beaver activity were evident. We estimated that only 0.4–1.7% of mountain beavers within the burn area survived the fire and immediate post-fire period. We monitored mountain beaver activity for 5 years at 8 sites where mountain beavers survived, and found little or no recovery. We estimate that the mountain beaver population will take 15–20 years post-fire to recover.

Thermal averages in a quantum point contact with a single coherent wave packet.

PubMed

Heller, E J; Aidala, K E; LeRoy, B J; Bleszynski, A C; Kalben, A; Westervelt, R M; Maranowski, K D; Gossard, A C

2005-07-01

A novel formal equivalence between thermal averages of coherent properties (e.g., conductance) and time averages of a single wave packet arises for Fermi gases and certain geometries. In the case of one open channel in a quantum point contact (QPC), only one wave packet history, with the wave packet width equal to the thermal length, completely determines the thermally averaged conductance. The formal equivalence moreover allows very simple physical interpretations of interference features surviving under thermal averaging. Simply put, pieces of the thermal wave packet returning to the QPC along independent paths must arrive at the same time in order to interfere. Remarkably, one immediate result of this approach is that higher temperature leads to narrower wave packets and therefore better resolution of events in the time domain. In effect, experiments at 4.2 K are performing time-gated experiments at better than a gigahertz. Experiments involving thermally averaged ballistic conductance in 2DEGS are presented as an application of this picture.

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

Wise, Nicholas A. D.C.

Cranial Laser Reflex Technique (CLRT) is a novel method involving a brief low level laser stimulation of specific cranial reflex points to reduce musculoskeletal pain. Objective: The objective of the study was to compare the immediate effects of CLRT with a sham treatment on chronic musculoskeletal pain using pressure algometry in a double-blinded randomized controlled trial. Methods: Fifty-seven (57) volunteers with various musculoskeletal pains gave informed consent and were randomly allocated to either the CLRT treatment or sham group. Painful trigger points and/or tender spinal joints were found in each patient. Using a digital algometer, the pain/pressure threshold (PPT) wasmore » determined and a pain rating was given using a numerical pain scale from 0-10. CLRT or a sham treatment was performed with a 50 mW, 840 nm laser, for a maximum of 20 seconds to the each cranial reflex. The initial pressure (PPT) was immediately delivered to the same spot, and the pain rated again. Results: There was a statistically significant difference in pain scores between CLRT and sham groups immediately following treatment. Improvement was reported in 95% of the treatment group, with 59% reporting an improvement of 2 points or greater. The average change in pain scores in the treatment group was 2.6 points (p 0.000) versus negligible change (p= 0.4) for the control group. Conclusion: The results show that CLRT is effective at immediately reducing chronic musculoskeletal pain. Further studies are needed with additional outcome measures to.« less

The application of Markov decision process in restaurant delivery robot

NASA Astrophysics Data System (ADS)

Wang, Yong; Hu, Zhen; Wang, Ying

2017-05-01

As the restaurant delivery robot is often in a dynamic and complex environment, including the chairs inadvertently moved to the channel and customers coming and going. The traditional path planning algorithm is not very ideal. To solve this problem, this paper proposes the Markov dynamic state immediate reward (MDR) path planning algorithm according to the traditional Markov decision process. First of all, it uses MDR to plan a global path, then navigates along this path. When the sensor detects there is no obstructions in front state, increase its immediate state reward value; when the sensor detects there is an obstacle in front, plan a global path that can avoid obstacle with the current position as the new starting point and reduce its state immediate reward value. This continues until the target is reached. When the robot learns for a period of time, it can avoid those places where obstacles are often present when planning the path. By analyzing the simulation experiment, the algorithm has achieved good results in the global path planning under the dynamic environment.

Dissemination and implementation of suicide prevention training in one Scottish region

PubMed Central

Gask, Linda; Lever-Green, Gillian; Hays, Rebecca

2008-01-01

Background As part of a national co-ordinated and multifaceted response to the excess suicide rate, the Choose Life initiative, the Highland Choose Life Group launched an ambitious programme of training for National Health Service (NHS), Council and voluntary organisation staff. In this study of the dissemination and implementation of STORM (Skills-based Training On Risk Management), we set out to explore not only the outcomes of training, but key factors involved in the processes of diffusion, dissemination and implementation of the educational intervention. Methods Participants attending STORM training in Highland Region provided by 12 trained facilitators during the period March 2004 to February 2005 were recruited. Quantitative data collection from participants took place at three time points; immediately before training, immediately post-training and six months after training. Semi-structured telephone interviews were carried out with the training facilitators and with a sample of course participants 6 months after they had been trained. We have utilized the conceptual model described by Greenhalgh and colleagues in a Framework analysis of the data, for considering the determinants of diffusion, dissemination and implementation of interventions in health service delivery and organization. Results Some 203 individuals completed a series of questionnaire measures immediately pre (time 1) and immediately post (time 2) training and there were significant improvements in attitudes and confidence of participants. Key factors in the diffusion, dissemination and implementation process were the presence of a champion or local opinion leader who supported and directed the intervention, local adaptation of the materials, commissioning of a group of facilitators who were provided with financial and administrative support, dedicated time to provide the training and regular peer-support. Conclusion Features that contributed to the success of STORM were related to both the context (the multi-dimensional support provided from the host organisation and the favourable policy environment) and the intervention (openness to local adaptation, clinical relevance and utility), and the dynamic interaction between context and the intervention. PMID:19055769

Reduced Short- and Long-Latency Afferent Inhibition Following Acute Muscle Pain: A Potential Role in the Recovery of Motor Output.

PubMed

Burns, Emma; Chipchase, Lucinda Sian; Schabrun, Siobhan May

2016-02-13

. Corticomotor output is reduced in response to acute muscle pain, yet the mechanisms that underpin this effect remain unclear. Here the authors investigate the effect of acute muscle pain on short-latency afferent inhibition, long-latency afferent inhibition, and long-interval intra-cortical inhibition to determine whether these mechanisms could plausibly contribute to reduced motor output in pain. . Observational same subject pre-post test design. . Neurophysiology research laboratory. . Healthy, right-handed human volunteers (n = 22, 9 male; mean age ± standard deviation, 22.6 ± 7.8 years). . Transcranial magnetic stimulation was used to assess corticomotor output, short-latency afferent inhibition, long-latency afferent inhibition, and long-interval intra-cortical inhibition before, during, immediately after, and 15 minutes after hypertonic saline infusion into right first dorsal interosseous muscle. Pain intensity and quality were recorded using an 11-point numerical rating scale and the McGill Pain Questionnaire. . Compared with baseline, corticomotor output was reduced at all time points (p = 0.001). Short-latency afferent inhibition was reduced immediately after (p = 0.039), and long-latency afferent inhibition 15 minutes after (p = 0.035), the resolution of pain. Long-interval intra-cortical inhibition was unchanged at any time point (p = 0.36). . These findings suggest short- and long-latency afferent inhibition, mechanisms thought to reflect the integration of sensory information with motor output at the cortex, are reduced following acute muscle pain. Although the functional relevance is unclear, the authors hypothesize a reduction in these mechanisms may contribute to the restoration of normal motor output after an episode of acute muscle pain. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Mental and physical activities delay cognitive decline in older persons with dementia.

PubMed

Cheng, Sheung-Tak; Chow, Pizza K; Song, You-Qiang; Yu, Edwin C S; Chan, Alfred C M; Lee, Tatia M C; Lam, John H M

2014-01-01

To examine the effects of cognitive stimulation (mahjong) and physical exercise (tai chi [TC]) on cognitive performance in persons with dementia. Cluster-randomized open-label controlled design. Nursing homes. One hundred ten residents, most of whom were cholinesterase-inhibitor naive. Inclusion criteria were Mini-Mental State Examination (MMSE) = 10-24 and suffering from at least very mild dementia (Clinical Dementia Rating ≥ 0.5). Exclusion criteria were being bedbound, audio/visual impairment, regular activity participation before study, or contraindications for physical or group activities. Homes were randomized into three conditions (mahjong, TC, and simple handicrafts [control]). Activities were conducted three times weekly for 12 weeks. Primary outcome was MMSE. Secondary outcomes were immediate/delayed recall, categorical fluency, and digit span. Various biological risk factors, including apolipoprotein E ε4 allele, were included as covariates. Measures were collected at 0 (baseline), 3 (posttreatment), 6, and 9 months. Intent-to-treat analyses were performed using mixed-effects regression. Mahjong's effect varied by time for MMSE, delayed recall, and forward digit span. TC had similar effects but not for delayed recall. The typical pattern was that control participants deteriorated while mahjong and TC participants maintained their abilities over time, leading to enlarged treatment effects as time progressed. By 9 months, mahjong and TC differed from control by 4.5 points (95% confidence interval: 2.0-6.9; d = 0.48) and 3.7 points (95% confidence interval: 1.4-6.0; d = 0.40), respectively, on MMSE. No treatment effects were observed for immediate recall and backward digit span. Mahjong and TC can preserve functioning or delay decline in certain cognitive domains, even in those with significant cognitive impairment. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Influence of taekwondo as security martial arts training on anaerobic threshold, cardiorespiratory fitness, and blood lactate recovery.

PubMed

Kim, Dae-Young; Seo, Byoung-Do; Choi, Pan-Am

2014-04-01

[Purpose] This study was conducted to determine the influence of Taekwondo as security martial arts training on anaerobic threshold, cardiorespiratory fitness, and blood lactate recovery. [Subjects and Methods] Fourteen healthy university students were recruited and divided into an exercise group and a control group (n = 7 in each group). The subjects who participated in the experiment were subjected to an exercise loading test in which anaerobic threshold, value of ventilation, oxygen uptake, maximal oxygen uptake, heart rate, and maximal values of ventilation / heart rate were measured during the exercise, immediately after maximum exercise loading, and at 1, 3, 5, 10, and 15 min of recovery. [Results] At the anaerobic threshold time point, the exercise group showed a significantly longer time to reach anaerobic threshold. The exercise group showed significantly higher values for the time to reach VO2max, maximal values of ventilation, maximal oxygen uptake and maximal values of ventilation / heart rate. Significant changes were observed in the value of ventilation volumes at the 1- and 5-min recovery time points within the exercise group; oxygen uptake and maximal oxygen uptake were significantly different at the 5- and 10-min time points; heart rate was significantly different at the 1- and 3-min time points; and maximal values of ventilation / heart rate was significantly different at the 5-min time point. The exercise group showed significant decreases in blood lactate levels at the 15- and 30-min recovery time points. [Conclusion] The study results revealed that Taekwondo as a security martial arts training increases the maximal oxygen uptake and anaerobic threshold and accelerates an individual's recovery to the normal state of cardiorespiratory fitness and blood lactate level. These results are expected to contribute to the execution of more effective security services in emergencies in which violence can occur.

Method for autologous single skin cell isolation for regenerative cell spray transplantation with non-cultured cells.

PubMed

Gerlach, Jörg C; Johnen, Christa; Ottomann, Christian; Ottoman, Christian; Bräutigam, Kirsten; Plettig, Jörn; Belfekroun, Claudia; Münch, Sandra; Hartmann, Bernd

2011-03-01

There is a therapeutic gap for patients with deep partial thickness wounds (Grade IIb) of moderate size that were initially not treated with split- or mesh grafting to avoid overgrafting, but developed delayed wound healing around two weeks after injury--at which time grafting is typically not indicated anymore. Delayed wound healing is often associated with esthetically unsatisfactory results and sometimes functional problems. An innovative cell isolation method for cell spray transplantation at the point of care, which eliminates cell culture prior to treatment, was implemented for this population of burn patients in our center. Autologous skin cell spray transplantation was initiated by taking healthy skin. The dermal/epidermal layers were separated using enzymatic digestion with 40 min dispase application, followed by 15 min trypsin application for basal kerationcyte isolation, 7 min cell washing by centrifugation, followed by transferring the cells for spraying into Ringer lactate solution. The procedure was performed on site in a single session immediately following the biopsy. After sharp wound debridement, cells were immediately transplanted by deposition with a cell sprayer for even distribution of the cell suspension. Eight patients were treated (mean age 30.3 years, mean burn total body surface area 14%, mean Abbreviated Burn Severity Index (5 points). The mean time to complete re-epithelialization was 12.6 days. All patients exhibited wound healing with improved esthetic and functional quality. Our initial experience for the use of non-cultured cells using a two-enzyme approach with cell washing suggests shortened time for wound closure, suggesting that the method may potentially avoid longer-term complications.

Changes in salivary periodontal pathogens after orthodontic treatment: An in vivo prospective study.

PubMed

Kim, Kyungsun; Jung, Woo-Sun; Cho, Soha; Ahn, Sug-Joon

2016-11-01

  To analyze the initial changes in salivary levels of periodontal pathogens after orthodontic treatment with fixed appliances.   The subjects consisted of 54 adult patients. The Simplified Oral Hygiene Index, Plaque Index, and Gingival Index were measured as periodontal parameters. Both the plaque and gingival indexes were obtained from the central and lateral incisors and first molars of both arches. Whole saliva and periodontal parameters were obtained at the following four time points: immediately before debonding (T1), 1 week after debonding (T2), 5 weeks after debonding (T3), and 13 weeks after debonding (T4). Repeated measures analysis of variance was used to determine salivary bacterial levels and periodontal parameters among the four time points after quantifying salivary levels of Aggregatibacter actinomycetemcomitans (Aa), Fusobacterium nucleatum (Fn), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Tannerella forsythia (Tf), and total bacteria using the real-time polymerase chain reaction.   All periodontal parameters were significantly decreased immediately after debonding (T2). The salivary levels of total bacteria and Pg were decreased at T3, while Pi and Tf levels were decreased at T4. However, the amount of Aa and Fn remained at similar levels in saliva during the experimental period. Interestingly, Aa and Fn were present in saliva at higher levels than were Pg, Pi, and Tf.   The higher salivary levels of Aa and Fn after debonding suggests that the risk of periodontal problems cannot be completely eliminated by the removal of fixed orthodontic appliances during the initial retention period, despite improved oral hygiene.

Increasing Realism in Virtual Marksmanship Simulators

DTIC Science & Technology

2012-12-01

M16 5.56 mm service rifle M2 .50-caliber machine gun M240 7.62 mm machine gun M9 9 mm Berretta MPI Mean Point of Impact NHQC Navy Handgun...Corps 14 Concepts in Programs, 2008, p. 214). ISMT has the capability to use a wide variety of weapons, including the .50cal. machinegun ( M2 ), 9...a time. ISMT has the unique capability to “provide immediate feedback to the instructor and trainee on weapon trigger pull, cant position, barrel

26 CFR 1.483-2 - Unstated interest.

Code of Federal Regulations, 2010 CFR

2010-04-01

... percentage points above the yield on 6-month Treasury bills at the mid-point of the semiannual period immediately preceding each interest payment date. Assume that the interest rate is a qualified floating rate...

Evaluating leadership training in African American HIV prevention organizations.

PubMed

Coleman, Jason D; Dauner, Kim Nichols; Richter, Donna L; Annang, Lucy; Sellers, Denethia B; Lindley, Lisa L

2011-09-01

This article aimed to examine changes in the HIV prevention capacity of HIV prevention program managers who completed the Institute for HIV Prevention Leadership ("Institute") between 2002 and 2004, and who worked in community-based organizations that primarily served African Americans. Participants completed a survey at three points in time, in which they rated the frequency with which they conducted activities related to HIV prevention practice. Participants also rated their confidence in performing activities. Repeated measures ANOVA was conducted to detect differences at three time points (baseline, immediate posttest, and 6 months posttest). A significant overall positive trend was found in the frequency and confidence of participants to perform specific HIV prevention practices and an overall positive trend in the frequency of processes that support HIV prevention practice. Investment in long-term, intensive, capacity-building programs like the Institute is critical to address the increasing incidence of HIV in many African American communities.

Modulation expression of tumor necrosis factor α in the radiation-induced lung injury by glycyrrhizic acid.

PubMed

Refahi, Soheila; Pourissa, Masoud; Zirak, Mohammad Reza; Hadadi, GholamHassan

2015-01-01

To evaluate the ability of glycyrrhizic acid (GLA) to reduce the tumor necrosis factor α (TNF-α), release on messenger ribonucleic acid (mRNA) and protein production in the lungs using GLA in response to irradiation were studied. The animals were divided into four groups: No treatment (NT group), GLA treatment only (GLA group), irradiation only (XRT group), and GLA treatment plus irradiation (GLA/XRT group). Rats were killed at different time points. Real-time reverse transcriptase polymerase chain reaction (RT-PCR) was used to evaluate the mRNA expression of TNF-α in the lungs (compared with non-irradiated lungs). An enzyme-linked immunosorbant assay (ELISA) assay was used to measure the TNF-α protein level. The TNF-α mRNA expression in the lungs of the XRT rats was clearly higher at all-time points compared to the NT rats. The TNF-α mRNA expression in the lungs of the GLA/XRT rats was lower at all-time points compared to the XRT rats. Release of the TNF-α on protein level in the lungs of the XRT rats increased at all-time points compared to the NT rats. In contrast to the XRT rats, the lungs of the GLA/XRT rats revealed a reduction on TNF-α protein level at 6 h after irradiation. This study has clearly showed the immediate down-regulation of the TNF-α mRNA and protein production in the lungs using GLA in response to irradiation.

Modulation expression of tumor necrosis factor α in the radiation-induced lung injury by glycyrrhizic acid

PubMed Central

Refahi, Soheila; Pourissa, Masoud; Zirak, Mohammad Reza; Hadadi, GholamHassan

2015-01-01

To evaluate the ability of glycyrrhizic acid (GLA) to reduce the tumor necrosis factor α (TNF-α), release on messenger ribonucleic acid (mRNA) and protein production in the lungs using GLA in response to irradiation were studied. The animals were divided into four groups: No treatment (NT group), GLA treatment only (GLA group), irradiation only (XRT group), and GLA treatment plus irradiation (GLA/XRT group). Rats were killed at different time points. Real-time reverse transcriptase polymerase chain reaction (RT-PCR) was used to evaluate the mRNA expression of TNF-α in the lungs (compared with non-irradiated lungs). An enzyme-linked immunosorbant assay (ELISA) assay was used to measure the TNF-α protein level. The TNF-α mRNA expression in the lungs of the XRT rats was clearly higher at all-time points compared to the NT rats. The TNF-α mRNA expression in the lungs of the GLA/XRT rats was lower at all-time points compared to the XRT rats. Release of the TNF-α on protein level in the lungs of the XRT rats increased at all-time points compared to the NT rats. In contrast to the XRT rats, the lungs of the GLA/XRT rats revealed a reduction on TNF-α protein level at 6 h after irradiation. This study has clearly showed the immediate down-regulation of the TNF-α mRNA and protein production in the lungs using GLA in response to irradiation. PMID:26170556

Immediate effects of hip mobilization with movement in patients with hip osteoarthritis: A randomised controlled trial.

PubMed

Beselga, Carlos; Neto, Francisco; Alburquerque-Sendín, Francisco; Hall, Toby; Oliveira-Campelo, Natália

2016-04-01

Mobilization with movement (MWM) has been shown to reduce pain, increase range of motion (ROM) and physical function in a range of different musculoskeletal disorders. Despite this evidence, there is a lack of studies evaluating the effects of MWM for hip osteoarthritis (OA). To determine the immediate effects of MWM on pain, ROM and functional performance in patients with hip OA. Randomized controlled trial with immediate follow-up. Forty consenting patients (mean age 78 ± 6 years; 54% female) satisfied the eligibility criteria. All participants completed the study. Two forms of MWM techniques (n = 20) or a simulated MWM (sham) (n = 20) were applied. pain recorded by numerical rating scale (NRS). hip flexion and internal rotation ROM, and physical performance (timed up and go, sit to stand, and 40 m self placed walk test) were assessed before and after the intervention. For the MWM group, pain decreased by 2 points on the NRS, hip flexion increased by 12.2°, internal rotation by 4.4°, and functional tests were also improved with clinically relevant effects following the MWM. There were no significant changes in the sham group for any outcome variable. Pain, hip flexion ROM and physical performance immediately improved after the application of MWM in elderly patients suffering hip OA. The observed immediate changes were of clinical relevance. Future studies are required to determine the long-term effects of this intervention. Copyright © 2015 Elsevier Ltd. All rights reserved.

Interactive-cut: Real-time feedback segmentation for translational research.

PubMed

Egger, Jan; Lüddemann, Tobias; Schwarzenberg, Robert; Freisleben, Bernd; Nimsky, Christopher

2014-06-01

In this contribution, a scale-invariant image segmentation algorithm is introduced that "wraps" the algorithm's parameters for the user by its interactive behavior, avoiding the definition of "arbitrary" numbers that the user cannot really understand. Therefore, we designed a specific graph-based segmentation method that only requires a single seed-point inside the target-structure from the user and is thus particularly suitable for immediate processing and interactive, real-time adjustments by the user. In addition, color or gray value information that is needed for the approach can be automatically extracted around the user-defined seed point. Furthermore, the graph is constructed in such a way, so that a polynomial-time mincut computation can provide the segmentation result within a second on an up-to-date computer. The algorithm presented here has been evaluated with fixed seed points on 2D and 3D medical image data, such as brain tumors, cerebral aneurysms and vertebral bodies. Direct comparison of the obtained automatic segmentation results with costlier, manual slice-by-slice segmentations performed by trained physicians, suggest a strong medical relevance of this interactive approach. Copyright © 2014 Elsevier Ltd. All rights reserved.

Single-blind randomized clinical trial to evaluate clinical and radiological outcomes after one year of immediate versus delayed implant placement supporting full-arch prostheses

PubMed Central

Pellicer-Chover, Hilario; Peñarrocha-Oltra, David; Bagán, Leticia; Fichy-Fernandez, Antonio J.; Canullo, Luigi

2014-01-01

Purpose: To evaluate and compare peri-implant health, marginal bone loss and success of immediate and delayed implant placement for rehabilitation with full-arch fixed prostheses. Material and Methods: The present study was a prospective, randomized, single-blind, clinical preliminary trial. Patients were randomized into two treatment groups. In Group A implants were placed immediately post-extraction and in Group B six months after extraction. The following control time-points were established: one week, six months and twelve months after loading. Measurements were taken of peri-implant crevicular fluid volume, plaque index, gingival retraction, keratinized mucosa, probing depth, modified gingival index and presence of mucositis. Implant success rates were evaluated for the two groups. The study sample included fifteen patients (nine women and six men) with a mean average age of 63.7 years. One hundred and forty-four implants were placed: 76 placed in healed sites and 68 placed immediately. Results: At the moment of prosthetic loading, keratinized mucosa width and probing depth were higher in immediate implants than delayed implants, with statistically significant differences. However, after six and twelve months, differences between groups had disappeared. Bone loss was 0.54 ± 0.39 mm for immediate implants and 0.66 ± 0.25 mm for delayed implants (p=0.201). No implants failed in either group. Conclusions: The present study with a short follow-up and a small sample yielded no statistically significant differences in implant success and peri-implant marginal bone loss between immediate and delayed implants with fixed full-arch prostheses. Peri-implant health showed no statistically significant differences for any of the studied parameters (crevicular fluid volume, plaque index, gingival retraction, keratinized mucosa, probing depth, modified gingival index and presence of mucositis) at the twelve-month follow-up. Key words:Immediate implants, delayed implants, peri-implant health, success rate. PMID:24316712

Pediatric Lung Abscess: Immediate Diagnosis by Point-of-Care Ultrasound.

PubMed

Kraft, Clara; Lasure, Benjamin; Sharon, Melinda; Patel, Paulina; Minardi, Joseph

2018-06-01

The diagnosis of lung abscess can be difficult to make and often requires imaging beyond plain chest x-ray. The decision to further image with computed tomography should be weighed against the risks of radiation exposure, especially in pediatric patients. In addition, the cost and potential impact on length of stay from obtaining computed tomography scans should be considered. In this report, we describe a case of lung abscess made immediately using point-of-care ultrasound in the emergency department. To our knowledge, there are no previous cases describing lung abscess diagnosed by point-of-care ultrasound. This case report aims to describe a case of pediatric lung abscess, review the ultrasound findings, and discuss relevant literature on the topic.

HIV disclosure by men who have sex with men to immediate family over time.

PubMed

Serovich, Julianne M; Esbensen, Anna J; Mason, Tina L

2005-08-01

Previous researchers have comprehensively documented rates of HIV disclosure to family at discrete time periods yet none have taken a dynamic approach to this phenomenon. The purpose of this study was to address the trajectory of HIV serostatus disclosure to family members. Time to disclosure was analyzed from data provided by 135 HIV-positive men who have sex with men. Results indicated that mothers remain the family member to be told in greatest proportion, yet the proportion of family members told changes over time in a different manner than presented in earlier research. Additionally, the rate at which family members are told at all time points generally does not significantly differ from each other when accounting for characteristics of participants and family members.

HIV Disclosure by Men Who have Sex with Men to Immediate Family over Time

PubMed Central

SEROVICH, JULIANNE M.; ESBENSEN, ANNA J.; MASON, TINA L.

2006-01-01

Previous researchers have comprehensively documented rates of HIV disclosure to family at discrete time periods yet none have taken a dynamic approach to this phenomenon. The purpose of this study was to address the trajectory of HIV serostatus disclosure to family members. Time to disclosure was analyzed from data provided by 135 HIV-positive men who have sex with men. Results indicated that mothers remain the family member to be told in greatest proportion, yet the proportion of family members told changes over time in a different manner than presented in earlier research. Additionally, the rate at which family members are told at all time points generally does not significantly differ from each other when accounting for characteristics of participants and family members. PMID:16124845

Clinical analysis of the stability of dental implants after preparation of the site by conventional drilling or piezosurgery.

PubMed

da Silva Neto, Ulisses Tavares; Joly, Julio Cesar; Gehrke, Sergio Alexandre

2014-02-01

We used resonance frequency analysis to evaluate the implant stability quotient (ISQ) of dental implants that were installed in sites prepared by either conventional drilling or piezoelectric tips. We studied 30 patients with bilateral edentulous areas in the maxillary premolar region who were randomised to have the implant inserted with conventional drilling, or with piezoelectric surgery. The stability of each implant was measured by resonance frequency analysis immediately after placement to assess the immediate stability (time 1) and again at 90 days (time 2) and 150 days (time 3). In the conventional group the mean (SD) ISQ for time 1 was 69.1 (6.1) (95% CI 52.4-77.3); for time 2, 70.7 (5.7) (95% CI 60.4-82.8); and for time 3, 71.7 (4.5) (95% CI 64.2-79.2). In the piezosurgery group the corresponding values were: 77.5 (4.6) (95% CI 71.1-84.3) for time 1, 77.0 (4.2) (95% CI, 69.7-85.2) for time 2, and 79.1 (3.1) (95% CI 74.5-87.3) for time 3. The results showed significant increases in the ISQ values for the piezosurgery group at each time point (p=0.04). The stability of implants placed using the piezoelectric method was greater than that of implants placed using the conventional technique. Copyright © 2013 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Immediate and long-term transcriptional response of hind muscle tissue to transient variation of incubation temperature in broilers.

PubMed

Naraballobh, Watcharapong; Trakooljul, Nares; Muráni, Eduard; Brunner, Ronald; Krischek, Carsten; Janisch, Sabine; Wicke, Michael; Ponsuksili, Siriluck; Wimmers, Klaus

2016-05-04

In oviparous species accidental variation of incubation temperatures may occur under natural conditions and mechanisms may have evolved by natural selection that facilitate coping with these stressors. However, under controlled artificial incubation modification of egg incubation temperature has been shown to have a wide-ranging impact on post-hatch development in several poultry species. Because developmental changes initiated in-ovo can affect poultry production, understanding the molecular routes and epigenetic alterations induced by incubation temperature differences may allow targeted modification of phenotypes. In order to identify molecular pathways responsive to variable incubation temperature, broiler eggs were incubated at a lower or higher temperature (36.8 °C, 38.8 °C) relative to control (37.8 °C) over two developmental intervals, embryonic days (E) 7-10 and 10-13. Global gene expression of M. gastrocnemius was assayed at E10, E13, and slaughter age [post-hatch day (D) 35] (6 groups; 3 time points; 8 animals each) by microarray analysis and treated samples were compared to controls within each time point. Transcript abundance differed for between 113 and 738 genes, depending on treatment group, compared to the respective control. In particular, higher incubation temperature during E7-10 immediately affected pathways involved in energy and lipid metabolism, cell signaling, and muscle development more so than did other conditions. But lower incubation temperature during E10-13 affected pathways related to cellular function and growth, and development of organ, tissue, and muscle as well as nutrient metabolism pathways at D35. Shifts in incubation temperature provoke specific immediate and long-term transcriptional responses. Further, the transcriptional response to lower incubation temperature, which did not affect the phenotypes, mediates compensatory effects reflecting adaptability. In contrast, higher incubation temperature triggers gene expression and has long-term effects on the phenotype, reflecting considerable phenotypic plasticity.

The Discoloration effect of White Mineral Trioxide Aggregate (WMTA), Calcium Enriched Mixture (CEM), and Portland Cement (PC) on Human Teeth.

PubMed

Salem-Milani, Amin; Ghasemi, Saeede; Rahimi, Saeed; Ardalan-Abdollahi, Amir; Asghari-Jafarabadi, Mohammad

2017-12-01

The aim of this study was to evaluate the discoloration induced by CEM cement, Portland cement (PC) and MTA mixed with propylene glycol (MTA-PG) in comparison to White MTA. Ninety extracted premolar and canine teeth were resected 2 mm below the CEJ. The coronal part of crown was prepared with peeso reamer and Gates-Glidden drills, and the specimens were randomly divided into 4 experimental (n=20) and one control (n=10) groups. The tooth crowns in experimental groups 1 to 4 were filled with White MTA, PC, CEM cement and MTA-PG, respectively; and in group 5, the teeth were kept empty. After incubation, digital photographs of teeth were acquired at 4 time points (before, immediately after placing the materials, 3 and 6 months afterwards). Images were transferred to Adobe Photoshop CS4 and CIE L*a*b color space was used for tooth shade assessment. One-Way ANOVA and One-Sample t-test were used to compare discoloration of teeth between groups. Significant statistical discoloration was only observed in the cervical one third of all groups at each time points (except between 3 and 6 months). Tooth discoloration was greatest in PC and lower in MTA and MTA-PG at the end of 6 months. The tooth discoloration between immediately and 3 months after placing the materials had significant difference only between MTA and PC; and also the tooth discoloration between immediately and 6 months after placing the materials was observed only between PC and MTA, and PC and MTA-PG. All of the experimental biomaterials caused tooth discoloration after 6 months, of those, PC had the most and MTA and MTA-PG had the least discoloration effect. Key words: Mineral trioxide aggregate (MTA). Calcium enriched mixture (CEM). Propylene glycol. Portland cement.

The effects of two different doses of ultraviolet-A light exposure on nitric oxide metabolites and cardiorespiratory outcomes.

PubMed

Monaghan, Chris; McIlvenna, Luke C; Liddle, Luke; Burleigh, Mia; Weller, Richard B; Fernandez, Bernadette O; Feelisch, Martin; Muggeridge, David J; Easton, Chris

2018-05-01

The present study investigated different doses of ultraviolet-A (UV-A) light on plasma nitric oxide metabolites and cardiorespiratory variables. Ten healthy male participants completed three experimental conditions, 7 days apart. Participants were exposed to no light (CON); 10 J cm 2 (15 min) of UV-A light (UVA10) and 20 J cm 2 (30 min) of UV-A light (UVA20) in a randomized order. Plasma nitrite [NO 2 - ] and nitrate [NO 3 - ] concentrations, blood pressure (BP), and heart rate (HR) were recorded before, immediately after exposure and 30 min post-exposure. Whole body oxygen utilization ([Formula: see text]), resting metabolic rate (RMR) and skin temperature were recorded continuously. None of the measured parameters changed significantly during CON (all P > 0.05). [Formula: see text] and RMR were significantly reduced immediately after UVA10 (P < 0.05) despite no change in plasma [NO 2 - ] (P > 0.05). Immediately after exposure to UVA20, plasma [NO 2 - ] was higher (P = 0.014) and [Formula: see text] and RMR tended to be lower compared to baseline (P = 0.06). There were no differences in [NO 2 - ] or [Formula: see text] at the 30 min time point in any condition. UV-A exposure did not alter systolic BP, diastolic BP or MAP (all P > 0.05). UV-A light did not alter plasma [NO 3 - ] at any time point (all P > 0.05). This study demonstrates that a UV-A dose of 20 J cm 2 is necessary to increase plasma [NO 2 - ] although a smaller dose is capable of reducing [Formula: see text] and RMR at rest. Exposure to UV-A did not significantly reduce BP in this cohort of healthy adults. These data suggest that exposure to sunlight has a meaningful acute impact on metabolic function.

Variability of United States Online Rehabilitation Protocols for Proximal Hamstring Tendon Repair.

PubMed

Lightsey, Harry M; Kantrowitz, David E; Swindell, Hasani W; Trofa, David P; Ahmad, Christopher S; Lynch, T Sean

2018-02-01

The optimal postoperative rehabilitation protocol following repair of complete proximal hamstring tendon ruptures is the subject of ongoing investigation, with a need for more standardized regimens and evidence-based modalities. To assess the variability across proximal hamstring tendon repair rehabilitation protocols published online by United States (US) orthopaedic teaching programs. Cross-sectional study. Online proximal hamstring physical therapy protocols from US academic orthopaedic programs were reviewed. A web-based search using the search term complete proximal hamstring repair rehabilitation protocol provided an additional 14 protocols. A comprehensive scoring rubric was developed after review of all protocols and was used to assess each protocol for both the presence of various rehabilitation components and the point at which those components were introduced. Of 50 rehabilitation protocols identified, 35 satisfied inclusion criteria and were analyzed. Twenty-five protocols (71%) recommended immediate postoperative bracing: 12 (34%) prescribed knee bracing, 8 (23%) prescribed hip bracing, and 5 (14%) did not specify the type of brace recommended. Fourteen protocols (40%) advised immediate nonweightbearing with crutches, while 16 protocols (46%) permitted immediate toe-touch weightbearing. Advancement to full weightbearing was allowed at a mean of 7.1 weeks (range, 4-12 weeks). Most protocols (80%) recommended gentle knee and hip passive range of motion and active range of motion, starting at a mean 1.4 weeks (range, 0-3 weeks) and 4.0 weeks (range, 0-6 weeks), respectively. However, only 6 protocols (17%) provided specific time points to initiate full hip and knee range of motion: a mean 8.0 weeks (range, 4-12 weeks) and 7.8 weeks (range, 0-12 weeks), respectively. Considerable variability was noted in the inclusion and timing of strengthening, stretching, proprioception, and cardiovascular exercises. Fifteen protocols (43%) required completion of specific return-to-sport criteria before resuming training. Marked variability is found in both the composition and timing of rehabilitation components across the various complete proximal hamstring repair rehabilitation protocols published online. This finding mirrors the variability of proposed rehabilitation protocols in the professional literature and represents an opportunity to improve patient care.

Effects of anesthesia and surgery on serial blood gas values and lactate concentrations in yellow perch (Perca flavescens), walleye pike (Sander vitreus), and koi (Cyprinus carpio).

PubMed

Hanley, Christopher S; Clyde, Victoria L; Wallace, Roberta S; Paul-Murphy, Joanne; Patterson, Tamatha A; Keuler, Nicholas S; Sladky, Kurt K

2010-05-15

OBJECTIVE-To evaluate serial blood gas values and lactate concentrations in 3 fish species undergoing surgery and to compare blood lactate concentrations between fish that survived and those that died during the short-term postoperative period. DESIGN-Prospective cohort study. Animals-10 yellow perch, 5 walleye pike, and 8 koi. PROCEDURES-Blood samples were collected from each fish at 3 time points: before anesthesia, during anesthesia, and immediately after surgery. Blood gas values and blood lactate concentrations were measured. Fish were monitored for 2 weeks postoperatively. RESULTS-All walleye and koi survived, but 2 perch died. Blood pH significantly decreased in perch from before to during anesthesia, but increased back to preanesthesia baseline values after surgery. Blood Pco(2) decreased significantly in perch from before anesthesia to immediately after surgery, and also from during anesthesia to immediately after surgery, whereas blood Pco(2) decreased significantly in koi from before to during anesthesia. Blood Po(2) increased significantly in both perch and koi from before to during anesthesia, and also in koi from before anesthesia to immediately after surgery. For all 3 species, blood lactate concentrations increased significantly from before anesthesia to immediately after surgery. Blood lactate concentration (mean +/- SD) immediately after surgery for the 8 surviving perch was 6.06 +/- 1.47 mmol/L, which was significantly lower than blood lactate concentrations in the 2 nonsurviving perch (10.58 and 10.72 mmol/L). CONCLUSIONS AND CLINICAL RELEVANCE-High blood lactate concentrations following surgery in fish may be predictive of a poor short-term postoperative survival rate.

Short- and long-term evaluation of cognitive functions after electroconvulsive therapy in a Japanese population.

PubMed

Takagi, Shunsuke; Takeuchi, Takashi; Yamamoto, Naoki; Fujita, Munehisa; Furuta, Ko; Ishikawa, Hiroyo; Motohashi, Nobutaka; Nishikawa, Toru

2018-02-01

While electroconvulsive therapy (ECT) is a well-established, safe, and effective treatment for mental illnesses, the potential for adverse effects on cognitive functions remains controversial. We aimed to evaluate multiple cognitive functions in different time periods before and after ECT in a Japanese population. A battery of five neurocognitive tests was administered to patients who underwent a course of ECT treatment at three time points: before, immediately after, and 4 weeks after ECT. A transient but significant decline in letter fluency function was observed immediately after ECT, but had recovered well by 4 weeks. We also observed a significant improvement in the trail-making task at 4 weeks after ECT. In a Japanese population, adverse effects of ECT on verbal fluency function-related and other cognitive impairments were transient. Over the longer term, we detected significant improvements in the performance of tasks that presumably reflected information processing speed and executive functions. © 2017 The Authors. Psychiatry and Clinical Neurosciences © 2017 Japanese Society of Psychiatry and Neurology.

Learning new faces in typical and atypical populations of children.

PubMed

Jones, Rebecca R; Blades, Mark; Coleman, Mike; Pascalis, Olivier

2013-02-01

Recognizing an individual as familiar is an important aspect of our social cognition, which requires both learning a face and recalling it. It has been suggested that children with autistic spectrum disorder (ASD) have deficits and abnormalities in face processing. We investigated whether the process by which unfamiliar faces become familiar differs in typically developing (TD) children, children with ASD, and children with developmental delay. Children were familiarized with a set of moving novel faces presented over a three-day period. Recognition of the learned faces was assessed at five time points during the three-day period. Both immediate and delayed recall of faces was tested. All groups showed improvements in face recognition at immediate recall, which indicated that learning had occurred. The TD population showed slightly better performance than the two other groups, however no difference was specific to the ASD group. All groups showed similar levels of improvements with time. Our results are discussed in terms of learning in ASD. © 2013 The Authors. Scandinavian Journal of Psychology © 2013 The Scandinavian Psychological Associations.

Immediate provisionalization of dental implants placed in healed alveolar ridges and extraction sockets: a 5-year prospective evaluation.

PubMed

Cooper, Lyndon F; Reside, Glenn J; Raes, Filiep; Garriga, Joan Soliva; Tarrida, Luis Giner; Wiltfang, Jörg; Kern, Matthias; De Bruyn, Hugo

2014-01-01

This 5-year prospective multicenter study compared implant survival and success, peri-implant health and soft tissue responses, crestal bone level stability, and complication rates following immediate loading of single OsseoSpeed implants placed in anterior maxillary healed ridges or extraction sockets. Individuals requiring anterior tooth replacement with single implants were treated and immediately provisionalized. Definitive all-ceramic crowns were placed at 12 weeks. Implant survival, bone levels, soft tissue levels, and peri-implant health were monitored for 5 years. One hundred thirteen patients received implants in fresh sockets (55) and healed ridges (58). After 5 years, 45 and 49 patients remained for evaluation, respectively. During the first year, three implants failed in the extraction socket group (94.6% survival) and one implant failed in the healed ridge group (98.3% survival); this difference was not significant. No further implant failures were recorded. After 5 years, the interproximal crestal bone levels were located a mean of 0.43 ± 0.63 mm and 0.38 ± 0.62 mm from the reference points of implants in sockets and healed ridges (not a significant difference). In both groups, papillae increased over time and peri-implant mucosal zenith positions were stable from the time of definitive crown placement in sockets and healed ridges. Compared to flap surgery for implants in healed ridges, flapless surgery resulted in increased peri-implant mucosal tissue dimension (average, 0.78 ± 1.34 mm vs 0.19 ± 0.79 mm). After 5 years, the bone and soft tissue parameters that characterize implant success and contribute to dental implant esthetics were similar following the immediate provisionalization of implants in sockets and healed ridges. The overall tissue responses and reported implant survival support the immediate provisionalization of dental implants in situations involving healed ridges and, under ideal circumstances, extraction sockets.

[Effect of dexmedetomidine and midazolam on respiration and circulation functions in patients undergoing open heart surgery under acupuncture-assisted general anesthesia].

PubMed

Tang, Wei; Wang, Jian; Fu, Guo-Qiang; Yuan, Lan

2014-06-01

To evaluate the effect of Dexmedetomidine and Midazolam on respiratory and circulation in patients experiencing open heart surgery under acupuncture-assisted general anesthesia. Sixty patients undergoing open heart surgery (cardiac valve replacement surgery and aortic valve replacement surgery) were randomly and equally divided into Dexmedetomidine (D) and Midazolam (M) groups. Electroacupuncture (EA) was applied to bilateral Yunmen (LU 2), Zhongfu (LU1), Lieque (LU7) and Neiguan (PC6). For patients of group D, Dexmedetomidine (i.v., loading dose: 1 microg/kg, and succedent dose: 0.2-1 microg x kg(-1) x h(-1)) was given. For patients of group M, Midazolam (i.v., loading dose: 0.05 mg/kg, succedent dose: 0.01-0.03 mg x kg(-1) x h(-1)) was given. Arterial oxygen pressure (PaO2), arterial carbondioxide tension (PaCO2), O2 saturation (SPO2), mean arterial pressure (MAP), heart rate (HR), anesthetic effect, time of spontaneous breathing recovery, and time of resuscitation were recorded before operation (T0), immediately after skin incision (T1), immediately after sternotomy (T2), before suspension of cardiopulmonary bypass (CPB, T3), immediately after cardiac re-beating (T4), immediately after CPB cessation (T5), and at the end of surgery (T6). Before operation, no significant differences were found between the group D and M in the levels of PaO2, PaCO2 and SPO2 (P > 0.05). The PaO2 and SPO2 levels after skin incision, sternotomy, before suspension of CPB and at the end of surgery were significantly lower in group M than in group D (P < 0.05), while the le- vels of PaCO2 after skin incision, sternotomy, before suspension of CPB and at the end of surgery, and HR after skin incision, sternotomy, before suspension of CPB, after heart re-beating,after CPB cessation and at the end of surgery in group M were considerably higher than those in group D (P < 0.05). In addition, the time of spontaneous breathing recovery of group M was significantly later than that of group D (P < 0.05). No significant differences were found between the two groups in MAP levels at the 6 time-points during surgery, in the PaO2, PaCO2 and SPO2 levels at the time-points of post-cardiac re-beating, and after CPB cessation (P > 0.05). It suggested that the respiration and circulation states in group D were more smoothly than those in group M. There was no significant difference between the two groups in the time of resuscitation (P > 0.05). Dexmedetomidine is superior to Midazolam in analgesia, and improving respiration and circulation functions for open heart surgery patients under acupuncture-assisted general anesthesia.

Examining Effects of Physical Exertion on the Dynamic Visual Acuity Test in Collegiate Athletes.

PubMed

Patterson, Jessie N; Murphy, Anna M; Honaker, Julie A

2017-01-01

Acute symptoms of dizziness and/or imbalance commonly experienced in athletes postconcussion are speculated to arise from dysfunction at multiple levels (i.e., inner ear or central vestibular system) to appropriately integrate afferent sensory information. Disruption along any pathway of the balance system can result in symptoms of dizziness, decreased postural control function (vestibulospinal reflex), and reduced vestibulo-ocular reflex function. This may also lead to decreased gaze stability with movements of the head and may account for symptoms of blurred vision or diplopia reported in almost half of athletes sustaining a concussion. Current concussion position statements include measures of postural control to examine changes to the balance system postconcussion. The Balance Error Scoring System (BESS) is a commonly used low-cost postural control measure for concussion assessment. Although this is a widely used measure for documenting balance function on both immediate (sideline) and recovery monitoring, the BESS has been shown to be affected by physical exertion. Therefore, the BESS may not be the most efficient means of examining functional changes to the balance system immediately after head injury. Dynamic Visual Acuity Test (DVAT) has been found to effectively evaluate and monitor changes to the gaze stability system postinjury. Thus, DVAT may be an additional measure in the concussion assessment battery, as well as an alternative for more immediate sideline assessment to help make objective return-to-play decisions. The aim of the study was to determine the effects of physical exertion on a clinical vestibular assessment, the DVAT, in collegiate athletes, as a first step in defining the role of this measure in the concussion assessment battery. Cross-sectional, repeated-measures design. Twenty-eight healthy collegiate athletes (20 males, 8 females; age = 20.25 ± 1.46 yr, range = 18-25 yr) volunteered to participate in the study. Participants were randomly assigned to complete a 20-min protocol of physical exertion or rest. DVAT was completed pre-exertion or rest (pre-DVAT), immediately following the 20-min protocol (post-DVAT I), and again 10 min after the completion of the 20-min protocol (post-DVAT II). Ratings of perceived exertion (RPE) and heart rate (HR) were monitored throughout testing. Repeated-measures analysis of the variance were used to examine the effects of exertion on DVAT. Additionally, intraclass correlation coefficients were used to examine test reliability. No significant main effect was observed for right and left DVAT logarithm of the minimal angle of resolution loss between groups or across time points (p > 0.05). A significant main effect was observed for RPE and HR for groups and time points (p < 0.001), indicating adequate physical exertion and rest. Fair to good reliability (intraclass correlation coefficient values between 0.4 and 0.74) was observed for both rightward and leftward movements of the head across the three time points. Findings from this study suggest that DVAT is not affected by physical exertion and may provide a more immediate assessment of the balance system that may be of use for the sideline concussion assessment. Future studies will be performed to examine additional factors (e.g., background noise, complex visual backgrounds) that may affect DVAT performance in the sideline environment. American Academy of Audiology

The Effects of Cold Whirlpool on Power, Speed, Agility, and Range of Motion

PubMed Central

Patterson, Stephen M.; Udermann, Brian E.; Doberstein, Scott T.; Reineke, David M.

2008-01-01

The purpose was to determine if cold whirlpool treatment decreases functional performance equally regardless of gender. A secondary aim was to determine if there is a gradual increase in functional performance across time. Twenty-one college-aged subjects volunteered to participate in this study and were required to perform four measures of functional performance including: counter movement vertical jump, T-test, 36.58-meter dash (40-yard), and active range of motion of the ankle. Participants were treated with a 20 minute, 10 degree Celsius cold whirlpool following the pre-test of a given functional performance measure. Participants demonstrated significant decreases in counter movement vertical jump, T-test, and 40-yard dash performance immediately following treatment. Vertical jump performance remained impaired for at least 32 minutes. While both the T-test and 40-yard dash were affected for 7 and 22 minutes post- treatment, respectively. Participants also demonstrated significant decreases in peak power and average power immediately after and for 32 minutes post-treatment. Dorsiflexion was significantly decreased 7 and 12 minutes following treatment. There were no differences for plantar flexion, inversion, or eversion. These data suggest functional performance was affected immediately following and for up to 32 minutes after cold whirlpool treatment. It was also evident that there is a gradual performance increase for each measure of functional performance across time. Therefore, the consequences should be carefully considered before returning athletes to activity following cold whirlpool treatment. Key pointsCryotherapy is a common and highly effective modality in treating acute and chronic athletic injuries.The results indicated that cold whirlpool does have an immediate and subsequent effect on functional performance.Understanding how cold whirlpool adversely affects functional performance allows clinicians to continue using this modality before vigorous athletic activity. PMID:24149907

Timing of nicotine lozenge administration to minimize trigger induced craving and withdrawal symptoms.

PubMed

Kotlyar, Michael; Lindgren, Bruce R; Vuchetich, John P; Le, Chap; Mills, Anne M; Amiot, Elizabeth; Hatsukami, Dorothy K

2017-08-01

Smokers are often advised to use nicotine lozenge when craving or withdrawal symptoms occur. This may be too late to prevent lapses. This study assessed if nicotine lozenge use prior to a common smoking trigger can minimize trigger induced increases in craving and withdrawal symptoms. Eighty-four smokers completed two laboratory sessions in random order. At one session, nicotine lozenge was given immediately after a stressor (to approximate current recommended use - i.e., after craving and withdrawal symptoms occur); at the other session subjects were randomized to receive nicotine lozenge at time points ranging from immediately to 30min prior to the stressor. Withdrawal symptoms and urge to smoke were measured using the Minnesota Nicotine Withdrawal Scale and the Questionnaire of Smoking Urges (QSU). Relative to receiving lozenge after the stressor, a smaller increase in pre-stressor to post-stressor withdrawal symptom scores occurred when lozenge was used immediately (p=0.03) and 10min prior (p=0.044) to the stressor. Results were similar for factors 1 and 2 of the QSU when lozenge was used immediately prior to the stressor (p<0.03) and for factor 1 of the QSU when lozenge was used 10min prior to the stressor (p=0.028). Absolute levels of post-stressor withdrawal symptom and urge to smoke severity were lower when lozenge was given prior to versus after a stressor. Administering the nicotine lozenge prior to a smoking trigger can decrease trigger induced craving and withdrawal symptoms. Future studies are needed to determine if such use would increase cessation rates. Clinicaltrials.gov # NCT01522963. Copyright © 2017 Elsevier Ltd. All rights reserved.

Patterns of emergency room visits, admissions and death following recommended pediatric vaccinations - a population based study of 969,519 vaccination events.

PubMed

Wilson, Kumanan; Hawken, Steven; Potter, Beth K; Chakraborty, Pranesh; Kwong, Jeff; Crowcroft, Natasha; Rothwell, Deanna; Manuel, Doug

2011-05-12

The risk of immediate adverse events due to the inflammation created by a vaccine is a potential concern for pediatric vaccine programs. We analyzed data on children born between March 2006 and March 2009 in the province of Ontario. Using the self-controlled case series design, we examined the risk of the combined endpoint of emergency room visit and hospital admission in the immediate 3 days post vaccination to a control period 9-18 days after vaccination. We examined the end points of emergency room visits, hospital admissions and death separately as secondary outcomes. We examined 969,519 separate vaccination events. The relative incidence of our combined end point was 0.85 (0.80-0.90) for vaccination at age 2 months, 0.74 (0.69-0.79) at age 4 months and 0.68 (0.63-0.72) at age 6 months. The relative incidence was reduced for the individual endpoints of emergency room visits, admissions and death. There were 5 or fewer deaths in the risk interval of all 969,519 vaccination events. In a post hoc analysis we observed a large reduction in events in the immediate 3 days prior to vaccination suggesting a large healthy vaccinee effect. There was no increased incidence of the combined end point of emergency room visits and hospitalizations in the 3-day period immediately following vaccination, nor for individual endpoints or death. The health vaccinee effect could create the perception of worsening health following vaccines in the absence of any vaccine adverse effect and could also mask an effect in the immediate post-vaccination period. Copyright © 2011 Elsevier Ltd. All rights reserved.

The Effects of Group Play Therapy on Self-Concept Among 7 to 11 Year-Old Children Suffering From Thalassemia Major.

PubMed

Tomaj, Ome Kolsoum; Estebsari, Fatemeh; Taghavi, Taraneh; Borim Nejad, Leili; Dastoorpoor, Maryam; Ghasemi, Afsaneh

2016-04-01

Children suffering from thalassemia have higher levels of depression and lower levels of self-concept. The aim of this study was to determine if group play therapy could significantly increase self-concept among children with thalassemia major ages 7 to 11 years old in teaching hospitals of Golestan province, Iran, in 2012. In this randomized, controlled clinical trial, 60 children with thalassemia major were randomly assigned to intervention (30 children) and control (30 children) groups. The intervention included eight 45 to 60 minute sessions during four weeks, during which the intervention group received group play therapy. The control group received no interventions. Self-concept was measured three times using the Piers-Harris children's self-concept scale: before, immediately after, and a month after the intervention. For the intervention group, results showed that the mean self-concept score was significantly higher at the second point in time compared to the baseline (P < 0.001), going from 60.539 to 69.908. Likewise, comparing the first and third time points, the mean score significantly increased and reached 70.611 (P < 0.001). Furthermore, changes in the mean score from the second to the third time point, though non-significant (P = 0.509), followed the trend, going from 69.908 to 70.611. For the control group, comparing the first, second, and third time points did not result in any significant change in the mean score (P > 0.05). The results showed that group play therapy improves self-concept in children suffering from thalassemia major.

Saccades and memory: baseline associations of the King-Devick and SCAT2 SAC tests in professional ice hockey players.

PubMed

Galetta, Matthew S; Galetta, Kristin M; McCrossin, Jim; Wilson, James A; Moster, Stephen; Galetta, Steven L; Balcer, Laura J; Dorshimer, Gary W; Master, Christina L

2013-05-15

The Sports Concussion Assessment Tool 2 (SCAT2) and King-Devick (K-D) tests have both been proposed as sideline tools to detect sports-related concussion. We performed an exploratory analysis to determine the relation of SCAT2 components, particularly the Standardized Assessment of Concussion (SAC), to K-D test scores in a professional ice hockey team cohort during pre-season baseline testing. We also examined changes in scores for two athletes who developed concussion and had rinkside testing. A modified SCAT2 (no balance testing) and the K-D test, a brief measure of rapid number naming, were administered to 27 members of a professional ice hockey team during the 2011-2012 pre-season. Athletes with concussion also underwent rinkside testing. Lower (worse) scores for the SCAT2 SAC Immediate Memory Score and the overall SAC score were associated with greater (worse) times required to complete the K-D test at baseline. On average, for every 1-point reduction in SAC Immediate Memory Score, we found a corresponding increase (worsening) of K-D time score of 7.3s (95% CI 4.9, 9.7, p<0.001, R(2)=0.62, linear regression, accounting for age). For the overall SAC score, 1-point reductions were associated with K-D score worsening of 2.2s (95% CI 0.6, 3.8, p=0.01, R(2)=0.25, linear regression). In two players tested rinkside immediately following concussion, K-D test scores worsened from baseline by 4.2 and 6.4s. These athletes had no differences found for SCAT2 SAC components, but reported symptoms of concussion. In this study of professional athletes, scores for the K-D test, a measure for which saccadic (fast) eye movements are required for the task of rapid number naming, were associated with reductions in Immediate Memory at a pre-season baseline. Both working memory and saccadic eye movements share closely related anatomical structures, including the dorsolateral prefrontal cortex (DLPFC). A composite of brief rapid sideline tests, including SAC and K-D (and balance testing for non-ice hockey sports), is likely to provide an effective clinical tool to assess the athlete with suspected concussion. Copyright © 2013 Elsevier B.V. All rights reserved.

SPATIAL AND TEMPORAL DIMENSIONS OF NEIGHBORHOOD EFFECTS ON HIGH SCHOOL GRADUATION.

PubMed

Crowder, Kyle; South, Scott J

2011-01-30

Research into the effects of neighborhood characteristics on children's behavior has burgeoned in recent years, but these studies have generally adopted a limited conceptualization of the spatial and temporal dimensions of neighborhood effects. We use longitudinal data from the Panel Study of Income Dynamics and techniques of spatial data analysis to examine how both the socioeconomic characteristics of extralocal neighborhoods-neighborhoods surrounding the immediate neighborhood of residence-and the duration of exposure to disadvantaged neighborhoods throughout the childhood life course influence the likelihood of graduating from high school. Among blacks and whites, socioeconomic advantage in the immediate neighborhood increases the likelihood of completing high school, but among whites higher levels of socioeconomic advantage in extralocal neighborhoods decrease high school graduation rates. Extralocal neighborhood advantage suppresses the influence of advantage in the immediate neighborhood so that controlling for extralocal conditions provides stronger support for the neighborhood effects hypothesis than has previously been observed. Exposure to advantaged neighborhoods over the childhood life course exerts a stronger effect than point-in-time measures on high school graduation, and racial differences in exposure to advantaged neighbors over the childhood life course help to suppress a net black advantage in the likelihood of completing high school.

SPATIAL AND TEMPORAL DIMENSIONS OF NEIGHBORHOOD EFFECTS ON HIGH SCHOOL GRADUATION

PubMed Central

Crowder, Kyle; South, Scott J.

2010-01-01

Research into the effects of neighborhood characteristics on children’s behavior has burgeoned in recent years, but these studies have generally adopted a limited conceptualization of the spatial and temporal dimensions of neighborhood effects. We use longitudinal data from the Panel Study of Income Dynamics and techniques of spatial data analysis to examine how both the socioeconomic characteristics of extralocal neighborhoods—neighborhoods surrounding the immediate neighborhood of residence—and the duration of exposure to disadvantaged neighborhoods throughout the childhood life course influence the likelihood of graduating from high school. Among blacks and whites, socioeconomic advantage in the immediate neighborhood increases the likelihood of completing high school, but among whites higher levels of socioeconomic advantage in extralocal neighborhoods decrease high school graduation rates. Extralocal neighborhood advantage suppresses the influence of advantage in the immediate neighborhood so that controlling for extralocal conditions provides stronger support for the neighborhood effects hypothesis than has previously been observed. Exposure to advantaged neighborhoods over the childhood life course exerts a stronger effect than point-in-time measures on high school graduation, and racial differences in exposure to advantaged neighbors over the childhood life course help to suppress a net black advantage in the likelihood of completing high school. PMID:21180398

Immediate effect of passive static stretching versus resistance exercises on postprandial blood sugar levels in type 2 diabetes mellitus: a randomized clinical trial.

PubMed

Gurudut, Peeyoosha; Rajan, Abey P

2017-10-01

The prevalence of diabetes is rapidly rising all over the globe at an alarming rate. In India, more than 61.3 million people have been presently diagnosed with type 2 diabetes mellitus. It is possible to control the circulating blood glucose levels by reducing life style risk factors through physical activities comprising of muscle stretches, aerobic training, resistance exercises (REs), yoga, etc. The aim of this study is to identify and compare the immediate effect of passive static stretching (PSS) versus RE on blood glucose level in individuals with type 2 diabetes mellitus. The present study included 51 participants between the age of 40-65 years with type 2 diabetes mellitus, to study the immediate effect of 60-min PSS (n=25) and 60-min RE (n=26). The outcome measure was blood glucose level which was checked by glucometer (free-style neo). Blood sugar was assessed at 3 points of time that included fasting blood sugar level, 2 hr after the meal and immediately after the exercise regimen. Results of this study showed significant reduction in blood glucose level in subjects according to glucometer with PSS ( P =0.000) and RE ( P =0.00). However, both groups demonstrated equal effect in terms of lowering blood sugar level immediately after the exercise. The conclusion is both PSS and RE are effective in reducing postprandial blood glucose level in type 2 diabetes mellitus and must be prescribed for the patients who demonstrate difficulty in controlling post prandial spike.

Dissociation of immediate and delayed effects of emotional arousal on episodic memory.

PubMed

Schümann, Dirk; Bayer, Janine; Talmi, Deborah; Sommer, Tobias

2018-02-01

Emotionally arousing events are usually better remembered than neutral ones. This phenomenon is in humans mostly studied by presenting mixed lists of neutral and emotional items. An emotional enhancement of memory is observed in these studies often already immediately after encoding and increases with longer delays and consolidation. A large body of animal research showed that the more efficient consolidation of emotionally arousing events is based on an activation of the central noradrenergic system and the amygdala (Modulation Hypothesis; Roozendaal & McGaugh, 2011). The immediately superior recognition of emotional items is attributed primarily to their attraction of attention during encoding which is also thought to be based on the amygdala and the central noradrenergic system. To investigate whether the amygdala and noradrenergic system support memory encoding and consolidation via shared neural substrates and processes a large sample of participants (n = 690) encoded neutral and arousing pictures. Their memory was tested immediately and after a consolidation delay. In addition, they were genotyped in two relevant polymorphisms (α 2B -adrenergic receptor and serotonin transporter). Memory for negative and positive emotional pictures was enhanced at both time points where these enhancements were correlated (immediate r = 0.60 and delayed test r = 0.46). Critically, the effects of emotional arousal on encoding and consolidation correlated only very low (negative r = 0.14 and positive r = 0.03 pictures) suggesting partly distinct underlying processes consistent with a functional heterogeneity of the central noradrenergic system. No effect of genotype on either effect was observed. Copyright © 2017 Elsevier Inc. All rights reserved.

Stability Development of Immediately Loaded Hybrid Self-Tapping Implants Inserted in the Posterior Maxilla: 1-Year Results of a Randomized Controlled Trial.

PubMed

Todorovic, Vladimir S; Vasovic, Miroslav; Beetge, Mia-Michaela; van Zyl, Andre W; Kokovic, Vladimir

2017-02-01

The objective of the present study was to elucidate stability development of immediately loaded hybrid self-tapping implants inserted in the posterior maxilla. Forty-eight hybrid self-tapping implants with a chemically modified surface (∅4.1; length: 8 mm) were inserted bilaterally in the maxillary first and second premolar and first molar sites of 8 patients. In each patient, both sides of the maxilla were assigned randomly to either immediate (IL) or early (EL) loading group. Implant stability was evaluated by means of resonance frequency analysis immediately after implant placement and after 1, 2, 3, 4, 5, 6, 12, 26, and 52 weeks. High values of primary stability were found in both groups (71.91 ± 6.52 implant stability quotient [ISQ] in IL group; 73.87 ± 6.5 ISQ in EL group), with significant differences between the groups at the different time points. Initial decrease in stability was observed between the first and fifth weeks in the IL group and between the first and third weeks for the EL group. In the IL group 1 implant was removed after 3 weeks due to lack of stability. Early results of this study showed the ability of hybrid self-tapping dental implants with a chemically modified surface to achieve sufficient primary stability and to maintain high values of secondary implant stability in bone type 3 and 4, even when loaded immediately. Minimal alterations in stability were observed for both investigated groups, but the EL group showed faster recovery after an initial drop in stability.

77 FR 3019 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-20

..., shrinks to the greater of: (a) 4 percentage points, or, (b) one-quarter the applicable percentage... national best offer, as appropriate, shrinks to the greater of: (a) 4 percentage points, or, (b) one...

Sediment storage time in a simulated meandering river's floodplain, comparisons of point bar and overbank deposits

NASA Astrophysics Data System (ADS)

Ackerman, T. R.; Pizzuto, J. E.

2016-12-01

Sediment may be stored briefly or for long periods in alluvial deposits adjacent to rivers. The duration of sediment storage may affect diagenesis, and controls the timing of sediment delivery, affecting the propagation of upland sediment signals caused by tectonics, climate change, and land use, and the efficacy of watershed management strategies designed to reduce sediment loading to estuaries and reservoirs. Understanding the functional form of storage time distributions can help to extrapolate from limited field observations and improve forecasts of sediment loading. We simulate stratigraphy adjacent to a modeled river where meander migration is driven by channel curvature. The basal unit is built immediately as the channel migrates away, analogous to a point bar; rules for overbank (flood) deposition create thicker deposits at low elevations and near the channel, forming topographic features analogous to natural levees, scroll bars, and terraces. Deposit age is tracked everywhere throughout the simulation, and the storage time is recorded when the channel returns and erodes the sediment at each pixel. 210 ky of simulated run time is sufficient for the channel to migrate 10,500 channel widths, but only the final 90 ky are analyzed. Storage time survivor functions are well fit by exponential functions until 500 years (point bar) or 600 years (overbank) representing the youngest 50% of eroded sediment. Then (until an age of 12 ky, representing the next 48% (point bar) or 45% (overbank) of eroding sediment), the distributions are well fit by heavy tailed power functions with slopes of -1 (point bar) and -0.75 (overbank). After 12 ky (6% of model run time) the remainder of the storage time distributions become exponential (light tailed). Point bar sediment has the greatest chance (6%) of eroding at 120 years, as the river reworks recently deposited point bars. Overbank sediment has an 8% chance of eroding after 1 time step, a chance that declines by half after 3 time steps. The high probability of eroding young overbank deposits occurs as the river reworks recently formed natural levees. These results show that depositional environment affects river floodplain storage times shorter than a few centuries, and suggest that a power law distribution with a truncated tail may be the most reasonable functional fit.

Point Clouds to Indoor/outdoor Accessibility Diagnosis

NASA Astrophysics Data System (ADS)

Balado, J.; Díaz-Vilariño, L.; Arias, P.; Garrido, I.

2017-09-01

This work presents an approach to automatically detect structural floor elements such as steps or ramps in the immediate environment of buildings, elements that may affect the accessibility to buildings. The methodology is based on Mobile Laser Scanner (MLS) point cloud and trajectory information. First, the street is segmented in stretches along the trajectory of the MLS to work in regular spaces. Next, the lower region of each stretch (the ground zone) is selected as the ROI and normal, curvature and tilt are calculated for each point. With this information, points in the ROI are classified in horizontal, inclined or vertical. Points are refined and grouped in structural elements using raster process and connected components in different phases for each type of previously classified points. At last, the trajectory data is used to distinguish between road and sidewalks. Adjacency information is used to classify structural elements in steps, ramps, curbs and curb-ramps. The methodology is tested in a real case study, consisting of 100 m of an urban street. Ground elements are correctly classified in an acceptable computation time. Steps and ramps also are exported to GIS software to enrich building models from Open Street Map with information about accessible/inaccessible entrances and their locations.

78 FR 62778 - Self-Regulatory Organizations; EDGX Exchange, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-22

...'') to add orders yielding Flag AA to the calculation of the average daily trading (``ADV'') threshold... AA to the calculation of the ADV threshold required to meet the MidPoint Match Volume Tier. Footnote... Match using MidPoint Match order type). The Exchange proposes to add orders yielding Flag AA (MidPoint...

Identification of effective exciton-exciton annihilation in squaraine-squaraine copolymers.

PubMed

Hader, Kilian; May, Volkhard; Lambert, Christoph; Engel, Volker

2016-05-11

Ultrafast time-resolved transient absorption spectroscopy is able to monitor the fate of the excited state population in molecular aggregates or polymers. Due to many competing decay processes, the identification of exciton-exciton annihilation (EEA) is difficult. Here, we use a microscopic model to describe exciton annihilation processes in squaraine-squaraine copolymers. Transient absorption time traces measured at different laser powers exhibit an unusual time-dependence. The analysis points towards dynamics taking place on three time-scales. Immediately after laser-excitation a localization of excitons takes place within the femtosecond time-regime. This is followed by exciton-exciton annihilation which is responsible for a fast decay of the exciton population. At later times, excitations being localized on units which are not directly connected remain so that diffusion dominates the dynamics and leads to a slower decay. We thus provide evidence for EEA tracked by time-resolved spectroscopy which has not been reported that clearly before.

Do specialty registrars change their attitudes, intentions and behaviour towards reporting incidents following a patient safety course?

PubMed Central

2010-01-01

Background Reporting incidents can contribute to safer health care, as an awareness of the weaknesses of a system could be considered as a starting point for improvements. It is believed that patient safety education for specialty registrars could improve their attitudes, intentions and behaviour towards incident reporting. The objective of this study was to examine the effect of a two-day patient safety course on the attitudes, intentions and behaviour concerning the voluntary reporting of incidents by specialty registrars. Methods A patient safety course was designed to increase specialty registrars' knowledge, attitudes and skills in order to recognize and cope with unintended events and unsafe situations at an early stage. Data were collected through an 11-item questionnaire before, immediately after and six months after the course was given. Results The response rate at all three points in time assessed was 100% (n = 33). There were significant changes in incident reporting attitudes and intentions immediately after the course, as well as during follow-up. However, no significant changes were found in incident reporting behaviour. Conclusions It is shown that patient safety education can have long-term positive effects on attitudes towards reporting incidents and the intentions of registrars. However, further efforts need to be undertaken to induce a real change in behaviour. PMID:20416053

The potential of low-power laser for reducing dental sensitivity after in-office bleaching: a case report.

PubMed

Mayer-Santos, Eric; Anhesini, Brunna Haddad; Shimokawa, Carlos Alberto Kenji; Aranha, Ana Cecília Corrêa; Eduardo, Carlos Paula; de Freitas, Patricia Moreira

2017-01-01

Postoperative sensitivity is one of the most common side effects of in-office bleaching with hydrogen peroxide. Laser phototherapy (LPT) has been suggested as an adjunctive treatment to prevent or minimize tooth sensitivity. This case report aimed to verify the efficacy of LPT in the reduction of sensitivity after in-office bleaching. Tooth bleaching was performed with 35% hydrogen peroxide activated with a hybrid LED-laser device. Immediately after the bleaching treatment, the patient reported dental sensitivity, as measured with a visual analog scale (VAS). To reduce sensitivity, LPT was applied with a 780-nm laser using the following parameters: 70 mW, exposure time of 10 seconds per point of irradiation (middle region of the buccal surfaces of each compromised tooth) in contact mode, energy of 1 J per point. Immediately after LPT, the patient reported a substantially lower level of pain on the VAS. Twenty-four hours after bleaching, the score on the VAS indicated that sensitivity levels had rebounded, and the patient received additional LPT. After 48 hours, the patient reported no dental sensitivity. The results in this patient indicated that irradiation with an infrared low-power laser substantially reduced dental pain generated by bleaching, suggesting that LPT should be considered as an auxiliary method to reduce postbleaching tooth sensitivity.

Point-of-care blood gases, electrolytes, chemistries, hemoglobin, and hematocrit measurement in venous samples from pet rabbits.

PubMed

Selleri, Paolo; Di Girolamo, Nicola

2014-01-01

Point-of-care testing is an attractive option in rabbit medicine, because it permits rapid analysis of a panel of electrolytes, chemistries, blood gases, hemoglobin, and hematocrit, requiring only 65 μL of blood. The purpose of this study was to evaluate the performance of a portable clinical analyzer for measurement of pH, partial pressure of CO2, Na, chloride, potassium, blood urea nitrogen, glucose, hematocrit, and hemoglobin in healthy and diseased rabbits. Blood samples obtained from 30 pet rabbits were analyzed immediately after collection by the portable clinical analyzer (PCA) and immediately thereafter (time <20 sec) by a reference analyzer. Bland-Altman plots and Passing-Bablok regression analysis were used to compare the results. Limits of agreement were wide for all the variables studied, with the exception of pH. Most variables presented significant proportional and/or constant bias. The current study provides sufficient evidence that the PCA presents reliability for pH, although its low agreement with a reference analyzer for the other variables does not support their interchangeability. Limits of agreement provided for each variable allow researchers to evaluate if the PCA is reliable enough for their scope. To the authors' knowledge, the present is the first report evaluating a PCA in the rabbit.

Efficacy of Nd:YAG and GaAlAs lasers in comparison to 2% fluoride gel for the treatment of dentinal hypersensitivity.

PubMed

Soares, Marília De Lima; Porciúncula, Geane Bandeira; Lucena, Mara Ilka Holanda Medeiros De; Gueiros, Luiz Alcino Monteiro; Leão, Jair Carneiro; Carvalho, Alessandra De Albuquerque Tavares

2016-01-01

Lasers demonstrate excellent therapeutic action and are often employed in dentistry for the treatment of diverse clinical conditions. The aim of this study was to compare the efficacy of neodymium-doped yttrium-aluminum-garnet (Nd:YAG) laser, gallium-aluminum-arsenide (GaAlAs) laser, and 2% neutral fluoride gel in the treatment of dentinal hypersensitivity. Twenty-three patients were evaluated, involving a total of 48 quadrants with at least 1 tooth with dentinal hypersensitivity (89 teeth total). Pain intensity was recorded on a visual analog scale at the time of clinical examination (baseline), immediately after treatment, and 1 week posttreatment. Teeth were treated with 60 seconds of 2% neutral fluoride gel application or 60 seconds of laser treatment-Nd:YAG laser at a distance of 0.5 cm (unfocused; 1 W and 10 Hz for 60 seconds, perpendicular to the cervical surfaces) or GaAlAs laser in contact (40 mW; 4 J/cm²; spot: 0.028 cm²; 15 seconds per point on 4 points [mesial, medial, distal, and apical])-as well as sham treatments so that patients remained blind to their treatment group. All treatments provided adequate pain reduction immediately posttreatment, but laser treatments resulted in significantly greater reductions in pain intensity.

At the Tipping Point

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

Wiley, H. S.

There comes a time in every field of science when things suddenly change. While it might not be immediately apparent that things are different, a tipping point has occurred. Biology is now at such a point. The reason is the introduction of high-throughput genomics-based technologies. I am not talking about the consequences of the sequencing of the human genome (and every other genome within reach). The change is due to new technologies that generate an enormous amount of data about the molecular composition of cells. These include proteomics, transcriptional profiling by sequencing, and the ability to globally measure microRNAs andmore » post-translational modifications of proteins. These mountains of digital data can be mapped to a common frame of reference: the organism’s genome. With the new high-throughput technologies, we can generate tens of thousands of data points from each sample. Data are now measured in terabytes and the time necessary to analyze data can now require years. Obviously, we can’t wait to interpret the data fully before the next experiment. In fact, we might never be able to even look at all of it, much less understand it. This volume of data requires sophisticated computational and statistical methods for its analysis and is forcing biologists to approach data interpretation as a collaborative venture.« less

75 FR 25013 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-06

... Change Amending Its Mid- Point Passive Liquidity Order April 29, 2010. Pursuant to Section 19(b)(1) \\1...-Point Passive Liquidity Order (``MPL Order''). The text of the proposed rule change is available on the...

Instance-based learning: integrating sampling and repeated decisions from experience.

PubMed

Gonzalez, Cleotilde; Dutt, Varun

2011-10-01

In decisions from experience, there are 2 experimental paradigms: sampling and repeated-choice. In the sampling paradigm, participants sample between 2 options as many times as they want (i.e., the stopping point is variable), observe the outcome with no real consequences each time, and finally select 1 of the 2 options that cause them to earn or lose money. In the repeated-choice paradigm, participants select 1 of the 2 options for a fixed number of times and receive immediate outcome feedback that affects their earnings. These 2 experimental paradigms have been studied independently, and different cognitive processes have often been assumed to take place in each, as represented in widely diverse computational models. We demonstrate that behavior in these 2 paradigms relies upon common cognitive processes proposed by the instance-based learning theory (IBLT; Gonzalez, Lerch, & Lebiere, 2003) and that the stopping point is the only difference between the 2 paradigms. A single cognitive model based on IBLT (with an added stopping point rule in the sampling paradigm) captures human choices and predicts the sequence of choice selections across both paradigms. We integrate the paradigms through quantitative model comparison, where IBLT outperforms the best models created for each paradigm separately. We discuss the implications for the psychology of decision making. © 2011 American Psychological Association

In-Situ Real-Time Focus Detection during Laser Processing Using Double-Hole Masks and Advanced Image Sensor Software

PubMed Central

Hoang, Phuong Le; Ahn, Sanghoon; Kim, Jeng-o; Kang, Heeshin; Noh, Jiwhan

2017-01-01

In modern high-intensity ultrafast laser processing, detecting the focal position of the working laser beam, at which the intensity is the highest and the beam diameter is the lowest, and immediately locating the target sample at that point are challenging tasks. A system that allows in-situ real-time focus determination and fabrication using a high-power laser has been in high demand among both engineers and scientists. Conventional techniques require the complicated mathematical theory of wave optics, employing interference as well as diffraction phenomena to detect the focal position; however, these methods are ineffective and expensive for industrial application. Moreover, these techniques could not perform detection and fabrication simultaneously. In this paper, we propose an optical design capable of detecting the focal point and fabricating complex patterns on a planar sample surface simultaneously. In-situ real-time focus detection is performed using a bandpass filter, which only allows for the detection of laser transmission. The technique enables rapid, non-destructive, and precise detection of the focal point. Furthermore, it is sufficiently simple for application in both science and industry for mass production, and it is expected to contribute to the next generation of laser equipment, which can be used to fabricate micro-patterns with high complexity. PMID:28671566

[Effects of astragalus polysaccharide on intestinal immune function of rats with severe scald injury].

PubMed

Huang, Cuilan; Zhan, Jianhua; Luo, Jinhua

2015-02-01

To observe the effects of astragalus polysaccharide (AP) on the intestinal mucosal morphology, level of secretory IgA (s-IgA) in intestinal mucus, and distribution of T lymphocyte subsets in Peyer's patch in rats with severe scald injury. One hundred and thirty SD rats were divided into sham injury group (SI, sham injured, n = 10), scald group (S, n = 30), low dosage group (LD, n = 30), moderate dosage group (MD, n = 30), and high dosage group (HD, n = 30) according to the random number table. Rats in the latter 4 groups were inflicted with 30% TBSA full-thickness scald on the back. From post injury hour 2, rats in groups LD, MD, and HD were intraperitoneally injected with 0.5 mL AP solution with the dosage of 100, 200, and 300 mg/kg each day respectively, and rats in group S were injected with 0.5 mL normal saline instead. Ten rats from group SI immediately after injury and 10 rats from each of the latter 4 groups on post injury day (PID) 3, 7, 14 were sacrificed, and their intestines were harvested. The morphology of ileal mucosa was examined after HE staining; the level of s-IgA in ileal mucus was determined with double-antibody sandwich ELISA method; the proportions of CD3⁺, CD4⁺, CD8⁺ T lymphocytes in Peyer's patches of intestine were determined with flow cytometer, and the proportion of CD4⁺ to CD8⁺ was calculated. Data were processed with one-way analysis of variance, analysis of variance of factorial design, and SNK test. (1) Villi in normal form and intact villus epithelial cells were observed in rats of group SI immediately after injury, while edema of villi and necrosis and desquamation of an enormous amount of villi were observed in groups with scalded rats on PID 3, with significant infiltration of inflammatory cells. On PID 7, no obvious improvement in intestinal mucosal lesion was observed in groups with scalded rats. On PID 14, the pathology in intestinal mucosa of rats remained nearly the same in group S, and it was alleviated obviously in groups LD and MD, and the morphology of intestinal mucosa of rats in group HD was recovered to that of group SI. (2) On PID 3, 7, and 14, the level of s-IgA in intestinal mucus significantly decreased in groups S, LD, MD, and HD [(43 ± 5), (45 ± 5), (46 ± 5) µg/mL; (47 ± 5), (48 ± 5), (49 ± 6) µg/mL; (50 ± 6), (51 ± 5), (52 ± 5) µg/mL; (53 ± 6), (54 ± 5), (55 ± 5) µg/mL] as compared with that of rats in group SI immediately after injury [(69 ± 4) µg/mL, with P values below 0.05]. The level of s-IgA in intestinal mucus of rats in group MD was significantly higher than that in group S at each time point (with P values below 0.05), and that of group HD was significantly higher than that in groups S and LD at each time point (with P values below 0.05). (3) Compared with those of rats in group SI immediately after injury, the proportions of CD3⁺ T lymphocytes and CD4⁺ T lymphocytes significantly decreased in groups with scalded rats at each time point (with P values below 0.05), except for those in group HD on PID 14. The proportion of CD4⁺ T lymphocytes of rats in group LD was significantly higher than that in group S on PID 3 (P < 0.05). The proportions of CD3⁺ T lymphocytes and CD4⁺ T lymphocytes were significantly higher in groups MD and HD than in groups S and LD (except for the proportion of CD4⁺ T lymphocytes in group MD on PID 3 and 14) at each time point (with P values below 0.05). The proportion of CD3⁺ T lymphocytes on PID 7 and 14 and that of CD4⁺ T lymphocytes on PID 3 were significantly higher in group HD than in group MD (with P values below 0.05). Compared with that of rats in group SI immediately after injury, the proportion of CD8⁺ T lymphocytes significantly increased in the other 4 groups at each time point (with P values below 0.05). The proportion of CD8⁺ T lymphocytes was significantly lower in rats of group LD on PID 7 and 14 and groups MD and HD at each time point than in group S (with P values below 0.05). The proportion of CD8⁺ T lymphocytes was significantly lower in rats of group MD on PID 7 and 14 and group HD at each time point than in group LD (with P values below 0.05). The proportion of CD8⁺ T lymphocytes was significantly lower in rats of group HD on PID 7 and 14 than in group MD (with P values below 0.05). On PID 3, 7, and 14, the proportion of CD4⁺ to CD8⁺ was significantly lower in groups S, LD, MD, and HD (0.65 ± 0.11, 0.68 ± 0.13, 0.73 ± 0.22; 0.76 ± 0.15, 0.78 ± 0.14, 0.90 ± 0.10; 0.85 ± 0.21, 0.89 ± 0.18, 1.08 ± 0.19; 0.99 ± 0.20, 1.05 ± 0.21, 1.25 ± 0.23) as compared with that of rats in group SI immediately after injury (1.74 ± 0.20, with P values below 0.05). The proportion of CD4⁺ to CD8⁺ was significantly higher in rats of group HD than in group MD on PID 7 (P < 0.05), and the proportion was significantly higher in these two groups than in group S at each time point (with P values below 0.05). The proportion of CD4⁺ to CD8⁺ was significantly higher in rats of group MD on PID 14 and group HD at each time point than in group LD (with P values below 0.05). Compared within each group, the proportions of CD3⁺, CD4⁺, CD8⁺ T lymphocytes and the proportion of CD4⁺ to CD8⁺ of rats in groups LD, MD, and HD showed a trend of gradual elevation along with passage of time. AP can improve the injury to intestinal mucosa and modulate the balance of T lymphocyte subsets in Peyer's patch in a time- and dose-dependent manner, and it can promote s-IgA secretion of intestinal mucosa in a dose-dependent manner.

Early intraoperative blood collection does not affect complete blood counts, von Willebrand factor or factor VIII levels in normal children.

PubMed

Darwish, Hanni; Mundell, Gillianne; Engen, Dale; Lillicrap, David; Silva, Mariana; James, Paula

2011-01-01

Obtaining blood from children for research studies can be difficult, particularly for controls. One solution is to obtain samples during elective surgery; however, consideration must be given to the potential effects of the timing of phlebotomy. Ten children were recruited and phlebotomy was carried out during a preoperative clinic visit and intraoperatively immediately after the induction of anesthesia but before the start of surgery. CBCs, VWF, and FVIII levels were measured at both time points and no significant differences were seen. This negative result may be beneficial to pediatric research by suggesting that early intraoperative blood collection for controls does not affect the results.

Correlation of tissue concentrations of the pyrethroid bifenthrin with neurotoxicity in the rat.

PubMed

Scollon, Edward J; Starr, James M; Crofton, Kevin M; Wolansky, Marcelo J; DeVito, Michael J; Hughes, Michael F

2011-11-28

The potential for human exposure to pyrethroid pesticides has prompted pharmacodynamic and pharmacokinetic research to better characterize risk. This work tested the hypothesis that blood and brain concentrations of the pyrethroid bifenthrin are predictive of neurotoxic effects. Adult male Long Evans rats received a single oral dose of bifenthrin dissolved in corn oil. Using figure-eight mazes, motor activity was measured for 1h at 4- and 7-h following exposure to bifenthrin (0-16mg/kg or 0-9mg/kg, respectively; n=4-8/group). Whole blood and brains were collected immediately following motor activity assays. Bifenthrin concentrations in blood and brain were quantified using HPLC/MS/MS. Bifenthrin exposure decreased motor activity from 20% to 70% in a dose-dependent manner at both time points. The relationship between motor activity data and administered dose, and blood and brain bifenthrin concentrations were described using a sigmoidal E(max) model. The relationships between motor activity and administered dose or blood concentrations were different between the 4- and 7-h time points. The relationship between motor activity and brain concentration was not significantly different between the two time points. These data suggest that momentary brain concentration of bifenthrin may be a more precise dose metric for predicting behavioral effects because the relationship between brain concentration and locomotor activity is independent of the time of exposure. Published by Elsevier Ireland Ltd.

78 FR 41154 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-09

... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-69926; File No. SR-NYSEArca-2013-67] Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing and Immediate Effectiveness of Proposed Rule Change Amending the NYSE Arca Equities Schedule of Fees and Charges for Exchange Services To Modify the Credits for Certain Mid-Point Passive...

Alterations in rotation thromboelastometry (ROTEM®) parameters: point-of-care testing vs analysis after pneumatic tube system transport.

PubMed

Martin, J; Schuster, T; Moessmer, G; Kochs, E F; Wagner, K J

2012-10-01

Thromboelastometry as point-of-care (POC) testing enables the analysis of the clotting process at the bedside, providing rapid results to guide haemostatic therapy. However, POC testing utilizes medical staff who are managing critically ill patients, as non-laboratory personnel may not be sufficiently trained to run the devices. To resolve these problems, thromboelastometry can be performed in the central laboratory and rapid transport of samples can be accomplished via a pneumatic tube system (PTS). This study compares thromboelastometry parameters of blood samples analysed immediately with those analysed after PTS transport. In patients with normal haemostasis, two arterial blood samples were collected from each patient (n=92) in citrated plastic tubes to investigate the assays INTEM (n=35), EXTEM (n=27), and FIBTEM (n=30). One blood sample was analysed immediately, the other sample after PTS transport. Thromboelastometry was performed using a single ROTEM(®) device. The mean clot firmness values were significantly lower for PTS samples in both the INTEM (-0.7 mm cf. -1.1 mm) and EXTEM (-1.4 cf. -1.7 mm) assays. INTEM coagulation time (CT) was significantly lower in PTS samples with a mean difference of -13 s. EXTEM CT was significantly higher in PTS samples with a mean difference of +3.9 s. Thromboelastometry parameters of blood samples analysed after PTS transport are significantly altered compared with those analysed immediately. However, in patients with normal haemostasis, the alterations were small and without clinical consequence, implying that analysis after PTS transport is an acceptable alternative to prompt analysis at the bedside. Further studies should focus on patients with impaired haemostasis.

CFHT's SkyProbe: a real-time sky-transparency monitor

NASA Astrophysics Data System (ADS)

Cuillandre, Jean-Charles; Magnier, Eugene A.; Isani, Sidik; Sabin, Daniel; Knight, Wiley; Kras, Simon; Lai, Kamson

2002-12-01

We have developed a system at the Canada-France-Hawaii Telescope (CFHT), SkyProbe, which allows for the direct measurement of the true attenuation by clouds once per minute, within a percent, directly on the field pointed by the telescope. It has been possible to make this system relatively inexpensively due to the low-cost CCD cameras from the amateur market. A crucial addition to this hardware is the quite recent availability of a full-sky photometry catalog at the appropriate depth: the Tycho catalog, from the Hipparcos mission. The central element is the automatic data analysis pipeline developed at CFHT, Elixir, for the improved operation of the CFHT wide-field imagers, CFH12K and MegaCam. SkyProbe"s FITS images are processed in real-time and the pipeline output (a zero point attenuation) provides the current sky transmission to the observers and helps immediate decision making. These measurements are also attached to the archived data, adding a key criteria for future use by other astronomers.

Maximum likelihood decoding of Reed Solomon Codes

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

Sudan, M.

We present a randomized algorithm which takes as input n distinct points ((x{sub i}, y{sub i})){sup n}{sub i=1} from F x F (where F is a field) and integer parameters t and d and returns a list of all univariate polynomials f over F in the variable x of degree at most d which agree with the given set of points in at least t places (i.e., y{sub i} = f (x{sub i}) for at least t values of i), provided t = {Omega}({radical}nd). The running time is bounded by a polynomial in n. This immediately provides a maximum likelihoodmore » decoding algorithm for Reed Solomon Codes, which works in a setting with a larger number of errors than any previously known algorithm. To the best of our knowledge, this is the first efficient (i.e., polynomial time bounded) algorithm which provides some maximum likelihood decoding for any efficient (i.e., constant or even polynomial rate) code.« less

Neoadjuvant Radiotherapy: Changing the Treatment Sequence to Allow Immediate Free Autologous Breast Reconstruction.

PubMed

Hughes, Kimberley; Neoh, Derek

2018-06-16

 Locally advanced breast cancer (LABC) is traditionally treated with a multimodal approach of chemotherapy, surgery, and postmastectomy radiotherapy (PMRT). The advantages of immediate breast reconstruction (IBR) are well described and include improved aesthetic outcomes, fewer surgical procedures, shorter treatment period, and a higher quality of life. However, this sequence makes immediate free autologous reconstruction more challenging as PMRT can have deleterious and unpredictable effects on the flap. We have reversed this treatment sequence with neoadjuvant chemotherapy and radiotherapy, followed by mastectomy and immediate free autologous reconstruction. To our knowledge, this is the first series to assess the outcomes of neoadjuvant radiotherapy on immediate free microvascular breast reconstruction.  A review of patients with LABC who underwent immediate free autologous breast reconstruction post neoadjuvant chemoradiotherapy between 2013 and 2017 was conducted. All reconstructions were performed by a single reconstructive team. The primary end points were flap failure and surgical complications. Secondary end points were pathological response rate and disease recurrence.  A total of 40 women with an average age of 48.1 (36-61) and average body mass index of 25.6 (18-37) were included. The most common choice of flap was immediate deep inferior epigastric perforator (DIEP, 31), followed by transverse or diagonal upper gracilis (5), muscle-sparing transversus abdominis (3), and stacked DIEP (1). Our major complication rate was 12.5% and minor complication 15%. There were no cases of local recurrence and only three cases (7.5%) of distant disease progression.  From our experience, this treatment sequence allows patients to have an immediate gold standard reconstruction without an increase in surgical morbidity. It affords the benefits of IBR without concern in delaying adjuvant therapy and appears to be safe from an oncological perspective. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Breaking bad news is a teachable skill in pediatric residents: A feasibility study of an educational intervention.

PubMed

Reed, Suzanne; Kassis, Karyn; Nagel, Rollin; Verbeck, Nicole; Mahan, John D; Shell, Richard

2015-06-01

Patients and physicians identify communication of bad news as a skill in need of improvement. Our objectives were to measure change in performance of first-year pediatric residents in the delivery of bad news after an educational intervention and to measure if changes in performance were sustained over time. Communication skills of 29 residents were assessed via videotaped standardized patient (SP) encounters at 3 time points: baseline, immediately post-intervention, and 3 months post-intervention. Educational intervention used was the previously published "GRIEV_ING Death Notification Protocol." The intraclass correlation coefficient demonstrated substantial inter-rater agreement with the assessment tool. Performance scores significantly improved from baseline to immediate post-intervention. Performance at 3 months post-intervention showed no change in two subscales and small improvement in one subscale. We concluded that breaking bad news is a complex and teachable skill that can be developed in pediatric residents. Improvement was sustained over time, indicating the utility of this educational intervention. This study brings attention to the need for improved communication training, and the feasibility of an education intervention in a large training program. Further work in development of comprehensive communication curricula is necessary in pediatric graduate medical education programs. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

76 FR 50276 - Self-Regulatory Organizations; OneChicago, LLC; Notice of Filing and Immediate Effectiveness of a...

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2011-08-12

... for Four Decimal Point Pricing for Block and Exchange for Physical (``EFPs'') Trades August 8, 2011... block trades and the futures component of EFP trades to be traded/priced in four decimals points. Regular trades (non-block or non EFP) will continue to trade in only two decimal points. The text of the...

Toxicity assessment of a common laundry detergent using the freshwater flagellate Euglena gracilis.

PubMed

Azizullah, Azizullah; Richter, Peter; Häder, Donat-Peter

2011-09-01

Synthetic detergents are among the commonly used chemicals in everyday life. Detergents, reaching aquatic environments through domestic and municipal wastewater, can cause many different effects in aquatic organisms. The present study was aimed at the toxicity evaluation of a commonly used laundry detergent, Ariel, using the freshwater flagellate Euglena gracilis as a biotest organism. Different parameters of the flagellate like motility, swimming velocity, cell shape, gravitactic orientation, photosynthesis and concentration of light harvesting pigments were used as end points for the toxicity assessment. No Observed Effect Concentration (NOEC) and EC(50) values were calculated for the end point parameters at four different incubation times, i.e. 0, 6, 24 and 72 h. After 72 h incubation, swimming velocity of the cells was found to be the most sensitive parameter giving NOEC and EC(50) values of 10.8 and 34 mg L(-1), respectively. After 72 h exposure to the detergent, chlorophyll a and total carotenoids were significantly decreased in cultures treated with Ariel at concentrations of 50 mg L(-1) and above while chlorophyll b significantly decreased at concentrations above 750 mg L(-1). The maximum inhibitory effect on the quantum yield of photosystem II was observed after 24 h exposure and thereafter a recovery trend was observed. Motility, gravitaxis and cell shape were strongly impaired immediately upon exposure to the detergent, but with increasing exposure time these parameters showed acclimatization to the stress and thus the NOEC values obtained after 72 h were higher than those immediately after exposure. Copyright © 2011 Elsevier Ltd. All rights reserved.

Investigating lexical competition and the cost of phonemic restoration.

PubMed

Balling, Laura Winther; Morris, David Jackson; Tøndering, John

2017-12-01

Due to phonemic restoration, listeners can reliably perceive words when a phoneme is replaced with noise. The cost associated with this process was investigated along with the effect of lexical uniqueness on phonemic restoration, using data from a lexical decision experiment where noise replaced phonemes that were either uniqueness points (the phoneme at which a word deviates from all nonrelated words that share the same onset) or phonemes immediately prior to these. A baseline condition was also included with no noise-interrupted stimuli. Results showed a significant cost of phonemic restoration, with 100 ms longer word identification times and a 14% decrease in word identification accuracy for interrupted stimuli compared to the baseline. Regression analysis of response times from the interrupted conditions showed no effect of whether the interrupted phoneme was a uniqueness point, but significant effects for several temporal attributes of the stimuli, including the duration and position of the interrupted segment. These results indicate that uniqueness points are not distinct breakpoints in the cohort reduction that occurs during lexical processing, but that temporal properties of the interrupted stimuli are central to auditory word recognition. These results are interpreted in the context of models of speech perception.

Learning enhances intrinsic excitability in a subset of lateral amygdala neurons

PubMed Central

Sehgal, Megha; Ehlers, Vanessa L.; Moyer, James R.

2014-01-01

Learning-induced modulation of neuronal intrinsic excitability is a metaplasticity mechanism that can impact the acquisition of new memories. Although the amygdala is important for emotional learning and other behaviors, including fear and anxiety, whether learning alters intrinsic excitability within the amygdala has received very little attention. Fear conditioning was combined with intracellular recordings to investigate the effects of learning on the intrinsic excitability of lateral amygdala (LA) neurons. To assess time-dependent changes, brain slices were prepared either immediately or 24-h post-conditioning. Fear conditioning significantly enhanced excitability of LA neurons, as evidenced by both decreased afterhyperpolarization (AHP) and increased neuronal firing. These changes were time-dependent such that reduced AHPs were evident at both time points whereas increased neuronal firing was only observed at the later (24-h) time point. Moreover, these changes occurred within a subset (32%) of LA neurons. Previous work also demonstrated that learning-related changes in synaptic plasticity are also evident in less than one-third of amygdala neurons, suggesting that the neurons undergoing intrinsic plasticity may be critical for fear memory. These data may be clinically relevant as enhanced LA excitability following fear learning could influence future amygdala-dependent behaviors. PMID:24554670

Low-dose caffeine administered in chewing gum does not enhance cycling to exhaustion.

PubMed

Ryan, Edward J; Kim, Chul-Ho; Muller, Matthew D; Bellar, David M; Barkley, Jacob E; Bliss, Matthew V; Jankowski-Wilkinson, Andrea; Russell, Morgan; Otterstetter, Ronald; Macander, Daniela; Glickman, Ellen L; Kamimori, Gary H

2012-03-01

Low-dose caffeine administered in chewing gum does not enhance cycling to exhaustion. The purpose of the current investigation was to examine the effect of low-dose caffeine (CAF) administered in chewing gum at 3 different time points during submaximal cycling exercise to exhaustion. Eight college-aged (26 ± 4 years), physically active (45.5 ± 5.7 ml·kg(-1)·min(-1)) volunteers participated in 4 experimental trials. Two pieces of caffeinated chewing gum (100 mg per piece, total quantity of 200 mg) were administered in a double-blind manner at 1 of 3 time points (-35, -5, and +15 minutes) with placebo at the other 2 points and at all 3 points in the control trial. The participants cycled at 85% of maximal oxygen consumption until volitional fatigue and time to exhaustion (TTE) were recorded in minutes. Venous blood samples were obtained at -40, -10, and immediately postexercise and analyzed for serum-free fatty acid and plasma catecholamine concentrations. Oxygen consumption, respiratory exchange ratio, heart rate, glucose, lactate, ratings of perceived exertion, and perceived leg pain measures were obtained at baseline and every 10 minutes during cycling. The results showed that there were no significant differences between the trials for any of the parameters measured including TTE. These findings suggest that low-dose CAF administered in chewing gum has no effect on TTE during cycling in recreational athletes and is, therefore, not recommended.

76 FR 30417 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing and Immediate Effectiveness of...

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2011-05-25

... Change Amending Rule 7.31(h)(5) To Reduce the Minimum Order Entry Size of a Mid-Point Passive Liquidity... order entry size of a Mid-Point Passive Liquidity Order (``MPL Order'') from 100 shares to one share...

A randomized study to compare the efficacy and safety of extended-release and immediate-release tramadol HCl/acetaminophen in patients with acute pain following total knee replacement.

PubMed

Park, Yong-Beom; Ha, Chul-Won; Cho, Sung-Do; Lee, Myung-Chul; Lee, Ju-Hong; Seo, Seung-Suk; Kang, Seung-Baik; Kyung, Hee-Soo; Choi, Choong-Hyeok; Chang, NaYoon; Rhim, Hyou Young Helen; Bin, Seong-Il

2015-01-01

To evaluate the relative efficacy and safety of extended-release tramadol HCl 75 mg/acetaminophen 650 mg (TA-ER) and immediate-release tramadol HCl 37.5 mg/acetaminophen 325 mg (TA-IR) for the treatment of moderate to severe acute pain following total knee replacement. This phase III, double-blind, placebo-controlled, parallel-group study randomized 320 patients with moderate to severe pain (≥4 intensity on an 11 point numeric rating scale) following total knee replacement arthroplasty to receive oral TA-ER (every 12 hours) or TA-IR (every 6 hours) over a period of 48 hours. In the primary analysis, TA-ER was evaluated for efficacy non-inferior to that of TA-IR based on the sum of pain intensity difference (SPID) at 48 hours after the first dose of study drug (SPID48). Secondary endpoints included SPID at additional time points, total pain relief at all on-therapy time points (TOTPAR), sum of SPID and TOTPAR at all on-therapy time points (SPID + TOTPAR), use of rescue medication, subjective pain assessment (PGIC, Patient Global Impression of Change), and adverse events (AEs). Analysis of the primary efficacy endpoint (SPID48) could not establish the non-inferiority of TA-ER to TA-IR. However, a post hoc analysis with a re-defined non-inferiority margin did demonstrate the non-inferiority of TA-ER to TA-IR. No statistically significant difference in SPID at 6, 12, or 24 hours was observed between the TA-ER and TA-IR groups. Similarly, analysis of TOTPAR showed that there were no significant differences between groups at any on-therapy time point, and SPID + TOTPAR at 6 and 48 hours were similar among groups. There was no difference in the mean frequency or dosage of rescue medication required by both groups, and the majority of patients in both the TA-ER and TA-IR groups rated their pain improvement as 'much' or 'somewhat better'. The overall incidence of ≥1 AEs was similar among the TA-ER (88.8%) and TA-IR (89.5%) groups. The most commonly reported AEs by patients treated with TA-ER and TA-IR included nausea (49.7% vs 44.4%), vomiting (28.0% vs 24.2%), and decreased hemoglobin (23.6% vs 26.1%). This study is limited by the lack of placebo control, and the invalidity of the initial non-inferiority margin. This study demonstrated that the analgesic effect of TA-ER is non-inferior to TA-IR, and supports TA-ER as an effective and safe treatment for moderate to severe acute pain post total knee replacement. Clinicaltrials.gov, NCT01814878.

The effect of acupressure on fatigue among female nurses with chronic back pain.

PubMed

Movahedi, Maryam; Ghafari, Somayeh; Nazari, Fateme; Valiani, Mahboubeh

2017-08-01

To investigate the effect of acupressure on fatigue among female nurses with chronic back pain. Chronic back pain is one of the most common problems among nurses and has numerous physical and psychological effects. One of these effects is fatigue that impairs an individual's life. This randomized single-blind clinical trial was conducted on 50 nurses with chronic back pain working at the selected hospitals in Isfahan, Iran. After convenient sampling, the subjects were randomly allocated, through lottery, to the two groups of experimental (n=25) and sham (n=25). In the experimental group, acupressure techniques were performed during 9 sessions, 3 times a week for 14min for each patient. In the sham group, points within 1cm of the main points were only touched. Data were collected using the Fatigue Severity Scale (FSS), before, and immediately, 2weeks, and 4weeks after the intervention. Data analysis was performed using SPSS software. The mean score of fatigue severity before the intervention was not significantly different between the two groups (P=0.990). However, it was significantly lower in the experimental group than the sham group immediately (P<0.001), 2weeks (P=0.005), and 1month after the intervention (P<0.001). Acupressure on specific points of the foot and back improves back pain so, reduces fatigue. Therefore, acupressure can be used as a drug-free and low-cost approach without side effects to improve fatigue in nurses with chronic back pain. Copyright © 2017. Published by Elsevier Inc.

The Interplay between Topic Shift and Focus in the Dynamic Construction of Discourse Representations.

PubMed

Yang, Xiaohong; Zhang, Xiuping; Wang, Cheng; Chang, Ruohan; Li, Weijun

2017-01-01

Previous studies have suggested that focusing an element can enhance the activation of the focused element and bring about a number of processing benefits. However, whether and how this local prominence of information interacts with global discourse organization remains unclear. In the present study, we addressed this issue in two experiments. Readers were presented with four-sentence discourses. The first sentence of each discourse contained a critical word that was either focused or unfocused in relation to a wh-question preceding the discourse. The second sentence either maintained or shifted the topic of the first sentence. Participants were told to read for comprehension and for a probe recognition task in which the memory of the critical words was tested. In Experiment 1, when the probe words were tested immediately after the point of topic shift, we found shorter response times for the focused critical words than the unfocused ones regardless of topic manipulation. However, in Experiment 2, when the probe words were tested two sentences away from the point of topic shift, we found the facilitation effect of focus only in the topic-maintained discourses, but not in the topic-shifted discourses. This suggests that the facilitation effect of focus was not immediately suppressed at the point of topic shifting, but when additional information was added to the new topic. Our findings provide evidence for the dynamic interplay between global topic structure and local salience of information and have important implications on how activation of information fluctuates in mental representation.

The Interplay between Topic Shift and Focus in the Dynamic Construction of Discourse Representations

PubMed Central

Yang, Xiaohong; Zhang, Xiuping; Wang, Cheng; Chang, Ruohan; Li, Weijun

2017-01-01

Previous studies have suggested that focusing an element can enhance the activation of the focused element and bring about a number of processing benefits. However, whether and how this local prominence of information interacts with global discourse organization remains unclear. In the present study, we addressed this issue in two experiments. Readers were presented with four-sentence discourses. The first sentence of each discourse contained a critical word that was either focused or unfocused in relation to a wh-question preceding the discourse. The second sentence either maintained or shifted the topic of the first sentence. Participants were told to read for comprehension and for a probe recognition task in which the memory of the critical words was tested. In Experiment 1, when the probe words were tested immediately after the point of topic shift, we found shorter response times for the focused critical words than the unfocused ones regardless of topic manipulation. However, in Experiment 2, when the probe words were tested two sentences away from the point of topic shift, we found the facilitation effect of focus only in the topic-maintained discourses, but not in the topic-shifted discourses. This suggests that the facilitation effect of focus was not immediately suppressed at the point of topic shifting, but when additional information was added to the new topic. Our findings provide evidence for the dynamic interplay between global topic structure and local salience of information and have important implications on how activation of information fluctuates in mental representation. PMID:29276496

Immediate effects of microsystem acupuncture in patients with oromyofacial pain and craniomandibular disorders (CMD): a double-blind, placebo-controlled trial.

PubMed

Simma, I; Gleditsch, J M; Simma, L; Piehslinger, E

2009-12-19

Patients presenting with oromyofacial disorders and pain in the head and neck area are often resistant to conventional therapy. Acupuncture has been shown to be effective in pain reduction. Twenty-three patients with craniomandibular disorders, headache and, in particular, local pain in the orofacial, cervical and temporomandibular joint areas were randomised into acupuncture or placebo laser therapy groups. Pain was assessed by a visual analogue scale (VAS) and by palpation of 14 muscles and groups of muscles immediately before and after treatment, the assessor being blinded to the patients' allocation. Applicable acupuncture points were searched and pricked using the 'very-point' technique. Pain reduction measured by VAS was significantly more pronounced after acupuncture than after placebo treatment (p=0.031). Sum of pain scores across 14 muscles was considerably more reduced after acupuncture as compared to sham laser treatment. Acupuncture may bring about immediate pain relief in patients with oromyofacial disorders, increasing the chance to initiate other therapeutic measures.

LATE EVALUATION OF DYSPHAGIA AFTER HELLER ESOPHAGEAL MYOTOMY WITH DOR FUNDOPLICATION FOR ACHALASIA.

PubMed

Câmara, Eduardo Rodrigues Zarco; Madureira, Fernando Athayde Veloso; Madureira, Delta; Salomão, Renato Manganelli; Iglesias, Antonio Carlos Ribeiro Garrido

2017-01-01

All available treatments for achalasia are palliative and aimed to eliminate the flow resistance caused by a hypertensive lower esophageal sphincter. To analyze the positive and negative prognostic factors in the improvement of dysphagia and to evaluate quality of life in patients undergoing surgery to treat esophageal achalasia by comparing findings before, immediately after, and in long follow-up. A total of 84 patients who underwent surgery for achalasia between 2001 and 2014 were retrospectively studied. The evaluation protocol with dysphagia scores compared preoperative, immediate (up to three months) postoperative and late (over one year) postoperative scores to estimate quality of life. The surgical procedure was Heller-Dor in 100% of cases, with 84 cases performed laparoscopically. The percent reduction in pre- and immediate postoperative lower esophageal sphincter pressurewas 60.35% in the success group and 32.49% in the failure group. Regarding the late postoperative period, the mean percent decrease was 60.15% in the success group and 31.4% in the failure group. The mean overall drop in dysphagia score between the pre- and immediate postoperative periods was 7.33 points, which represents a decrease of 81.17%. Reduction greater than 60% percent in lower esophageal sphincter pressurebetween the pre- and postoperative periods suggests that this metric is a predictor of good prognosis for surgical response. Surgical treatment was able to have a good affect in quality of life and drastically changed dysphagia over time.

The Effects of Group Play Therapy on Self-Concept Among 7 to 11 Year-Old Children Suffering From Thalassemia Major

PubMed Central

Tomaj, Ome Kolsoum; Estebsari, Fatemeh; Taghavi, Taraneh; Borim Nejad, Leili; Dastoorpoor, Maryam; Ghasemi, Afsaneh

2016-01-01

Background Children suffering from thalassemia have higher levels of depression and lower levels of self-concept. Objectives The aim of this study was to determine if group play therapy could significantly increase self-concept among children with thalassemia major ages 7 to 11 years old in teaching hospitals of Golestan province, Iran, in 2012. Patients and Methods In this randomized, controlled clinical trial, 60 children with thalassemia major were randomly assigned to intervention (30 children) and control (30 children) groups. The intervention included eight 45 to 60 minute sessions during four weeks, during which the intervention group received group play therapy. The control group received no interventions. Self-concept was measured three times using the Piers-Harris children’s self-concept scale: before, immediately after, and a month after the intervention. Results For the intervention group, results showed that the mean self-concept score was significantly higher at the second point in time compared to the baseline (P < 0.001), going from 60.539 to 69.908. Likewise, comparing the first and third time points, the mean score significantly increased and reached 70.611 (P < 0.001). Furthermore, changes in the mean score from the second to the third time point, though non-significant (P = 0.509), followed the trend, going from 69.908 to 70.611. For the control group, comparing the first, second, and third time points did not result in any significant change in the mean score (P > 0.05). Conclusions The results showed that group play therapy improves self-concept in children suffering from thalassemia major. PMID:27275402

78 FR 15997 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-13

... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-69058; File No. SR-NASDAQ-2013-039] Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate Effectiveness of a Proposed Rule Change To Replace the Current Mid-Point Test Applied to the Definition of Theoretical Price March 7, 2013. Pursuant to Section 19(b)(1)...

Nondiscrimination on the basis of handicap relating to health care for handicapped infants--Office of the Secretary, HHS. Proposed rules.

PubMed

1983-07-05

The notice of proposed rulemaking proposes to modify existing regulations to meet the exigent needs that can arise when a handicapped infant is discriminatorily denied food or medically indicated treatment. Several current regulatory provisions are proposed to be modified to allow timely reporting of violations, expeditious investigation, and immediate enforcement action when necessary to protect a handicapped infant whose life is endangered by discrimination in a program or activity receiving federal financial assistance. Recipients that provide health care to infants would be required to post a conspicuous notice in locations that provide such care. The notice would describe the protections under federal law against discrimination toward the handicapped, and would provide a contact point in the Department of HHS for reporting violations immediately by telephone. Notice and complaint procedures have been effective instruments for deterrence and enforcement in a variety of civil rights contexts. The Secretary believes that the proposed rule provides the best means to ensure that violations can be reported in time to save the lives of handicapped infants who are denied food or are otherwise imperiled by discrimination in the provision of health care by federally assisted programs or activities.

Measurement of flow separation in a human vocal folds model

NASA Astrophysics Data System (ADS)

Šidlof, Petr; Doaré, Olivier; Cadot, Olivier; Chaigne, Antoine

2011-07-01

The paper provides experimental data on flow separation from a model of the human vocal folds. Data were measured on a four times scaled physical model, where one vocal fold was fixed and the other oscillated due to fluid-structure interaction. The vocal folds were fabricated from silicone rubber and placed on elastic support in the wall of a transparent wind tunnel. A PIV system was used to visualize the flow fields immediately downstream of the glottis and to measure the velocity fields. From the visualizations, the position of the flow separation point was evaluated using a semiautomatic procedure and plotted for different airflow velocities. The separation point position was quantified relative to the orifice width separately for the left and right vocal folds to account for flow asymmetry. The results indicate that the flow separation point remains close to the narrowest cross-section during most of the vocal fold vibration cycle, but moves significantly further downstream shortly prior to and after glottal closure.

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2010-04-22

... the new fee schedule will continue to reward those who have been using the MatchPoint system for share... into the MatchPoint system. The proposed fee schedule, which will be effective upon filing, rewards all...Point\\SM\\ System April 15, 2010. Pursuant to Section 19(b)(1) \\1\\ of the Securities Exchange Act of 1934...

Real-time three-dimensional optical coherence tomography image-guided core-needle biopsy system.

PubMed

Kuo, Wei-Cheng; Kim, Jongsik; Shemonski, Nathan D; Chaney, Eric J; Spillman, Darold R; Boppart, Stephen A

2012-06-01

Advances in optical imaging modalities, such as optical coherence tomography (OCT), enable us to observe tissue microstructure at high resolution and in real time. Currently, core-needle biopsies are guided by external imaging modalities such as ultrasound imaging and x-ray computed tomography (CT) for breast and lung masses, respectively. These image-guided procedures are frequently limited by spatial resolution when using ultrasound imaging, or by temporal resolution (rapid real-time feedback capabilities) when using x-ray CT. One feasible approach is to perform OCT within small gauge needles to optically image tissue microstructure. However, to date, no system or core-needle device has been developed that incorporates both three-dimensional OCT imaging and tissue biopsy within the same needle for true OCT-guided core-needle biopsy. We have developed and demonstrate an integrated core-needle biopsy system that utilizes catheter-based 3-D OCT for real-time image-guidance for target tissue localization, imaging of tissue immediately prior to physical biopsy, and subsequent OCT imaging of the biopsied specimen for immediate assessment at the point-of-care. OCT images of biopsied ex vivo tumor specimens acquired during core-needle placement are correlated with corresponding histology, and computational visualization of arbitrary planes within the 3-D OCT volumes enables feedback on specimen tissue type and biopsy quality. These results demonstrate the potential for using real-time 3-D OCT for needle biopsy guidance by imaging within the needle and tissue during biopsy procedures.

Parallel, stochastic measurement of molecular surface area.

PubMed

Juba, Derek; Varshney, Amitabh

2008-08-01

Biochemists often wish to compute surface areas of proteins. A variety of algorithms have been developed for this task, but they are designed for traditional single-processor architectures. The current trend in computer hardware is towards increasingly parallel architectures for which these algorithms are not well suited. We describe a parallel, stochastic algorithm for molecular surface area computation that maps well to the emerging multi-core architectures. Our algorithm is also progressive, providing a rough estimate of surface area immediately and refining this estimate as time goes on. Furthermore, the algorithm generates points on the molecular surface which can be used for point-based rendering. We demonstrate a GPU implementation of our algorithm and show that it compares favorably with several existing molecular surface computation programs, giving fast estimates of the molecular surface area with good accuracy.

The iPad: tablet technology to support nursing and midwifery student learning: an evaluation in practice.

PubMed

Brown, Janie; McCrorie, Pamela

2015-03-01

This research explored the impact of tablet technology, in the form of Apple iPads, on undergraduate nursing and midwifery students' learning outcomes. In simulated clinical learning environments, first-year nursing students (n = 30) accessed apps and reference materials on iPads. Third-year nursing students (n = 88) referred to clinical guidelines to aid their decision making when problem solving. First-year midwifery students (n = 25) filmed themselves undertaking a skill and then immediately played back the video file. A total of 45 students completed an online questionnaire that allowed for qualitative comments. Students reported finding the use of iPads easy and that iPads provided point-of-care access to resources, ensuring an evidence-based approach to clinical decision making. iPads reportedly improved student efficiency and time management, while improving their ability to provide patient education. Students who used iPads for the purpose of formative self-assessment appreciated the immediate feedback and opportunity to develop clinical skills.

Intra-accumbal blockade of endocannabinoid CB1 receptors impairs learning but not retention of conditioned relief.

PubMed

Bergado Acosta, Jorge R; Schneider, Miriam; Fendt, Markus

2017-10-01

Humans and animals are able to associate an environmental cue with the feeling of relief from an aversive event, a phenomenon called relief learning. Relief from an aversive event is rewarding and a relief-associated cue later induces an attenuation of the startle magnitude or approach behavior. Previous studies demonstrated that the nucleus accumbens is essential for relief learning. Here, we asked whether accumbal cannabinoid type 1 (CB1) receptors are involved in relief learning. In rats, we injected the CB1 receptor antagonist/inverse agonist SR141716A (rimonabant) directly into the nucleus accumbens at different time points during a relief learning experiment. SR141716A injections immediately before the conditioning inhibited relief learning. However, SR141716A injected immediately before the retention test was not effective when conditioning was without treatment. These findings indicate that accumbal CB1 receptors play an important role in the plasticity processes underlying relief learning. Copyright © 2017 Elsevier Inc. All rights reserved.

Short- and Long-Term Lead Release after Partial Lead Service Line Replacements in a Metropolitan Water Distribution System.

PubMed

Deshommes, Elise; Laroche, Laurent; Deveau, Dominique; Nour, Shokoufeh; Prévost, Michèle

2017-09-05

Thirty-three households were monitored in a full-scale water distribution system, to investigate the impact of recent (<2 yr) or old partial lead service line replacements (PLSLRs). Total and particulate lead concentrations were measured using repeat sampling over a period of 1-20 months. Point-of-entry filters were installed to capture sporadic release of particulate lead from the lead service lines (LSLs). Mean concentrations increased immediately after PLSLRs and erratic particulate lead spikes were observed over the 18 month post-PLSLR monitoring period. The mass of lead released during this time frame indicates the occurrence of galvanic corrosion and scale destabilization. System-wide, lead concentrations were however lower in households with PLSLRs as compared to those with no replacement, especially for old PLSLRs. Nonetheless, 61% of PLSLR samples still exceeded 10 μg/L, reflecting the importance of implementing full LSL replacement and efficient risk communication. Acute concentrations measured immediately after PLSLRs demonstrate the need for appropriate flushing procedures to prevent lead poisoning.

The immediate effects of atlanto-occipital joint manipulation and suboccipital muscle inhibition technique on active mouth opening and pressure pain sensitivity over latent myofascial trigger points in the masticatory muscles.

PubMed

Oliveira-Campelo, Natalia M; Rubens-Rebelatto, José; Martí N-Vallejo, Francisco J; Alburquerque-Sendí N, Francisco; Fernández-de-Las-Peñas, César

2010-05-01

A randomized controlled trial. To investigate the immediate effects on pressure pain thresholds over latent trigger points (TrPs) in the masseter and temporalis muscles and active mouth opening following atlanto-occipital joint thrust manipulation or a soft tissue manual intervention targeted to the suboccipital muscles. Previous studies have described hypoalgesic effects of neck manipulative interventions over TrPs in the cervical musculature. There is a lack of studies analyzing these mechanisms over TrPs of muscles innervated by the trigeminal nerve. One hundred twenty-two volunteers, 31 men and 91 women, between the ages of 18 and 30 years, with latent TrPs in the masseter muscle, were randomly divided into 3 groups: a manipulative group who received an atlanto-occipital joint thrust, a soft tissue group who received an inhibition technique over the suboccipital muscles, and a control group who did not receive an intervention. Pressure pain thresholds over latent TrPs in the masseter and temporalis muscles, and active mouth opening were assessed pretreatment and 2 minutes posttreatment by a blinded assessor. Mixed-model analyses of variance (ANOVA) were used to examine the effects of interventions on each outcome, with group as the between-subjects variable and time as the within-subjects variable. The primary analysis was the group-by-time interaction. The 2-by-3 mixed-model ANOVA revealed a significant group-by-time interaction for changes in pressure pain thresholds over masseter (P<.01) and temporalis (P = .003) muscle latent TrPs and also for active mouth opening (P<.001) in favor of the manipulative and soft tissue groups. Between-group effect sizes were small. The application of an atlanto-occipital thrust manipulation or soft tissue technique targeted to the suboccipital muscles led to an immediate increase in pressure pain thresholds over latent TrPs in the masseter and temporalis muscles and an increase in maximum active mouth opening. Nevertheless, the effects of both interventions were small and future studies are required to elucidate the clinical relevance of these changes. Therapy, level 1b.J Orthop Sports Phys Ther 2010;40(5):310-317, Epub 12 April 2010. doi:10.2519/jospt.2010.3257.

Rutgers zodiacal light experiment on OSO-6

NASA Technical Reports Server (NTRS)

Carroll, B.

1975-01-01

A detector was placed in a slowly spinning wheel on OSO-6 whose axis was perpendicular to the line drawn to the sun, to measure the surface brightness and polarization at all elongations from the immediate neighborhood of the sun to the anti-solar point. Different wavelength settings and polarizations were calculated from the known order of magnitude brightness of the zodiacal light. The measuring sequence was arranged to give longer integration times for the regions of lower surface brightness. Three types of analysis to which the data on OSO-6 were subjected are outlined; (1) photometry, (2) colorimetry and (3) polarimetry.

Immunohistochemical evaluation of the heat shock response to nonablative fractional resurfacing

NASA Astrophysics Data System (ADS)

Hantash, Basil M.; Bedi, Vikramaditya P.; Struck, Steven K.; Chan, Kin F.

2010-11-01

Despite the emergence of nonablative fractional resurfacing (NFR) as a new therapeutic modality for skin photoaging, little is known about the molecular events that underlie the heat shock response to different treatment parameters. Human subjects are treated with a scanned 1550-nm fractional laser at pulse energies spanning 6 to 40 mJ and a 140-μm spot size. The heat shock response is assessed immunohistochemically immediately through 7 days posttreatment. At the immediately posttreatment time point, we observe subepidermal clefting in most sections. The basal epidermis and dermal zones of sparing are both found to express HSP47, but not HSP72. By day 1, expression of HSP72 is detected throughout the epidermis, while that of HSP47 remains restricted to the basal layer. Both proteins are detected surrounding the dermal portion of the microscopic treatment zone (MTZ). This pattern of expression persists through day 7 post-NFR, although neither protein is found within the MTZ. Immediately posttreatment, the mean collagen denaturation zone width is 50 μm at 6 mJ, increasing to 202 μm at 40 mJ. The zone of cell death exceeds the denaturation zone by 19 to 55% over this pulse energy range. The two zones converge by day 7 posttreatment.

PCI Strategies in Patients with Acute Myocardial Infarction and Cardiogenic Shock.

PubMed

Thiele, Holger; Akin, Ibrahim; Sandri, Marcus; Fuernau, Georg; de Waha, Suzanne; Meyer-Saraei, Roza; Nordbeck, Peter; Geisler, Tobias; Landmesser, Ulf; Skurk, Carsten; Fach, Andreas; Lapp, Harald; Piek, Jan J; Noc, Marko; Goslar, Tomaž; Felix, Stephan B; Maier, Lars S; Stepinska, Janina; Oldroyd, Keith; Serpytis, Pranas; Montalescot, Gilles; Barthelemy, Olivier; Huber, Kurt; Windecker, Stephan; Savonitto, Stefano; Torremante, Patrizia; Vrints, Christiaan; Schneider, Steffen; Desch, Steffen; Zeymer, Uwe

2017-12-21

In patients who have acute myocardial infarction with cardiogenic shock, early revascularization of the culprit artery by means of percutaneous coronary intervention (PCI) improves outcomes. However, the majority of patients with cardiogenic shock have multivessel disease, and whether PCI should be performed immediately for stenoses in nonculprit arteries is controversial. In this multicenter trial, we randomly assigned 706 patients who had multivessel disease, acute myocardial infarction, and cardiogenic shock to one of two initial revascularization strategies: either PCI of the culprit lesion only, with the option of staged revascularization of nonculprit lesions, or immediate multivessel PCI. The primary end point was a composite of death or severe renal failure leading to renal-replacement therapy within 30 days after randomization. Safety end points included bleeding and stroke. At 30 days, the composite primary end point of death or renal-replacement therapy had occurred in 158 of the 344 patients (45.9%) in the culprit-lesion-only PCI group and in 189 of the 341 patients (55.4%) in the multivessel PCI group (relative risk, 0.83; 95% confidence interval [CI], 0.71 to 0.96; P=0.01). The relative risk of death in the culprit-lesion-only PCI group as compared with the multivessel PCI group was 0.84 (95% CI, 0.72 to 0.98; P=0.03), and the relative risk of renal-replacement therapy was 0.71 (95% CI, 0.49 to 1.03; P=0.07). The time to hemodynamic stabilization, the risk of catecholamine therapy and the duration of such therapy, the levels of troponin T and creatine kinase, and the rates of bleeding and stroke did not differ significantly between the two groups. Among patients who had multivessel coronary artery disease and acute myocardial infarction with cardiogenic shock, the 30-day risk of a composite of death or severe renal failure leading to renal-replacement therapy was lower among those who initially underwent PCI of the culprit lesion only than among those who underwent immediate multivessel PCI. (Funded by the European Union 7th Framework Program and others; CULPRIT-SHOCK ClinicalTrials.gov number, NCT01927549 .).

Non-invasive evaluation of stable renal allograft function using point shear-wave elastography.

PubMed

Kim, Bom Jun; Kim, Chan Kyo; Park, Jung Jae

2018-01-01

To investigate the feasibility of point shear-wave elastography (SWE) in evaluating patients with stable renal allograft function who underwent protocol biopsies. 95 patients with stable renal allograft function that underwent ultrasound-guided biopsies at predefined time points (10 days or 1 year after transplantation) were enrolled. Ultrasound and point SWE examinations were performed immediately before protocol biopsies. Patients were categorized into two groups: subclinical rejection (SCR) and non-SCR. Tissue elasticity (kPa) on SWE was measured in the cortex of all renal allografts. SCR was pathologically confirmed in 34 patients. Tissue elasticity of the SCR group (31.0 kPa) was significantly greater than that of the non-SCR group (24.5 kPa) (=0.016), while resistive index value did not show a significant difference between the two groups (p = 0.112). Tissue elasticity in renal allografts demonstrated significantly moderate negative correlation with estimated glomerular filtration rate (correlation coefficient = -0.604, p < 0.001). Tissue elasticity was not independent factor for SCR prediction on multivariate analysis. As a non-invasive tool, point SWE appears feasible in distinguishing between patients with SCR and without SCR in stable functioning renal allografts. Moreover, it may demonstrate the functional state of renal allografts. Advances in knowledge: On point SWE, SCR has greater tissue elasticity than non-SCR.

A comparison of simulation-based education versus lecture-based instruction for toxicology training in emergency medicine residents.

PubMed

Maddry, Joseph K; Varney, Shawn M; Sessions, Daniel; Heard, Kennon; Thaxton, Robert E; Ganem, Victoria J; Zarzabal, Lee A; Bebarta, Vikhyat S

2014-12-01

Simulation-based teaching (SIM) is a common method for medical education. SIM exposes residents to uncommon scenarios that require critical, timely actions. SIM may be a valuable training method for critically ill poisoned patients whose diagnosis and treatment depend on key clinical findings. Our objective was to compare medical simulation (SIM) to traditional lecture-based instruction (LEC) for training emergency medicine (EM) residents in the acute management of critically ill poisoned patients. EM residents completed two pre-intervention questionnaires: (1) a 24-item multiple-choice test of four toxicological emergencies and (2) a questionnaire using a five-point Likert scale to rate the residents' comfort level in diagnosing and treating patients with specific toxicological emergencies. After completing the pre-intervention questionnaires, residents were randomized to SIM or LEC instruction. Two toxicologists and three EM physicians presented four toxicology topics to both groups in four 20-min sessions. One group was in the simulation center, and the other in a lecture hall. Each group then repeated the multiple-choice test and questionnaire immediately after instruction and again at 3 months after training. Answers were not discussed. The primary outcome was comparison of immediate mean post-intervention test scores and final scores 3 months later between SIM and LEC groups. Test score outcomes between groups were compared at each time point (pre-test, post-instruction, 3-month follow-up) using Wilcoxon rank sum test. Data were summarized by descriptive statistics. Continuous variables were characterized by means (SD) and tested using t tests or Wilcoxon rank sum. Categorical variables were summarized by frequencies (%) and compared between training groups with chi-square or Fisher's exact test. Thirty-two EM residents completed pre- and post-intervention tests and comfort questionnaires on the study day. Both groups had higher post-intervention mean test scores (p < 0.001), but the LEC group showed a greater improvement compared to the SIM group (5.6 [2.3] points vs. 3.6 [2.4], p = 0.02). At the 3-month follow-up, 24 (75 %) tests and questionnaires were completed. There was no improvement in 3-month mean test scores in either group compared to immediate post-test scores. The SIM group had higher final mean test scores than the LEC group (16.6 [3.1] vs. 13.3 [2.2], p = 0.009). SIM and LEC groups reported similar diagnosis and treatment comfort level scores at baseline and improved equally after instruction. At 3 months, there was no difference between groups in comfort level scores for diagnosis or treatment. Lecture-based teaching was more effective than simulation-based instruction immediately after intervention. At 3 months, the SIM group showed greater retention than the LEC group. Resident comfort levels for diagnosis and treatment were similar regardless of the type of education.

Efficacy of a single dose of low-level laser therapy in reducing pain, swelling, and trismus following third molar extraction surgery.

PubMed

Landucci, A; Wosny, A C; Uetanabaro, L C; Moro, A; Araujo, M R

2016-03-01

The clinical efficacy of low-level laser therapy (LLLT) for the reduction of pain, swelling, and trismus following the surgical extraction of third molars was evaluated. Mandibular third molars, with similar radiographic positions on two distinct sections, were extracted from 22 patients. Immediately after extraction from the randomly selected right or left side, LLLT was applied (study group). The same extraction procedure was performed 21 days later on the other third molar, without the application of LLLT (control group). LLLT was applied at 10 points: four intraoral in close proximity to the socket and six extraoral along the masseter muscle. Pain intensity was assessed using a visual analogue scale, swelling was measured as the distance from the tragus to the median base of the mentum, and trismus was assessed by the extent of mouth opening. Data were collected at four time points: before surgery, immediately after surgery, 48h postoperatively, and 7 days postoperatively. Compared with the control group, the study group showed significant reductions in pain, swelling, and trismus at 48h and 7 days postoperatively. In conclusion, a single dose of LLLT was effective at reducing the postoperative discomforts (pain, swelling, and trismus) associated with third molar extraction surgery. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Double-stranded RNA innate immune response activation from long-term adeno-associated virus vector transduction.

PubMed

Shao, Wenwei; Earley, Lauriel F; Chai, Zheng; Chen, Xiaojing; Sun, Junjiang; He, Ting; Deng, Meng; Hirsch, Matthew L; Ting, Jenny; Samulski, R Jude; Li, Chengwen

2018-06-21

Data from clinical trials for hemophilia B using adeno-associated virus (AAV) vectors have demonstrated decreased transgenic coagulation factor IX (hFIX) expression 6-10 weeks after administration of a high vector dose. While it is likely that capsid-specific cytotoxic T lymphocytes eliminate vector-transduced hepatocytes, thereby resulting in decreased hFIX, this observation is not intuitively consistent with restored hFIX levels following prednisone application. Although the innate immune response is immediately activated following AAV vector infection via TLR pathways, no studies exist regarding the role of the innate immune response at later time points after AAV vector transduction. Herein, activation of the innate immune response in cell lines, primary human hepatocytes, and hepatocytes in a human chimeric mouse model was observed at later time points following AAV vector transduction. Mechanistic analysis demonstrated that the double-stranded RNA (dsRNA) sensor MDA5 was necessary for innate immune response activation and that transient knockdown of MDA5, or MAVS, decreased IFN-β expression while increasing transgene production in AAV-transduced cells. These results both highlight the role of the dsRNA-triggered innate immune response in therapeutic transgene expression at later time points following AAV transduction and facilitate the execution of effective strategies to block the dsRNA innate immune response in future clinical trials.

Perceptions on the Impact of a Just-in-Time Room on Trainees and Supervising Physicians in a Pediatric Emergency Department.

PubMed

Thomas, Anita A; Uspal, Neil G; Oron, Assaf P; Klein, Eileen J

2016-12-01

Just-in-time (JIT) training refers to education occurring immediately prior to clinical encounters. An in situ JIT room in a pediatric emergency department (ED) was created for procedural education. We examined trainee self-reported JIT room use, its impact on trainee self-perception of procedural competence/confidence, and the effect its usage has on the need for intervention by supervising physicians during procedures. Cross-sectional survey study of a convenience sample of residents rotating through the ED and supervising pediatric emergency medicine physicians. Outcomes included JIT room use, trainee procedural confidence, and frequency of supervisor intervention during procedures. Thirty-one of 32 supervising physicians (97%) and 122 of 186 residents (66%) completed the survey, with 71% of trainees reporting improved confidence, and 68% reporting improved procedural skills ( P  < .05, +1.4-point average skills improvement on a 5-point Likert scale). Trainees perceived no difference among supervising physicians intervening in procedures with or without JIT room use ( P  = .30, paired difference -0.0 points). Nearly all supervisors reported improved trainee procedural confidence, and 77% reported improved trainee procedural skills after JIT room use ( P  < .05, paired difference +1.8 points); 58% of supervisors stated they intervene in procedures without trainee JIT room use, compared with 42% with JIT room use ( P  < .05, paired difference -0.4 points). Use of the JIT room led to improved trainee confidence and supervisor reports of less procedural intervention. Although it carries financial and time costs, an in situ JIT room may be important for convenient JIT training.

Perceptions on the Impact of a Just-in-Time Room on Trainees and Supervising Physicians in a Pediatric Emergency Department

PubMed Central

Thomas, Anita A.; Uspal, Neil G.; Oron, Assaf P.; Klein, Eileen J.

2016-01-01

Background  Just-in-time (JIT) training refers to education occurring immediately prior to clinical encounters. An in situ JIT room in a pediatric emergency department (ED) was created for procedural education. Objective  We examined trainee self-reported JIT room use, its impact on trainee self-perception of procedural competence/confidence, and the effect its usage has on the need for intervention by supervising physicians during procedures. Methods  Cross-sectional survey study of a convenience sample of residents rotating through the ED and supervising pediatric emergency medicine physicians. Outcomes included JIT room use, trainee procedural confidence, and frequency of supervisor intervention during procedures. Results  Thirty-one of 32 supervising physicians (97%) and 122 of 186 residents (66%) completed the survey, with 71% of trainees reporting improved confidence, and 68% reporting improved procedural skills (P < .05, +1.4-point average skills improvement on a 5-point Likert scale). Trainees perceived no difference among supervising physicians intervening in procedures with or without JIT room use (P = .30, paired difference −0.0 points). Nearly all supervisors reported improved trainee procedural confidence, and 77% reported improved trainee procedural skills after JIT room use (P < .05, paired difference +1.8 points); 58% of supervisors stated they intervene in procedures without trainee JIT room use, compared with 42% with JIT room use (P < .05, paired difference −0.4 points). Conclusions  Use of the JIT room led to improved trainee confidence and supervisor reports of less procedural intervention. Although it carries financial and time costs, an in situ JIT room may be important for convenient JIT training. PMID:28018542

A Natural Language Intelligent Tutoring System for Training Pathologists - Implementation and Evaluation

PubMed Central

El Saadawi, Gilan M.; Tseytlin, Eugene; Legowski, Elizabeth; Jukic, Drazen; Castine, Melissa; Fine, Jeffrey; Gormley, Robert; Crowley, Rebecca S.

2009-01-01

Introduction We developed and evaluated a Natural Language Interface (NLI) for an Intelligent Tutoring System (ITS) in Diagnostic Pathology. The system teaches residents to examine pathologic slides and write accurate pathology reports while providing immediate feedback on errors they make in their slide review and diagnostic reports. Residents can ask for help at any point in the case, and will receive context-specific feedback. Research Questions We evaluated (1) the performance of our natural language system, (2) the effect of the system on learning (3) the effect of feedback timing on learning gains and (4) the effect of ReportTutor on performance to self-assessment correlations. Methods The study uses a crossover 2×2 factorial design. We recruited 20 subjects from 4 academic programs. Subjects were randomly assigned to one of the four conditions - two conditions for the immediate interface, and two for the delayed interface. An expert dermatopathologist created a reference standard and 2 board certified AP/CP pathology fellows manually coded the residents' assessment reports. Subjects were given the opportunity to self grade their performance and we used a survey to determine student response to both interfaces. Results Our results show a highly significant improvement in report writing after one tutoring session with 4-fold increase in the learning gains with both interfaces but no effect of feedback timing on performance gains. Residents who used the immediate feedback interface first experienced a feature learning gain that is correlated with the number of cases they viewed. There was no correlation between performance and self-assessment in either condition. PMID:17934789

A natural language intelligent tutoring system for training pathologists: implementation and evaluation.

PubMed

El Saadawi, Gilan M; Tseytlin, Eugene; Legowski, Elizabeth; Jukic, Drazen; Castine, Melissa; Fine, Jeffrey; Gormley, Robert; Crowley, Rebecca S

2008-12-01

We developed and evaluated a Natural Language Interface (NLI) for an Intelligent Tutoring System (ITS) in Diagnostic Pathology. The system teaches residents to examine pathologic slides and write accurate pathology reports while providing immediate feedback on errors they make in their slide review and diagnostic reports. Residents can ask for help at any point in the case, and will receive context-specific feedback. We evaluated (1) the performance of our natural language system, (2) the effect of the system on learning (3) the effect of feedback timing on learning gains and (4) the effect of ReportTutor on performance to self-assessment correlations. The study uses a crossover 2 x 2 factorial design. We recruited 20 subjects from 4 academic programs. Subjects were randomly assigned to one of the four conditions--two conditions for the immediate interface, and two for the delayed interface. An expert dermatopathologist created a reference standard and 2 board certified AP/CP pathology fellows manually coded the residents' assessment reports. Subjects were given the opportunity to self grade their performance and we used a survey to determine student response to both interfaces. Our results show a highly significant improvement in report writing after one tutoring session with 4-fold increase in the learning gains with both interfaces but no effect of feedback timing on performance gains. Residents who used the immediate feedback interface first experienced a feature learning gain that is correlated with the number of cases they viewed. There was no correlation between performance and self-assessment in either condition.

No Effect of Exercise Intensity on Appetite in Highly-Trained Endurance Women

PubMed Central

Howe, Stephanie M.; Hand, Taryn M.; Larson-Meyer, D. Enette; Austin, Kathleen J.; Alexander, Brenda M.; Manore, Melinda M.

2016-01-01

In endurance-trained men, an acute bout of exercise is shown to suppress post-exercise appetite, yet limited research has examined this response in women. The purpose of this study was to investigate the effect of exercise intensity on appetite and gut hormone responses in endurance-trained women. Highly-trained women (n = 15, 18–40 years, 58.4 ± 6.4 kg, VO2MAX = 55.2 ± 4.3 mL/kg/min) completed isocaloric bouts (500 kcals or 2093 kJ) of moderate-intensity (MIE, 60% VO2MAX) and high-intensity (HIE, 85% VO2MAX) treadmill running at the same time of day, following a similar 48-h diet/exercise period, and at least 1-week apart. Blood was drawn pre-exercise (baseline), immediately post-exercise and every 20-min for the next 60-min. Plasma concentrations of acylated ghrelin, PYY3–36, GLP-1 and subjective appetite ratings via visual analog scale (VAS) were assessed at each time point. Acylated ghrelin decreased (p = 0.014) and PYY3–36 and GLP-1 increased (p = 0.036, p < 0.0001) immediately post-exercise, indicating appetite suppression. VAS ratings of hunger and desire to eat decreased immediately post-exercise (p = 0.0012, p = 0.0031, respectively), also indicating appetite suppression. There were no differences between exercise intensities for appetite hormones or VAS. Similar to males, post-exercise appetite regulatory hormones were altered toward suppression in highly-trained women and independent of energy cost of exercise. Results are important for female athletes striving to optimize nutrition for endurance performance. PMID:27096869

Coordination and Interpretation of Vocal and Visible Resources: "Trail-Off" Conjunctions

ERIC Educational Resources Information Center

Walker, Gareth

2012-01-01

The empirical focus of this paper is a conversational turn-taking phenomenon in which conjunctions produced immediately after a point of possible syntactic and pragmatic completion are treated by co-participants as points of possible completion and transition relevance. The data for this study are audio-video recordings of 5 unscripted…

ACUTE EFFECTS OF DIFFERENT ANTERIOR THIGH SELF-MASSAGE ON HIP RANGE-OF-MOTION IN TRAINED MEN.

PubMed

Monteiro, Estêvão Rios; Vigotsky, Andrew D; Novaes, Jefferson da Silva; Škarabot, Jakob

2018-02-01

Self-massage is a ubiquitous intervention similar to massage, but performed by the recipient him- or herself rather than by a therapist, most often using a tool (e.g., foam roller, roller massager). Self-massage has been found to have a wide range of effects. It is particularly known for increasing flexibility acutely, although not always. The variability of the results in previous studies may potentially be a function of the tool used. Recent findings also suggest that self-massage exerts global effects. Therefore, increased flexibility should be expected in the areas adjacent to the ones treated. To investigate the acute effects of foam rolling and rolling massage of anterior thigh on hip range-of-motion (ROM) - i.e., hip extension and hip flexion - in trained men. Eighteen recreationally active, resistance trained males visited the lab on two occasions over a 4-day period separated by at least a day. Each session included two baseline ROM measures of passive hip flexion and extension taken in a randomized fashion. Recording of baseline measures was followed by the intervention of the day, which was either foam rolling or rolling massage of the anterior thigh as per randomization. Immediately post intervention, passive hip flexion and hip extension ROM were reassessed. In order to assess the time course of improvements in ROM, hip flexion and hip extension ROM were reevaluated at 10, 20, and 30 minutes post-intervention. Hip flexion and hip extension ROM increased immediately following both interventions (foam rolling or roller massager) and remained increased for 30 minutes post intervention. Foam rolling was statistically superior in improving hip flexion and hip extension ROM immediately post intervention. However, immediately post-intervention was the only time point that measurements exceeded the minimum detectable change for both interventions. Both foam rolling and rolling massage appear to be effective interventions for improving hip flexion and extension ROM when applied to the anterior thigh, but the observed effects are transient in nature. 2b.

Biopsy and selective recall compared with immediate large loop excision in management of women with low grade abnormal cervical cytology referred for colposcopy: multicentre randomised controlled trial.

PubMed

2009-07-28

To compare the effectiveness of punch biopsy and selective recall for treatment versus a policy of immediate treatment by large loop excision in the management of women with low grade abnormal cervical cytology referred for colposcopy. Multicentre individually randomised controlled trial, nested within the NHS cervical screening programmes. Grampian, Tayside, and Nottingham. 1983 women, aged 20-59, with cytology showing borderline nuclear abnormalities or mild dyskaryosis, October 1999-October 2002. Immediate large loop excision or up to four targeted punch biopsies taken immediately with recall for treatment (by large loop excision) if these showed cervical intraepithelial neoplasia grade II or III or worse. Participants were followed for three years, concluding with an exit colposcopy. Clinical end points: cumulative incidence of cervical intraepithelial neoplasia grade II or worse and grade III or worse at three years. Clinically significant anxiety and depression and self reported after effects assessed six weeks after colposcopy, biopsies, or large loop excision. 879 women (44%) had a normal transformation zone at colposcopy and had no further procedures at that time. Colposcopists were less likely to classify the transformation zone as abnormal when the allocation was large loop excision (603 (60%) in the biopsy and selective recall group; 501 (51%) in the immediate large loop excision group). Of women randomised to biopsy and recall, 157 (16%) required a second clinic visit for treatment. Specimens from almost 60% (n=296) of women who underwent immediate large loop excision showed no cervical intraepithelial neoplasia (31%; n=156) or showed cervical intraepithelial neoplasia grade I (28%; n=140). The percentages of women diagnosed with grade II or worse up to and including the exit examination were 22% (n=216) in the biopsy and recall arm and 23% (n=228) in the immediate large loop excision arm. There was no significant difference between the arms in cumulative incidence of cervical intraepithelial neoplasia grade II or worse (adjusted relative for risk large loop excision v biopsy 1.04, 95% confidence interval 0.86 to 1.25) or grade III or worse (1.03, 0.79 to 1.34). A greater proportion of disease was detected at initial investigation and less during follow-up and at exit in the immediate large loop excision arm, but time of detection did not differ significantly between arms. Levels of anxiety and depression and reported pain did not differ between arms. Higher proportions of women randomised to large loop excision reported moderate or more severe bleeding and discharge. A policy of targeted punch biopsies with subsequent treatment for cervical intraepithelial neoplasia grade II or III and cytological surveillance for grade I or less provides the best balance between benefits and harms for the management of women with low grade abnormal cytology referred for colposcopy. Immediate large loop excision results in overtreatment and more after effects and should not be recommended. ISRCTN 34841617.

Effects of beta-adrenergic antagonist, propranolol on spatial memory and exploratory behavior in mice.

PubMed

Sun, Huaying; Mao, Yu; Wang, Jianhong; Ma, Yuanye

2011-07-08

The beta-adrenergic system has been suggested to be involved in novelty detection and memory modulation. The present study aimed to investigate the role of beta-adrenergic receptors on novelty-based spatial recognition memory and exploratory behavior in mice using Y-maze test and open-field respectively. Mice were injected with three doses of beta-adrenergic receptor antagonist, propranolol (2, 10 and 20 mg/kg) or saline at three different time points (15 min prior to training, immediately after training and 15 min before test). The results showed that higher doses of propranolol (10 and 20 mg/kg) given before the training trial impaired spatial recognition memory while those injected at other two time points did not. A detailed analysis of exploratory behavior in open-field showed that lower dose (2 mg/kg) of propranolol reduced exploratory behavior of mice. Our findings indicate that higher dose of propranolol can impair acquisition of spatial information in the Y-maze without altering locomotion, suggesting that the beta-adrenergic system may be involved in modulating memory processes at the time of learning. Copyright © 2011. Published by Elsevier Ireland Ltd.

Impacts of the phenylpyrazole insecticide fipronil on larval fish: time-series gene transcription responses in fathead minnow (Pimephales promelas) following short-term exposure.

PubMed

Beggel, Sebastian; Werner, Inge; Connon, Richard E; Geist, Juergen P

2012-06-01

The utilization of molecular endpoints in ecotoxicology can provide rapid and valuable information on immediate organismal responses to chemical stressors and is increasingly used for mechanistic interpretation of effects at higher levels of biological organization. This study contributes knowledge on the sublethal effects of a commonly used insecticide, the phenylpyrazole fipronil, on larval fathead minnow (Pimephales promelas), utilizing a quantitative transcriptomic approach. Immediately after 24h of exposure to fipronil concentrations of ≥31 μg.L(-1), highly significant changes in gene transcription were observed for aspartoacylase, metallothionein, glucocorticoid receptor, cytochrome P450 3A126 and vitellogenin. Different mechanisms of toxicity were apparent over the course of the experiment, with short-term responses indicating neurotoxic effects. After 6 days of recovery, endocrine effects were observed with vitellogenin being up-regulated 90-fold at 61 μg.L(-1) fipronil. Principal component analysis demonstrated a significant increase in gene transcription changes over time and during the recovery period. In conclusion, multiple mechanisms of action were observed in response to fipronil exposure, and unknown delayed effects would have been missed if transcriptomic responses had only been measured at a single time-point. These challenges can be overcome by the inclusion of multiple endpoints and delayed effects in experimental designs. Copyright © 2012 Elsevier B.V. All rights reserved.

Osteophyte formation after ACL rupture in mice is associated with joint restabilization and loss of range of motion

PubMed Central

Hsia, Allison W.; Anderson, Matthew J.; Heffner, Mollie A.; Lagmay, Earl P.; Zavodovskaya, Regina; Christiansen, Blaine A.

2016-01-01

Osteophytes are a typical radiographic finding during osteoarthritis (OA). Osteophytes are thought to form in response to joint instability, however the time course of osteophyte formation and joint stabilization following joint injury is not well understood. In this study, we investigated the time course of osteophyte formation and joint function following non-invasive knee injury in mice. We hypothesized that initial joint instability following knee injury would initiate osteophyte formation, which would in turn restabilize the joint and reduce range of motion (ROM). Mice were subjected to non-invasive anterior cruciate ligament (ACL) rupture. Anterior-posterior (AP) joint laxity, ROM, and chondro/osteophyte formation were measured immediately after injury, and 2, 4, 6, and 8 weeks post-injury. Chondrophyte areas at each time point were measured with histology, while mineralized osteophyte volume was determined using micro-computed tomography. Immediately after ACL rupture, AP joint laxity was increased 2-fold, while ROM was increased 11.7%. Chondrophytes appeared by 2 weeks post-injury, corresponding with a decrease in AP joint laxity and ROM. By 8 weeks post-injury, considerable osteophyte formation was observed around the joint, AP joint laxity returned to control levels, and joint ROM decreased to 61% of control values. These data support a role for chondro/osteophytes in joint restabilization after injury, and provide crucial insight into the time course and pathology of joint degeneration during OA development in the mouse. PMID:27031945

Long-term psychosocial impact of alternative management policies in women with low-grade abnormal cervical cytology referred for colposcopy: a randomised controlled trial.

PubMed

Sharp, L; Cotton, S; Gray, N; Avis, M; Russell, I; Walker, L; Waugh, N; Whynes, D; Woolley, C; Thornton, A; Smart, L; Cruickshank, M; Little, J

2011-01-18

The debate continues regarding the best management for women with low-grade abnormal cervical cytology attending colposcopy. We compared psychosocial outcomes of alternative management policies in these women. In all, 989 women, aged 20-59 years, with low-grade abnormal cytology, were randomised to immediate large loop excision (LLETZ) or two to four targeted punch biopsies taken immediately with recall for LLETZ if these showed cervical intra-epithelial neoplasia 2/3. At 6 weeks after the last procedure, women completed the hospital anxiety and depression scale (HADS) and the impact of event scale (IES). At 12, 18, 24 and 30 months post recruitment, women completed the HADS and process outcome specific measure (POSM). Prevalence of significant depression (≥ 8), significant anxiety (≥ 11) and distress (≥ 9) and median POSM scores were compared between arms. Multivariate odds ratios (ORs) for immediate LLETZ vs biopsy and recall were computed. Over the entire follow-up, there was no significant difference between arms in cumulative prevalence or risk of significant depression (OR=0.78, 95% CI 0.52-1.17) or significant anxiety (OR=0.83, 95% CI 0.57-1.19). At 6 weeks post procedure, distress did not differ significantly between arms. At later time points, 8-11% had significant depression and 14-16% had significant anxiety but with no differences between arms. The POSM scores did not differ between the arms. There is no difference in long- or short-term psychosocial outcomes of immediate LLETZ and punch biopsies with selective recall.

Immediate postpartum mood assessment and postpartum depressive symptoms.

PubMed

Miller, Michelle L; Kroska, Emily B; Grekin, Rebecca

2017-01-01

Negative affect (NA) and positive affect (PA) in the early postpartum period have been associated with postpartum depressive symptoms, but the exact relationship is not well understood. This study aimed to determine if NA and PA in the immediate postpartum period predicted postpartum depressive symptoms over and above well-established predictors (previous trauma, history of depression). Participants were prospectively recruited from a Mother-Baby Unit at a large Midwestern academic medical center in the United States from April 2011 to April 2014. Participants (N=526) completed the Daily Experiences Questionnaire (DEQ), a self-report measure which assessed NA and PA, within three days post-delivery. Participants then reported their depressive symptoms at two weeks (n=364) and twelve weeks postpartum (n=271). Hierarchical regression analyses indicated that low PA and high NA after birth significantly predicted depressive symptoms early (at 2 weeks) and later (at 12 weeks) in the postpartum period, over and above previous traumatic experiences and history of depression. The sample was relatively homogenous, and data were from self-report instruments. The current study found NA and PA in the days immediately after birth predicted depressive symptoms at multiple time points in the postpartum period. Because the perinatal period places women at a higher risk for depressive symptomatology, prevention and early intervention are critical. Measuring affect in hospitals immediately after birth may provide a more normalized set of items that is predictive of later depression, which will allow physicians to identify those at highest risk for developing depressive symptoms. Copyright © 2016 Elsevier B.V. All rights reserved.

Immediate Postpartum Mood Assessment and Postpartum Depressive Symptoms

PubMed Central

Miller, Michelle L.; Kroska, Emily B.; Grekin, Rebecca

2016-01-01

Background Negative affect (NA) and positive affect (PA) in the early postpartum period have been associated with postpartum depressive symptoms, but the exact relationship is not well understood. This study aimed to determine if NA and PA in the immediate postpartum period predicted postpartum depressive symptoms over and above well-established predictors (previous trauma, history of depression). Methods Participants were prospectively recruited from a Mother-Baby Unit at a large Midwestern academic medical center in the United States from April 2011 to April 2014. Participants (N = 526) completed the Daily Experiences Questionnaire (DEQ), a self-report measure which assessed NA and PA, within three days post-delivery. Participants then reported their depressive symptoms at two weeks (n = 364) and twelve weeks postpartum (n = 271). Results Hierarchical regression analyses indicated that low PA and high NA after birth significantly predicted depressive symptoms early (at 2 weeks) and later (at 12 weeks) in the postpartum period, over and above previous traumatic experiences and history of depression. Limitations The sample was relatively homogenous, and data were from self-report instruments. Conclusions The current study found NA and PA in the days immediately after birth predicted depressive symptoms at multiple time points in the postpartum period. Because the perinatal period places women at a higher risk for depressive symptomatology, prevention and early intervention are critical. Measuring affect in hospitals immediately after birth may provide a more normalized set of items that is predictive of later depression, which will allow physicians to identify those at highest risk for developing depressive symptoms. PMID:27716540

Prospective computerized analyses of sensibility in breast reconstruction with non-reinnervated DIEP flap.

PubMed

Santanelli, Fabio; Longo, Benedetto; Angelini, Matteo; Laporta, Rosaria; Paolini, Guido

2011-05-01

The deep inferior epigastric perforator (DIEP) flap is considered the definitive standard for autologous breast reconstruction because of its ability to restore shape, its consistency, and its static and dynamic symmetry, but the degree of spontaneous sensory recovery is still widely discussed. To clarify the real need for sensitive nerve coaptation, return of sensibility in DIEP flaps was investigated using a pressure-specifying sensory device. Thirty consecutive patients with breast cancer scheduled for modified radical mastectomy, axillary node dissection, and immediate reconstruction with cutaneous-adipose DIEP flaps without nerve repair were enrolled in the study. Sensibility for one and two points, static and moving, was tested preoperatively on the breasts and abdomen, and postoperatively at 6 and 12 months on the DIEP flaps. A t test was used for comparison of paired data and to investigate which factors affected sensory recovery. Preoperative healthy breast and abdomen pressure thresholds were lower for two-point than one-point discrimination and for moving discriminations compared with static ones at 6 and 12 months. Although they were significantly higher than those for contralateral healthy breasts (p < 0.05), pressure thresholds in DIEP flaps at 12 months were lower than at 6 months, showing a significant progressive sensory recovery (p < 0.05). At 12 months postoperatively, the best sensibility recovery was found at the inferior lateral quadrant, the worst at the superior medial quadrant. Age and flap weight were factors related to the performance of sensory recovery. DIEP flap transfer for immediate breast reconstruction undergoes satisfactory progressive spontaneous sensitive recovery at 6 and 12 months after surgery, and operative time spent dissecting sensitive perforator branches and their coaptation in recipient site could be spared.

Triggering Factor of Strong Earthquakes and Its Prediction Verification

NASA Astrophysics Data System (ADS)

Ren, Z. Q.; Ren, S. H.

After 30 yearsS research, we have found that great earthquakes are triggered by tide- generation force of the moon. ItSs not the tide-generation force in classical view- points, but is a non-classical viewpoint tide-generation force. We call it as TGFR (Tide-Generation ForcesS Resonance). TGFR strongly depends on the tide-generation force at time of the strange astronomical points (SAP). The SAP mostly are when the moon and another celestial body are arranged with the earth along a straight line (with the same apparent right ascension or 180o difference), the other SAP are the turning points of the moonSs relatively motion to the earth. Moreover, TGFR have four different types effective areas. Our study indicates that a majority of earthquakes are triggering by the rare superimposition of TGFRsS effective areas. In China the great earthquakes in the plain area of Hebei Province, Taiwan, Yunnan Province and Sichuan province are trigger by the decompression TGFR; Other earthquakes are trig- gered by compression TGFR which are in Gansu Province, Ningxia Provinces and northwest direction of Beijing. The great earthquakes in Japan, California, southeast of Europe also are triggered by compression of the TGFR. and in the other part of the world like in Philippines, Central America countries, and West Asia, great earthquakes are triggered by decompression TGFR. We have carried out examinational immediate prediction cooperate TGFR method with other earthquake impending signals such as suggested by Professor Li Junzhi. The successful ratio is about 40%(from our fore- cast reports to the China Seismological Administration). Thus we could say the great earthquake can be predicted (include immediate earthquake prediction). Key words: imminent prediction; triggering factor; TGFR (Tide-Generation ForcesS Resonance); TGFR compression; TGFR compression zone; TGFR decompression; TGFR decom- pression zone

Can aviation-based team training elicit sustainable behavioral change?

PubMed

Sax, Harry C; Browne, Patrick; Mayewski, Raymond J; Panzer, Robert J; Hittner, Kathleen C; Burke, Rebecca L; Coletta, Sandra

2009-12-01

To quantify effects of aviation-based crew resource management training on patient safety-related behaviors and perceived personal empowerment. Prospective study of checklist use, error self-reporting, and a 10-point safety empowerment survey after participation in a crew resource management training intervention. Seven hundred twenty-two-bed university hospital; 247-bed affiliated community hospital. There were 857 participants, the majority of whom were nurses (50%), followed by ancillary personnel (28%) and physicians (22%). Preoperative checklist use over time; number and type of entries on a Web-based incident reporting system; and measurement of degree of empowerment (1-5 scale) on a 10-point survey of safety attitudes and actions given prior to, immediately after, and a minimum of 2 months after training. Since 2003, 10 courses trained 857 participants in multiple disciplines. Preoperative checklist use rose (75% in 2003, 86% in 2004, 94% in 2005, 98% in 2006, and 100% in 2007). Self-initiated reports increased from 709 per quarter in 2002 to 1481 per quarter in 2008. The percentage of reports related to environment as opposed to actual events increased from 15.9% prior to training to 20.3% subsequently (P < .01). Perceived self-empowerment, creating a culture of safety, rose by an average of 0.5 point in all 10 realms immediately posttraining (mean [SD] rating, 3.0 [0.07] vs 3.5 [0.05]; P < .05). This was maintained after a minimum of 2 months. There was a trend toward a hierarchical effect with participants less comfortable confronting incompetence in a physician (mean [SD] rating, 3.1 [0.8]) than in nurses or technicians (mean [SD] rating, 3.4 [0.7] for both) (P>.05). Crew resource management programs can influence personal behaviors and empowerment. Effects may take years to be ingrained into the culture.

Towards Guided Underwater Survey Using Light Visual Odometry

NASA Astrophysics Data System (ADS)

Nawaf, M. M.; Drap, P.; Royer, J. P.; Merad, D.; Saccone, M.

2017-02-01

A light distributed visual odometry method adapted to embedded hardware platform is proposed. The aim is to guide underwater surveys in real time. We rely on image stream captured using portable stereo rig attached to the embedded system. Taken images are analyzed on the fly to assess image quality in terms of sharpness and lightness, so that immediate actions can be taken accordingly. Images are then transferred over the network to another processing unit to compute the odometry. Relying on a standard ego-motion estimation approach, we speed up points matching between image quadruplets using a low level points matching scheme relying on fast Harris operator and template matching that is invariant to illumination changes. We benefit from having the light source attached to the hardware platform to estimate a priori rough depth belief following light divergence over distance low. The rough depth is used to limit points correspondence search zone as it linearly depends on disparity. A stochastic relative bundle adjustment is applied to minimize re-projection errors. The evaluation of the proposed method demonstrates the gain in terms of computation time w.r.t. other approaches that use more sophisticated feature descriptors. The built system opens promising areas for further development and integration of embedded computer vision techniques.

Predicting procedural pain after ureteroscopy: does hydrodistention play a role?

PubMed Central

Gul, Zeynep; Alazem, Kareem; Li, Ina; Monga, Manoj

2016-01-01

ABSTRACT Purpose: To identify perioperative predictors of immediate pain after ureteroscopy, specifically evaluating the impact of hydrodistention from irrigation on pain. Materials and Methods: We retrospectively identified patients who underwent ureteroscopy for the treatment of calculi. Data recorded for these patients included their maximum pain score in the post-anesthesia care unit (PACU), average flow rate of irrigant used during the procedure, patient and stone characteristics, operative procedure, and details of patients' immediate, post-operative course. Spearman's rho was used to determine the relationship between non-parametric, continuous variables. Then, a linear regression was performed to assess which variables could predict the peak pain score. Results: A total of 131 patients were included in the study. A non-parametric correlation analysis revealed that maximum pain score was negatively correlated with being male (r = −0.18, p=0.04), age (r = −0.34, p<0.001), and post-op foley placement (r = −0.20, p=0.02) but positively correlated with the preoperative pain score (r = 0.41, p<0.001), time in the PACU (r = 0.19, p = 0.03), and the morphine equivalent dose (MED) of narcotics administered in the PACU (r = 0.67, p<0.001). On linear regression, the significant variables were age, preoperative pain score, and stent placement. For every ten-year increase in age post-operative pain score decreased by 4/10 of a point (p = 0.03). For every 1 point increase in preoperative pain score there was a 3/10 of a point increase in the maximum pain score (p = 0.01), and leaving a stent in place post-operatively was associated with a 1.6 point increase in the maximum pain score. Conclusions: Hydrodistention does not play a role in post-ureteroscopy pain. Patients who are younger, have higher preoperative pain scores, or who are stented will experience more post-operative pain after ureteroscopy. PMID:27564284

Petroleum geochemistry of oils and rocks in Arctic National Wildlife Refuge, Alaska

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

Magoon, L.B.; Anders, D.E.

1987-05-01

Thirteen oil seeps or oil-stained outcrops in or adjacent to the coastal plain of the Arctic National Wildlife Refuge (ANWR) in northeastern Alaska indicate that commercial quantities of hydrocarbons may be present in the subsurface. The area is flanked by two important petroleum provinces: the Prudhoe Bay area on the west and the Mackenzie delta on the east. Organic carbon content (wt. %), organic matter type, and pyrolysis hydrocarbon yield show that rock units such as the Kingak Shale (average 1.3 wt. %), pebble shale unit (2.1 wt. %), and Canning Formation (1.9 wt. %) contain predominantly type III organicmore » matter. The exception is the Hue Shale (5.9 wt. %), which contains type II organic matter. Pre-Cretaceous rocks that crop out in the Brooks Range could not be adequately evaluated because of high thermal maturity. Thermal maturity thresholds for oil, condensate, and gas calculated from vitrinite reflectance gradients in the Point Thomson area are 4000, 7300, and 9330 m, respectively (12,000, 22,500, and 28,000 ft). Time-temperature index (TTI) calculations for the Beli-1 and Point Thomson-1 wells immediately west of ANWR indicate that maturity first occurred in the south and progressed north. The Cretaceous Hue Shale matured in the Beli-1 well during the Eocene and in the Point Thomson-1 well in the late Miocene to early Pliocene. In the Point Thomson area, the condensate and gas recovered from the Thomson sandstone and basement complex based on API gravity and gas/oil ratio (GOR) probably originated from the pebble shale unit, and on the same basis, the oil recovered from the Canning Formation probably originated from the Hue Shale. The gas recovered from the three wells in the Kavik area is probably thermal gas from overmature source rocks in the immediate area.« less

The Effect of the Younger Dryas on Paleoindian Occupations in Eastern North America Evidence from Artifactual, Pollen, and Radiocarbon Records

NASA Astrophysics Data System (ADS)

Anderson, D. G.; Meeks, S. C.; Miller, D. S.; Yerka, S. J.; Gillam, J. C.; Goodyear, A. C.; Johanson, E. N.; West, A.

2008-12-01

The Younger Dryas appears to have been a period when human populations in Eastern North America were undergoing significant stress. Attribute and locational data on Paleoindian materials from across the continent is available from the Paleoindian Database of the Americas or PIDBA, available on-line at http://pidba.utk.edu. Tallying the diagnostic projectile point sample from PIDBA in the on-line "entire sample" dated 24 April 2008, suggests that a population decline followed by a rebound may have occurred, particularly in southeastern North America. Following Clovis, fluted points with deeply indented bases and short to full flutes occur in many areas, such as the Redstone, Barnes, Cumberland, and Folsom types. In southeastern North America, these are thought to have been replaced by unfluted lanceolate and waisted forms, including the Beaver Lake, Suwannee/Simpson, and Quad types, which are in turn replaced by Dalton forms. Within the Southeast, a significant decline occurs between Clovis (N=1993 points) and presumably immediate post-Clovis full fluted forms (N=947 points). This may correspond to a similar decline in population, assuming the point types occurred for comparable periods of time, and were used in a similar fashion. Goodyear noted a similar pattern between Clovis (n=179) and presumed immediate post-Clovis Redstone (n=40) forms in South Carolina. Comparable declines have also been observed in North Carolina by Daniel and Goodyear ( and in Virginia by MacAvoy. In the PIDBA database across the Southeast, projectile point numbers increase following the immediate post Clovis decline, from 947 full fluted to 1717 unfluted and then 2594 Dalton points. The increase in the latter part of the Younger Dryas may actually be even more pronounced, since Dalton points, which are quite widespread, are only systematically recorded in a few states. Radiocarbon dates from Paleoindian and Early Archaic assemblages reveal a similar pattern. Dates falling in the initial centuries of the Younger Dryas are decidedly uncommon in the Southeast and over the larger region. In a sample of 218 dates from the Southeast and adjoining areas, only seven fall between 10,900 and 10,570 14C yr BP or between ca. 12,850 and 12,600 cal yr BP, and all of these are at the recent end of this range, between 10,570 and 10,710 14C yr BP. In the Southeast, at least, there appears to be a ca. 250-300 year 'gap' in the distribution of radiocarbon dates, with few reported from ca. 12,900-12,600 cal yr BP. Finally, analyses of fossil pollen records from the southeastern United States, although admittedly few in number, indicate that major vegetational shifts, both abrupt and characterized by oscillations, were occurring across the region during the Pleistocene/Holocene transition and that these shifts appear to be synchronic or quasi-synchronic with the Younger Dryas. The results suggests that the earliest inhabitants in the southeastern United States were faced with an environment that was anything but stable.

Delimiting regulatory sequences of the Drosophila melanogaster Ddc gene.

PubMed Central

Hirsh, J; Morgan, B A; Scholnick, S B

1986-01-01

We delimited sequences necessary for in vivo expression of the Drosophila melanogaster dopa decarboxylase gene Ddc. The expression of in vitro-altered genes was assayed following germ line integration via P-element vectors. Sequences between -209 and -24 were necessary for normally regulated expression, although genes lacking these sequences could be expressed at 10 to 50% of wild-type levels at specific developmental times. These genes showed components of normal developmental expression, which suggests that they retain some regulatory elements. All Ddc genes lacking the normal immediate 5'-flanking sequences were grossly deficient in larval central nervous system expression. Thus, this upstream region must contain at least one element necessary for this expression. A mutated Ddc gene without a normal TATA boxlike sequence used the normal RNA start points, indicating that this sequences is not required for start point specificity. Images PMID:3099170

Simulation of the Francis-99 Hydro Turbine During Steady and Transient Operation

NASA Astrophysics Data System (ADS)

Dewan, Yuvraj; Custer, Chad; Ivashchenko, Artem

2017-01-01

Numerical simulation of the Francis-99 hydroturbine with correlation to experimental measurements are presented. Steady operation of the hydroturbine is analyzed at three operating conditions: the best efficiency point (BEP), high load (HL), and part load (PL). It is shown that global quantities such as net head, discharge and efficiency are well predicted. Additionally, time-averaged velocity predictions compare well with PIV measurements obtained in the draft tube immediately downstream of the runner. Differences in vortex rope structure between operating points are discussed. Unsteady operation of the hydroturbine from BEP to HL and from BEP to PL are modeled. It is shown that simulation methods used to model the steady operation produce predictions that correlate well with experiment for transient operation. Time-domain unsteady simulation is used for both steady and unsteady operation. The full-fidelity geometry including all components is meshed using an unstructured polyhedral mesh with body-fitted prism layers. Guide vane rotation for transient operation is imposed using fully-conservative, computationally efficient mesh morphing. The commercial solver STAR-CCM+ is used for all portions of the analysis including meshing, solving and post-processing.

Adult Spinal Deformity Patients Recall Fewer Than 50% of the Risks Discussed in the Informed Consent Process Preoperatively and the Recall Rate Worsens Significantly in the Postoperative Period.

PubMed

Saigal, Rajiv; Clark, Aaron J; Scheer, Justin K; Smith, Justin S; Bess, Shay; Mummaneni, Praveen V; McCarthy, Ian M; Hart, Robert A; Kebaish, Khaled M; Klineberg, Eric O; Deviren, Vedat; Schwab, Frank; Shaffrey, Christopher I; Ames, Christopher P

2015-07-15

Recall of the informed consent process in patients undergoing adult spinal deformity surgery and their family members was investigated prospectively. To quantify the percentage recall of the most common complications discussed during the informed consent process in adult spinal deformity surgery, assess for differences between patients and family members, and correlate with mental status. Given high rates of complications in adult spinal deformity surgery, it is critical to shared decision making that patients are adequately informed about risks and are able to recall preoperative discussion of possible complications to mitigate medical legal risk. Patients undergoing adult spinal deformity surgery underwent an augmented informed consent process involving both verbal and video explanations. Recall of the 11 most common complications was scored. Mental status was assessed with the mini-mental status examination-brief version. Patients subjectively scored the informed consent process and video. After surgery, the recall test and mini-mental status examination-brief version were readministered at 5 additional time points: hospital discharge, 6 to 8 weeks, 3 months, 6 months, and 1 year postoperatively. Family members were assessed at the first 3 time points for comparison. Fifty-six patients enrolled. Despite ranking the consent process as important (median overall score: 10/10; video score: 9/10), median patient recall was only 45% immediately after discussion and video re-enforcement and subsequently declined to 18% at 6 to 8 weeks and 1 year postoperatively. Median family recall trended higher at 55% immediately and 36% at 6 to 8 weeks postoperatively. The perception of the severity of complications significantly differs between patient and surgeon. Mental status scores showed a transient, significant decrease from preoperation to discharge but were significantly higher at 1 year. Despite being well-informed in an optimized informed consent process, patients cannot recall most surgical risks discussed and recall declines over time. Significant progress remains to improve informed consent retention. 3.

Fluid intake, hydration, work physiology of wildfire fighters working in the heat over consecutive days.

PubMed

Raines, Jenni; Snow, Rodney; Nichols, David; Aisbett, Brad

2015-06-01

(i) To evaluate firefighters' pre- and post-shift hydration status across two shifts of wildfire suppression work in hot weather conditions. (ii) To document firefighters' fluid intake during and between two shifts of wildfire suppression work. (iii) To compare firefighters' heart rate, activity, rating of perceived exertion (RPE), and core temperature across the two consecutive shifts of wildfire suppression work. Across two consecutive days, 12 salaried firefighters' hydration status was measured immediately pre- and post-shift. Hydration status was also measured 2h post-shift. RPE was also measured immediately post-shift on each day. Work activity, heart rate, and core temperature were logged continuously during each shift. Ten firefighters also manually recorded their food and fluid intake before, during, and after both fireground shifts. Firefighters were not euhydrated at all measurement points on Day one (292±1 mOsm l(-1)) and euhydrated across these same time points on Day two (289±0.5 mOsm l(-1)). Fluid consumption following firefighters' shift on Day one (1792±1134ml) trended (P = 0.08) higher than Day two (1108±1142ml). Daily total fluid intake was not different (P = 0.27), averaging 6443±1941ml across both days. Core temperature and the time spent ≥ 70%HRmax were both elevated on Day one (when firefighters were not euhydrated). Firefighters' work activity profile was not different between both days of work. There was no difference in firefighters' pre- to post-shift hydration within each shift, suggesting ad libitum drinking was at least sufficient to maintain pre-shift hydration status, even in hot conditions. Firefighters' relative hypohydration on Day one (despite a slightly lower ambient temperature) may have been associated with elevations in core temperature, more time in the higher heart rate zones, and 'post-shift' RPE. © The Author 2015. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

Implementation of HbA1c Point of Care Testing in 3 German Medical Practices: Impact on Workflow and Physician, Staff, and Patient Satisfaction.

PubMed

Patzer, Karl-Heinz; Ardjomand, Payam; Göhring, Katharina; Klempt, Guido; Patzelt, Andreas; Redzich, Markus; Zebrowski, Mathias; Emmerich, Susanne; Schnell, Oliver

2018-05-01

Medical practices face challenges of time and cost pressures with scarce resources. Point-of-care testing (POCT) has the potential to accelerate processes compared to central laboratory testing and can increase satisfaction of physicians, staff members, and patients. The objective of this study was to evaluate the effects of introducing HbA1c POCT in practices specialized in diabetes. Three German practices that manage 400, 550, and 950 diabetes patients per year participated in this evaluation. The workflow and required time before and after POCT implementation (device: Alere Afinion AS100 Analyzer) was evaluated in each practice. Physician (n = 5), staff (n = 9), and patient (n = 298) satisfaction was assessed with questionnaires and interviews. After POCT implementation the number of required visits scheduled was reduced by 80% (88% vs 17.6%, P < .0001), the number of venous blood collections by 75% (91% vs 23%, P < .0001). Of patients, 82% (vs 13% prior to POCT implementation) were able to discuss their HbA1c values with treating physicians immediately during their first visit ( P < .0001). In two of the practices the POCT process resulted in significant time savings of approximately 20 and 22 working days per 1000 patients per year (95% CI 2-46; 95% CI 10-44). All physicians indicated that POCT HbA1c implementation improved the practice workflow and all experienced a relief of burden for the office and the patients. All staff members indicated that they found the POCT measurement easy to perform and experienced a relief of burden. The majority (61.3%) of patients found the capillary blood collection more pleasant and 83% saw an advantage in the immediate availability of HbA1c results. The implementation of HbA1c POCT leads to an improved practice workflow and increases satisfaction of physicians, staff members and patients.

The Effects of an Injury Prevention Program on Landing Biomechanics Over Time.

PubMed

DiStefano, Lindsay J; Marshall, Stephen W; Padua, Darin A; Peck, Karen Y; Beutler, Anthony I; de la Motte, Sarah J; Frank, Barnett S; Martinez, Jessica C; Cameron, Kenneth L

2016-03-01

Knowledge is limited regarding how long improvements in biomechanics remain after completion of a lower extremity injury prevention program. To evaluate the effects of an injury prevention program on movement technique and peak vertical ground-reaction forces (VGRF) over time compared with a standard warm-up (SWU) program. Controlled laboratory study. A total of 1104 incoming freshmen (age range, 17-22 years) at a military academy in the United States volunteered to participate. Participants were cluster-randomized by military company to either the Dynamic Integrated Movement Enhancement (DIME) injury prevention program or SWU. A random subsample of participants completed a standardized jump-landing task at each time point: immediately before the intervention (PRE), immediately after (POST), and 2 (POST2M), 4 (POST4M), 6 (POST6M), and 8 months (POST8M) after the intervention. VGRF data collected during the jump-landing task were normalized to body weight (%BW). The Landing Error Scoring System (LESS) was used to evaluate movement technique during the jump landing. The change scores (Δ) for each variable (LESS, VGRF) between the group's average value at PRE and each time point were calculated. Separate univariate analyses of variance were performed to evaluate group differences. The results showed a greater decrease in mean (±SD) VGRF in the DIME group compared with the SWU group at all retention time points: POST2M (SWU [Δ%BW], -0.13 ± 0.82; DIME, -0.62 ± 0.91; P = .001), POST4M (SWU, -0.15 ± 0.98; DIME,-0.46 ± 0.64; P = .04), POST6M (SWU, -0.04 ± 0.96; DIME, -0.53 ± 0.83; P = .004), and POST8M (SWU, 0.38 ± 0.95; DIME, -0.11 ± 0.98; P = .003), but there was not a significant improvement in the DIME group between PRE and POST8M (Δ%BW, -0.11 ± 0.98). No group differences in Δ LESS were observed. The study findings demonstrated that an injury prevention program performed as a warm-up can reduce vertical ground-reaction forces compared with a standard warm-up but a maintenance program is likely necessary in order for continued benefit. Injury prevention programs may need to be performed constantly, or at least every sport season, in order for participants to maintain the protective effects against injury. © 2016 The Author(s).

76 FR 9616 - Self-Regulatory Organizations; New York Stock Exchange LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-18

... Delete the Text of Rule 1500, Which Governs MatchPoint's Functionality February 11, 2011. Pursuant to... the text of Rule 1500, which governs MatchPoint's functionality. The text of the proposed rule change... the proposed rule change. The text of those statements may be examined at the places specified in Item...

78 FR 16561 - Self-Regulatory Organizations; New York Stock Exchange LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-15

... interest. Accordingly, at the $22.00 price point, both the entire amount of B4 and the remaining balance of...-side interest, Exchange systems would cancel the remaining balance of the incoming STPN order that... STPN could execute at multiple price points, the incoming STPN would execute at the multiple prices...

Longer wait times affect future use of VHA primary care.

PubMed

Wong, Edwin S; Liu, Chuan-Fen; Hernandez, Susan E; Augustine, Matthew R; Nelson, Karin; Fihn, Stephan D; Hebert, Paul L

2017-07-29

Improving access to the Veterans Health Administration (VHA) is a high priority, particularly given statutory mandates of the Veterans Access, Choice and Accountability Act. This study examined whether patient-reported wait times for VHA appointments were associated with future reliance on VHA primary care services. This observational study examined 13,595 VHA patients dually enrolled in fee-for-service Medicare. Data sources included VHA administrative data, Medicare claims and the Survey of Healthcare Experiences of Patients (SHEP). Primary care use was defined as the number of face-to-face visits from VHA and Medicare in the 12 months following SHEP completion. VHA reliance was defined as the number of VHA visits divided by total visits (VHA+Medicare). Wait times were derived from SHEP responses measuring the usual number of days to a VHA appointment with patients' primary care provider for those seeking immediate care. We defined appointment wait times categorically: 0 days, 1day, 2-3 days, 4-7 days and >7 days. We used fractional logistic regression to examine the relationship between wait times and reliance. Mean VHA reliance was 88.1% (95% CI = 86.7% to 89.5%) for patients reporting 0day waits. Compared with these patients, reliance over the subsequent year was 1.4 (p = 0.041), 2.8 (p = 0.001) and 1.6 (p = 0.014) percentage points lower for patients waiting 2-3 days, 4-7 days and >7 days, respectively. Patients reporting longer usual wait times for immediate VHA care exhibited lower future reliance on VHA primary care. Longer wait times may reduce care continuity and impact cost shifting across two federal health programs. Copyright © 2017. Published by Elsevier Inc.

Study of switching electric circuits with DC hybrid breaker, one stage

NASA Astrophysics Data System (ADS)

Niculescu, T.; Marcu, M.; Popescu, F. G.

2016-06-01

The paper presents a method of extinguishing the electric arc that occurs between the contacts of direct current breakers. The method consists of using an LC type extinguishing group to be optimally sized. From this point of view is presented a theoretical approach to the phenomena that occurs immediately after disconnecting the load and the specific diagrams are drawn. Using these, the elements extinguishing group we can choose. At the second part of the paper there is presented an analyses of the circuit switching process by decomposing the process in particular time sequences. For every time interval there was conceived a numerical simulation model in MATLAB-SIMULINK medium which integrates the characteristic differential equation and plots the capacitor voltage variation diagram and the circuit dumping current diagram.

Time-resolved laser-induced incandescence characterization of metal nanoparticles

NASA Astrophysics Data System (ADS)

Sipkens, T. A.; Singh, N. R.; Daun, K. J.

2017-01-01

This paper presents a comparative analysis of time-resolved laser-induced incandescence measurements of iron, silver, and molybdenum aerosols. Both the variation of peak temperature with fluence and the temperature decay curves strongly depend on the melting point and latent heat of vaporization of the nanoparticles. Recovered nanoparticle sizes are consistent with ex situ analysis, while thermal accommodation coefficients follow expected trends with gas molecular mass and structure. Nevertheless, there remain several unanswered questions and unexplained behaviors: the radiative properties of laser-energized iron nanoparticles do not match those of bulk molten iron; the absorption cross sections of molten iron and silver at the excitation laser wavelength exceed theoretical predictions; and there is an unexplained feature in the temperature decay of laser-energized molybdenum nanoparticles immediately following the laser pulse.

Situational Strength Cues from Social Sources at Work: Relative Importance and Mediated Effects

PubMed Central

Alaybek, Balca; Dalal, Reeshad S.; Sheng, Zitong; Morris, Alexander G.; Tomassetti, Alan J.; Holland, Samantha J.

2017-01-01

Situational strength is considered one of the most important situational forces at work because it can attenuate the personality–performance relationship. Although organizational scholars have studied the consequences of situational strength, they have paid little attention to its antecedents. To address this gap, the current study focused on situational strength cues from different social sources as antecedents of overall situational strength at work. Specifically, we examined how employees combine situational strength cues emanating from three social sources (i.e., coworkers, the immediate supervisor, and top management). Based on field theory, we hypothesized that the effect of situational strength from coworkers and immediate supervisors (i.e., proximal sources of situational strength) on employees' perceptions of overall situational strength on the job would be greater than the effect of situational strength from the top management (i.e., the distal source of situational strength). We also hypothesized that the effect of situational strength from the distal source would be mediated by the effects of situational strength from the proximal sources. Data from 363 full-time employees were collected at two time points with a cross-lagged panel design. The former hypothesis was supported for one of the two situational strength facets studied. The latter hypothesis was fully supported. PMID:28928698

Positivity effect specific to older adults with subclinical memory impairment

PubMed Central

Leal, Stephanie L.; Noche, Jessica A.; Murray, Elizabeth A.

2016-01-01

Numerous studies have suggested that older adults preferentially remember positive information (“positivity effect”), however others have reported mixed results. One potential source of conflict is that aging is not a unitary phenomenon and individual differences exist. We modified a standard neuropsychological test to vary emotional content and tested memory at three time points (immediate/20 min/1 wk). Cognitively normal older adults were stratified into those with and without subclinical memory impairment. We found that the positivity effect was limited to those with subclinical memory impairment, suggesting that consideration of subclinical memory impairment is necessary for understanding age-related emotional memory alterations. PMID:27421893

ION SOURCE FOR A CALUTRON

DOEpatents

Lofgren, E.J.

1959-04-14

This patcnt relates to calutron devices and deals particularly with the mechanism used to produce the beam of ions wherein a charge material which is a vapor at room temperature is used. A charge container located outside the tank is connected through several conduits to various points along the arc chamber of the ion source. In addition, the rate of flow of the vapor to the arc chamber is controlled by a throttle valve in each conduit. By this arrangement the arc can be regulated accurately and without appreciable time lag, inasmuch as the rate of vapor flow is immediately responsive to the manipulation of the throttle valves.

Short-term effects of instillation of a rebamipide suspension on visual function.

PubMed

Kaido, Minako; Ishida, Reiko; Dogru, Murat; Tsubota, Kazuo

2014-05-01

To investigate the short-term adverse effects of using rebamipide for the treatment of dry eye by assessing visual function and optical quality. This interventional noncomparative study included 14 right eyes of 14 healthy volunteers. Serial measurements of visual acuity (VA) and higher-order aberrations were obtained prior to instillation of the rebamipide suspension (baseline) and immediately after and at 5, 10, 20, and 30 min after instillation. Functional VA measurement was performed over a 60-s period with the subject blinking naturally. Ocular aberrations were measured for 10 s while the subject was told not to blink, but no topical anesthesia was applied. Each patient also filled out a questionnaire exploring the rebamipide-associated adverse effects. There was no significant difference between functional VA measured at baseline and at each time point after the instillation of rebamipide. In contrast, the root mean square of third-order and total higher-order aberrations increased significantly immediately after drug instillation (P<0.05). The severity of higher-order aberrations at baseline was similar to that observed at 5, 10, 20, and 30 min after instillation (P>0.05). The transient reduction in optical quality immediately after administration of rebamipide is corrected by the patient's natural blink reflex. The adverse effects observed in this study do not outweigh the benefits of rebamipide treatment.

A Randomized, Double-Blind, Placebo-Controlled Study of the Effect of a High-Potency Topical Corticosteroid After Sclerotherapy for Reticular and Telangiectatic Veins of the Lower Extremities.

PubMed

Friedmann, Daniel P; Liolios, Ana M; Wu, Douglas C; Goldman, Mitchel P; Eimpunth, Sasima

2015-10-01

Although typically mild, transient, and expected, most adverse events (AEs) postsclerotherapy are inflammatory in nature. To evaluate the effects of a high-potency topical corticosteroid (TC) applied immediately postsclerotherapy. Subjects undergoing bilateral lower extremity sclerotherapy with polidocanol had extremities randomized to a single application of betamethasone dipropionate and placebo saline solutions immediately post-treatment in a double-blind manner. Adverse events were assessed for each extremity by subjects at t = 0 (preapplication) and t = 15 (15 minutes postapplication) and by an investigator at t = 0 and t = 15, and at Days 14 and 60. Subjects and investigator evaluated efficacy with a quartile improvement scale. Sixteen female subjects completed the study. Subjects reported no statistically significant differences in AEs between TC and placebo at either t = 0 or t = 15. Investigator scores for erythema and swelling/urtication were not significantly different between groups at the same time points. Although most subjects demonstrated 26% to 75% improvement at Day 60, results were not significantly different between extremities on subject and investigator evaluation. High-potency TC application immediately postsclerotherapy produced no statistically significant differences in subject- and investigator-assessed AEs and clearance rates compared with placebo. Foam sclerotherapy with polidocanol is safe and effective for the treatment of lower extremity reticular veins.

Respiratory distress and chest pain: a perforated peptic ulcer with an unusual presentation.

PubMed

Bruner, David I; Gustafson, Corey

2011-06-22

Dyspnea and chest pain are common presenting complaints to the ED, and coupled together can present a challenging diagnostic dilemma in patients in extremis. A thoughtful evaluation is required, giving due diligence to the immediate life threats as well as multiple etiologies which can cause serious morbidity. A perforated peptic ulcer is one such possibility and requires rapid diagnosis and prompt intervention to avoid the associated high risk of morbidity and mortality. We present a case report of a 54 year old man with respiratory distress and chest pain as the initial Emergency Department presentation of a perforated duodenal ulcer. We discuss an unusual presentation of a perforated duodenal ulcer that was recognized in the emergency department and treated promptly. The patient was surgically treated immediately, had a prolonged and complicated post-operative course, but is ultimately doing well. We also provide a brief literature review of the risk factors, imaging choices, and management decision required to treat a perforated ulcer. Perforated ulcers can have highly varied presentations and are occasionally difficult to diagnose in a complicated patient. Knowledge of the risk factors and a thorough history and physical can point to the diagnosis, but timely and appropriate imaging is often required because delays in diagnosis and treatment lead to poor outcomes. Early administration of antibiotics and immediate surgical repair are necessary to limit morbidity and mortality.

Respiratory distress and chest pain: a perforated peptic ulcer with an unusual presentation

PubMed Central

2011-01-01

Background Dyspnea and chest pain are common presenting complaints to the ED, and coupled together can present a challenging diagnostic dilemma in patients in extremis. A thoughtful evaluation is required, giving due diligence to the immediate life threats as well as multiple etiologies which can cause serious morbidity. A perforated peptic ulcer is one such possibility and requires rapid diagnosis and prompt intervention to avoid the associated high risk of morbidity and mortality. Method We present a case report of a 54 year old man with respiratory distress and chest pain as the initial Emergency Department presentation of a perforated duodenal ulcer. Results We discuss an unusual presentation of a perforated duodenal ulcer that was recognized in the emergency department and treated promptly. The patient was surgically treated immediately, had a prolonged and complicated post-operative course, but is ultimately doing well. We also provide a brief literature review of the risk factors, imaging choices, and management decision required to treat a perforated ulcer. Conclusions Perforated ulcers can have highly varied presentations and are occasionally difficult to diagnose in a complicated patient. Knowledge of the risk factors and a thorough history and physical can point to the diagnosis, but timely and appropriate imaging is often required because delays in diagnosis and treatment lead to poor outcomes. Early administration of antibiotics and immediate surgical repair are necessary to limit morbidity and mortality. PMID:21696590

Comprehensive comparing percutaneous endoscopic lumbar discectomy with posterior lumbar internal fixation for treatment of adjacent segment lumbar disc prolapse with stable retrolisthesis: A retrospective case-control study.

PubMed

Sun, Yapeng; Zhang, Wei; Qie, Suhui; Zhang, Nan; Ding, Wenyuan; Shen, Yong

2017-07-01

The study was to comprehensively compare the postoperative outcome and imaging parameter characters in a short/middle period between the percutaneous endoscopic lumbar discectomy (PELD) and the internal fixation of bone graft fusion (the most common form is posterior lumbar interbody fusion [PLIF]) for the treatment of adjacent segment lumbar disc prolapse with stable retrolisthesis after a previous lumbar internal fixation surgery.In this retrospective case-control study, we collected the medical records from 11 patients who received PELD operation (defined as PELD group) for and from 13 patients who received the internal fixation of bone graft fusion of lumbar posterior vertebral lamina decompression (defined as control group) for the treatment of the lumbar disc prolapse combined with stable retrolisthesis at Department of Spine Surgery, the Third Hospital of Hebei Medical University (Shijiazhuang, China) from May 2010 to December 2015. The operation time, the bleeding volume of perioperation, and the rehabilitation days of postoperation were compared between 2 groups. Before and after surgery at different time points, ODI, VAS index, and imaging parameters (including Taillard index, inter-vertebral height, sagittal dislocation, and forward bending angle of lumbar vertebrae) were compared.The average operation time, the blooding volume, and the rehabilitation days of postoperation were significantly less in PELD than in control group. The ODI and VAS index in PELD group showed a significantly immediate improving on the same day after the surgery. However, Taillard index, intervertebral height, sagittal dislocation in control group showed an immediate improving after surgery, but no changes in PELD group till 12-month after surgery. The forward bending angle of lumbar vertebrae was significantly increased and decreased in PELD and in control group, respectively.PELD operation was superior in terms of operation time, bleeding volume, recovery period, and financial support, if compared with lumbar internal fixation operation. Radiographic parameters reflect lumber structure changes, which could be observed immediately after surgery in both methods; however, the recoveries on nerve function and pain relief required a longer time, especially after PLIF operation.

The influence of wildfires on aerosol size distributions in rural areas.

PubMed

Alonso-Blanco, E; Calvo, A I; Fraile, R; Castro, A

2012-01-01

The number of particles and their size distributions were measured in a rural area, during the summer, using a PCASP-X. The aim was to study the influence of wildfires on particle size distributions. The comparative studies carried out reveal an average increase of around ten times in the number of particles in the fine mode, especially in sizes between 0.10 and 0.14 μm, where the increase is of nearly 20 times. An analysis carried out at three different points in time--before, during, and after the passing of the smoke plume from the wildfires--shows that the mean geometric diameter of the fine mode in the measurements affected by the fire is smaller than the one obtained in the measurements carried out immediately before and after (0.14 μm) and presents average values of 0.11 μm.

Functional outcomes of "floating elbow" injuries in adult patients.

PubMed

Yokoyama, K; Itoman, M; Kobayashi, A; Shindo, M; Futami, T

1998-05-01

To assess elbow function, complications, and problems of floating elbow fractures in adults receiving surgical treatment. Retrospective clinical review. Level I trauma center in Kanagawa, Japan. Fourteen patients with fifteen floating elbow injuries, excluding one immediate amputation, seen at the Kitasato University Hospital from January 1, 1984, to April 30, 1995. All fractures were managed surgically by various methods. In ten cases, the humeral and forearm fractures were treated simultaneously with immediate fixation. In three cases, both the humeral and forearm fractures were treated with delayed fixation on Day 1, 4, or 7. In the remaining two cases, the open forearm fracture was managed with immediate fixation and the humerus fracture with delayed fixation on Day 10 or 25. All subjects underwent standardized elbow evaluations, and results were compared with an elbow score based on a 100-point scale. The parameters evaluated were pain, motion, elbow and grip strength, and function during daily activities. Complications such as infections, nonunions, malunions, and refractures were investigated. Mean follow-up was forty-three months (range 13 to 112 months). At final follow-up, the mean elbow function score was 79 points, with 67 percent (ten of fifteen) of the subjects having good or excellent results. The functional outcome did not correlate with the Injury Severity Score of the individual patients, the existence of open injuries or neurovascular injuries, or the timing of surgery. There were one deep infection, two nonunions of the humerus, two nonunions of the forearm, one varus deformity of the humerus, and one forearm refracture. Based on the present data, we could not clarify the factors influencing the final functional outcome after floating elbow injury. These injuries, however, potentially have many complications, such as infection or nonunion, especially when there is associated brachial plexus injury. We consider that floating elbow injuries are severe injuries and that surgical stabilization is needed; beyond that, there are no specific forms of surgical treatment to reliably guarantee excellent results.

JPL's GNSS Real-Time Earthquake and Tsunami (GREAT) Alert System

NASA Astrophysics Data System (ADS)

Bar-Sever, Yoaz; Miller, Mark; Vallisneri, Michele; Khachikyan, Robert; Meyer, Robert

2017-04-01

We describe recent developments to the GREAT Alert natural hazard monitoring service from JPL's Global Differential GPS (GDGPS) System. GREAT Alert provides real-time, 1 Hz positioning solutions for hundreds of GNSS tracking sites, from both global and regional networks, aiming to monitor ground motion in the immediate aftermath of earthquakes. We take advantage of the centralized data processing, which is collocated with the GNSS orbit determination operations of the GDGPS System, to combine orbit determination with large-scale point-positioning in a grand estimation scheme, and as a result realize significant improvement to the positioning accuracy compared to conventional stand-alone point positioning techniques. For example, the measured median site (over all sites) real-time horizontal positioning accuracy is 2 cm 1DRMS, and the median real-time vertical accuracy is 4 cm RMS. The GREAT Alert positioning service is integrated with automated global earthquake notices from the United States Geodetic Survey (USGS) to support near-real-time calculations of co-seismic displacements with attendant formal errors based both short-term and long-term error analysis for each individual site. We will show the millimeter-level resolution of co-seismic displacement can be achieved by this system. The co-seismic displacements, in turn, are fed into a JPL geodynamics and ocean models, that estimate the Earthquake magnitude and predict the potential tsunami scale.

Global chaotization of fluid particle trajectories in a sheared two-layer two-vortex flow.

PubMed

Ryzhov, Evgeny A; Koshel, Konstantin V

2015-10-01

In a two-layer quasi-geostrophic approximation, we study the irregular dynamics of fluid particles arising due to two interacting point vortices embedded in a deformation flow consisting of shear and rotational components. The two vortices are arranged within the bottom layer, but an emphasis is on the upper-layer fluid particle motion. Vortices moving in one layer induce stirring of passive scalars in the other layer. This is of interest since point vortices induce singular velocity fields in the layer they belong to; however, in the other layer, they induce regular velocity fields that generally result in a change in passive particle stirring. If the vortices are located at stagnation points, there are three different types of the fluid flow. We examine how properties of each flow configuration are modified if the vortices are displaced from the stagnation points and thus circulate in the immediate vicinity of these points. To that end, an analysis of the steady-state configurations is presented with an emphasis on the frequencies of fluid particle oscillations about the elliptic stagnation points. Asymptotic relations for the vortex and fluid particle zero-oscillation frequencies are derived in the vicinity of the corresponding elliptic points. By comparing the frequencies of fluid particles with the ones of the vortices, relations between the parameters that lead to enhanced stirring of fluid particles are established. It is also demonstrated that, if the central critical point is elliptic, then the fluid particle trajectories in its immediate vicinity are mostly stable making it harder for the vortex perturbation to induce stirring. Change in the type of the central point to a hyperbolic one enhances drastically the size of the chaotic dynamics region. Conditions on the type of the central critical point also ensue from the derived asymptotic relations.

Evolution of the ablation region after magnetic resonance-guided high-intensity focused ultrasound ablation in a Vx2 tumor model.

PubMed

Wijlemans, Joost W; Deckers, Roel; van den Bosch, Maurice A A J; Seinstra, Beatrijs A; van Stralen, Marijn; van Diest, Paul J; Moonen, Chrit T W; Bartels, Lambertus W

2013-06-01

Volumetric magnetic resonance (MR)-guided high-intensity focused ultrasound (HIFU) is a completely noninvasive image-guided thermal ablation technique. Recently, there has been growing interest in the use of MR-HIFU for noninvasive ablation of malignant tumors. Of particular interest for noninvasive ablation of malignant tumors is reliable treatment monitoring and evaluation of response. At this point, there is limited evidence on the evolution of the ablation region after MR-HIFU treatment. The purpose of the present study was to comprehensively characterize the evolution of the ablation region after volumetric MR-HIFU ablation in a Vx2 tumor model using MR imaging, MR temperature data, and histological data. Vx2 tumors in the hind limb muscle of New Zealand White rabbits (n = 30) were ablated using a clinical MR-HIFU system. Twenty-four animals were available for analyses. Magnetic resonance imaging was performed before and immediately after ablation; MR temperature mapping was performed during the ablation. The animals were distributed over 7 groups with different follow-up lengths. Depending on the group, animals were reimaged and then killed on day 0, 1, 3, 7, 14, 21, or 28 after ablation. For all time points, the size of nonperfused areas (NPAs) on contrast-enhanced T1-weighted (CE-T1-w) images was compared with lethal thermal dose areas (ie, the tissue area that received a thermal dose of 240 equivalent minutes or greater [EM] at 43°C) and with the necrotic tissue areas on histology sections. The NPA on CE-T1-w imaging showed an increase in median size from 266 ± 148 to 392 ± 178 mm(2) during the first day and to 343 ± 170 mm(2) on day 3, followed by a gradual decrease to 113 ± 103 mm(2) on day 28. Immediately after ablation, the NPA was 1.6 ± 1.4 times larger than the area that received a thermal dose of 240 EM or greater in all animals. The median size of the necrotic area on histology was 1.7 ± 0.4 times larger than the NPA immediately after ablation. After 7 days, the size of the NPA was in agreement with the necrotic tissue area on histology (ratio, 1.0 ± 0.2). During the first 3 days after MR-HIFU ablation, the ablation region increases in size, after which it gradually decreases in size. The NPA on CE-T1-w imaging underestimates the extent of tissue necrosis on histology in the initial few days, but after 1 week, the NPA is reliable in delineating the necrotic tissue area. The 240-EM thermal dose limit underestimates the necrotic tissue area immediately after MR-HIFU ablation. Reliable treatment evaluation techniques are particularly important for noninvasive, image-guided tumor ablation. Our results indicate that CE-T1-w imaging is reliable for MR-HIFU treatment evaluation after 1 week.

Physical Compatibility of Micafungin With Sodium Bicarbonate Hydration Fluids Commonly Used With High-Dose Methotrexate Chemotherapy.

PubMed

Joiner, Logan C; Tynes, Clay; Arnold, John; Miller, Rachel R; Gorman, Greg

2018-04-01

Purpose: The purpose of this study was to determine the physical compatibility of micafungin with commonly used concentrations of sodium bicarbonate hydration fluids administered via a Y-site connected to a central venous catheter (Y-site/CVC). Methods: Micafungin sodium (evaluated concentration of 1.5 mg/mL) was combined in a 3:1 (vehicle:drug) ratio with the following commonly used hydration vehicles: 40 mEq/L sodium bicarbonate in 5% dextrose in water with ¼ normal saline (40SB-D5W-1/4NS), 75 mEq/L sodium bicarbonate in D5W (75SB-D5W), and 154 mEq/L sodium bicarbonate in D5W (154SB-D5W). A 3:1 ratio was used based on the flow rates (typically 125 mL/m 2 /h for bicarbonate-containing vehicles and 50 mL/h for micafungin) of the corresponding solutions in a clinical setting. Visual observations recorded to determine physical compatibility included visual inspection against different backgrounds (unaided, black, and white). Other physical observations were as follows: odor, evolution of gas, pH, and turbidity immediately recorded after mixing and at specified time points up to 2 hours. Evaluations at each time point were compared against baseline observation values at Time 0. Results: All combinations tested were found to be compatible up to 2 hours. Time points beyond 2 hours cannot be safely verified as compatible. Conclusion: Micafungin may be administered safely using a Y-site/CVC delivery system with all the vehicles tested in this study.

The effects of a transcontinental flight on markers of coagulation and fibrinolysis in healthy men after vigorous physical activity.

PubMed

Kupchak, Brian R; Kraemer, William J; Hooper, David R; Saenz, Cathy; Dulkis, Lexie L; Secola, Paul J; Brown, Lee E; Galpin, Andrew J; Coburn, Jared W; DuPont, William H; Caldwell, Lydia K; Volek, Jeff S; Maresh, Carl M

2017-01-01

Athletes and military service members are known to undergo strenuous exercise and sometimes have to take long haul flights soon afterwards; however, its combined effect on many physiological functions is relatively unknown. Therefore, we examined the combined effects of a full-body muscle-damaging workout and transcontinental flight on coagulation and fibrinolysis in healthy, resistance trained men. We also determined the efficacy of a full-body compression garment in limiting their coagulation responses. Nineteen healthy, resistance trained men flew from Connecticut (CT) to California (CA), performed a full-body muscle-damaging workout and then flew back to CT. Ten participants wore full-body compression garments (FCG) for the duration of both flights and during all other portions of the study except during workouts and blood draws, when they wore loose clothing. Nine controls wore loose clothing (CON) throughout the study. Blood samples were collected at 16 h and 3 h before the initial flight from CT, immediately after landing in CA, immediately before and immediately after the full-body workout in CA, immediately after landing in CT, and at 29 h after landing in CT. Plasma markers of coagulation included activated partial thromboplastin time (aPTT), prothrombin fragment 1+2 (PTF 1+2) and thrombin ant-thrombin (TAT). Markers of the fibrinolytic system included the tissue plasmigen activator (tPA), plasminogen activator inhibitor-1 (PAI-1) and D-Dimer. Both FCG and CON groups exhibited a faster aPTT after the full-body workout compared to all other time points.  Thrombin generation markers, TAT and PTF 1+2, increased significantly after the full-body workout and immediately after landing in CT. Additionally, tPA increased after the full-body workout, while PAI-1 increased before the flight to CA, after the full-body workout, and just after landing in CT. The D-Dimer significantly increased after the full-body workout and at 29 h post-flight in both groups. Between groups, aPTT was significantly faster and TAT elevated with the CON group at 29 h post-flight. Also, PAI-1 demonstrated higher concentrations immediately after landing in CT for the CON group. A full-body muscle-damaging workout in conjunction with a trans-continental flight activated the coagulation and fibrinolytic systems. Additionally, wearing a full-body compression garment may limit coagulation following a workout through the recovery period.

Hands in the Air: Using Ungrounded Iconic Gestures to Teach Children Conservation of Quantity

ERIC Educational Resources Information Center

Ping, Raedy M.; Goldin-Meadow, Susan

2008-01-01

Including gesture in instruction facilitates learning. Why? One possibility is that gesture points out objects in the immediate context and thus helps ground the words learners hear in the world they see. Previous work on gesture's role in instruction has used gestures that either point to or trace paths on objects, thus providing support for this…

Mean-force-field and mean-spherical approximations for the electric microfield distribution at a charged point in the charged-hard-particles fluid

NASA Astrophysics Data System (ADS)

Rosenfeld, Yaakov

1989-01-01

The linearized mean-force-field approximation, leading to a Gaussian distribution, provides an exact formal solution to the mean-spherical integral equation model for the electric microfield distribution at a charged point in the general charged-hard-particles fluid. Lado's explicit solution for plasmas immediately follows this general observation.

78 FR 16544 - Self-Regulatory Organizations; NYSE MKT LLC; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-15

... interest. Accordingly, at the $22.00 price point, both the entire amount of B4 and the remaining balance of...-STP opposite-side interest, Exchange systems would cancel the remaining balance of the incoming STPN.... If an STPN could execute at multiple price points, the incoming STPN would execute at the multiple...

76 FR 40413 - Self-Regulatory Organizations; New York Stock Exchange LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-08

... the investment bank syndicate the night before the first day of trading, to determine the LRP value... Point Value Range During the First Day of Trading of an Initial Public Offering on the Exchange July 1... for a different liquidity replenishment point (``LRP'') value range during the first day of trading of...

The Effects of Message Summaries on the Immediate Free Recall of Main Points.

ERIC Educational Resources Information Center

Shellen, Wesley N.

This study was designed to test the effects of message summaries on the recall of main points of an informative message. Two different types of summary techniques, a mnemonic and a traditional type, were identified and compared with each other and with a third treatment involving no summaries. One hundred and eleven volunteer subjects were…

78 FR 62903 - Self-Regulatory Organizations; EDGX Exchange, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-22

....0027 per share; (vi) lower the ADV threshold required to meet the MidPoint Match Volume Tier; and (vii...) lower the ADV threshold required to meet the MidPoint Match Volume Tier; and (vii) decrease the rebate... shares in average daily volume (``ADV'') on a daily basis, measured monthly; and (2) add at least 1,000...

78 FR 60939 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-02

... Calculation of the Mid-Point Passive Liquidity Order Tier September 26, 2013. Pursuant to Section 19(b)(1) \\1...'') regarding calculation of the Mid-Point Passive Liquidity (``MPL'') Order Tier. The Exchange proposes to...), 78 FR 41154 (July 9, 2013) (SR-NYSEArca-2013-67). A Passive Liquidity (``PL'') Order is an order to...

Paperless registration during survey enumerations and large oral cholera mass vaccination in Zanzibar, the United Republic of Tanzania

PubMed Central

Deen, Jaqueline L; Khatib, Ahmed; Enwere, Godwin; von Seidlein, Lorenz; Reyburn, Rita; Ali, Said Mohammed; Chang, Na Yoon; Perroud, Valérie; Marodon, Frédérique; Saleh, Abdul A; Hashim, R; Lopez, Anna Lena; Beard, James; Ley, Benedikt N; Thriemer, Kamala; Puri, Mahesh K; Sah, Binod; Jiddawi, Mohamed Saleh; Clemens, John D

2010-01-01

Abstract Problem Field trials require extensive data preparation and complex logistics. The use of personal digital assistants (PDAs) can bypass many of the traditional steps that are necessary in a paper-based data entry system. Approach We programmed, designed and supervised the use of PDAs for a large survey enumeration and mass vaccination campaign. Local setting The project was implemented in Zanzibar in the United Republic of Tanzania. Zanzibar is composed of two main islands, Unguja and Pemba, where outbreaks of cholera have been reported since the 1970s. Relevant changes PDAs allowed us to digitize information at the initial point of contact with the respondents. Immediate response by the system in case of error helped ensure the quality and reliability of the data. PDAs provided quick data summaries that allowed subsequent research activities to be implemented in a timely fashion. Lessons learnt Portability, immediate recording and linking of information enhanced structure data collection in our study. PDAs could be more useful than paper-based systems for data collection in the field, especially in impoverished settings in developing countries. PMID:20616976

Beyond initial encoding: measures of the post-encoding status of memory traces predict long-term recall during infancy.

PubMed

Pathman, Thanujeni; Bauer, Patricia J

2013-02-01

The first years of life are witness to rapid changes in long-term recall ability. In the current research we contributed to an explanation of the changes by testing the absolute and relative contributions to long-term recall of encoding and post-encoding processes. Using elicited imitation, we sampled the status of 16-, 20-, and 24-month-old infants' memory representations at various time points after experience of events. In Experiment 1, infants were tested immediately, 1 week after encoding, and again after 1 month. The measure of 1-week trace status was a unique predictor of 1-month delayed recall. In Experiment 2, infants were tested immediately, 15 min, 48 h, and 2 weeks after encoding and again 1 month later. The measures of 15-min and 48-h trace strength contributed unique variance in 1-month delayed recall. The findings highlight the need to consider post-encoding processes in explanations of variability in long-term memory during infancy. Copyright © 2012 Elsevier Inc. All rights reserved.

Paperless registration during survey enumerations and large oral cholera mass vaccination in Zanzibar, the United Republic of Tanzania.

PubMed

Ali, Mohammad; Deen, Jaqueline L; Khatib, Ahmed; Enwere, Godwin; von Seidlein, Lorenz; Reyburn, Rita; Ali, Said Mohammed; Chang, Na Yoon; Perroud, Valérie; Marodon, Frédérique; Saleh, Abdul A; Hashim, R; Lopez, Anna Lena; Beard, James; Ley, Benedikt N; Thriemer, Kamala; Puri, Mahesh K; Sah, Binod; Jiddawi, Mohamed Saleh; Clemens, John D

2010-07-01

Field trials require extensive data preparation and complex logistics. The use of personal digital assistants (PDAs) can bypass many of the traditional steps that are necessary in a paper-based data entry system. We programmed, designed and supervised the use of PDAs for a large survey enumeration and mass vaccination campaign. The project was implemented in Zanzibar in the United Republic of Tanzania. Zanzibar is composed of two main islands, Unguja and Pemba, where outbreaks of cholera have been reported since the 1970s. PDAs allowed us to digitize information at the initial point of contact with the respondents. Immediate response by the system in case of error helped ensure the quality and reliability of the data. PDAs provided quick data summaries that allowed subsequent research activities to be implemented in a timely fashion. Portability, immediate recording and linking of information enhanced structure data collection in our study. PDAs could be more useful than paper-based systems for data collection in the field, especially in impoverished settings in developing countries.

Effectiveness of post‐match recovery strategies in rugby players

PubMed Central

Gill, N D; Beaven, C M; Cook, C

2006-01-01

Objectives To examine the effectiveness of four interventions on the rate and magnitude of muscle damage recovery, as measured by creatine kinase (CK). Methods 23 elite male rugby players were monitored transdermally before, immediately after, 36 hours after, and 84 hours after competitive rugby matches. Players were randomly assigned to complete one of four post‐match strategies: contrast water therapy (CWT), compression garment (GAR), low intensity active exercise (ACT), and passive recovery (PAS). Results Significant increases in CK activity in transdermal exudate were observed as a result of the rugby match (p<0.01). The magnitude of recovery in the PAS intervention was significantly worse than in the ACT, CWT, and GAR interventions at the 36 and 84 hour time points (p<0.05). Conclusions An enhanced rate and magnitude of recovery was observed in the ACT, CWT, and GAR treatment groups when compared with the PAS group. Low impact exercise immediately post‐competition, wearing compression garments, or carrying out contrast water therapy enhanced CK clearance more than passive recovery in young male athletes. PMID:16505085

Medical withdrawals from college for mental health reasons and their relation to academic performance.

PubMed

Meilman, P W; Manley, C; Gaylor, M S; Turco, J H

1992-03-01

A collaborative study among the university health service, the dean's office, and the registrar's office examined the academic performance of 77 students who took medical withdrawals for mental health reasons from Dartmouth College during a 3-year period. In 71.4% of the cases, students withdrew from a term in progress; the remainder arranged to withdraw after they had completed a term but before starting a new term. Depression was a major factor in approximately half of the withdrawals. Grade point average improved significantly after return from the withdrawal, with a large jump in individual term averages occurring between the terms immediately preceding and immediately following return. We found no significant difference between the number of students who experienced disciplinary trouble before withdrawal and those who were disciplined afterward. Students who were depressed at the time of withdrawal did not fare as well academically upon return as those students who had not been depressed. The data suggest that procedures for handling mental health withdrawals and readmission are important ways in which the campus counseling center can support the university's academic mission.

Becker's rational addiction theory: An empirical test with price elasticities for distilled spirits in Denmark 1911-31.

PubMed

Skog, Ole-Jørgen; Melberg, Hans Olav

2006-10-01

To test an implication of Becker's rational addiction theory, namely that price changes will lead both to simultaneous consumption changes as well as lagged changes (and potentially also immediate changes if future changes in prices are anticipated). Time-series analysis, first of aggregate sales of distilled spirits and prices, controlled for gross national product (GNP), and secondly of deaths from delirium tremens. Denmark 1911-31. Price changes were very large in the period 1916-18 due to shortages during World War I, and the Danish case can be conceived as a natural experiment. No evidence for lagged price effects in the expected direction was found. On the contrary, the evidence pointed in the opposite direction. The immediate reduction in sales following rising prices are, to some degree, counteracted by an adjustment in the opposite direction the following year. The delirium tremens data confirm this pattern. Becker's theory is not confirmed. Several possible explanations are discussed. If the pattern observed in these data is representative of a more general mechanism, current price elasticity estimates may be too high, by ignoring lagged compensatory effects.

Comparison of the Effectiveness of Transcutaneous Electrical Nerve Stimulation and Interferential Therapy on the Upper Trapezius in Myofascial Pain Syndrome: A Randomized Controlled Study.

PubMed

Dissanayaka, Thusharika Dilrukshi; Pallegama, Ranjith Wasantha; Suraweera, Hilari Justus; Johnson, Mark I; Kariyawasam, Anula Padma

2016-09-01

The aim of this study was to compare the effectiveness of transcutaneous electrical nerve stimulation and interferential therapy (IFT) both in combination with hot pack, myofascial release, active range of motion exercise, and a home exercise program on myofascial pain syndrome patients with upper trapezius myofascial trigger point. A total of 105 patients with an upper trapezius myofascial trigger point were recruited to this single-blind randomized controlled trial. Following random allocation of patients to three groups, three therapeutic regimens-control-standard care (hot pack, active range of motion exercises, myofascial release, and a home exercise program with postural advice), transcutaneous electrical nerve stimulation-standard care and IFT-standard care-were administered eight times during 4 wks at regular intervals. Pain intensity and cervical range of motions (cervical extension, lateral flexion to the contralateral side, and rotation to the ipsilateral side) were measured at baseline, immediately after the first treatment, before the eighth treatment, and 1 wk after the eighth treatment. Immediate and short-term improvements were marked in the transcutaneous electrical nerve stimulation group (n = 35) compared with the IFT group (n = 35) and the control group (n = 35) with respect to pain intensity and cervical range of motions (P < 0.05). The IFT group showed significant improvement on these outcome measurements than the control group did (P < 0.05). Transcutaneous electrical nerve stimulation with standard care facilitates recovery better than IFT does in the same combination.

Economical Video Monitoring of Traffic

NASA Technical Reports Server (NTRS)

Houser, B. C.; Paine, G.; Rubenstein, L. D.; Parham, O. Bruce, Jr.; Graves, W.; Bradley, C.

1986-01-01

Data compression allows video signals to be transmitted economically on telephone circuits. Telephone lines transmit television signals to remote traffic-control center. Lines also carry command signals from center to TV camera and compressor at highway site. Video system with television cameras positioned at critical points on highways allows traffic controllers to determine visually, almost immediately, exact cause of traffic-flow disruption; e.g., accidents, breakdowns, or spills, almost immediately. Controllers can then dispatch appropriate emergency services and alert motorists to minimize traffic backups.

A Workshop on Environmental Technology Assessment Held at the University of Cambridge, England Held on 24-26 April, 1985,

DTIC Science & Technology

1985-01-01

almost immediately upon corona onset, the current starts to flow uncontrollably with an immediate decrease in voltage which stops the ESP from...operating. With large diameter electrodes, the current starts to flow at the corona onset point and there is a range where it varies with increasing voltage...Modal. WEST GERMANY - Use of a Pibersape for Control Purpoaes in toe sarixo uitr3ioutioa bysta. -Special Cent Mortar Lining of Ductile Cat Iron Pipes

Simulation as a set-up for technical proficiency: can a virtual warm-up improve live fibre-optic intubation?

PubMed

Samuelson, S T; Burnett, G; Sim, A J; Hofer, I; Weinberg, A D; Goldberg, A; Chang, T S; DeMaria, S

2016-03-01

Fibre-optic intubation (FOI) is an advanced technical skill, which anaesthesia residents must frequently perform under pressure. In surgical subspecialties, a virtual 'warm-up' has been used to prime a practitioner's skill set immediately before performance of challenging procedures. This study examined whether a virtual warm-up improved the performance of elective live patient FOI by anaesthesia residents. Clinical anaesthesia yr 1 and 2 (CA1 and CA2) residents were recruited to perform elective asleep oral FOI. Residents either underwent a 5 min, guided warm-up (using a bronchoscopy simulator) immediately before live FOI on patients with predicted normal airways or performed live FOI on similar patients without the warm-up. Subjects were timed performing FOI (from scope passing teeth to viewing the carina) and were graded on a 45-point skill scale by attending anaesthetists. After a washout period, all subjects were resampled as members of the opposite cohort. Multivariate analysis was performed to control for variations in previous FOI experience of the residents. Thirty-three anaesthesia residents were recruited, of whom 22 were CA1 and 11 were CA2. Virtual warm-up conferred a 37% reduction in time for CA1s (mean 35.8 (SD 3.2) s vs. 57 (SD 3.2) s, P<0.0002) and a 26% decrease for CA2s (mean 23 (SD 1.7) s vs. 31 (SD 1.7) s, P=0.0118). Global skill score increased with warm-up by 4.8 points for CA1s (mean 32.8 (SD 1.2) vs. 37.6 (SD 1.2), P=0.0079) and 5.1 points for CA2s (37.7 (SD 1.1) vs. 42.8 (SD 1.1), P=0.0125). Crossover period and sequence did not show a statistically significant association with performance. Virtual warm-up significantly improved performance by residents of FOI in live patients with normal airway anatomy, as measured both by speed and by a scaled evaluation of skills. © The Author 2016. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A novel comparative pattern count analysis reveals a chronic ethanol-induced dynamic shift in immediate early NF-κB genome-wide promoter binding during liver regeneration.

PubMed

Kuttippurathu, Lakshmi; Patra, Biswanath; Hoek, Jan B; Vadigepalli, Rajanikanth

2016-03-01

Liver regeneration after partial hepatectomy is a clinically important process that is impaired by adaptation to chronic alcohol intake. We focused on the initial time points following partial hepatectomy (PHx) to analyze the genome-wide binding activity of NF-κB, a key immediate early regulator. We investigated the effect of chronic alcohol intake on immediate early NF-κB genome-wide localization, in the adapted state as well as in response to partial hepatectomy, using chromatin immunoprecipitation followed by promoter microarray analysis. We found many ethanol-specific NF-κB binding target promoters in the ethanol-adapted state, corresponding to the regulation of biosynthetic processes, oxidation-reduction and apoptosis. Partial hepatectomy induced a diet-independent shift in NF-κB binding loci relative to the transcription start sites. We employed a novel pattern count analysis to exhaustively enumerate and compare the number of promoters corresponding to the temporal binding patterns in ethanol and pair-fed control groups. The highest pattern count corresponded to promoters with NF-κB binding exclusively in the ethanol group at 1 h post PHx. This set was associated with the regulation of cell death, response to oxidative stress, histone modification, mitochondrial function, and metabolic processes. Integration with the global gene expression profiles to identify putative transcriptional consequences of NF-κB binding patterns revealed that several of ethanol-specific 1 h binding targets showed ethanol-specific differential expression through 6 h post PHx. Motif analysis yielded co-incident binding loci for STAT3, AP-1, CREB, C/EBP-β, PPAR-γ and C/EBP-α, likely participating in co-regulatory modules with NF-κB in shaping the immediate early response to PHx. We conclude that adaptation to chronic ethanol intake disrupts the NF-κB promoter binding landscape with consequences for the immediate early gene regulatory response to the acute challenge of PHx.

Quality of life after hip, vertebral, and distal forearm fragility fractures measured using the EQ-5D-3L, EQ-VAS, and time-trade-off: results from the ICUROS.

PubMed

Svedbom, Axel; Borgström, Fredrik; Hernlund, Emma; Ström, Oskar; Alekna, Vidmantas; Bianchi, Maria Luisa; Clark, Patricia; Curiel, Manuel Díaz; Dimai, Hans Peter; Jürisson, Mikk; Uusküla, Anneli; Lember, Margus; Kallikorm, Riina; Lesnyak, Olga; McCloskey, Eugene; Ershova, Olga; Sanders, Kerrie M; Silverman, Stuart; Tamulaitiene, Marija; Thomas, Thierry; Tosteson, Anna N A; Jönsson, Bengt; Kanis, John A

2018-03-01

The International Costs and Utilities Related to Osteoporotic fractures Study is a multinational observational study set up to describe the costs and quality of life (QoL) consequences of fragility fracture. This paper aims to estimate and compare QoL after hip, vertebral, and distal forearm fracture using time-trade-off (TTO), the EuroQol (EQ) Visual Analogue Scale (EQ-VAS), and the EQ-5D-3L valued using the hypothetical UK value set. Data were collected at four time-points for five QoL point estimates: within 2 weeks after fracture (including pre-fracture recall), and at 4, 12, and 18 months after fracture. Health state utility values (HSUVs) were derived for each fracture type and time-point using the three approaches (TTO, EQ-VAS, EQ-5D-3L). HSUV were used to estimate accumulated QoL loss and QoL multipliers. In total, 1410 patients (505 with hip, 316 with vertebral, and 589 with distal forearm fracture) were eligible for analysis. Across all time-points for the three fracture types, TTO provided the highest HSUVs, whereas EQ-5D-3L consistently provided the lowest HSUVs directly after fracture. Except for 13-18 months after distal forearm fracture, EQ-5D-3L generated lower QoL multipliers than the other two methods, whereas no equally clear pattern was observed between EQ-VAS and TTO. On average, the most marked differences between the three approaches were observed immediately after the fracture. The approach to derive QoL markedly influences the estimated QoL impact of fracture. Therefore the choice of approach may be important for the outcome and interpretation of cost-effectiveness analysis of fracture prevention.

Redesign of a fixture mount to be used as an impression coping and a provisional abutment as well

PubMed Central

Chang, Glenn Hsuan-Chen; Tian, Chen; Hung, Yuen-Siang

2011-01-01

Purpose: An integrated fixture mount/impression coping/ temporary abutment can provide many advantages for immediate loading of dental implants, such as simpler procedure, less chair time, cost reduction, and comfort for the patients. Materials and Methods: A newly designed dental implant fixture mount (DIFMA) can be used as an impression coping for taking an immediate impression. An immediate load provisional prosthesis can then be fabricated shortly after implant placement to immediately load the implants. This fixture mount can also serve as a temporary abutment for immediate chair-side fabrication of provisional prosthesis. Two clinical cases are presented. Results: A clinical case utilizing the fixture mount abutment (DIFMA)/implant assembly is presented. The precision of fitting between the impression copings and implants is secured with this system. The chair time for taking an immediate impression is greatly reduced. Less cost for the restoration is provided and patient comfort is delivered. Conclusions: More patient satisfaction can be conferred by employing the fixture mount in the process of immediate impression taking and as an immediate provisional abutment. PMID:22090763

36 CFR 261.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... female person is also nude if she has failed to cover both breasts below a point immediately above the... identified to accomplish one or more of the following objectives: provide skills training; education; useful...

36 CFR 261.2 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... female person is also nude if she has failed to cover both breasts below a point immediately above the... identified to accomplish one or more of the following objectives: provide skills training; education; useful...

Changes in dynamic resting state network connectivity following aphasia therapy.

PubMed

Duncan, E Susan; Small, Steven L

2017-10-24

Resting state magnetic resonance imaging (rsfMRI) permits observation of intrinsic neural networks produced by task-independent correlations in low frequency brain activity. Various resting state networks have been described, with each thought to reflect common engagement in some shared function. There has been limited investigation of the plasticity in these network relationships after stroke or induced by therapy. Twelve individuals with language disorders after stroke (aphasia) were imaged at multiple time points before (baseline) and after an imitation-based aphasia therapy. Language assessment using a narrative production task was performed at the same time points. Group independent component analysis (ICA) was performed on the rsfMRI data to identify resting state networks. A sliding window approach was then applied to assess the dynamic nature of the correlations among these networks. Network correlations during each 30-second window were used to cluster the data into ten states for each window at each time point for each subject. Correlation was performed between changes in time spent in each state and therapeutic gains on the narrative task. The amount of time spent in a single one of the (ten overall) dynamic states was positively associated with behavioral improvement on the narrative task at the 6-week post-therapy maintenance interval, when compared with either baseline or assessment immediately following therapy. This particular state was characterized by minimal correlation among the task-independent resting state networks. Increased functional independence and segregation of resting state networks underlies improvement on a narrative production task following imitation-based aphasia treatment. This has important clinical implications for the targeting of noninvasive brain stimulation in post-stroke remediation.

Practical experience and challenges in the operation of medical cyclotron.

PubMed

Kumar, Rajeev; Sonkawade, Rajendra G; Pandey, Anil K; Tripathi, Madhavi; Damle, Nishikant A; Kumar, Praveen; Bal, Chandra S

2017-01-01

The aim of this article was to share 10 years of operational experience of medical cyclotron and to provide working knowledge on the same. This experience has helped us gain working knowledge on cyclotron operation with practical points, which may help in improving F yield, minimizing the breakdown time, and help in the prevention of the occurrence of unusual events. Our facility has a self-shielded radioisotope delivery system eclipse 111 medical cyclotron with an 11 MeV proton beam in use for the past 10 years to produce positron emitters - namely, F, N, and F-2 gas - for PET imaging. During F production, we have followed a set protocol comprising the following: monitoring target pressure, rinsing the target with O water just immediately after bombardment, ion source feedback, radiofrequency (RF) feedback, and recording any unusual events that occurred during the operation. Besides this, enrichment of O water, target volume, target current, energy of the beam, variation in argon pressure on the target, bombardment duration, target status (new or old target or total number of previous bombardments on the same target), status of the delivery lines from target to the radiochemistry module (old or new) were also recorded. Rinsing with O water immediately after bombardment increases the life of the target and delivery line. The frequent problems encountered were with the ion source, RF, and target foil rupture. These problems were solved by rebuilding the ion source, changing the fuse of RF, and rebuilding the target. F yield can be increased by rinsing with O water immediately after bombardment. The effect of target leak - that is, rupture of vacuum window - can be avoided by immediate stoppage of bombardment.

The effect of intermittent use of occlusal splint devices on sleep bruxism: a 4-week observation with a portable electromyographic recording device.

PubMed

Matsumoto, H; Tsukiyama, Y; Kuwatsuru, R; Koyano, K

2015-04-01

This randomised controlled study investigated the effect of intermittent use of occlusal splints on sleep bruxism compared with that of continuous use by measuring masseter muscle electromyographic activity using a portable electromyographic recording system. Twenty bruxers were randomly allocated to the continuous group and intermittent group. Subjects in the continuous group wore stabilisation splints during sleep for 29 nights continuously, whereas those in the intermittent group wore splints during sleep every other week, that is they used splints on the 1st-7th, 15th-21st and 29th nights. Electromyographic activity of the masseter muscle during sleep was recorded for the following six time points: before (baseline), immediately after, and 1, 2, 3 and 4 weeks after the insertion of a stabilisation splint. The number of nocturnal masseter electromyographic events, duration and the total activity of sleep bruxism were analysed. In the continuous group, nocturnal masseter electromyographic events were significantly reduced immediately and 1 week after the insertion of the stabilisation splint, and duration was reduced immediately after the insertion (P < 0·05, Dunnett's test), but no reduction was observed at 2, 3 and 4 weeks after insertion. In the intermittent group, nocturnal masseter electromyographic events and duration were significantly reduced immediately after and also 4 weeks after insertion of the stabilisation splint (P < 0·05, Dunnett's test). The obtained results of the present exploratory trial indicate that the intermittent use of stabilisation splints may reduce sleep bruxism activity for a longer period compared with that of continuous use. © 2014 John Wiley & Sons Ltd.

36 CFR 7.67 - Cape Cod National Seashore.

Code of Federal Regulations, 2013 CFR

2013-07-01

... volunteers to provide education, inventorying, monitoring, field support, and other activities involving off..., or female breast below a point immediately above the top of the areola when in a public place. Public...

36 CFR 7.67 - Cape Cod National Seashore.

Code of Federal Regulations, 2012 CFR

2012-07-01

... volunteers to provide education, inventorying, monitoring, field support, and other activities involving off..., or female breast below a point immediately above the top of the areola when in a public place. Public...

36 CFR 7.67 - Cape Cod National Seashore.

Code of Federal Regulations, 2014 CFR

2014-07-01

... volunteers to provide education, inventorying, monitoring, field support, and other activities involving off..., or female breast below a point immediately above the top of the areola when in a public place. Public...

36 CFR 7.67 - Cape Cod National Seashore.

Code of Federal Regulations, 2011 CFR

2011-07-01

... volunteers to provide education, inventorying, monitoring, field support, and other activities involving off..., or female breast below a point immediately above the top of the areola when in a public place. Public...

36 CFR 7.67 - Cape Cod National Seashore.

Code of Federal Regulations, 2010 CFR

2010-07-01

... volunteers to provide education, inventorying, monitoring, field support, and other activities involving off..., or female breast below a point immediately above the top of the areola when in a public place. Public...

Timing of Initiation of Antiretroviral Therapy in Human Immunodeficiency Virus (HIV)–Associated Tuberculous Meningitis

PubMed Central

Török, M. Estee; Yen, Nguyen Thi Bich; Chau, Tran Thi Hong; Mai, Nguyen Thi Hoang; Phu, Nguyen Hoan; Mai, Pham Phuong; Dung, Nguyen Thi; Van Vinh Chau, Nguyen; Bang, Nguyen Duc; Tien, Nguyen Anh; Minh, N. H.; Hien, Nguyen Quang; Thai, Phan Vuong Khac; Dong, Doan The; Anh, Do Thi Tuong; Thoa, Nguyen Thi Cam; Hai, Nguyen Ngoc; Lan, Nguyen Ngoc; Lan, Nguyen Thi Ngoc; Quy, Hoang Thi; Dung, Nguyen Huy; Hien, Tran Tinh; Chinh, Nguyen Tran; Simmons, Cameron Paul; de Jong, Menno; Wolbers, Marcel; Farrar, Jeremy James

2015-01-01

Background The optimal time to initiate antiretroviral therapy (ART) in human immunodeficiency virus (HIV)–associated tuberculous meningitis is unknown. Methods We conducted a randomized, double-blind, placebo-controlled trial of immediate versus deferred ART in patients with HIV-associated tuberculous meningitis to determine whether immediate ART reduced the risk of death. Antiretroviral drugs (zidovudine, lamivudine, and efavirenz) were started either at study entry or 2 months after randomization. All patients were treated with standard antituberculosis treatment, adjunctive dexamethasone, and prophylactic co-trimoxazole and were followed up for 12 months. We conducted intention-to-treat, per-protocol, and prespecified subgroup analyses. Results A total of 253 patients were randomized, 127 in the immediate ART group and 126 in the deferred ART group; 76 and 70 patients died within 9 months in the immediate and deferred ART groups, respectively. Immediate ART was not significantly associated with 9-month mortality (hazard ratio [HR], 1.12; 95% confidence interval [CI], .81–1.55; P = .50) or the time to new AIDS events or death (HR, 1.16; 95% CI, .87–1.55; P = .31). The percentage of patients with severe (grade 3 or 4) adverse events was high in both arms (90% in the immediate ART group and 89% in the deferred ART group; P = .84), but there were significantly more grade 4 adverse events in the immediate ART arm (102 in the immediate ART group vs 87 in the deferred ART group; P = .04). Conclusions Immediate ART initiation does not improve outcome in patients presenting with HIV-associated tuberculous meningitis. There were significantly more grade 4 adverse events in the immediate ART arm, supporting delayed initiation of ART in HIV-associated tuberculous meningitis. Clinical Trials Registration ISRCTN63659091. PMID:21596680

Immediate effects of Tuina techniques on working-related musculoskeletal disorder of professional orchestra musicians.

PubMed

Sousa, Cláudia Maria; Moreira, Luis; Coimbra, Daniela; Machado, Jorge; Greten, Henry J

2015-07-01

Musicians are a prone group to suffer from working-related musculoskeletal disorder (WRMD). Conventional solutions to control musculoskeletal pain include pharmacological treatment and rehabilitation programs but their efficiency is sometimes disappointing. The aim of this research is to study the immediate effects of Tuina techniques on WRMD of professional orchestra musicians from the north of Portugal. We performed a prospective, controlled, single-blinded, randomized study. Professional orchestra musicians with a diagnosis of WRMD were randomly distributed into the experimental group (n=39) and the control group (n=30). During an individual interview, Chinese diagnosis took place and treatment points were chosen. Real acupoints were treated by Tuina techniques into the experimental group and non-specific skin points were treated into the control group. Pain was measured by verbal numerical scale before and immediately after intervention. After one treatment session, pain was reduced in 91.8% of the cases for the experimental group and 7.9% for the control group. Although results showed that Tuina techniques are effectively reducing WRMD in professional orchestra musicians of the north of Portugal, further investigations with stronger measurements, double-blinding designs and bigger simple sizes are needed.

Time Is Money: The Decision Making of Smartphone High Users in Gain and Loss Intertemporal Choice.

PubMed

Tang, Zixuan; Zhang, Huijun; Yan, An; Qu, Chen

2017-01-01

Nowadays the smartphone plays an important role in our lives. While it brings us convenience and efficiency, its overuse can cause problems. Although a great number of studies have demonstrated that people affected by substance abuse, pathological gambling, and internet addiction disorder have lower self-control than average, scarcely any study has investigated the decision making of smartphone high users by using a behavioral paradigm. The present study employed an intertemporal task, the Smartphone Addiction Inventory (SPAI) and the Barratt Impulsiveness Scale 11th version (BIS-11) to explore the decision control of smartphone high users in a sample of 125 college students. Participants were divided into three groups according to their SPAI scores. The upper third (69 or higher), middle third (from 61 to 68) and lower third (60 or lower) of scores were defined as high smartphone users, medium users and low users, respectively. We compared the percentage of small immediate reward/penalty choices in different conditions between the three groups. Relative to the low users group, high users and medium users were more inclined to request an immediate monetary reward. Moreover, for the two dimensions of time and money in intertemporal choice, high users and medium users showed a bias in intertemporal choice task among most of the time points and value magnitude compared to low users. These findings demonstrated that smartphone overuse was associated with problematic decision-making, a pattern similar to that seen in persons affected by a variety of addictions.

Evaluation of digital dental models obtained from dental cone-beam computed tomography scan of alginate impressions

PubMed Central

Jiang, Tingting; Lee, Sang-Mi; Hou, Yanan; Chang, Xin

2016-01-01

Objective To investigate the dimensional accuracy of digital dental models obtained from the dental cone-beam computed tomography (CBCT) scan of alginate impressions according to the time elapse when the impressions are stored under ambient conditions. Methods Alginate impressions were obtained from 20 adults using 3 different alginate materials, 2 traditional alginate materials (Alginoplast and Cavex Impressional) and 1 extended-pour alginate material (Cavex ColorChange). The impressions were stored under ambient conditions, and scanned by CBCT immediately after the impressions were taken, and then at 1 hour intervals for 6 hours. After reconstructing three-dimensional digital dental models, the models were measured and the data were analyzed to determine dimensional changes according to the elapsed time. The changes within the measurement error were regarded as clinically acceptable in this study. Results All measurements showed a decreasing tendency with an increase in the elapsed time after the impressions. Although the extended-pour alginate exhibited a less decreasing tendency than the other 2 materials, there were no statistically significant differences between the materials. Changes above the measurement error occurred between the time points of 3 and 4 hours after the impressions. Conclusions The results of this study indicate that digital dental models can be obtained simply from a CBCT scan of alginate impressions without sending them to a remote laboratory. However, when the impressions are not stored under special conditions, they should be scanned immediately, or at least within 2 to 3 hours after the impressions are taken. PMID:27226958

Perception and the strongest sensory memory trace of multi-stable displays both form shortly after the stimulus onset.

PubMed

Pastukhov, Alexander

2016-02-01

We investigated the relation between perception and sensory memory of multi-stable structure-from-motion displays. The latter is an implicit visual memory that reflects a recent history of perceptual dominance and influences only the initial perception of multi-stable displays. First, we established the earliest time point when the direction of an illusory rotation can be reversed after the display onset (29-114 ms). Because our display manipulation did not bias perception towards a specific direction of illusory rotation but only signaled the change in motion, this means that the perceptual dominance was established no later than 29-114 ms after the stimulus onset. Second, we used orientation-selectivity of sensory memory to establish which display orientation produced the strongest memory trace and when this orientation was presented during the preceding prime interval (80-140 ms). Surprisingly, both estimates point towards the time interval immediately after the display onset, indicating that both perception and sensory memory form at approximately the same time. This suggests a tighter integration between perception and sensory memory than previously thought, warrants a reconsideration of its role in visual perception, and indicates that sensory memory could be a unique behavioral correlate of the earlier perceptual inference that can be studied post hoc.

Immediate liposuction could shorten the time for endoscopic axillary lymphadenectomy in breast cancer patients.

PubMed

Shi, Fujun; Huang, Zonghai; Yu, Jinlong; Zhang, Pusheng; Deng, Jianwen; Zou, Linhan; Zhang, Cheng; Luo, Yunfeng

2017-01-31

Endoscopic axillary lymphadenectomy (EALND) was introduced to clinical work to reduce side effects of conventional axillary lymphadenectomy, while the lipolysis and liposuction of EALND made the process consume more time. The aim of the study was to determine whether immediate liposuction after tumescent solution injection to the axilla could shorten the total time of EALND. Fifty-nine patients were enrolled in the study, 30 of them received EALND with traditional liposuction method (TLM), and the rest 29 patients received EALND with immediate liposuction method (ILM). The operation time, cosmetic result, drainage amount, and hospitalization time of the two groups were compared. The median EALND operation time of TLM group and ILM group were 68 and 46 min, respectively, the difference was significant (P < 0.05); the median cosmetic results of the two groups were 6.6 and 6.4, respectively; the median drainage amount of the two groups were 366 and 385 ml, respectively; the hospitalization time of the two groups were 15 and 16 days, respectively. For the last three measures, no significant difference was confirmed (P > 0.05). Our work suggests immediate liposuction could shorten the endoscopic axillary lymphadenectomy process, and this method would not compromise the operation results. However, due to the limitations of the research, more work needs to be done to prove the availability and feasibility of immediate liposuction.

Chat reference service in medical libraries: part 2--Trends in medical school libraries.

PubMed

Dee, Cheryl R

2003-01-01

An increasing number of medical school libraries offer chat service to provide immediate, high quality information at the time and point of need to students, faculty, staff, and health care professionals. Part 2 of Chat Reference Service in Medical Libraries presents a snapshot of the current trends in chat reference service in medical school libraries. In late 2002, 25 (21%) medical school libraries provided chat reference. Trends in chat reference services in medical school libraries were compiled from an exploration of medical school library Web sites and informal correspondence from medical school library personnel. Many medical libraries are actively investigating and planning new chat reference services, while others have decided not to pursue chat reference at this time. Anecdotal comments from medical school library staff provide insights into chat reference service.

Political orientation moderates worldview defense in response to Osama bin Laden’s death

PubMed Central

Chopik, William J.; Konrath, Sara H.

2016-01-01

The current study examines Americans’ psychological responses to Osama bin Laden’s death. We tracked changes in how different participants responded to dissimilar others from the night of bin Laden’s death for five weeks. Liberal participants reported lower worldview defense (i.e., a defensive reaction to uphold one’s cultural worldview) immediately after bin Laden’s death but then returned to similar levels as their conservative counterparts over time. Conservative participants reported greater worldview defense during each point of the study and did not significantly change over time. These temporal differences between liberals and conservatives were only present in the year of bin Laden’s death and not one year prior before. The current findings demonstrate that liberals and conservatives may react differently after major societal events in predictable ways considering their moral foundations. PMID:28239251

Slow updating of the achromatic point after a change in illumination

PubMed Central

Lee, R. J.; Dawson, K. A.; Smithson, H. E.

2015-01-01

For a colour constant observer, the colour appearance of a surface is independent of the spectral composition of the light illuminating it. We ask how rapidly colour appearance judgements are updated following a change in illumination. We obtained repeated binary colour classifications for a set of stimuli defined by their reflectance functions and rendered under either sunlight or skylight. We used these classifications to derive boundaries in colour space that identify the observer’s achromatic point. In steady-state conditions of illumination, the achromatic point lay close to the illuminant chromaticity. In our experiment the illuminant changed abruptly every 21 seconds (at the onset of every 10th trial), allowing us to track changes in the achromatic point that were caused by the cycle of illuminant changes. In one condition, the test reflectance was embedded in a spatial pattern of reflectance samples under consistent illumination. The achromatic point migrated across colour space between the chromaticities of the steady-state achromatic points. This update took several trials rather than being immediate. To identify the factors that governed perceptual updating of appearance judgements we used two further conditions, one in which the test reflectance was presented in isolation and one in which the surrounding reflectances were rendered under an inconsistent and unchanging illumination. Achromatic settings were not well predicted by the information available from scenes at a single time-point. Instead the achromatic points showed a strong dependence on the history of chromatic samples. The strength of this dependence differed between observers and was modulated by the spatial context. PMID:22275468

It's about time: Earlier rewards increase intrinsic motivation.

PubMed

Woolley, Kaitlin; Fishbach, Ayelet

2018-06-01

Can immediate (vs. delayed) rewards increase intrinsic motivation? Prior research compared the presence versus absence of rewards. By contrast, this research compared immediate versus delayed rewards, predicting that more immediate rewards increase intrinsic motivation by creating a perceptual fusion between the activity and its goal (i.e., the reward). In support of the hypothesis, framing a reward from watching a news program as more immediate (vs. delayed) increased intrinsic motivation to watch the program (Study 1), and receiving more immediate bonus (vs. delayed, Study 2; and vs. delayed and no bonus, Study 3) increased intrinsic motivation in an experimental task. The effect of reward timing was mediated by the strength of the association between an activity and a reward, and was specific to intrinsic (vs. extrinsic) motivation-immediacy influenced the positive experience of an activity, but not perceived outcome importance (Study 4). In addition, the effect of the timing of rewards was independent of the effect of the magnitude of the rewards (Study 5). (PsycINFO Database Record (c) 2018 APA, all rights reserved).

ANALYSIS: mobile phones integrated into diabetes management: a logical progression.

PubMed

Malasanos, Toree

2008-01-01

In this issue of Journal of Diabetes Science and Technology, the intervention described by D. Katz, "Novel Interactive Cell-Phone Technology for Health Enhancement," uses cell phones to provide the rapid communication necessary for the support of intensive management of diabetes. Mobile technology is widely accepted in today's society and can be an effective tool for this cause. There have been numerous interventions using various communication tools, including cell phones, to manage chronic disease, which all propose that improved communication and feedback to patients would improve health status. Dr. Katz has taken the next step by giving semiautomated, real-time, immediate feedback on each data point all transmitted by cell phone.

Imaging in lung transplants: Checklist for the radiologist.

PubMed

Madan, Rachna; Chansakul, Thanissara; Goldberg, Hilary J

2014-10-01

Post lung transplant complications can have overlapping clinical and imaging features, and hence, the time point at which they occur is a key distinguisher. Complications of lung transplantation may occur along a continuum in the immediate or longer postoperative period, including surgical and mechanical problems due to size mismatch and vascular as well as airway anastomotic complication, injuries from ischemia and reperfusion, acute and chronic rejection, pulmonary infections, and post-transplantation lymphoproliferative disorder. Life expectancy after lung transplantation has been limited primarily by chronic rejection and infection. Multiple detector computed tomography (MDCT) is critical for evaluation and early diagnosis of complications to enable selection of effective therapy and decrease morbidity and mortality among lung transplant recipients.

Continuous inline blending of antimisting kerosene

NASA Technical Reports Server (NTRS)

Parikh, P.; Yavrouian, A.; Sarohia, V.

1985-01-01

A continuous inline blender was developed to blend polymer slurries with a stream of jet A fuel. The viscosity of the slurries ranged widely. The key element of the blender was a static mixer placed immediately downstream of the slurry injection point. A positive displacement gear pump for jet A was employed, and a progressive cavity rotary screw pump was used for slurry pumping. Turbine flow meters were employed for jet A metering while the slurry flow rate was calibrated against the pressure drop in the injection tube. While using one of the FM-9 variant slurries, a provision was made for a time delay between the addition of slurry and the addition of amine sequentially into the jet A stream.

Spontaneous Cracking in Unfired Magnesia Compacts Upon Standing in Air

NASA Technical Reports Server (NTRS)

Davies, Myron O.; Grimes, Hubert H.; May, Charles E.

1961-01-01

Analytical-grade magnesium oxide powder without binder was compressed hydrostatically to 50,000 lb. per sq. in. to form compacts. When exposed to moist air immediately after pressing, these compacts developed irregularly shaped cracks. Controlled tests, in which these compacts were exposed for various lengths of time to various atmospheres, indicated that in general water vapor, carbon dioxide, and residual stresses had to be present if cracking was to occur. The probable cause of the cracking was the formation of a less dense and mechanically weak basic carbonate of magnesium at crystallite surface points of high stress concentration which developed during the compacting. The adsorption of dry CO2 at such sites prevented subsequent delayed fracture.

Modifying the brain activation of poor readers during sentence comprehension with extended remedial instruction: a longitudinal study of neuroplasticity.

PubMed

Meyler, Ann; Keller, Timothy A; Cherkassky, Vladimir L; Gabrieli, John D E; Just, Marcel Adam

2008-08-01

This study used fMRI to longitudinally assess the impact of intensive remedial instruction on cortical activation among 5th grade poor readers during a sentence comprehension task. The children were tested at three time points: prior to remediation, after 100 h of intensive instruction, and 1 year after the instruction had ended. Changes in brain activation were also measured among 5th grade good readers at the same time points for comparison. The central finding was that prior to instruction, the poor readers had significantly less activation than good readers bilaterally in the parietal cortex. Immediately after instruction, poor readers made substantial gains in reading ability, and demonstrated significantly increased activation in the left angular gyrus and the left superior parietal lobule. Activation in these regions continued to increase among poor readers 1 year post-remediation, resulting in a normalization of the activation. These results are interpreted as reflecting changes in the processes involved in word-level and sentence-level assembly. Areas of overactivation were also found among poor readers in the medial frontal cortex, possibly indicating a more effortful and attentive guided reading strategy.

Modifying the Brain Activation of Poor Readers during Sentence Comprehension with Extended Remedial Instruction: A Longitudinal Study of Neuroplasticity

PubMed Central

Meyler, Ann; Keller, Timothy A.; Cherkassky, Vladimir L.; Gabrieli, John D. E.; Just, Marcel Adam

2008-01-01

This study used fMRI to longitudinally assess the impact of intensive remedial instruction on cortical activation among 5th grade poor readers during a sentence comprehension task. The children were tested at 3 time points: prior to remediation, after 100 hours of intensive instruction, and 1 year after the instruction had ended. Changes in brain activation were also measured among 5th grade good readers at the same time points for comparison. The central finding was that prior to instruction, the poor readers had significantly less activation than good readers bilaterally in the parietal cortex. Immediately after instruction, poor readers made substantial gains in reading ability, and demonstrated significantly increased activation in the left angular gyrus and the left superior parietal lobule. Activation in these regions continued to increase among poor readers 1 year post-remediation, resulting in a normalization of the activation. These results are interpreted as reflecting changes in the processes involved in word-level and sentence-level assembly. Areas of overactivation were also found among poor readers in the medial frontal cortex, possibly indicating a more effortful and attentionally-guided reading strategy. PMID:18495180

Comparison of delayed versus immediate pushing during second stage of labor for nulliparous women with epidural anesthesia.

PubMed

Gillesby, Erica; Burns, Suzan; Dempsey, Amy; Kirby, Shirley; Mogensen, Kami; Naylor, Kelly; Petrella, Joann; Vanicelli, Rebecca; Whelan, Breon

2010-01-01

To determine if the use of delayed pushing after the onset of the second stage of labor decreases the time of active pushing and decreases maternal fatigue. Randomized clinical trial. Labor and delivery unit of a not-for-profit community hospital. Convenience sample of nulliparous laboring women with epidural anesthesia. Immediate or delayed pushing (2 hours) during the second stage of labor at the time of complete cervical dilatation. The length of pushing, total length of the second stage, and maternal fatigue. A total of 77 women were studied (immediate pushing group=39; delayed pushing=38). The immediate pushing group averaged 94 (± 57) minutes in active pushing, while the delayed pushing group averaged 68 (± 46) minutes, a statistically significant difference (p=.04). No significant differences were found in fatigue scores between the immediate and delayed pushing groups (p>.05). We found that by delaying the onset of active pushing for 2 hours after the beginning of the second stage of labor, the time that nulliparous women with epidural anesthesia spent in active pushing was significantly decreased by 27%. Although the delayed pushing group rested for up to 2 hours, the total time in the second stage of labor averaged only 59 minutes longer than the immediate pushing group. © 2010 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

Worrying about one's children after breast cancer diagnosis: desired timing of psychosocial intervention.

PubMed

Stinesen Kollberg, Karin; Wilderäng, Ulrica; Möller, Anders; Steineck, Gunnar

2014-11-01

The purposes of this observational study were to analyze at what time point mothers desired psychosocial support regarding the worry about their children during the year after breast cancer diagnosis and to identify any psychosocial factors associated with this worry. In a population-based study, we analyzed data from 280 mothers diagnosed with breast cancer at Sahlgrenska University Hospital in Gothenburg, Sweden. Of those who did not receive chemotherapy treatment, 70 out of 112 women (63 %) reported a desire to receive support about the worry about their children, and of those who received chemotherapy treatment, 20 out of 49 (41 %) reported a need for support immediately following diagnosis and before surgery. We identified having children at home (P < 0.0001), worry about sex life (P = 0.0009), fear of dying from breast cancer (P = 0.0055), and worried about one's personal financial situation (P = 0.0413) as the variables most closely related to worry about the children. Our population-based study shows that mothers with breast cancer had an immediate desire to receive psychosocial support regarding the worry about their own children. If we wish to shorten the pain associated with this worry among women diagnosed with breast cancer, it may be helpful to offer support as early in the disease trajectory as possible as it may reduce the risk of a later, more complicated, unnecessarily prolonged psychosocial rehabilitation process.

Development of In Vitro-In Vivo Correlation for Amorphous Solid Dispersion Immediate-Release Suvorexant Tablets and Application to Clinically Relevant Dissolution Specifications and In-Process Controls.

PubMed

Kesisoglou, Filippos; Hermans, Andre; Neu, Colleen; Yee, Ka Lai; Palcza, John; Miller, Jessica

2015-09-01

Although in vitro-in vivo correlations (IVIVCs) are commonly pursued for modified-release products, there are limited reports of successful IVIVCs for immediate-release (IR) formulations. This manuscript details the development of a Multiple Level C IVIVC for the amorphous solid dispersion formulation of suvorexant, a BCS class II compound, and its application to establishing dissolution specifications and in-process controls. Four different 40 mg batches were manufactured at different tablet hardnesses to produce distinct dissolution profiles. These batches were evaluated in a relative bioavailability clinical study in healthy volunteers. Although no differences were observed for the total exposure (AUC) of the different batches, a clear relationship between dissolution and Cmax was observed. A validated Multiple Level C IVIVC against Cmax was developed for the 10, 15, 20, 30, and 45 min dissolution time points and the tablet disintegration time. The relationship established between tablet tensile strength and dissolution was subsequently used to inform suitable tablet hardness ranges within acceptable Cmax limits. This is the first published report for a validated Multiple Level C IVIVC for an IR solid dispersion formulation demonstrating how this approach can facilitate Quality by Design in formulation development and help toward clinically relevant specifications and in-process controls. © 2015 Wiley Periodicals, Inc. and the American Pharmacists Association.

25 CFR 292.2 - How are key terms defined in this part?

Code of Federal Regulations, 2010 CFR

2010-04-01

... or a public road or right-of-way and includes parcels that touch at a point. Former reservation means... establish that its governmental functions, infrastructure or services will be directly, immediately and...

25 CFR 292.2 - How are key terms defined in this part?

Code of Federal Regulations, 2011 CFR

2011-04-01

... or a public road or right-of-way and includes parcels that touch at a point. Former reservation means... establish that its governmental functions, infrastructure or services will be directly, immediately and...

A Descriptive Longitudinal Study of Changes in Vape Shop Characteristics and Store Policies in Anticipation of the 2016 FDA Regulations of Tobacco Products, Including E-Cigarettes.

PubMed

Yu, Sheila; Escobedo, Patricia; Garcia, Robert; Cruz, Tess Boley; Unger, Jennifer B; Baezconde-Garbanati, Lourdes; Meza, Leah; Sussman, Steve

2018-02-11

After proposing the "Deeming Rule" in 2014, the U.S. Food and Drug Administration (FDA) began regulating the manufacturing, marketing, and sales of electronic cigarette (e-cigarette) products as tobacco products in 2016. The current study conducted vape shop store observations and surveyed Los Angeles-area shop employees (assessing their beliefs, awareness, and perceptions of e-cigarettes and related FDA regulations) at two time points one year apart to better understand what vape shop retailers would do given FDA's soon-to-be-enacted Deeming Rule. The study also compared retailer beliefs/awareness/actions and store characteristics immediately after the Deeming Rule proposal versus a year after the Rule had been proposed, right before its enactment. Two data collection waves occurred before the Deeming Rule enactment, with Year 1 surveying 77 shops (2014) and Year 2 surveying 61 shops (2015-2016). Between the data collection points, 16 shops had closed. Among the shops that were open at both time points, the majority (95% in Year 1; 74% in Year 2) were aware of some FDA regulations or other policies applying to vape shops. However, overall awareness of FDA regulations and state/local policies governing e-cigarettes significantly decreased from Year 1 to Year 2. At both time points, all shops offered customers free puffs of nicotine-containing e-liquids (prohibited by the then upcoming Deeming Rule). Perceptions of e-cigarette safety also significantly decreased between the years. Exploring vape shop retailer perceptions and store policies (i.e., free puffs/samples displays, perceptions of e-cigarette safety, etc.) over time will help the FDA assess the needs of the vape shop community and develop more effective retailer education campaigns and materials targeted to increase compliance with the newly enacted regulations.

A Descriptive Longitudinal Study of Changes in Vape Shop Characteristics and Store Policies in Anticipation of the 2016 FDA Regulations of Tobacco Products, Including E-Cigarettes

PubMed Central

Escobedo, Patricia; Baezconde-Garbanati, Lourdes; Meza, Leah; Sussman, Steve

2018-01-01

After proposing the “Deeming Rule” in 2014, the U.S. Food and Drug Administration (FDA) began regulating the manufacturing, marketing, and sales of electronic cigarette (e-cigarette) products as tobacco products in 2016. The current study conducted vape shop store observations and surveyed Los Angeles–area shop employees (assessing their beliefs, awareness, and perceptions of e-cigarettes and related FDA regulations) at two time points one year apart to better understand what vape shop retailers would do given FDA’s soon-to-be-enacted Deeming Rule. The study also compared retailer beliefs/awareness/actions and store characteristics immediately after the Deeming Rule proposal versus a year after the Rule had been proposed, right before its enactment. Two data collection waves occurred before the Deeming Rule enactment, with Year 1 surveying 77 shops (2014) and Year 2 surveying 61 shops (2015–2016). Between the data collection points, 16 shops had closed. Among the shops that were open at both time points, the majority (95% in Year 1; 74% in Year 2) were aware of some FDA regulations or other policies applying to vape shops. However, overall awareness of FDA regulations and state/local policies governing e-cigarettes significantly decreased from Year 1 to Year 2. At both time points, all shops offered customers free puffs of nicotine-containing e-liquids (prohibited by the then upcoming Deeming Rule). Perceptions of e-cigarette safety also significantly decreased between the years. Exploring vape shop retailer perceptions and store policies (i.e., free puffs/samples displays, perceptions of e-cigarette safety, etc.) over time will help the FDA assess the needs of the vape shop community and develop more effective retailer education campaigns and materials targeted to increase compliance with the newly enacted regulations. PMID:29439464

Fibrin-Targeted Magnetic Resonance Imaging Allows In Vivo Quantification of Thrombus Fibrin Content and Identifies Thrombi Amenable for Thrombolysis

PubMed Central

Jenkins, Julia; Modarai, Bijan; Wiethoff, Andrea J.; Phinikaridou, Alkystis; Grover, Steven P.; Patel, Ashish S.; Schaeffter, Tobias; Smith, Alberto; Botnar, Rene M.

2014-01-01

Objective Deep venous thrombosis is a major health problem. Thrombolytic therapies are effective in recanalizing the veins and preventing post-thrombotic complications, but there is no consensus on selection criteria. The aim of this study was to investigate a fibrin-specific MRI contrast agent (EP-2104R) for the accurate quantification of thrombus’ fibrin content in vivo and for the identification of thrombus suitable for thrombolysis. Approach and Results Venous thrombosis was induced in the inferior vena cava of 8- to 10-week-old male BALB/C mice and MRI performed 2, 4, 7, 10, 14, and 21 days later. Eighteen mice were scanned at each time point pre and 2 hours post injection of EP-2104R (8.0 μmol/kg) with 12 mice at each time point used to correlate fibrin contrast uptake with thrombus’ histological stage and fibrin content. Six mice at each time point were immediately subjected to intravascular thrombolytic therapy (10 mg/kg of tissue-type plasminogen activator). Mice were imaged to assess response to lytic therapy 24 hours after thrombolytic treatment. Two mice at each time point were scanned post injection of 0.2 mmol/kg of Gd-DTPA (gadolinium with diethylenetriaminepentacetate, Magnevist, Schering AG, Berlin, Germany) for control purpose. Contrast uptake was correlated positively with the fibrin content of the thrombus measured by Western blotting (R2=0.889; P<0.001). Thrombus relaxation rate (R1) post contrast and the change in visualized thrombus size on late gadolinium enhancement inversion recovery MRI pre–EP-2104R and post–EP-2104R injection were the best predictors for successful thrombolysis (area under the curve, 0.989 [95% confidence interval, 0.97–1.00] and 0.994 [95% confidence interval, 0.98–1.00] respectively). Conclusions MRI with a fibrin-specific contrast agent accurately estimates thrombus fibrin content in vivo and identifies thrombi that are amenable for thrombolysis. PMID:24723557

77 FR 38113 - Self-Regulatory Organizations; EDGA Exchange, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-26

...'') proposes to amend Exchange Rule 11.5(c) to add a new order type, the Mid-Point Discretionary Order, to the... functionality to its System \\3\\ and its Users,\\4\\ the Exchange proposes to add a new order type, the Mid-Point Discretionary Order (the ``MDO''), to Rule 11.5(c)(17). MDOs to buy would be displayed at and pegged to the...

4. View looking from the north of George Washington's 'Potowmack' ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

4. View looking from the north of George Washington's 'Potowmack' Canal at Great Falls on the Potomac River, taken September 1, 1943. The low water of the Potomac is definitely shown by the markings on the bank of the river, immediately across stream from where photograph was taken. The usual water mark existing under normal conditions, is shown on the rock in the immediate foreground at a point about even with the spectator's pipe. The spectator is pointing to the evidences of old drillings made in this hard rock by General Washington and his courageous crew, who either blasted or cleaved this opening in the solid wall of rock, to permit boats to pass around the Great Falls and thence into the Potomac River. In the foreground, a slab of stone is ... - Potowmack Company: Great Falls Canal, Locks No. 3, 4, 5, Great Falls, Fairfax County, VA

Green Tea Consumption after Intense Taekwondo Training Enhances Salivary Defense Factors and Antibacterial Capacity

PubMed Central

Lin, Shiuan-Pey; Li, Chia-Yang; Suzuki, Katsuhiko; Chang, Chen-Kang; Chou, Kuei-Ming; Fang, Shih-Hua

2014-01-01

The aim of this study was to investigate the short-term effects of green tea consumption on selected salivary defense proteins, antibacterial capacity and anti-oxidation activity in taekwondo (TKD) athletes, following intensive training. Twenty-two TKD athletes performed a 2-hr TKD training session. After training, participants ingested green tea (T, caffeine 6 mg/kg and catechins 22 mg/kg) or an equal volume of water (W). Saliva samples were collected at three time points: before training (BT-T; BT-W), immediately after training (AT-T; AT-W), and 30 min after drinking green tea or water (Rec-T; Rec-W). Salivary total protein, immunoglobulin A (SIgA), lactoferrin, α-amylase activity, free radical scavenger activity (FRSA) and antibacterial capacity were measured. Salivary total protein, lactoferrin, SIgA concentrations and α-amylase activity increased significantly immediately after intensive TKD training. After tea drinking and 30 min rest, α-amylase activity and the ratio of α-amylase to total protein were significantly higher than before and after training. In addition, salivary antibacterial capacity was not affected by intense training, but green tea consumption after training enhanced salivary antibacterial capacity. Additionally, we observed that salivary FRSA was markedly suppressed immediately after training and quickly returned to pre-exercise values, regardless of which fluid was consumed. Our results show that green tea consumption significantly enhances the activity of α-amylase and salivary antibacterial capacity. PMID:24498143

Delaying in vivo exposure to a tarantula with very brief exposure to phobic stimuli.

PubMed

Siegel, Paul; Gallagher, Kimberly Alyse

2015-03-01

Research has documented the very brief exposure (VBE) effect: the reduction of phobic fear by continuous presentation of masked phobic pictures. In prior studies, phobic participants approached a live tarantula immediately after the masked stimuli were presented. This study tested the hypothesis that VBE would reduce phobic avoidance of the tarantula 24 h later. 86 spider-phobic participants were identified with a fear questionnaire and Behavioral Avoidance Test (BAT) with a live tarantula indicative of a DSM-IV diagnosis of Specific Phobia. One week later, they were randomly assigned in double-blind fashion to presentation of a continuous series of 25 trials of masked images of either spiders or flowers (33-ms each), i.e., to VBE or control exposure. The participants gave subjective distress ratings just before and after these exposures. Then they engaged in the BAT again either immediately thereafter or 24 h later to measure changes in avoidance of the tarantula. Masked images of spiders reduced avoidance of the tarantula both immediately after exposure and 24 h later without causing subjective distress. The effect sizes at these two time points did not significantly differ from each other. We did not manipulate awareness of the spider images by presenting them unmasked to a third group. Conclusions about the effect of awareness of the stimuli cannot be drawn. VBE induces a process of fear reduction before phobic individuals engage in in vivo exposure, which is more distressing. Thus, VBE may help phobic-resistant individuals start treatment more gradually.

Tolerance of females to +Gz centrifugation before and after bedrest

NASA Technical Reports Server (NTRS)

Newsom, B. D.; Goldenrath, W. L.; Sandler, H.; Winter, W. R.

1977-01-01

Because women may be included as passengers in the proposed Space Shuttle System, experiments were conducted on 12 female subjects aged 24-35 yr to investigate the +Gz tolerance of women and the possible degradation of this tolerance after a period of weightlessness as simulated by bedrest. Over a 1-week period, each subject was exposed to +Gz levels starting at +2 Gz and increasing by 0.5 Gz increments to a gray-out point. This point was determined by peripheral vision loss with a standard lightbar and by reverse blood flow in the temporal artery. Ultimately, each woman was subjected to three runs at the +3 Gz level for about 55 min long each, separated by 5-min rest periods. Eight subjects with the best tolerance times were selected for 14 days of bedrest in a horizontal position; the other four being ambulatory controls. Tests before bedrest, immediately following, and 5 d later showed that average +Gz tolerance decreased by 67% after bedrest.

Distributed intrusion monitoring system with fiber link backup and on-line fault diagnosis functions

NASA Astrophysics Data System (ADS)

Xu, Jiwei; Wu, Huijuan; Xiao, Shunkun

2014-12-01

A novel multi-channel distributed optical fiber intrusion monitoring system with smart fiber link backup and on-line fault diagnosis functions was proposed. A 1× N optical switch was intelligently controlled by a peripheral interface controller (PIC) to expand the fiber link from one channel to several ones to lower the cost of the long or ultra-long distance intrusion monitoring system and also to strengthen the intelligent monitoring link backup function. At the same time, a sliding window auto-correlation method was presented to identify and locate the broken or fault point of the cable. The experimental results showed that the proposed multi-channel system performed well especially whenever any a broken cable was detected. It could locate the broken or fault point by itself accurately and switch to its backup sensing link immediately to ensure the security system to operate stably without a minute idling. And it was successfully applied in a field test for security monitoring of the 220-km-length national borderline in China.

Realtime Gas Emission Monitoring at Hazardous Sites Using a Distributed Point-Source Sensing Infrastructure.

PubMed

Manes, Gianfranco; Collodi, Giovanni; Gelpi, Leonardo; Fusco, Rosanna; Ricci, Giuseppe; Manes, Antonio; Passafiume, Marco

2016-01-20

This paper describes a distributed point-source monitoring platform for gas level and leakage detection in hazardous environments. The platform, based on a wireless sensor network (WSN) architecture, is organised into sub-networks to be positioned in the plant's critical areas; each sub-net includes a gateway unit wirelessly connected to the WSN nodes, hence providing an easily deployable, stand-alone infrastructure featuring a high degree of scalability and reconfigurability. Furthermore, the system provides automated calibration routines which can be accomplished by non-specialized maintenance operators without system reliability reduction issues. Internet connectivity is provided via TCP/IP over GPRS (Internet standard protocols over mobile networks) gateways at a one-minute sampling rate. Environmental and process data are forwarded to a remote server and made available to authenticated users through a user interface that provides data rendering in various formats and multi-sensor data fusion. The platform is able to provide real-time plant management with an effective; accurate tool for immediate warning in case of critical events.

Detectability of Chelyabinsk-like impactors with Pan-STARRS

NASA Astrophysics Data System (ADS)

Micheli, Marco; Wainscoat, Richard J.; Denneau, Larry

2018-03-01

In this work we present the results of our analysis of the detectability of an object in the size range of the recent Chelyabinsk impactor under the current discovery and follow-up capabilities, using the specific observational strategy of the Pan-STARRS survey as a reference point. We first discuss the observability of real-life cases inspired by the impact trajectories of 2008 TC3, 2014 AA, the past Earth encounters with 2014 RC and 2015 TB145, the upcoming fly-by of 2012 TC4 and the Chelyabinsk event. We then expand our analysis with the investigation of synthetic impactors with realistic orbital distributions. Among the various conclusions of our analysis, we discuss how the time of first detectability of an object does not necessarily correspond to the moment when that same object can be recognized as an impactor. We also point out how objects discovered only a few days before impact can be immediately identified as impactors, partly thanks to the good astrometric quality that telescopes like Pan-STARRS currently achieve.

A Fixed Point Theorem in Weak Topology for Successively Recurrent System of Set-Valued Mapping Equations and Its Applications

NASA Astrophysics Data System (ADS)

Horiuchi, Kazuo

Let us introduce n (≥ 2) mappings fi(i = 1, …, n ≡ 0) defined on reflexive real Banach spaces Xi-1 and let fi : Xi-1 → Yi be completely continuous on bounded convex closed subsets X_{i-1}^{(0)} \\\\subset X_{i-1}. Moreover, let us introduce n set-valued mappings F_i : X_{i-1} \\\\times Y_i \\\\to {\\\\cal F}_c(X_i) (the family of all non-empty compact subsets of Xi), (i=1, …, n ≡ 0). Here, we have a fixed point theorem in weak topology on the successively recurrent system of set-valued mapping equations: xi ∈ Fi(xi-1, fi(xi-1)), (i=1, …, n ≡ 0). This theorem can be applied immediately to analysis of the availability of system of circular networks of channels undergone by uncertain fluctuations and to evaluation of the tolerability of behaviors of those systems.

78 FR 70388 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-25

...-Only Orders may not have a time-in-force designation of Good Til Cancelled or Immediate or Cancel. (f... designation of Good Til Cancelled or Immediate or Cancel.\\8\\ Post-Only Orders received prior to the opening...

Cytological surveillance compared with immediate referral for colposcopy in management of women with low grade cervical abnormalities: multicentre randomised controlled trial.

PubMed

2009-07-28

To examine the effectiveness of cytological surveillance in primary care compared with immediate referral for colposcopic examination in women with low grade abnormal results on cervical cytology tests. Multicentre individually randomised controlled trial. NHS cervical screening programmes in Grampian, Tayside, and Nottingham. 4439 women, aged 20-59, with a cytology result showing borderline nuclear abnormalities or mild dyskaryosis, October 1999-October 2002. Cytological screening every six months in primary care (n=2223) or referral for colposcopy and related interventions (n=2216). All women were followed for three years, concluding with an exit appointment at which colposcopic examination was undertaken. Colposcopists assessing outcome at this appointment were blinded to randomisation. Primary end point: cumulative incidence of cervical intraepithelial neoplasia grade II or more severe disease. Other end points: cervical intraepithelial neoplasia grade III or worse, clinically significant anxiety and depression, other self reported after effects, and rates of non-attendance. Analysis was by intention to treat; all those randomised were included. The cumulative incidence of cervical intraepithelial neoplasia grade II or worse was 79 per 1000 person years in the colposcopy arm and 58 per 1000 person years in the cytological surveillance arm (relative risk 1.37, 95% confidence interval 1.19 to 1.57). This difference was less marked for cervical intraepithelial neoplasia grade III or more severe disease, but the incidence was still higher in the colposcopy arm (relative risk 1.26, 1.04 to 1.53). Among women randomised to immediate colposcopy, 79% (74.9% to 82.5%) of cases of cervical intraepithelial neoplasia grade II or worse were diagnosed at the time of the immediate colposcopy, while among women randomised to cytological surveillance, 77% (72.1% to 81.2%) of cases were detected by surveillance cytology and related interventions. Similar proportions of women were anxious or depressed in the two arms. A higher proportion of women in the colposcopy arm reported after effects, and these were of longer duration and more severe. Non-attendance was low in both arms. The more marked difference between the arms in the occurrence of cervical intraepithelial neoplasia grade II or worse than in the occurrence of grade III or worse can probably be accounted for by the spontaneous regression of some cases of grade II neoplasia. Compared with cytological surveillance, a policy of immediate colposcopy detects more cervical intraepithelial neoplasia grade II or worse, and some more grade III or worse, but might lead to overtreatment. Such a policy is associated with a higher rate of reported after effects, which are more severe and of longer duration than those associated with cytological surveillance. ISRCTN 34841617.

Lessons learned from the American College of Surgeons National Surgical Quality Improvement Program Database: has centralized data collection improved immediate breast reconstruction outcomes and safety?

PubMed

Wang, Frederick; Koltz, Peter F; Sbitany, Hani

2014-11-01

The American College of Surgeons National Surgical Quality Improvement Program database was implemented to longitudinally track surgical 30-day surgical outcomes and complications. The authors analyze the program-reported outcomes for immediate breast reconstruction from 2007 to 2011, to assess whether longitudinal data collection has improved national outcomes and to highlight areas in need of continued improvement. The authors reviewed the database from 2007 to 2011 and identified encounters for immediate breast reconstruction using Current Procedural Terminology codes for prosthetic and autologous reconstruction. Demographics and comorbidities were tabulated for all patients. Postoperative complications analyzed included surgical-site infection, wound dehiscence, implant or flap loss, pulmonary embolism, and respiratory infections. A total of 15,978 patients underwent mastectomy and immediate reconstruction. Fewer smokers underwent immediate reconstruction over time (p=0.126), whereas more obese patients (p=0.001) and American Society of Anesthesiologists class 3 and 4 patients (p<0.001) underwent surgery. An overall increase in superficial surgical-site infection was noted, from 1.7 percent to 2.3 percent (p=0.214). Wound dehiscence (p=0.036) increased over time, whereas implant loss (p=0.015) and flap loss (p=0.012) decreased over time. Mean operative times increased over the analyzed years, as did all complications for prosthetic and autologous reconstruction. The American College of Surgeons National Surgical Quality Improvement Program data set has shown an increase in complications for immediate breast reconstruction over time, because of a longitudinally higher number of comorbid patients and longer operative times. This knowledge allows plastic surgeons the unique opportunity to improve patient selection criteria and efficiency. Therapeutic, III.

Exposure to traffic pollution, acute inflammation and autonomic response in a panel of car commuters.

PubMed

Sarnat, Jeremy A; Golan, Rachel; Greenwald, Roby; Raysoni, Amit U; Kewada, Priya; Winquist, Andrea; Sarnat, Stefanie E; Dana Flanders, W; Mirabelli, Maria C; Zora, Jennifer E; Bergin, Michael H; Yip, Fuyuen

2014-08-01

Exposure to traffic pollution has been linked to numerous adverse health endpoints. Despite this, limited data examining traffic exposures during realistic commutes and acute response exists. We conducted the Atlanta Commuters Exposures (ACE-1) Study, an extensive panel-based exposure and health study, to measure chemically-resolved in-vehicle exposures and corresponding changes in acute oxidative stress, lipid peroxidation, pulmonary and systemic inflammation and autonomic response. We recruited 42 adults (21 with and 21 without asthma) to conduct two 2-h scripted highway commutes during morning rush hour in the metropolitan Atlanta area. A suite of in-vehicle particulate components were measured in the subjects' private vehicles. Biomarker measurements were conducted before, during, and immediately after the commutes and in 3 hourly intervals after commutes. At measurement time points within 3h after the commute, we observed mild to pronounced elevations relative to baseline in exhaled nitric oxide, C-reactive-protein, and exhaled malondialdehyde, indicative of pulmonary and systemic inflammation and oxidative stress initiation, as well as decreases relative to baseline levels in the time-domain heart-rate variability parameters, SDNN and rMSSD, indicative of autonomic dysfunction. We did not observe any detectable changes in lung function measurements (FEV1, FVC), the frequency-domain heart-rate variability parameter or other systemic biomarkers of vascular injury. Water soluble organic carbon was associated with changes in eNO at all post-commute time-points (p<0.0001). Our results point to measureable changes in pulmonary and autonomic biomarkers following a scripted 2-h highway commute. Copyright © 2014 Elsevier Inc. All rights reserved.

Exposure to traffic pollution, acute inflammation and autonomic response in a panel of car commuters

PubMed Central

Sarnat, Jeremy A.; Golan, Rachel; Greenwald, Roby; Raysoni, Amit U.; Kewada, Priya; Winquist, Andrea; Sarnat, Stefanie E.; Flanders, W. Dana; Mirabelli, Maria C.; Zora, Jennifer E.; Bergin, Michael H.; Yip, Fuyuen

2015-01-01

Background Exposure to traffic pollution has been linked to numerous adverse health endpoints. Despite this, limited data examining traffic exposures during realistic commutes and acute response exists. Objectives: We conducted the Atlanta Commuters Exposures (ACE-1) Study, an extensive panel-based exposure and health study, to measure chemically-resolved in-vehicle exposures and corresponding changes in acute oxidative stress, lipid peroxidation, pulmonary and systemic inflammation and autonomic response. Methods We recruited 42 adults (21 with and 21 without asthma) to conduct two 2-h scripted highway commutes during morning rush hour in the metropolitan Atlanta area. A suite of in-vehicle particulate components were measured in the subjects’ private vehicles. Biomarker measurements were conducted before, during, and immediately after the commutes and in 3 hourly intervals after commutes. Results At measurement time points within 3 h after the commute, we observed mild to pronounced elevations relative to baseline in exhaled nitric oxide, C-reactive-protein, and exhaled malondialdehyde, indicative of pulmonary and systemic inflammation and oxidative stress initiation, as well as decreases relative to baseline levels in the time-domain heart-rate variability parameters, SDNN and rMSSD, indicative of autonomic dysfunction. We did not observe any detectable changes in lung function measurements (FEV1, FVC), the frequency-domain heart-rate variability parameter or other systemic biomarkers of vascular injury. Water soluble organic carbon was associated with changes in eNO at all post-commute time-points (p < 0.0001). Conclusions Our results point to measureable changes in pulmonary and autonomic biomarkers following a scripted 2-h highway commute. PMID:24906070

Change in Physical Activity and Sitting Time After Myocardial Infarction and Mortality Among Postmenopausal Women in the Women's Health Initiative-Observational Study.

PubMed

Gorczyca, Anna M; Eaton, Charles B; LaMonte, Michael J; Manson, JoAnn E; Johnston, Jeanne D; Bidulescu, Aurelian; Waring, Molly E; Manini, Todd; Martin, Lisa W; Stefanick, Marcia L; He, Ka; Chomistek, Andrea K

2017-05-15

How physical activity (PA) and sitting time may change after first myocardial infarction (MI) and the association with mortality in postmenopausal women is unknown. Participants included postmenopausal women in the Women's Health Initiative-Observational Study, aged 50 to 79 years who experienced a clinical MI during the study. This analysis included 856 women who had adequate data on PA exposure and 533 women for sitting time exposures. Sitting time was self-reported at baseline, year 3, and year 6. Self-reported PA was reported at baseline through year 8. Change in PA and sitting time were calculated as the difference between the cumulative average immediately following MI and the cumulative average immediately preceding MI. The 4 categories of change were: maintained low, decreased, increased, and maintained high. The cut points were ≥7.5 metabolic equivalent of task hours/week versus <7.5 metabolic equivalent of task hours/week for PA and ≥8 h/day versus <8 h/day for sitting time. Cox proportional hazard models estimated hazard ratios and 95% CIs for all-cause, coronary heart disease, and cardiovascular disease mortality. Compared with women who maintained low PA (referent), the risk of all-cause mortality was: 0.54 (0.34-0.86) for increased PA and 0.52 (0.36-0.73) for maintained high PA. Women who had pre-MI levels of sitting time <8 h/day, every 1 h/day increase in sitting time was associated with a 9% increased risk (hazard ratio=1.09, 95% CI: 1.01, 1.19) of all-cause mortality. Meeting the recommended PA guidelines pre- and post-MI may have a protective role against mortality in postmenopausal women. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

24 CFR 901.5 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... otherwise indicated, the assessed fiscal year is the immediate past fiscal year of a PHA. Assistant... the vacancy rate in the PHMAP assessment year (the immediate past fiscal year) with the vacancy rate... time it took to complete non-emergency work orders in the PHMAP assessment year (the immediate past...

Nursing student evaluation of NIOSH workplace violence prevention for nurses online course.

PubMed

Brann, Maria; Hartley, Dan

2017-02-01

As primary targets of workplace violence in health care settings, nurses may suffer negative physical and psychological consequences. NIOSH created an online course to educate nurses about violence prevention techniques. A mixed-methods approach assessed workplace violence awareness and knowledge among nursing students. A pre/post/post-test survey and focus group discussions evaluated participant awareness and knowledge, assessed course design, and solicited recommendations for increasing participation and strategies for improving message retention. The mean awareness scores differed significantly between pre-course and both post-course time points (Wilk's λ=0.319, F(2, 46)=49.01, p<0.001). Post hoc tests using the Bonferroni correction revealed that course participation increased awareness of workplace violence from pre-course scores (M=0.75, SD=0.438) to immediate post-course (M=2.13, SD=0.789) and four-week post-course (M=1.96, SD=0.771) scores on a 3-item measure. Similarly, mean knowledge scores increased between pre-course and both post-course time points (Wilk's λ=0.495, F(1.57, 73.66)=37.26, p<0.001). Post hoc tests using the Bonferroni correction revealed that course participation increased knowledge of workplace violence from pre-course scores (M=6.65, SD=1.45) to immediate post-course (M=8.56, SD=1.32) and four-week post-course (M=8.19, SD=1.42) scores on a 10-item measure. Qualitative data from the focus groups reinforced the quantitative findings. Participants citing benefits from the content strongly recommended including the course in nursing curriculums. Incorporating the course early in the nursing educational experience will better prepare students to deal with workplace violence when they enter health care professions. The results indicate that NIOSH and its partners created an effective online workplace violence awareness and prevention course. Practical applications: Nursing students and professionals can be effectively educated about workplace violence using an online format. Copyright © 2016 National Safety Council and Elsevier Ltd. All rights reserved.

Copolymer-1 vaccination regimens for neuroprotection in laser-induced retinal injuries

NASA Astrophysics Data System (ADS)

Belokopytov, Mark; Dubinsky, Galina; Belkin, Michael; Epstein, Yoram; Rosner, Mordechai

2005-04-01

The neuroprotective effect of immunization by glatiramer acetate (Copolymer-1, Cop-1, Copaxone) in adjuvant against laser-induced retinal damage was previously reported. The present study quantitatively compares various regimens of this vaccination for reducing the spread of laser-induced retinal damage and investigates the cellular mechanism of Cop-1 activity. Standard argon laser lesions were created in 78 DA pigmented rats divided into five groups: three Cop-1 single treatment groups (treated 7 days before, immediately after, or 24 hours after the injury), one group treated twice (7 days before and 20 days after injury), and a control group treated with adjuvant 7 days before the injury. The retinal lesions were evaluated 3, 20, and 60 days after the injury. Immunostaining of the retinas of the pretreated and control group animals 3 days after the laser injury was performed for T-cell detection. Cop-1 pre-immunization reduced photoreceptor loss at all time points as measured over the central zone of the lesion and 3 and 20 days after lasing as measured over the whole damaged area. Lesion diameter was reduced only 60 days after laser injury in pre-treated animals. Cop-1 given immediately after injury reduced cell loss as measured 20 and 60 days later in the whole lesion and 20 days after the laser irradiation, when measured in the center of lesion. It had no effect on lesion diameter. Late treatment reduced only the lesion diameter at all time points. Repeated treatment enhanced the neuroprotective effect, decreasing the cell loss in the center of lesion and reducing the diameter of lesion. T-cells were detected in the retinal lesions of pre-immunized animals and not in non-treated group, demonstrating the cellular immune mechanism of Cop-1. Immunization with Cop-1 is neuroprotective against laser-induced retinal injuries, and repeating the treatment enhances this effect. Cellular immune action of Cop-1 of was detected.

Environmental enrichment facilitates cocaine-cue extinction, deters reacquisition of cocaine self-administration and alters AMPAR GluA1 expression and phosphorylation.

PubMed

Gauthier, Jamie M; Lin, Amy; Nic Dhonnchadha, Bríd Á; Spealman, Roger D; Man, Heng-Ye; Kantak, Kathleen M

2017-01-01

This study investigated the combination of environmental enrichment (EE) with cocaine-cue extinction training on reacquisition of cocaine self-administration. Rats were trained under a second-order schedule for which responses were maintained by cocaine injections and cocaine-paired stimuli. During three weekly extinction sessions, saline was substituted for cocaine but cocaine-paired stimuli were presented. Rats received 4-h periods of EE at strategic time points during extinction training, or received NoEE. Additional control rats received EE or NoEE without extinction training. One week later, reacquisition of cocaine self-administration was evaluated for 15 sessions, and then GluA1 expression, a cellular substrate for learning and memory, was measured in selected brain regions. EE provided both 24 h before and immediately after extinction training facilitated extinction learning and deterred reacquisition of cocaine self-administration for up to 13 sessions. Each intervention by itself (EE alone or extinction alone) was ineffective, as was EE scheduled at individual time points (EE 4 h or 24 h before, or EE immediately or 6 h after, each extinction training session). Under these conditions, rats rapidly reacquired baseline rates of cocaine self-administration. Cocaine self-administration alone decreased total GluA1 and/or pSer845GluA1 expression in basolateral amygdala and nucleus accumbens. Extinction training, with or without EE, opposed these changes and also increased total GluA1 in ventromedial prefrontal cortex and dorsal hippocampus. EE alone increased pSer845GluA1 and EE combined with extinction training decreased pSer845GluA1 in ventromedial prefrontal cortex. EE might be a useful adjunct to extinction therapy by enabling neuroplasticity that deters relapse to cocaine self-administration. © 2015 Society for the Study of Addiction.

A comparison of terbutaline and fenoterol unit dose vials in treating children with acute asthmatic attacks.

PubMed

Lin, Yung-Zen; Huang, Fu-Yuan

2002-01-01

To compare the bronchodilation and adverse effects of two commercially marketed short-acting beta2-adrenergic agonists, terbutaline (Bricanyl, 5.0 mg/2ml) and fenoterol (Berotec,1.25 mg/2ml) unit dose vials (UDV), 108 acute asthmatic children, aged 5 to 14, were randomly enrolled into this study. Nebulization treatment for 10 minutes using an air compressor nebulizer was performed after measurements of baseline spirometry, SaO2, blood pressure and pulse rate. Same measurements were repeated at 0, 5, 15 and 30 minutes after the end of the nebulization treatment. The blood pressure was also monitored immediately and 30 minutes after treatment. Almost all the spirometric parameters of both treatments at various time points significantly improved. The pulse rate significantly increased at 15 and 30 min. The SaO2 significantly increased at 30 min. The systolic blood pressure significantly decreased immediately (terbutaline only) and at 30 min (fenoterol only). No significant change was found in diastolic blood pressure. When the laboratory parameters at the same time points were compared. Significant better results for fenoterol treatment were found in FEV, at 30 min (p = 0.048), PEF at 15 and 30 min (p = 0.049 and p = 0.027, respectively), FEF25-75% at 30 min (p = 0.033), mean absolute increase of PEF at 15 min (p = 0.034) and 30 min (p = 0.021), FEF25-75% at 30 min (p = 0.046), and in mean percent increase of FEF25-75% at 30 min (p = 0.047). The adverse effects for both groups were almost equal and around 21%. In conclusion, both terbutaline and fenoterol UDV nebulization treatments are effective in treating acute asthmatic children. The adverse effects are nearly equal. The fenoterol UDV nebulization treatment shows a little better result in improving pulmonary function than does terbutaline.

An adaptive, individualized fMRI delay discounting procedure to increase flexibility and optimize scanner time.

PubMed

Koffarnus, Mikhail N; Deshpande, Harshawardhan U; Lisinski, Jonathan M; Eklund, Anders; Bickel, Warren K; LaConte, Stephen M

2017-11-01

Research on the rate at which people discount the value of future rewards has become increasingly prevalent as discount rate has been shown to be associated with many unhealthy patterns of behavior such as drug abuse, gambling, and overeating. fMRI research points to a fronto-parietal-limbic pathway that is active during decisions between smaller amounts of money now and larger amounts available after a delay. Researchers in this area have used different variants of delay discounting tasks and reported various contrasts between choice trials of different types from these tasks. For instance, researchers have compared 1) choices of delayed monetary amounts to choices of the immediate monetary amounts, 2) 'hard' choices made near one's point of indifference to 'easy' choices that require little thought, and 3) trials where an immediate choice is available versus trials where one is unavailable, regardless of actual eventual choice. These differences in procedure and analysis make comparison of results across studies difficult. In the present experiment, we designed a delay discounting task with the intended capability of being able to construct contrasts of all three comparisons listed above while optimizing scanning time to reduce costs and avoid participant fatigue. This was accomplished with an algorithm that customized the choice trials presented to each participant with the goal of equalizing choice trials of each type. We compared this task, which we refer to here as the individualized discounting task (IDT), to two other delay discounting tasks previously reported in the literature (McClure et al., 2004; Amlung et al., 2014) in 18 participants. Results show that the IDT can examine each of the three contrasts mentioned above, while yielding a similar degree of activation as the reference tasks. This suggests that this new task could be used in delay discounting fMRI studies to allow researchers to more easily compare their results to a majority of previous research while minimizing scanning duration. Copyright © 2017 Elsevier Inc. All rights reserved.

75 FR 14223 - Self-Regulatory Organizations; Notice of Filing and Immediate Effectiveness of Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-24

... Exchange's system. This schedule is known as the DMM Capital Commitment Schedule (``CCS'').\\12\\ CCS... points outside, at and inside the Exchange BBO. CCS interest is separate and distinct from other DMM...

49 CFR 172.332 - Identification number markings.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 160 mm (6.3 inches) high by 400 mm (15.7 inches) wide with a 15 mm (0.6 inches) black outer border... points high immediately within the upper border of the space on the placard bearing the identification...

49 CFR 172.332 - Identification number markings.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 160 mm (6.3 inches) high by 400 mm (15.7 inches) wide with a 15 mm (0.6 inches) black outer border... points high immediately within the upper border of the space on the placard bearing the identification...

Radiation Therapy Versus No Radiation Therapy to the Neo-breast Following Skin-Sparing Mastectomy and Immediate Autologous Free Flap Reconstruction for Breast Cancer: Patient-Reported and Surgical Outcomes at 1 Year-A Mastectomy Reconstruction Outcomes Consortium (MROC) Substudy.

PubMed

Cooke, Andrew L; Diaz-Abele, Julian; Hayakawa, Tom; Buchel, Ed; Dalke, Kimberly; Lambert, Pascal

2017-09-01

To determine whether adjuvant radiation therapy (RT) is associated with adverse patient-reported outcomes and surgical complications 1 year after skin-sparing mastectomy and immediate autologous free flap reconstruction for breast cancer. We compared 24 domains of patient-reported outcome measures 1 year after autologous reconstruction between patients who received adjuvant RT and those who did not. A total of 125 patients who underwent surgery between 2012 and 2015 at our institution were included from the Mastectomy Reconstruction Outcomes Consortium study database. Adjusted multivariate models were created incorporating RT technical data, age, cancer stage, estrogen receptor, chemotherapy, breast size, body mass index, and income to determine whether RT was associated with outcomes. At 1 year after surgery, European Organisation for Research and Treatment of Cancer (EORTC) Breast Cancer-Specific Quality of Life Questionnaire breast symptoms were significantly greater in 64 patients who received RT (8-point difference on 100-point ordinal scale, P<.0001) versus 61 who did not receive RT in univariate and multivariate models. EORTC arm symptoms (20-point difference on 100-point ordinal scale, P=.0200) differed on univariate analysis but not on multivariate analysis. All other outcomes-including Numerical Pain Rating Scale, BREAST-Q (Post-operative Reconstruction Module), Patient-Report Outcomes Measurement Information System Profile 29, McGill Pain Questionnaire-Short Form (MPQ-SF) score, Generalized Anxiety Disorder Scale, and Patient Health Questionnaire-were not statistically different between groups. Surgical complications were uncommon and did not differ by treatment. RT to the neo-breast compared with no RT following immediate autologous free flap reconstruction for breast cancer is well tolerated at 1 year following surgery despite patients undergoing RT also having a higher cancer stage and more intensive surgical and systemic treatment. Neo-breast symptoms are more common in patients receiving RT by the EORTC Breast Cancer-Specific Quality of Life Questionnaire but not by the BREAST-Q. Patient-reported results at 1 year after surgery suggest RT following immediate autologous free flap breast reconstruction is well tolerated. Copyright © 2017 Elsevier Inc. All rights reserved.

Unilateral Plantar Flexors Static-Stretching Effects on Ipsilateral and Contralateral Jump Measures

PubMed Central

da Silva, Josinaldo Jarbas; Behm, David George; Gomes, Willy Andrade; Silva, Fernando Henrique Domingues de Oliveira; Soares, Enrico Gori; Serpa, Érica Paes; Vilela Junior, Guanis de Barros; Lopes, Charles Ricardo; Marchetti, Paulo Henrique

2015-01-01

The aim of this study was to evaluate the acute effects of unilateral ankle plantar flexors static-stretching (SS) on the passive range of movement (ROM) of the stretched limb, surface electromyography (sEMG) and single-leg bounce drop jump (SBDJ) performance measures of the ipsilateral stretched and contralateral non-stretched lower limbs. Seventeen young men (24 ± 5 years) performed SBDJ before and after (stretched limb: immediately post-stretch, 10 and 20 minutes and non-stretched limb: immediately post-stretch) unilateral ankle plantar flexor SS (6 sets of 45s/15s, 70-90% point of discomfort). SBDJ performance measures included jump height, impulse, time to reach peak force, contact time as well as the sEMG integral (IEMG) and pre-activation (IEMGpre-activation) of the gastrocnemius lateralis. Ankle dorsiflexion passive ROM increased in the stretched limb after the SS (pre-test: 21 ± 4° and post-test: 26.5 ± 5°, p < 0.001). Post-stretching decreases were observed with peak force (p = 0.029), IEMG (P<0.001), and IEMGpre-activation (p = 0.015) in the stretched limb; as well as impulse (p = 0.03), and jump height (p = 0.032) in the non-stretched limb. In conclusion, SS effectively increased passive ankle ROM of the stretched limb, and transiently (less than 10 minutes) decreased muscle peak force and pre-activation. The decrease of jump height and impulse for the non-stretched limb suggests a SS-induced central nervous system inhibitory effect. Key points When considering whether or not to SS prior to athletic activities, one must consider the potential positive effects of increased ankle dorsiflexion motion with the potential deleterious effects of power and muscle activity during a simple jumping task or as part of the rehabilitation process. Since decreased jump performance measures can persist for 10 minutes in the stretched leg, the timing of SS prior to performance must be taken into consideration. Athletes, fitness enthusiasts and therapists should also keep in mind that SS one limb has generalized effects upon contralateral limbs as well. PMID:25983580

Expected Time of Test and the Acquisition of Knowledge.

ERIC Educational Resources Information Center

D'Ydewalle, G.; And Others

1981-01-01

Subjects from four physics or literature classes expected a delayed or an immediate test after their class. All were tested immediately. Male subjects expecting the immediate test performed better than males expecting a delayed test. Absence of interaction effects with personality measurement suggested the inadequacy of the goal gradient…

Microcurrent Point Stimulation Applied to Lower Back Acupuncture Points for the Treatment of Nonspecific Neck Pain.

PubMed

Armstrong, Kelly; Gokal, Raman; Chevalier, Antoine; Todorsky, William; Lim, Mike

2017-04-01

Although acupuncture and microcurrent are widely used for chronic pain, there remains considerable controversy as to their therapeutic value for neck pain. We aimed to determine the effect size of microcurrent applied to lower back acupuncture points to assess the impact on the neck pain. This was a cohort analysis of treatment outcomes pre- and postmicrocurrent stimulation, involving 34 patients with a history of nonspecific chronic neck pain. Consenting patients were enrolled from a group of therapists attending educational seminars and were asked to report pain levels pre-post and 48 hours after a single MPS application. Direct current microcurrent point stimulation (MPS) applied to standardized lower back acupuncture protocol points was used. Evaluations entailed a baseline visual analog scale (VAS) pain scale assessment, using a VAS, which was repeated twice after therapy, once immediately postelectrotherapy and again after a 48-h follow-up period. All 34 patients received a single MPS session. Results were analyzed using paired t tests. Results and Outcomes: Pain intensity showed an initial statistically significant reduction of 68% [3.9050 points; 95% CI (2.9480, 3.9050); p = 0.0001], in mean neck pain levels after standard protocol treatment, when compared to initial pain levels. There was a further statistically significant reduction of 35% in mean neck pain levels at 48 h when compared to pain levels immediately after standard protocol treatment [0.5588 points; 95% CI (0.2001, 0.9176); p = 0.03], for a total average pain relief of 80%. The positive results in this study could have applications for those patients impacted by chronic neck pain.

The Influence of Wildfires on Aerosol Size Distributions in Rural Areas

PubMed Central

Alonso-Blanco, E.; Calvo, A. I.; Fraile, R.; Castro, A.

2012-01-01

The number of particles and their size distributions were measured in a rural area, during the summer, using a PCASP-X. The aim was to study the influence of wildfires on particle size distributions. The comparative studies carried out reveal an average increase of around ten times in the number of particles in the fine mode, especially in sizes between 0.10 and 0.14 μm, where the increase is of nearly 20 times. An analysis carried out at three different points in time—before, during, and after the passing of the smoke plume from the wildfires—shows that the mean geometric diameter of the fine mode in the measurements affected by the fire is smaller than the one obtained in the measurements carried out immediately before and after (0.14 μm) and presents average values of 0.11 μm. PMID:22629191

Trajectories of electrons with large longitudinal momenta in the phase plane during surfatron acceleration by an electromagnetic wave

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

Mkrtichyan, G. S., E-mail: hay-13@mail.ru

2015-07-15

The trajectories of electrons with large longitudinal momenta in the phase plane in the course of their surfatron acceleration by an electromagnetic wave propagating in space plasma across the external magnetic field are analyzed. Electrons with large longitudinal momenta are trapped immediately if the initial wave phase Ψ(0) on the particle trajectory is positive. For negative values of Ψ(0), no electrons trapping by the wave is observed over the available computational times. According to numerical calculations, the trajectories of trapped particles in the phase plane have a singular point of the stable focus type and the behavior of the trajectorymore » corresponds to the motion in a complex nonstationary effective potential well. For some initial phases, electrons are confined in the region of the accelerating electric field for relatively short time, the energy gain being about 50–130% and more.« less

Immediate and long term effects of compaction on the stress-strain behaviour of soil

NASA Astrophysics Data System (ADS)

Noor, Sarah T.; Chowdhury, Prantick; Chowdhury, Tasnim

2018-04-01

This paper explores whether delay in construction after compaction can benefit from the gain in soil’s strength and stability point of view. An experimental investigation has been carried out to examine the gradual development of soil’s shear strength by ageing of mechanically compacted soil at three relative densities. In order to separate the gain in strength due to ageing from that occurring from the reduction in soil moisture, the soil samples prepared in moulds were kept in desiccators for different periods of time (1, 9 and 17 days) before testing unconfined compressive strength test. The soil in densely compacted state is found to gain in strength due to ageing faster than that in medium compacted state. Only due to ageing of 9 days or more, unconfined compressive strength of compacted soil is found about 1.7 to 2.4 times of that attained in day 1 after compaction.

A Scenario-Based Virtual Patient Program to Support Substance Misuse Education.

PubMed

Zlotos, Leon; Power, Ailsa; Hill, Duncan; Chapman, Paul

2016-04-25

Objective. To evaluate virtual patient (VP) programs for injecting equipment provision (IEP) and opiate substitution therapy (OST) services with respect to confidence and knowledge among preregistration pharmacist trainees. Methods. Preregistration trainee pharmacists pilot-tested the VP programs and were invited to complete pre/post and 6-month assessments of knowledge and perceived confidence. Results. One hundred six trainees participated and completed the pre/postassessments. Forty-six (43.4%) participants repeated the assessments at six months. Scores in perceived confidence increased in all domains at both time points postprogram. Knowledge scores were greater posteducation than preeducation. Knowledge scores were also greater six months after education than preeducation. Knowledge scores at six months were lower than posteducation for both programs. Conclusion. Virtual patients programs increased preregistration pharmacists' knowledge and confidence with regard to IEP and OST immediately after use and at six months postprogram. There was a loss of clinical knowledge over time but confidence change was sustained.

Unmanned spacecraft for surveying earth's resources

NASA Technical Reports Server (NTRS)

George, T. A.

1970-01-01

The technical objectives and payloads for ERTS A and B are discussed. The primary emphasis is on coverage of the United States and the ocean areas immediately adjacent, using 3-camera return beam vidicon TV system, 4-channel multispectral point scanner, data collection system, and wideband video tape recorder. The expected performance and system characteristics of the RBV system and the 4-band multispectral object plane point scanner are outlined. Ground station considerations are also given.

Can 28-Month-Old Children Learn Spatial Prepositions Robustly from Pictures? Yes, When Narrative Input Is Provided

PubMed Central

Rohlfing, Katharina J.; Nachtigäller, Kerstin

2016-01-01

The learning of spatial prepositions is assumed to be based on experience in space. In a slow mapping study, we investigated whether 31 German 28-month-old children could robustly learn the German spatial prepositions hinter [behind] and neben [next to] from pictures, and whether a narrative input can compensate for a lack of immediate experience in space. One group of children received pictures with a narrative input as a training to understand spatial prepositions. In two further groups, we controlled (a) for the narrative input by providing unconnected speech during the training and (b) for the learning material by training the children on toys rather than pictures. We assessed children’s understanding of spatial prepositions at three different time points: pretest, immediate test, and delayed posttest. Results showed improved word retention in children from the narrative but not the control group receiving unconnected speech. Neither of the trained groups succeeded in generalization to novel referents. Finally, all groups were instructed to deal with untrained material in the test to investigate the robustness of learning across tasks. None of the groups succeeded in this task transfer. PMID:27471479

Conformable liquid metal printed epidermal electronics for smart physiological monitoring and simulation treatment

NASA Astrophysics Data System (ADS)

Wang, Xuelin; Zhang, Yuxin; Guo, Rui; Wang, Hongzhang; Yuan, Bo; Liu, Jing

2018-03-01

Conformable epidermal printed electronics enabled from gallium-based liquid metals (LMs), highly conductive and low-melting-point alloys, are proposed as the core to achieving immediate contact between skin surface and electrodes, which can avoid the skin deformation often caused by conventional rigid electrodes. When measuring signals, LMs can eliminate resonance problems with shorter time to reach steady state than Pt and gelled Pt electrodes. By comparing the contact resistance under different working conditions, it is demonstrated that both ex vivo and in vivo LM electrode-skin models have the virtues of direct and immediate contact with skin surface without the deformation encountered with conventional rigid electrodes. In addition, electrocardio electrodes composed of conformable LM printed epidermal electronics are adopted as smart devices to monitor electrocardiogram signals of rabbits. Furthermore, simulation treatment for smart defibrillation offers a feasible way to demonstrate the effect of liquid metal electrodes (LMEs) on the human body with less energy loss. The remarkable features of soft epidermal LMEs such as high conformability, good conductivity, better signal stability, and fine biocompatibility represent a critical step towards accurate medical monitoring and future smart treatments.

Running-induced patellofemoral pain fluctuates with changes in patella water content.

PubMed

Ho, Kai-Yu; Hu, Houchun H; Colletti, Patrick M; Powers, Christopher M

2014-01-01

Although increased bone water content resulting from repetitive patellofemoral joint loading has been suggested to be a possible mechanism underlying patellofemoral pain (PFP), there is little data to support this mechanism. The purpose of the current study was to determine whether running results in increases in patella water content and pain and whether 48 hours of rest reduces patella water content and pain to pre-running levels. Ten female runners with a diagnosis of PFP (mean age 25.1 years) participated. Patella water content was quantified using a chemical-shift-encoded water-fat magnetic resonance imaging (MRI) protocol. The visual analog scale (VAS) was used to quantify subjects' pain levels. MRI and pain data were obtained prior to running, immediately following a 40-minute running session, and 48 hours post-running. Pain and patella water content were compared among the 3 time points using one-way ANOVA's with repeated measures. Immediately post-running, persons with PFP reported significant increases in pain and exhibited elevated patella water content. Pain and patella water content decreased to pre-running levels following 48 hours of rest. Our findings suggest that transient changes in patella water content associated with running may, in part, contribute to patellofemoral symptoms.

Testing the temporal nature of social disorder through abandoned buildings and interstitial spaces.

PubMed

Wallace, Danielle; Schalliol, David

2015-11-01

With the recent housing crisis, studying abandoned buildings has once again become important. However, it has been some time since abandoned buildings were the subject of direct study, leaving scholars with scant knowledge about the characteristics of abandoned buildings, how they change, and their relationship to neighborhood processes. To fill this gap, we employed longitudinal photographic and SSO evaluations of 36 abandoned buildings and their immediate surroundings in Chicago for one year (n=587). Results demonstrate the presence and severity of social disorder cues vary across time points and the time of day of observation. There is a relationship between abandoned buildings and social disorder, though the relationship is not a trend. Also, social disorder is diminished around extremely decayed buildings. Lastly, we find that our results are driven by the measurement of places ignored by most SSO studies, including alleys and the rear side of buildings. Copyright © 2015 Elsevier Inc. All rights reserved.

Microfluidic Remote Loading for Rapid Single-Step Liposomal Drug Preparation

PubMed Central

Hood, R.R.; Vreeland, W. N.; DeVoe, D.L.

2014-01-01

Microfluidic-directed formation of liposomes is combined with in-line sample purification and remote drug loading for single step, continuous-flow synthesis of nanoscale vesicles containing high concentrations of stably loaded drug compounds. Using an on-chip microdialysis element, the system enables rapid formation of large transmembrane pH and ion gradients, followed by immediate introduction of amphipathic drug for real-time remote loading into the liposomes. The microfluidic process enables in-line formation of drug-laden liposomes with drug:lipid molar ratios of up to 1.3, and a total on-chip residence time of approximately 3 min, representing a significant improvement over conventional bulk-scale methods which require hours to days for combined liposome synthesis and remote drug loading. The microfluidic platform may be further optimized to support real-time generation of purified liposomal drug formulations with high concentrations of drugs and minimal reagent waste for effective liposomal drug preparation at or near the point of care. PMID:25003823

Dynamics of postoperative serum cortisol after transsphenoidal surgery for Cushing's disease: implications for immediate reoperation and remission.

PubMed

Mayberg, Marc; Reintjes, Stephen; Patel, Anika; Moloney, Kelley; Mercado, Jennifer; Carlson, Alex; Scanlan, James; Broyles, Frances

2017-12-22

OBJECTIVE Successful transsphenoidal surgery for adrenocorticotropin hormone (ACTH)-producing pituitary tumors is associated with subnormal postoperative serum cortisol levels, which may guide decisions regarding immediate reoperation. However, little is known about the detailed temporal course of changes in serum cortisol in the immediate postoperative period, and the relationship of postoperative cortisol dynamics to remission and late recurrence. METHODS A single-center retrospective cohort analysis was performed for all patients undergoing pituitary surgery from 2007 through 2015. Standardized diagnostic and treatment algorithms were applied to all patients with potential Cushing's disease (CD), including microsurgical transsphenoidal adenomectomy (TSA) by a single surgeon. All patients had serum cortisol levels drawn at 6-hour intervals for 72 hours after surgery, and were offered reoperation within 3 days for normal or supranormal postoperative cortisol levels. Primary outcomes were 6-month remission and late recurrence; secondary outcomes were persistent postoperative hypocortisolism and surgical morbidity. Discriminatory levels of postoperative serum cortisol for predicting remission were calculated at various intervals after surgery using receiver operating characteristic (ROC) curves. RESULTS Among 89 patients diagnosed with CD, 81 underwent initial TSA for a potentially curable lesion; 23 patients (25.8%) underwent an immediate second TSA. For the entire cohort, 6-month remission was achieved in 77.8% and late recurrences occurred in 9.5%, at a mean of 43.5 months. Compared with patients with a single surgery, those with an immediate second TSA had similar rates of remission (78.3% vs 77.6%) and late recurrence (5.6% vs 11.1%). The rate of hypocortisolism for patients with 2 surgeries (12/23, 52.2%) was significantly greater than that for patients with single surgeries (13/58, 22.4%; p < 0.001). There was no difference in the incidence of CSF leaks between the first and second operations. Remission was achieved in 58 (92.1%) of 64 patients who completed the 2-surgery protocol. The temporal course of postoperative serum cortisol levels among patients varied considerably, with subnormal nadir levels < 2 μg/dl occurring between 12 hours and 66 hours. Patients achieving remission had significantly lower mean serum cortisol levels at every time point after surgery (p < 0.01). By ROC curve analysis, nadir cortisol levels < 2.1 μg/dl were predictive of 6-month remission for the entire cohort over 3 days (positive predictive value [PPV] = 94%); discriminating cortisol levels for predicting remission on postoperative day (POD) 2 were < 5.4 μg/dl (PPV = 97%), although patients with remission after postoperative cortisol levels of 2-5 μg/dl had a significantly higher rate of late recurrence. CONCLUSIONS There is substantial variation in the temporal course of serum cortisol levels over the first 72 hours after TSA for CD, with nadir levels predictive for remission occurring as late as POD 3. Although a cortisol level of 2.1 μg/dl at any point was an accurate predictor of 6-month remission, levels less than 5.4 μg/dl on POD 2 were reasonably accurate. These data may enable decisions regarding the efficacy of an immediate second surgical procedure performed during the same hospitalization; immediate reoperation is associated with excellent remission rates and low recurrence rates in patients otherwise unlikely to achieve remission, but carries a higher risk of permanent hypocortisolism.

EPINEPHRINE OR GV-26 ELECTRICAL STIMULATION REDUCES INHALANT ANESTHESTIC RECOVERY TIME IN COMMON SNAPPING TURTLES (CHELYDRA SERPENTINA).

PubMed

Goe, Alexandra; Shmalberg, Justin; Gatson, Bonnie; Bartolini, Pia; Curtiss, Jeff; Wellehan, James F X

2016-06-01

Prolonged anesthetic recovery times are a common clinical problem in reptiles following inhalant anesthesia. Diving reptiles have numerous adaptations that allow them to submerge and remain apneic for extended periods. An ability to shunt blood away from pulmonary circulation, possibly due to changes in adrenergic tone, may contribute to their unpredictable inhalant anesthetic recovery times. Therefore, the use of epinephrine could antagonize this response and reduce recovery time. GV-26, an acupuncture point with reported β-adrenergic and respiratory effects, has reduced anesthetic recovery times in other species. In this prospective randomized crossover study, six common snapping turtles (Chelydra serpentina) were anesthetized with inhalant isoflurane for 90 min. Turtles were assigned one of three treatments, given immediately following discontinuation of isoflurane: a control treatment (0.9% saline, at 0.1 ml/kg i.m.), epinephrine (0.1 mg/kg i.m.), or acupuncture with electrical stimulation at GV-26. Each turtle received all treatments, and treatments were separated by 48 hr. Return of spontaneous ventilation was 55% faster in turtles given epinephrine and 58% faster in the GV-26 group versus saline (P < 0.001). The times to movement and to complete recovery were also significantly faster for both treatments than for saline (P < 0.02). Treated turtles displayed increases in temperature not documented in the control (P < 0.001). Turtles administered epinephrine showed significantly increased heart rates and end-tidal CO(2) (P < 0.001). No adverse effects were noted in the study animals. The mechanisms of action were not elucidated in the present investigation. Nevertheless, the use of parenteral epinephrine or GV-26 stimulation in the immediate postanesthetic period produces clinically relevant reductions in anesthetic recovery time in common snapping turtle. Further research is necessary to evaluate the effects of concurrent GV-26 and epinephrine administration and to assess responses in other reptilian species.

Time Is Money: The Decision Making of Smartphone High Users in Gain and Loss Intertemporal Choice

PubMed Central

Tang, Zixuan; Zhang, Huijun; Yan, An; Qu, Chen

2017-01-01

Nowadays the smartphone plays an important role in our lives. While it brings us convenience and efficiency, its overuse can cause problems. Although a great number of studies have demonstrated that people affected by substance abuse, pathological gambling, and internet addiction disorder have lower self-control than average, scarcely any study has investigated the decision making of smartphone high users by using a behavioral paradigm. The present study employed an intertemporal task, the Smartphone Addiction Inventory (SPAI) and the Barratt Impulsiveness Scale 11th version (BIS-11) to explore the decision control of smartphone high users in a sample of 125 college students. Participants were divided into three groups according to their SPAI scores. The upper third (69 or higher), middle third (from 61 to 68) and lower third (60 or lower) of scores were defined as high smartphone users, medium users and low users, respectively. We compared the percentage of small immediate reward/penalty choices in different conditions between the three groups. Relative to the low users group, high users and medium users were more inclined to request an immediate monetary reward. Moreover, for the two dimensions of time and money in intertemporal choice, high users and medium users showed a bias in intertemporal choice task among most of the time points and value magnitude compared to low users. These findings demonstrated that smartphone overuse was associated with problematic decision-making, a pattern similar to that seen in persons affected by a variety of addictions. PMID:28344568

A HEL Testbed for High Accuracy Beam Pointing and Control

DTIC Science & Technology

2009-07-01

Control by Dojong Kim, Duane Frist, Jae Jun Kim, Brij Agrawal 01 July 2009 Approved for......distant targets immediately. The issues of the technology on the HEL system include various types of high energy laser devices, beam control systems

78 FR 42692 - Safety Zone; Chicago Harbor, Navy Pier Southeast, Chicago, IL

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-17

... necessary and intended to ensure safety of life on the navigable waters of the United States immediately..., 087[deg]36'09'' W; then back to the point of origin. All vessels must obtain permission from the...

Circadian Rhythms in Human Memory.

ERIC Educational Resources Information Center

Folkard, Simon; Monk, Timothy H.

1980-01-01

Two experiments are described that examined the influence of time-of-day of presentation on immediate and delayed retention and its potential effects on retrieval from long-term memory. Time of presentation was found to influence both immediate and delayed (28 day) retention, but not retrieval from long-term memory. (Author/SJL)

Emergency department physician activation of the catheterization laboratory and immediate transfer to an immediately available catheterization laboratory reduce door-to-balloon time in ST-elevation myocardial infarction.

PubMed

Khot, Umesh N; Johnson, Michele L; Ramsey, Curtis; Khot, Monica B; Todd, Randall; Shaikh, Saeed R; Berg, William J

2007-07-03

Consensus guidelines and hospital quality-of-care programs recommend that ST-elevation myocardial infarction patients achieve a door-to-balloon time of < or = 90 minutes. However, there are limited prospective data on specific measures to significantly reduce door-to-balloon time. We prospectively determined the impact on median door-to-balloon time of a protocol mandating (1) emergency department physician activation of the catheterization laboratory and (2) immediate transfer of the patient to an immediately available catheterization laboratory by an in-house transfer team consisting of an emergency department nurse, a critical care unit nurse, and a chest pain unit nurse. We collected door-to-balloon time for 60 consecutive ST-elevation myocardial infarction patients undergoing emergency percutaneous intervention within 24 hours of presentation from October 1, 2004, through August 31, 2005, and compared this group with 86 consecutive ST-elevation myocardial infarction patients from September 1, 2005, through June 26, 2006, after protocol implementation. Median door-to-balloon time decreased overall (113.5 versus 75.5 minutes; P<0.0001), during regular hours (83.5 versus 64.5 minutes; P=0.005), during off-hours (123.5 versus 77.5 minutes; P<0.0001), and with transfer from an outside affiliated emergency department (147 versus 85 minutes; P=0.0006). Treatment within 90 minutes increased from 28% to 71% (P<0.0001). Mean infarct size decreased (peak creatinine kinase, 2623+/-3329 versus 1517+/-1556 IU/L; P=0.0089), as did hospital length of stay (5+/-7 versus 3+/-2 days; P=0.0097) and total hospital costs per admission ($26,826+/-29,497 versus $18,280+/-8943; P=0.0125). Emergency department physician activation of the catheterization laboratory and immediate transfer of the patient to an immediately available catheterization laboratory reduce door-to-balloon time, leading to a reduction in myocardial infarct size, hospital length of stay, and total hospital costs.

Reduction of admit wait times: the effect of a leadership-based program.

PubMed

Patel, Pankaj B; Combs, Mary A; Vinson, David R

2014-03-01

Prolonged admit wait times in the emergency department (ED) for patients who require hospitalization lead to increased boarding time in the ED, a significant cause of ED congestion. This is associated with decreased quality of care, higher morbidity and mortality, decreased patient satisfaction, increased costs for care, ambulance diversion, higher numbers of patients who leave without being seen (LWBS), and delayed care with longer lengths of stay (LOS) for other ED patients. The objective was to assess the effect of a leadership-based program to expedite hospital admissions from the ED. This before-and-after observational study was undertaken from 2006 through 2011 at one community hospital ED. A team of ED and hospital leaders implemented a program to reduce admit wait times, using a computerized hospital-wide tracking system to monitor inpatient and ED bed status. The team collaboratively and consistently moved ED patients to their inpatient beds within an established goal of 60 minutes after an admission decision was reached. Top leadership actively intervened in real time by contacting staff whenever delays occurred to expedite immediate solutions to achieve the 60-minute goal. The primary outcome measures were the percentage of ED patients who were admitted to inpatient beds within 60 minutes from the time the beds were requested and ED boarding time. LOS, patient satisfaction, LWBS rate, and ambulance diversion hours were also measured. After ED census, hospital admission rates, and ED bed capacity were controlled for using a multivariable linear regression analysis, the admit wait time reduction program contributed to an increase in patients being admitted to the hospital within 60 minutes by 16 percentage points (95% confidence intervals [CI] = 10 to 22 points; p < 0.0001) and a decrease in boarding time per admission of 46 minutes (95% CI = 63 to 82 minutes; p < 0.0001). LOS decreased for admitted patients by 79 minutes (95% CI = 55 to 104 minutes; p < 0.0001), for discharged patients by 17 minutes (95% CI = 12 to 23 minutes; p < 0.0001), and for all patients by 34 minutes (95% CI = 25 to 43 minutes; p < 0.0001). Patient satisfaction increased 4.9 percentage points (95% CI = 3.8 to 6.0 points; p < 0.0001). LWBS patients decreased 0.9 percentage points (95% CI = 0.6 to 1.2 points; p < 0.0001) and monthly ambulance diversion decreased 8.2 hours (95% CI = 4.6 to 11.8 hours; p < 0.0001). A leadership-based program to reduce admit wait times and boarding times was associated with a significant increase in the percentage of patients admitted to the hospital within 60 minutes and a significant decrease in boarding time. Also associated with the program were decreased ED LOS, LWBS rate, and ambulance diversion, as well as increased patient satisfaction. © 2014 by the Society for Academic Emergency Medicine.

Heel and toe driving on fuel cell vehicle

DOEpatents

Choi, Tayoung; Chen, Dongmei

2012-12-11

A system and method for providing nearly instantaneous power in a fuel cell vehicle. The method includes monitoring the brake pedal angle and the accelerator pedal angle of the vehicle, and if the vehicle driver is pressing both the brake pedal and the accelerator pedal at the same time and the vehicle is in a drive gear, activating a heel and toe mode. When the heel and toe mode is activated, the speed of a cathode compressor is increased to a predetermined speed set-point, which is higher than the normal compressor speed for the pedal position. Thus, when the vehicle brake is removed, the compressor speed is high enough to provide enough air to the cathode, so that the stack can generate nearly immediate power.

[Dose-effect relationship of orally administered Pyritinol in the chronic organic brain syndrome (author's transl)].

PubMed

Glatzel, J

1978-08-04

161 patients with the chronic organic brain syndrome (average age 64 years) were treated with various oral doses of Pyritinol for various periods of time. Statistical analysis of the data by means of "Konfigurationsfrequenzanalyse" showed that the success rate of treatment increases significantly with increasing dose and duration of the treatment. This means that the recommended daily dose should be exceeded if - for example at the start of treatment and in severe cases or in hospitalized patients - there is no immediate clear improvement in the condition. From the point of view of method this study shows that a retrospective analysis of a group of patients treated in a clinic can also provide interesting results and appropriately supplement controlled studies.

Effect of β-3-Thienylalanine on Antibody Synthesis V. Immunosuppression in Mice by Short Diet and Drug Treatments

PubMed Central

Misefari, Aldo; La Via, Mariano F.

1971-01-01

The analogue of phenylalanine, β-3-thienylalanine, depresses severely the primary and secondary immune response to sheep erythrocytes in mice when administered for a few days immediately before and after each injection of antigen. For this immunosuppression to occur, animals must be maintained on a phenylalanine-free diet during the times of drug injection since dietary phenylalanine will restore anamnestic response. With these experimental conditions, the number of direct and indirect plaque-forming cells is greatly reduced during immune responses. The finding that marked immunosuppression can be obtained with a very short drug and diet treatment points to a potential usefullness of the analogue as a powerful immunosuppressant. PMID:5154884

Impact of brief communication training among hospital social workers.

PubMed

Bunting, Morgan; Cagle, John G

2016-01-01

Hospital social workers are often the fulcrum of communication between physicians, patients, and families especially when patients are facing life-threatening illness. This study aims to understand the impact of a brief training for hospital social workers. The training is designed to improve communication skills and self-efficacy, as well as lessen fears of death and dying. Repeated-measures tests were used to assess outcomes across three time points. Twenty-nine university-based hospital social workers participated. Results trended in the desired directions. Communication self-efficacy improved immediately following the training, and this was sustained 1 month following training completion. Although participants were relatively experienced, improvement was still demonstrated and maintained suggesting brief communication training is promising for hospital social workers across the career.

A computational fluid dynamics simulation of high- and low-current arcs in self-blast circuit breakers

NASA Astrophysics Data System (ADS)

Claessens, M.; Möller, K.; Thiel, H. G.

1997-07-01

Computational fluid dynamics calculations for high- and low-current arcs in an interrupter of the self-blast type have been performed. The mixing process of the hot PTFE cloud with the cold 0022-3727/30/13/011/img6 in the pressure chamber is strongly inhomogeneous. The existence of two different species has been taken into account by interpolation of the material functions according to their mass fraction in each grid cell. Depending on the arcing time, fault current and interrupter geometry, blow temperatures of up to 2000 K have been found. The simulation results for a decaying arc immediately before current zero yield a significantly reduced arc cooling at the stagnation point for high blow temperatures.

Organization of Experience among Family Members in the Immediate Present: A Gestalt/Systems Integration.

ERIC Educational Resources Information Center

Kaplan, Marvin L.; Kaplan, Netta R.

1982-01-01

Outlines two formulations that generate conceptual perspectives of immediate phenomena: (1) the family system has a time-enduring stability; (2) the family system has an immediate and temporary organization. Integrates systems thinking and Gestalt Therapy while recognizing individual experience as embedded in a self-maintaining system of the…

Overcoming nursing barriers to intensive care unit early mobilisation: A quality improvement project.

PubMed

Hunter, Oluwatobi O; George, Elisabeth L; Ren, Dianxu; Morgan, Douglas; Rosenzweig, Margaret; Klinefelter Tuite, Patricia

2017-06-01

To increase adherence with intensive care unit mobility by developing and implementing a mobility training program that addresses nursing barriers to early mobilisation. An intensive care unit mobility training program was developed, implemented and evaluated with a pre-test, immediate post-test and eight-week post-test. Patient mobility was tracked before and after training. A ten bed cardiac intensive care unit. The training program's efficacy was measured by comparing pre-test, immediate post-test and 8-week post-test scores. Patient mobilisation rates before and after training were compared. Protocol compliance was measured in the post training group. Nursing knowledge increased from pre-test to immediate post-test (p<0.0001) and pre-test to 8-week post-test (p<0.0001). Mean test scores decreased by seven points from immediate post-test (80±12) to 8-week post-test (73±14). Fear significantly decreased from pre-test to immediate post-test (p=0.03), but not from pre-test to 8-week post-test (p=0.06) or immediate post-test to 8-week post-test (p=0.46). Post training patient mobility rates increased although not significantly (p=0.07). Post training protocol compliance was 78%. The project successfully increased adherence with intensive care unit mobility and indicates that a training program could improve adoption of early mobility. Copyright © 2016 Elsevier Ltd. All rights reserved.

The relation between doses or post-plasma time points and apoptosis of leukemia cells induced by dielectric barrier discharge plasma

NASA Astrophysics Data System (ADS)

Wang, Chao; Zhang, Haixia; Xue, Zhixiao; Yin, Huijuan; Niu, Qing; Chen, Hongli

2015-12-01

The dielectric barrier discharge (DBD) plasma was applied to induce apoptosis of LT-12 leukemia cells. Plasma effects on cell death was evaluated by MTT assay and FCM apoptosis assay with Annexin V/PI double staining, suggesting that plasma killing cells rate and inducing cell apoptosis rate both positively were related to the plasma doses or the post-plasma time points. The cell death rates increased from 15.2% to 33.1% and the apoptosis rate raise from 23.8% to 28% when the dose raise from 60s to 120 s at 8 h post-plasma, while they increased from 15.4% to 34.9% and from 48% to 55.3% respectively at the same doses at 12 h post-plasma. Furthermore, the production of reactive oxygen species (ROS), gene and protein expression for Caspases and Bcl-2 family members were measured for exploring the related apoptotic mechanisms phenomenon. We found ROS immediately increased to 1.24 times of the original amount, then increasing to 5.39-fold at 20 h after treatment. The gene and protein expression for Caspases and Bcl-2 family members are very active at 8-12 h post-plasma. Our results demonstrate that DBD plasma can effectively induce tumor cell death through primarily related apoptotic mechanisms.

Postecdysis Sclerotization of Mouthparts of the Formosan Subterranean Termites (Isoptera: Rhinotermitidae).

PubMed

Kakkar, Garima; Chouvenc, Thomas; Su, Nan-Yao

2016-04-01

In termites, it is challenging to recognize the incidence of molting in workers because of their successive stationary molt, asynchronous molting among individuals, cryptic behavior, a soft and poorly sclerotized cuticle, and they immediately consume the shed exuvia of nestmates. This study describes a method in which the degree of sclerotization of the mouthparts in newly molted workers of the Formosan subterranean termite can be quantified and used to determine if an individual has recently molted, within a 36-h time frame. Changes in the tanning of mouthparts over time were used as a measure of the index of sclerotization in workers postmolting. Upon ecdysis, the primary point of articulation of the mandible already initiated sclerotization, which may allow the movement of the mandibles during the shedding of the exuvium. The sclerotization of the secondary point of articulation and the mandibular teeth, and the width of sclerotization of the mandibles, progressively increased until reaching a plateau around 36-h postecdysis, which imply that workers can regain some level of activity as early as 2 d after ecdysis. Our observations allowed for the determination of variables for the sclerotization of the mouthparts to easily identify workers that recently molted, and this method will be useful in future studies that focus on the molting activity of workers over time and space within a termite colony, in the scope of improving current control strategies for termite pests.

Clinical and Histomorphometric Assessment of Lateral Alveolar Ridge Augmentation Using a Corticocancellous Freeze-Dried Allograft Bone Block.

PubMed

Ahmadi, Roya Shariatmadar; Sayar, Ferena; Rakhshan, Vahid; Iranpour, Babak; Jahanbani, Jahanfar; Toumaj, Ahmad; Akhoondi, Nasrin

2017-06-01

Horizontal ridge augmentation with allografts has attracted notable attention because of its proper success rate and the lack of disadvantages of autografts. Corticocancellous block allografts have not been adequately studied in humans. Therefore, this study clinically and histomorphometrically evaluated the increase in ridge width after horizontal ridge augmentation using corticocancellous block allografts as well as implant success after 12 to 18 months after implantation. In 10 patients receiving implants (3 women, 7 men; mean age = 45 years), defective maxillary alveolar ridges were horizontally augmented using freeze-dried bone allograft blocks. Ridge widths were measured before augmentation, immediately after augmentation, and ∼6 months later in the reentry surgery for implantation. This was done at points 2 mm (A) and 5 mm (B) apically to the crest. Biopsy cores were acquired from the implantation site. Implant success was assessed 15.1 ± 2.7 months after implantation (range = 12-18 months). Data were analyzed using Friedman and Dunn tests (α = 0.05). At point A, ridge widths were 2.77 ± 0.37, 8.02 ± 0.87, and 6.40 ± 0.66 mm, respectively, before surgery, immediately after surgery, and before implantation. At point B, ridge widths were 3.40 ± 0.39, 9.35 ± 1.16, and 7.40 ± 1.10 mm, respectively, before surgery, immediately after surgery, and before implantation. The Friedman test showed significant increases in ridge widths, both at point A and point B (both P = .0000). Postaugmentation resorption was about 1.5-2 mm and was statistically significant at points A and B (P < .05, Dunn). The percentage of newly formed bone, residual graft material, and soft tissue were 33.0% ± 11.35% (95% confidence interval [CI] = 24.88%-41.12%), 37.50% ± 19.04% (95% CI = 23.88%-51.12%), and 29.5%, respectively. The inflammation was limited to grades 1 or zero. Twelve to 18 months after implantation, no implants caused pain or showed exudates or pockets. Radiographic bone loss was 2.0 ± 0.7 mm (range = 1-3). It can be concluded that lateral ridge augmentation with corticocancellous allograft blocks might be successful both clinically and histologically. Implants might have a proper clinical success after a minimum of 12 months.

A 5-year comparison of marginal bone level following immediate loading of single-tooth implants placed in healed alveolar ridges and extraction sockets in the maxilla.

PubMed

Berberi, Antoine N; Sabbagh, Joseph M; Aboushelib, Moustafa N; Noujeim, Ziad F; Salameh, Ziad A

2014-01-01

The aim of present investigation was to evaluate marginal bone level after 5-year follow-up of implants placed in healed ridges and fresh extraction sockets in maxilla with immediate loading protocol. Thirty-six patients in need of a single-tooth replacement in the anterior maxilla received 42 Astra Tech implants (Astra Tech Implant system™, Dentsply Implants, Mölndal, Sweden). Implants were placed either in healed ridges (group I) or immediately into fresh extraction sockets (group II). Implants were restored and placed into functional loading immediately by using a prefabricated abutment. Marginal bone level relative to the implant reference point was recorded at implant placement, crown cementation, 12, 36, and 60 months following loading using intra-oral radiographs. Measurements were made on the mesial and distal sides of each implant. Overall, two implants were lost from the group II, before final crown cementation: they were excluded from the study. The mean change in marginal bone loss (MBL) after implant placement was 0.26 ± 0.161 mm for 1 year, and 0.26 ± 0.171 mm for 3 years, and 0.21 ± 0.185 mm for 5 years in extraction sockets and was 0.26 ± 0.176 mm for 1 year and 0.21 ± 0.175 mm for 3 years, and 0.19 ± 0.172 mm for 5 years in healed ridges group. Significant reduction of marginal bone was more pronounced in implants inserted in healed ridges (P < 0.041) compared to fresh surgical extraction sockets (P < 0.540). Significant MBL was observed on the mesial side of the implant after cementation of the provisional (P < 0.007) and after 12 months (P < 0.034) compared to the distal side which remained stable for 3 and 5 years observation period. Within the limitations of this study, responses of local bone to immediately loaded implants placed either in extraction sockets or healed ridges were similar. Functional loading technique by using prefabricated abutment placed during the surgery time seems to maintain marginal bone around implant in both healed and fresh extraction sites.

An Experiment to Detect Lunar Horizon Glow with the Lunar Orbit Laser Altimeter Laser Ranging Telescope

NASA Astrophysics Data System (ADS)

Smith, David E.; Zuber, Maria T.; Barker, Michael; Mazarico, Erwan; Neumann, Gregory A.; McClanahan, Timothy P.; Sun, Xiaoli

2016-04-01

Lunar horizon glow (LHG) was an observation by the Apollo astronauts of a brightening of the horizon around the time of sunrise. The effect has yet to be fully explained or confirmed by instruments on lunar orbiting spacecraft despite several attempts. The Lunar Reconnaissance Orbiter (LRO) spacecraft carries the laser altimeter (LOLA) instrument which has a 2.5 cm aperture telescope for Earth-based laser ranging (LR) mounted and bore-sighted with the high gain antenna (HGA). The LR telescope is connected to LOLA by a fiber-glass cable to one of its 5 detectors. For the LGH experiments the LR telescope is pointed toward the horizon shortly before lunar sunrise with the intent of observing any forward scattering of sunlight due to the presence of dust or particles in the field of view. Initially, the LR telescope is pointed at the dark lunar surface, which provides a measure of the dark count, and moves toward the lunar limb so as to measure the brightness of the sky just above the lunar limb immediately prior to lunar sunrise. At no time does the sun shine directly into the LR telescope, although the LR telescope is pointed as close to the sun as the 1.75-degree field of view permits. Experiments show that the LHG signal seen by the astronauts can be detected with a four-second integration of the noise counts.

Performance of point-of-care Xpert HIV-1 plasma viral load assay at a tertiary HIV care centre in Southern India.

PubMed

Swathirajan, Chinnambedu Ravichandran; Vignesh, Ramachandran; Boobalan, Jayaseelan; Solomon, Sunil Suhas; Saravanan, Shanmugam; Balakrishnan, Pachamuthu

2017-10-01

Sustainable suppression of HIV replication forms the basis of anti-retroviral therapy (ART) medication. Thus, reliable quantification of HIV viral load has become an essential factor to monitor the effectiveness of the ART. Longer turnaround-time (TAT), batch testing and technical skills are major drawbacks of standard real-time PCR assays. The performance of the point-of-care Xpert HIV-1 viral load assay was evaluated against the Abbott RealTime PCR m2000rt system. A total of 96 plasma specimens ranging from 2.5 log10 copies ml -1 to 4.99 log10 copies ml -1 and proficiency testing panel specimens were used. Precision and accuracy were checked using the Pearson correlation co-efficient test and Bland-Altman analysis. Compared to the Abbott RealTime PCR, the Xpert HIV-1 viral load assay showed a good correlation (Pearson r=0.81; P<0.0001) with a mean difference of 0.27 log10 copies ml -1 (95 % CI, -0.41 to 0.96 log10 copies ml -1 ; sd, 0.35 log10 copies ml -1 ). Reliable and ease of testing individual specimens could make the Xpert HIV-1 viral load assay an efficient alternative method for ART monitoring in clinical management of HIV disease in resource-limited settings. The rapid test results (less than 2 h) could help in making an immediate clinical decision, which further strengthens patient care.

Depressive Symptoms, Disclosure, HIV-Related Stigma, and Coping Following HIV Testing Among Outpatients in Uganda: A Daily Process Analysis.

PubMed

Kiene, Susan M; Dove, Meredith; Wanyenze, Rhoda K

2018-05-01

As efforts to end the HIV epidemic accelerate there is emphasis on reaching those living with undiagnosed HIV infection. Newly diagnosed individuals face a number of psychosocial challenges, yet we know little about depressive symptoms in the weeks immediately following diagnosis and how disclosure, coping, and other factors may affect short and longer-term depressive symptoms. Purposively sampled Ugandan outpatients completed structured interviews immediately prior to testing for HIV, daily for 28 days after receiving their test results, and at 3 and 6 months post-test. The sample included a total of 244 participants: 20 who tested HIV positive at baseline and who provided 342 daily data points, and 224 who tested HIV negative at baseline and who provided 4388 daily data points. We used linear mixed effects modeling to examine changes in depressive symptom scores over the 28 day daily interview period and predictors of depressive symptom scores and changes over time. Results from the mixed modeling revealed that while those diagnosed with HIV showed initially high depressive symptoms following diagnosis, their symptoms decreased significantly and on average fell below the cutoff for possible depression approximately 15 days after diagnosis. Among those who tested HIV-negative, on average their depressive symptoms were below the cutoff for possible depression and did not change over time. Among those diagnosed with HIV, disclosure, especially to a partner, on a particular day was associated with higher depressive symptoms that day. However, those who disclosed to their partner during the 28 days after diagnosis had significantly lower depression scores by the end of the 28 days as well as lower depression scores 3 and 6 months after diagnosis than did those who did not disclose to their partner during the 28 days after diagnosis. Scoring higher on HIV-related stigma on a particular day was associated with higher depressive symptoms that day and engaging in positive coping on a particular day was associated with lower depressive symptoms that day. Positive coping also accelerated the decrease in depressive symptoms over time. These data underscore the importance of timely disclosure to partners and suggest that regular depression screening after diagnosis and provision of mental health services could improve HIV care engagement and treatment outcomes.

Mentoring, Networking and Supervision: Parallelogram, Vortex, or Merging Point?

ERIC Educational Resources Information Center

Hernandez, Mary N.

1994-01-01

Discussion of recruiting and hiring minorities in academic libraries focuses on steps needed for the retention of these minorities. Highlights include literature search strategies; mentoring systems; networking within and outside the organization; and supervision, including immediate feedback. (Contains 20 references.) (LRW)

Comparison of Immediate With Delayed Stenting Using the Minimalist Immediate Mechanical Intervention Approach in Acute ST-Segment-Elevation Myocardial Infarction: The MIMI Study.

PubMed

Belle, Loic; Motreff, Pascal; Mangin, Lionel; Rangé, Grégoire; Marcaggi, Xavier; Marie, Antoine; Ferrier, Nadine; Dubreuil, Olivier; Zemour, Gilles; Souteyrand, Géraud; Caussin, Christophe; Amabile, Nicolas; Isaaz, Karl; Dauphin, Raphael; Koning, René; Robin, Christophe; Faurie, Benjamin; Bonello, Laurent; Champin, Stanislas; Delhaye, Cédric; Cuilleret, François; Mewton, Nathan; Genty, Céline; Viallon, Magalie; Bosson, Jean Luc; Croisille, Pierre

2016-03-01

Delayed stent implantation after restoration of normal epicardial flow by a minimalist immediate mechanical intervention aims to decrease the rate of distal embolization and impaired myocardial reperfusion after percutaneous coronary intervention. We sought to confirm whether a delayed stenting (DS) approach (24-48 hours) improves myocardial reperfusion, versus immediate stenting, in patients with acute ST-segment-elevation myocardial infarction undergoing primary percutaneous coronary intervention. In the prospective, randomized, open-label minimalist immediate mechanical intervention (MIMI) trial, patients (n=140) with ST-segment-elevation myocardial infarction ≤12 hours were randomized to immediate stenting (n=73) or DS (n=67) after Thrombolysis In Myocardial Infarction 3 flow restoration by thrombus aspiration. Patients in the DS group underwent a second coronary arteriography for stent implantation a median of 36 hours (interquartile range 29-46) after randomization. The primary end point was microvascular obstruction (% left ventricular mass) on cardiac magnetic resonance imaging performed 5 days (interquartile range 4-6) after the first procedure. There was a nonsignificant trend toward lower microvascular obstruction in the immediate stenting group compared with DS group (1.88% versus 3.96%; P=0.051), which became significant after adjustment for the area at risk (P=0.049). Median infarct weight, left ventricular ejection fraction, and infarct size did not differ between groups. No difference in 6-month outcomes was apparent for the rate of major cardiovascular and cerebral events. The present findings do not support a strategy of DS versus immediate stenting in patients with ST-segment-elevation infarction undergoing primary percutaneous coronary intervention and even suggested a deleterious effect of DS on microvascular obstruction size. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01360242. © 2016 American Heart Association, Inc.

Time Ordering in Frontal Lobe Patients: A Stochastic Model Approach

ERIC Educational Resources Information Center

Magherini, Anna; Saetti, Maria Cristina; Berta, Emilia; Botti, Claudio; Faglioni, Pietro

2005-01-01

Frontal lobe patients reproduced a sequence of capital letters or abstract shapes. Immediate and delayed reproduction trials allowed the analysis of short- and long-term memory for time order by means of suitable Markov chain stochastic models. Patients were as proficient as healthy subjects on the immediate reproduction trial, thus showing spared…

Penile fracture: retrospective analysis of our case history with long-term assessment of the erectile and sexological outcome.

PubMed

Pavan, Nicola; Tezzot, Giorgia; Liguori, Giovanni; Napoli, Renata; Umari, Paolo; Rizzo, Michele; Chiriacò, Giovanni; Chiapparrone, Gaetano; Vedovo, Francesca; Bertolotto, Michele; Trombetta, Carlo

2014-12-30

To review the cases of patients with suspected penile fracture and asses erectile and sexological outcomes. from 1987 to 2013 presented to the Urology Clinic of Trieste and at the AIED of Pordenone a total of 41 cases that were divided into two groups according to the timing of treatment: 18 patients with anamnestic diagnosis of penile fracture treated nonimmediately and 23 patients treated immediately after the trauma. For all patients we evaluated the type of treatment adopted, the occurrence of complications and reoperations and the follow-up. The erectile function was also evaluated through the IIEF, as well as the psychological impact of the trauma on social and sex life, using a psycho- sexological questionnaire. Among patients treated immediately after the trauma 14 were subjected to surgery. About a year after surgery, penile curvature was reported in 1 patient, pain in 3 patients, urinary disorders in 1 patient, while none reported erectile dysfunction (ED). Out of these, only 3 patients underwent reoperation. Among those treated conservatively 1 patient reported curvature, 1 patient reported pain and none reported ED. Among patients who were admitted at a later date, 14 reported curvature and 4 reported pain whereas urinary disorders were reported in 1 and ED in 4 patients. From a psychological point of view, the trauma caused in most cases a fear of new trauma and of repercussions on erectile function and sensitivity. The diagnosis is mainly clinical; however, radiological investigation is essential to confirm the diagnosis, assess the site and extent of the trauma and possible urethral involvement, so as to plan the most appropriate treatment. In addition, immediate treatment leads to better long-term results, with a lower incidence of ED and penile curvature. Psychologically, penile trauma intensifies the fear of reoccurrence; it decreases, however, with the passage of time.

The relative value of growth.

PubMed

Mass, Nathaniel J

2005-04-01

Most executives would say that adding a point of growth and gaining a point of operating-profit margin contribute about equally to shareholder value. Margin improvements hit the bottom line immediately, while growth compounds value over time. But the reality is that the two are rarely equivalent. Growth often is far more valuable than managers think. For some companies, convincing the market that they can grow by just one additional percentage point can be worth six, seven, or even ten points of margin improvement. This article presents a new strategic metric, called the relative value of growth (RVG), which gives managers a clear picture of how growth projects and margin improvement initiatives affect shareholder value. Using basic balance sheet and income sheet data, managers can determine their companies' RVGs, as well as those of their competitors. Calculating RVGs gives managers insights into which corporate strategies are working to deliver value and whether their companies are pulling the most powerful value-creation levers. The author examines a number of well-known companies and explains what their RVG numbers say about their strategies. He reviews the unspoken assumption that growth and profits are incompatible over the long term and shows that a fair number of companies are effective at delivering both. Finally, he explains how managers can use the RVG framework to help them define strategies that balance growth and profitability at both the corporate and business unit levels.

Use of geometric properties of landmark arrays for reorientation relative to remote cities and local objects.

PubMed

Mou, Weimin; Nankoo, Jean-François; Zhou, Ruojing; Spetch, Marcia L

2014-03-01

Five experiments investigated how human adults use landmark arrays in the immediate environment to reorient relative to the local environment and relative to remote cities. Participants learned targets' directions with the presence of a proximal 4 poles forming a rectangular shape and an array of more distal poles forming a rectangular shape. Then participants were disoriented and pointed to targets with the presence of the proximal poles or the distal poles. Participants' orientation was estimated by the mean of their pointing error across targets. The targets could be 7 objects in the immediate local environment in which the poles were located or 7 cities around Edmonton (Alberta, Canada) where the experiments occurred. The directions of the 7 cities could be learned from reading a map first and then from pointing to the cities when the poles were presented. The directions of the 7 cities could also be learned from viewing labels of cities moving back and forth in the specific direction in the immediate local environment in which the poles were located. The shape of the array of the distal poles varied in salience by changing the number of poles on each edge of the rectangle (2 vs. 34). The results showed that participants regained their orientation relative to local objects using the distal poles with 2 poles on each edge; participants could not reorient relative to cities using the distal pole array with 2 poles on each edge but could reorient relative to cities using the distal pole array with 34 poles on each edge. These results indicate that use of cues in reorientation depends not only on the cue salience but also on which environment people need to reorient to.

Velocity and pressure fields associated with near-wall turbulence structures

NASA Technical Reports Server (NTRS)

Johansson, Arne V.; Alfredsson, P. Henrik; Kim, John

1990-01-01

Computer generated databases containing velocity and pressure fields in three-dimensional space at a sequence of time-steps, were used for the investigation of near-wall turbulence structures, their space-time evolution, and their associated pressure fields. The main body of the results were obtained from simulation data for turbulent channel flow at a Reynolds number of 180 (based on half-channel height and friction velocity) with a grid of 128 x 129 x and 128 points. The flow was followed over a total time of 141 viscous time units. Spanwise centering of the detected structures was found to be essential in order to obtain a correct magnitude of the associated Reynolds stress contribution. A positive wall-pressure peak is found immediately beneath the center of the structure. The maximum amplitude of the pressure pattern was, however, found in the buffer region at the center of the shear-layer. It was also found that these flow structures often reach a maximum strength in connection with an asymmetric spanwise motion, which motivated the construction of a conditional sampling scheme that preserved this asymmetry.

A composite lithology log while drilling

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

Tannenbaum, E.; Sutcliffe, B.; Franks, A.

A new method for producing a computerized composite lithology log (CLL) while drilling by integrating MWD (measurement while drilling) and surface data is described. The CLL integrates three types of data (MWD mechanical, MWD geophysical, and surface cuttings) acquired during drilling, in three time stages: (1) Real Time. MWD drilling mechanical data including the rate of penetration and the downhole torque. This stage would provide bed boundaries and some inferred lithology. This would assist the driller with immediate drilling decisions and determine formation tops for coring, casing point, and correlation. (2) MWD Time. Recomputation of the above by adding MWDmore » geophysical data (gamma-ray, resistivity, neutron-density). This stage would upgrade the lithology inference, and give higher resolution of bed boundaries. (3) Lag Time. Detailed analysis of surface cuttings to confirm the inferred lithologies. This last input will result in a high-quality CLL with accurate lithologies and bed boundaries. The log will serve the geologist as well as the driller, petrophysicist, and reservoir engineer. It will form the basis for more comprehensive formation evaluation while drilling by adding hydrocarbon and MWD log data.« less

Should We Perform an Immediate Coronary Angiogram in All Patients After Cardiac Arrest?: Insights From a Large French Registry.

PubMed

Bougouin, Wulfran; Dumas, Florence; Karam, Nicole; Maupain, Carole; Marijon, Eloi; Lamhaut, Lionel; Jost, Daniel; Geri, Guillaume; Beganton, Frankie; Varenne, Olivier; Spaulding, Christian; Jouven, Xavier; Cariou, Alain

2018-02-12

This study sought to assess the relationship between an immediate invasive strategy and survival after an out-of-hospital cardiac arrest (OHCA) of presumed cardiac cause, according to prognosis evaluated on hospital arrival. An immediate coronary angiogram (CAG) may be associated with better outcome after OHCA in neurologically preserved patients but could be futile in other cases. From May 2011 to May 2015, we collected data for all patients admitted in hospital after OHCA in Paris and its suburbs (France). Risk of in-hospital death was retrospectively calculated using the validated Cardiac Arrest Hospital Prognosis score, which includes age, setting, initial rhythm, durations from collapse to basic life support and from basic life support to return of spontaneous circulation, pH, and epinephrine dose. Independent predictors of survival at discharge (including immediate CAG) were assessed in multivariate logistic regression in each of the 3 pre-defined subgroups of Cardiac Arrest Hospital Prognosis score: low risk (<150 points), medium risk (150 to 200 points), and high risk (>200 points) for in-hospital death. A total of 1,410 patients were included and overall survival rate at hospital discharge was 32%. Distribution in the low-, medium-, and high-risk Cardiac Arrest Hospital Prognosis subgroups was 667 (47%), 469 (33%), and 274 patients (20%), respectively. The rate of early CAG was 86%, 66%, and 47% in the low-, medium-, and high-risk subgroups, respectively (p < 0.001). Early invasive strategy was independently associated with better survival in low-risk patients (odds ratio: 2.3; 95% confidence interval: 1.4 to 3.9; p = 0.001), but not in medium-risk (p = 0.55) and high-risk (p = 0.43) patients. Sensitivity analysis found consistent results. In cardiac arrest patients, our results suggest that investigations regarding early CAG after OHCA should focus on patients with preserved neurological status. Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Induction of cortical plasticity and improved motor performance following unilateral and bilateral transcranial direct current stimulation of the primary motor cortex.

PubMed

Kidgell, Dawson J; Goodwill, Alicia M; Frazer, Ashlyn K; Daly, Robin M

2013-07-01

Transcranial direct current stimulation (tDCS) is a non-invasive technique that modulates the excitability of neurons within the primary motor cortex (M1). Research shows that anodal-tDCS applied over the non-dominant M1 (i.e. unilateral stimulation) improves motor function of the non-dominant hand. Similarly, previous studies also show that applying cathodal tDCS over the dominant M1 improves motor function of the non-dominant hand, presumably by reducing interhemispheric inhibition. In the present study, one condition involved anodal-tDCS over the non-dominant M1 (unilateral stimulation) whilst a second condition involved applying cathodal-tDCS over the dominant M1 and anodal-tDCS over non-dominant M1 (bilateral stimulation) to determine if unilateral or bilateral stimulation differentially modulates motor function of the non-dominant hand. Using a randomized, cross-over design, 11 right-handed participants underwent three stimulation conditions: 1) unilateral stimulation, that involved anodal-tDCS applied over the non-dominant M1, 2) bilateral stimulation, whereby anodal-tDCS was applied over the non-dominant M1, and cathodal-tDCS over the dominant M1, and 3) sham stimulation. Transcranial magnetic stimulation (TMS) was performed before, immediately after, 30 and 60 minutes after stimulation to elucidate the neural mechanisms underlying any potential after-effects on motor performance. Motor function was evaluated by the Purdue pegboard test. There were significant improvements in motor function following unilateral and bilateral stimulation when compared to sham stimulation at all-time points (all P < 0.05); however there was no difference across time points between unilateral and bilateral stimulation. There was also a similar significant increase in corticomotor excitability with both unilateral and bilateral stimulation immediately post, 30 minutes and 60 minutes compared to sham stimulation (all P < 0.05). Unilateral and bilateral stimulation reduced short-interval intracortical inhibition (SICI) immediately post and at 30 minutes (all P < 0.05), but returned to baseline in both conditions at 60 minutes. There was no difference between unilateral and bilateral stimulation for SICI (P > 0.05). Furthermore, changes in corticomotor plasticity were not related to changes in motor performance. These results indicate that tDCS induced behavioural changes in the non-dominant hand as a consequence of mechanisms associated with use-dependant cortical plasticity that is independent of the electrode arrangement.

Impact of post-colposcopy management on women's long-term worries: results from the UK population-based TOMBOLA trial.

PubMed

Sharp, Linda; Cotton, Seonaidh; Cruickshank, Margaret; Gray, Nicola; Smart, Louise; Whynes, David; Little, Julian

2016-01-01

Effective cervical screening reduces cancer incidence and mortality. However, these benefits may be accompanied by some harms, potentially including, adverse psychological impacts. Studies suggest women may have concerns about various specific issues, such as cervical cancer. To compare worries about cervical cancer, future fertility, having sex, and general health between women managed by alternative policies at colposcopy. Multicentre individually-randomised controlled trial, nested within the National Health Service Cervical Screening Programmes. UK. 1515 women, aged 20-59 years, with low-grade cytology who attended colposcopy during February 2001-October 2002, were randomised to immediate loop excision or punch biopsies with recall for treatment if cervical intraepithelial neoplasia (CIN)2/3 was confirmed. Women completed questionnaires at recruitment and after 12, 18, 24 and 30 months. Outcomes were prevalence of worries at each time-point (point prevalence) and at any time-point during follow-up (12-30 months; cumulative prevalence). Primary analysis was by intention-to-treat (ITT); secondary per-protocol analysis compared groups according to management received among women with an abnormal transformation zone. Cumulative prevalence of worries was: cervical cancer 40%; having sex 26%, future fertility 24%, and general health 60%. In ITT analyses, there were no statistically significant differences between management arms in cumulative or point prevalence of any of the worries. In per-protocol analyses, between-group differences were significant only for future fertility; cumulative prevalence was highest in women who underwent punch biopsies and treatment. There is no difference in the prevalence of specific worries in women randomised to alternative post-colposcopy management policies. 34841617. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

When is an implant ready for a tooth?

PubMed

Tupac, Robert G

2003-12-01

The capability of placing an osseointegrated implant at the time of tooth extraction and immediately placing a restoration on the implant depends upon a number of factors. This paper describes the traditional Brånemark protocol, the evolution of single-stage surgery, the guidelines for immediate placement, the measurement of implant stability, and the considerations critical to immediately loading.

Micro-Computed Tomography Evaluation of Human Fat Grafts in Nude Mice

PubMed Central

Chung, Michael T.; Hyun, Jeong S.; Lo, David D.; Montoro, Daniel T.; Hasegawa, Masakazu; Levi, Benjamin; Januszyk, Michael; Longaker, Michael T.

2013-01-01

Background Although autologous fat grafting has revolutionized the field of soft tissue reconstruction and augmentation, long-term maintenance of fat grafts is unpredictable. Recent studies have reported survival rates of fat grafts to vary anywhere between 10% and 80% over time. The present study evaluated the long-term viability of human fat grafts in a murine model using a novel imaging technique allowing for in vivo volumetric analysis. Methods Human fat grafts were prepared from lipoaspirate samples using the Coleman technique. Fat was injected subcutaneously into the scalp of 10 adult Crl:NU-Foxn1nu CD-1 male mice. Micro-computed tomography (CT) was performed immediately following injection and then weekly thereafter. Fat volume was rendered by reconstructing a three-dimensional (3D) surface through cubic-spline interpolation. Specimens were also harvested at various time points and sections were prepared and stained with hematoxylin and eosin (H&E), for macrophages using CD68 and for the cannabinoid receptor 1 (CB1). Finally, samples were explanted at 8- and 12-week time points to validate calculated micro-CT volumes. Results Weekly CT scanning demonstrated progressive volume loss over the time course. However, volumetric analysis at the 8- and 12-week time points stabilized, showing an average of 62.2% and 60.9% survival, respectively. Gross analysis showed the fat graft to be healthy and vascularized. H&E analysis and staining for CD68 showed minimal inflammatory reaction with viable adipocytes. Immunohistochemical staining with anti-human CB1 antibodies confirmed human origin of the adipocytes. Conclusions Studies assessing the fate of autologous fat grafts in animals have focused on nonimaging modalities, including histological and biochemical analyses, which require euthanasia of the animals. In this study, we have demonstrated the ability to employ micro-CT for 3D reconstruction and volumetric analysis of human fat grafts in a mouse model. Importantly, this model provides a platform for subsequent study of fat manipulation and soft tissue engineering. PMID:22916732

The Immediate and Chronic Influence of Spatio-Temporal Metaphors on the Mental Representations of Time in English, Mandarin, and Mandarin-English Speakers

PubMed Central

Lai, Vicky Tzuyin; Boroditsky, Lera

2013-01-01

In this paper we examine whether experience with spatial metaphors for time has an influence on people’s representation of time. In particular we ask whether spatio-temporal metaphors can have both chronic and immediate effects on temporal thinking. In Study 1, we examine the prevalence of ego-moving representations for time in Mandarin speakers, English speakers, and Mandarin-English (ME) bilinguals. As predicted by observations in linguistic analyses, we find that Mandarin speakers are less likely to take an ego-moving perspective than are English speakers. Further, we find that ME bilinguals tested in English are less likely to take an ego-moving perspective than are English monolinguals (an effect of L1 on meaning-making in L2), and also that ME bilinguals tested in Mandarin are more likely to take an ego-moving perspective than are Mandarin monolinguals (an effect of L2 on meaning-making in L1). These findings demonstrate that habits of metaphor use in one language can influence temporal reasoning in another language, suggesting the metaphors can have a chronic effect on patterns in thought. In Study 2 we test Mandarin speakers using either horizontal or vertical metaphors in the immediate context of the task. We find that Mandarin speakers are more likely to construct front-back representations of time when understanding front-back metaphors, and more likely to construct up-down representations of time when understanding up-down metaphors. These findings demonstrate that spatio-temporal metaphors can also have an immediate influence on temporal reasoning. Taken together, these findings demonstrate that the metaphors we use to talk about time have both immediate and long-term consequences for how we conceptualize and reason about this fundamental domain of experience. PMID:23630505

Waveform analysis-guided treatment versus a standard shock-first protocol for the treatment of out-of-hospital cardiac arrest presenting in ventricular fibrillation: results of an international randomized, controlled trial.

PubMed

Freese, John P; Jorgenson, Dawn B; Liu, Ping-Yu; Innes, Jennifer; Matallana, Luis; Nammi, Krishnakant; Donohoe, Rachael T; Whitbread, Mark; Silverman, Robert A; Prezant, David J

2013-08-27

Ventricular fibrillation (VF) waveform properties have been shown to predict defibrillation success and outcomes among patients treated with immediate defibrillation. We postulated that a waveform analysis algorithm could be used to identify VF unlikely to respond to immediate defibrillation, allowing selective initial treatment with cardiopulmonary resuscitation in an effort to improve overall survival. In a multicenter, double-blind, randomized study, out-of-hospital cardiac arrest patients in 2 urban emergency medical services systems were treated with automated external defibrillators using either a VF waveform analysis algorithm or the standard shock-first protocol. The VF waveform analysis used a predefined threshold value below which return of spontaneous circulation (ROSC) was unlikely with immediate defibrillation, allowing selective treatment with a 2-minute interval of cardiopulmonary resuscitation before initial defibrillation. The primary end point was survival to hospital discharge. Secondary end points included ROSC, sustained ROSC, and survival to hospital admission. Of 6738 patients enrolled, 987 patients with VF of primary cardiac origin were included in the primary analysis. No immediate or long-term survival benefit was noted for either treatment algorithm (ROSC, 42.5% versus 41.2%, P=0.70; sustained ROSC, 32.4% versus 33.4%, P=0.79; survival to admission, 34.1% versus 36.4%, P=0.46; survival to hospital discharge, 15.6% versus 17.2%, P=0.55, respectively). Use of a waveform analysis algorithm to guide the initial treatment of out-of-hospital cardiac arrest patients presenting in VF did not improve overall survival compared with a standard shock-first protocol. Further study is recommended to examine the role of waveform analysis for the guided management of VF.

Effect of epidural blood injection on upright posture intolerance in patients with headaches due to intracranial hypotension: A prospective study.

PubMed

Qureshi, Adnan I; Kherani, Danish; Waqas, Muhammad A; Qureshi, Mushtaq H; Raja, Faisal M; Wallery, Shawn S

2018-06-19

We performed a prospective study to quantify changes in various aspects of upright posture intolerance in patients with intracranial hypotension. Six patients were provided a standard questionnaire before, immediately after epidural blood patch injection and at follow-up visit within 1 month after epidural blood injection inquiring: (a) How long can they stand straight without any support? (b) Do they feel any sense of sickness when they sit or lie down after standing? (c) How long do they have to wait before they are comfortable standing again after they have stood straight? (d) How effectively and fast can they get up from sitting or lying position to stand straight? and (e) Rate their activities in upright posture without support on a standard vertical visual analogue scale between 100 (can do everything) and 0 (cannot do anything). All patients responded that they could not stand straight for ≥30 min (four responding <5 min) on pretreatment evaluation. All patients reported improvement in this measure immediately postprocedure with two reporting ≥30 min. At follow-up, three patients reported further improvement and one patient reported worsening in this measure. The magnitude of improvement ranged from 10 to 80 points increase immediately postprocedure in their ability to perform activities, while they are standing without any support on visual analogue scale. At follow-up, four patient reported additional improvement in their ability to perform activities, while they are standing without any support (ranged from 10 to 20 points increase compared with immediately postprocedure rating). We present semiquantitative data on various aspects of upright posture intolerance in patients with intracranial hypotension before and after epidural blood injection. © 2018 The Authors. Brain and Behavior published by Wiley Periodicals, Inc.

Physiologic effects of prolonged conducted electrical weapon discharge in ethanol-intoxicated adults.

PubMed

Moscati, Ronald; Ho, Jeffrey D; Dawes, Donald M; Miner, James R

2010-06-01

This study examines the physiologic effects of prolonged conducted electrical weapon (CEW) exposure on alcohol-intoxicated adult subjects. Adult volunteers were recruited at a TASER International training conference. All subjects ingested mixed drinks until clinical intoxication or until a minimum breath alcohol level of 0.08 mg/dL was achieved. Blood samples for venous pH, Pco(2), bicarbonate, and lactate were measured in all subjects at baseline, immediately after alcohol ingestion, immediately after exposure to a 15-second TASER X26 discharge (Taser International Inc, Scottsdale, AZ), and 24 hours post-alcohol ingestion. Laboratory values were compared at sampling times using repeated-measure analysis of variance. A focused analysis comparing time points within groups was then performed using paired t tests. Twenty-two subjects were enrolled into the study. There was a decrease in pH and bicarbonate and an increase in lactate after alcohol ingestion. There was a further increase in lactate and drop in pH after CEW exposure. No subject experienced a significant adverse event. All values had returned to baseline levels at 24 hours except lactate, which demonstrated a small but clinically insignificant increase. Prolonged continuous CEW exposure in the setting of acute alcohol intoxication has no clinically significant effect on subjects in terms of markers of metabolic acidosis. The acidosis seen is consistent with what occurs with ethanol intoxication or moderate exertion. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Acute effects of high- and low-intensity exercise bouts on leukocyte counts.

PubMed

Neves, Pedro Rogério Da Silva; Tenório, Thiago Ricardo Dos Santos; Lins, Tatiana Acioli; Muniz, Maria Tereza Cartaxo; Pithon-Curi, Tânia Cristina; Botero, João Paulo; Do Prado, Wagner Luiz

2015-06-01

It is widely accepted that physical exercise may bring about changes in the immune system. Even acute bouts of exercise can alter the number and function of leukocytes, but the degree of white blood cell trafficking depends on the intensity and duration of exercise. The aim of this study was to analyze the acute and short-term effects of exercise intensity on leukocyte counts and leukocyte subsets. Nine physically healthy, active young males (21.0 ± 1.9 years) underwent three experimental trials: high exercise intensity [80% peak oxygen consumption (VO 2peak )], low exercise intensity (40% VO 2peak ), and the control condition (no exercise). Blood samples were collected prior to exercise, immediately after exercise, and 2 hours after exercise. Two-way analysis of variance for repeated measures was used to evaluate differences between the trials and the time-points, and to compare times within trials. There was a greater increase in the leukocyte count after high-intensity exercise, compared to the control condition ( p  < 0.01) and low-intensity exercise ( p  < 0.01). This effect was still present 2 hours after passive recovery ( p  < 0.01). When the same participants were submitted to different exercise intensities, the acute and short-term effects of exercise on white blood cells were intensity-dependent immediately after exercise (i.e., lymphocytosis and monocytosis) and 2 hours after passive recovery (i.e., neutrophilia).

Immediate Partial Breast Reconstruction with Endoscopic Latissimus Dorsi Muscle Flap Harvest

PubMed Central

Yang, Chae Eun; Roh, Tai Suk; Yun, In Sik; Lew, Dae Hyun

2014-01-01

Background Currently, breast conservation therapy is commonly performed for the treatment of early breast cancer. Depending on the volume excised, patients may require volume replacement, even in cases of partial mastectomy. The use of the latissimus dorsi muscle is the standard method, but this procedure leaves an unfavorable scar on the donor site. We used an endoscope for latissimus dorsi harvesting to minimize the incision, thus reducing postoperative scars. Methods Ten patients who underwent partial mastectomy and immediate partial breast reconstruction with endoscopic latissimus dorsi muscle flap harvest were reviewed retrospectively. The total operation time, hospital stay, and complications were reviewed. Postoperative scarring, overall shape of the reconstructed breast, and donor site deformity were assessed using a 10-point scale. Results In the mean follow-up of 11 weeks, no tumor recurrence was reported. The mean operation time was 294.5 (±38.2) minutes. The postoperative hospital stay was 11.4 days. Donor site seroma was reported in four cases and managed by office aspiration and compressive dressing. Postoperative scarring, donor site deformity, and the overall shape of the neobreast were acceptable, scoring above 7. Conclusions Replacement of 20% to 40% of breast volume in the upper and the lower outer quadrants with a latissimus dorsi muscle flap by using endoscopic harvesting is a good alternative reconstruction technique after partial mastectomy. Short incision benefits from a very acceptable postoperative scar, less pain, and early upper extremity movement. PMID:25276643

Recovery of gait after quadriceps muscle fatigue.

PubMed

Barbieri, Fabio Augusto; Beretta, Stephannie Spiandor; Pereira, Vinicius A I; Simieli, Lucas; Orcioli-Silva, Diego; dos Santos, Paulo Cezar Rocha; van Dieën, Jaap H; Gobbi, Lilian Teresa Bucken

2016-01-01

The aim of this study was to investigate the effect of recovery time after quadriceps muscle fatigue on gait in young adults. Forty young adults (20-40 years old) performed three 8-m gait trials at preferred velocity before and after muscle fatigue, and after 5, 10 and 20min of passive rest. In addition, at each time point, two maximal isometric voluntary contractions were preformed. Muscle fatigue was induced by repeated sit-to-stand transfers until task failure. Spatio-temporal, kinetic and muscle activity parameters, measured in the central stride of each trial, were analyzed. Data were compared between before and after the muscle fatigue protocol and after the recovery periods by one-way repeated measures ANOVA. The voluntary force was decreased after the fatigue protocol (p<0.001) and after 5, 10 and 20min of recovery compared to before the fatigue protocol. Step width (p<0.001) and RMS of biceps femoris (p<0.05) were increased immediately after the fatigue protocol and remained increased after the recovery periods. In addition, stride duration was decreased immediately after the fatigue protocol compared to before and to after 10 and 20min of rest (p<0.001). The anterior-posterior propulsive impulse was also decreased after the fatigue protocol (p<0.001) and remained low after 5, 10 and 20min of rest. We conclude that 20min is not enough to see full recovery of gait after exhaustive quadriceps muscle fatigue. Copyright © 2015 Elsevier B.V. All rights reserved.

Comparison study of global and local approaches describing critical phenomena on the Polish stock exchange market

NASA Astrophysics Data System (ADS)

Czarnecki, Łukasz; Grech, Dariusz; Pamuła, Grzegorz

2008-12-01

We confront global and local methods to analyze the financial crash-like events on the Polish financial market from the critical phenomena point of view. These methods are based on the analysis of log-periodicity and the local fractal properties of financial time series in the vicinity of phase transitions (crashes). The whole history (1991-2008) of Warsaw Stock Exchange Index (WIG) describing the largest developing financial market in Europe, is analyzed in a daily time horizon. We find that crash-like events on the Polish financial market are described better by the log-divergent price model decorated with log-periodic behavior than the corresponding power-law-divergent price model. Predictions coming from log-periodicity scenario are verified for all main crashes that took place in WIG history. It is argued that crash predictions within log-periodicity model strongly depend on the amount of data taken to make a fit and therefore are likely to contain huge inaccuracies. Turning to local fractal description, we calculate the so-called local (time dependent) Hurst exponent H for the WIG time series and we find the dependence between the behavior of the local fractal properties of the WIG time series and the crashes appearance on the financial market. The latter method seems to work better than the global approach - both for developing as for developed markets. The current situation on the market, particularly related to the Fed intervention in September’07 and the situation on the market immediately after this intervention is also analyzed from the fractional Brownian motion point of view.

Improving education: just-in-time splinting video.

PubMed

Wang, Vincent; Cheng, Yu-Tsun; Liu, Deborah

2016-06-01

Just-in-time training (JITT) is an emerging concept in medical procedural education, but with few studies to support its routine use. Providing a brief educational intervention in the form of a digital video immediately prior to patient care may be an effective method to reteach knowledge for procedural techniques learned previously. Paediatric resident physicians were taught to perform a volar splint in a small workshop setting. Subsequently, they were asked to demonstrate their splinting proficiency by performing a splint on another doctor. Proficiency was scored on a five-point assessment tool. After 2-12 months, participants were asked to demonstrate their splinting proficiency on one of the investigators, and were divided into the control group (no further instruction) and the intervention group, which viewed a 3-minute JITT digital video demonstrating the splinting technique prior to performing the procedure. Thirty subjects were enrolled between August 2012 and July 2013, and 29 of 30 completed the study. The retest splinting time was not significantly different, but if the JITT group included watching the video, the total time difference was statistically significant: 3.86 minutes (control) versus 7.07 minutes (JITT) (95% confidence interval: 2.20-3.90 minutes). The average assessment score difference was 1.87 points higher for the JITT group, which was a statistically significant difference (95% confidence interval: 1.00-3.00). Just-in-time training is an emerging concept in medical procedural education JITT seems to be an effective tool in medical education for reinforcing previously learned skills. JITT may offer other possibilities for enhancing medical education. © 2015 John Wiley & Sons Ltd.

A 3-armed randomized controlled trial of nurses' continuing education meetings on adverse drug reactions.

PubMed

Sarayani, Amir; Naderi-Behdani, Fahimeh; Hadavand, Naser; Javadi, Mohammadreza; Farsad, Fariborz; Hadjibabaie, Molouk; Gholami, Kheirollah

2015-01-01

Nurses' insufficient knowledge of adverse drug reactions is reported as a barrier to spontaneous reporting. Therefore, CE meetings could be utilized to enhance nurses' competencies. In a 3-armed randomized controlled trial, 496 nurses, working in a tertiary medical center, were randomly allocated to a didactic lecture, brainstorming workshop, or the control group (delayed education). Similar instructors (2 clinical pharmacists) prepared and delivered the educational content to all 3 groups. Outcomes were declarative/procedural knowledge (primary outcome), participation rate, and satisfaction. Knowledge was evaluated using a validated researcher-made questionnaire in 3 time points: immediately before, immediately after, and 3 months after each session. Participants' satisfaction was assessed immediately after each meeting via a standard tool. Data were analyzed using appropriate parametric and nonparametric tests. Rate of participation was 37.7% for the lecture group and 47.5% for the workshop group. The workshop participants were significantly more satisfied in comparison with the lecture group (p < .05). Mean knowledge scores were similar at baseline in the 3 study groups (43-47). Immediately after the meeting, knowledge was significantly higher in the lecture group (79.1 ± 11.9 vs 73.7 ± 11.3; p = .01). At the follow-up, knowledge scores of the lecture and workshop groups were similar, while significantly higher than the control group. However, the reduction of knowledge score was significantly higher in the lecture group (-13.0 ± 15.9% vs -5.7 ± 15.1%, p = .02). Educational interventions can improve nurses' knowledge of adverse drug reactions. Short-term learning could be achieved with lecture, but the retention of knowledge will be enhanced by simple interactive techniques. © 2015 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

78 FR 1286 - Self-Regulatory Organizations; NYSE MKT LLC; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-08

... (``CCS'').\\12\\ CCS provides the Display Book[supreg] \\13\\ with the amount of shares that the DMM is willing to trade at price points outside, at and inside the Exchange Best Bid or Best Offer (``BBO''). CCS...

The neurophysiological effects of dry needling in patients with upper trapezius myofascial trigger points: study protocol of a controlled clinical trial

PubMed Central

Abbaszadeh-Amirdehi, Maryam; Ansari, Noureddin Nakhostin; Naghdi, Soofia; Olyaei, Gholamreza; Nourbakhsh, Mohammad Reza

2013-01-01

Introduction Dry needling (DN) is an effective method for the treatment of myofascial trigger points (MTrPs). There is no report on the neurophysiological effects of DN in patients with MTrPs. The aim of the present study will be to assess the immediate neurophysiological efficacy of deep DN in patients with upper trapezius MTrPs. Methods and analysis A prospective, controlled clinical trial was designed to include patients with upper trapezius MTrPs and volunteered healthy participants to receive one session of DN. The primary outcome measures are neuromuscular junction response and sympathetic skin response. The secondary outcomes are pain intensity and pressure pain threshold. Data will be collected at baseline and immediately after intervention. Ethics and dissemination This study protocol has been approved by the Research Council, School of Rehabilitation and the Ethics Committee of Tehran University of Medical Sciences. The results of the study will be disseminated in a peer-reviewed journal and presented at international congresses. PMID:23793673

Scientific Revolutions to the nth power: n = 0, 1, 2, 3.

NASA Astrophysics Data System (ADS)

Beichler, James

2008-04-01

Thomas Kuhn's description and characterization of scientific revolutions set the standard for interpreting and understanding these events, but his characterization introduced an anomaly. Newtonian science was at the pinnacle of its success immediately prior to the Second Scientific Revolution. From an evolutionary point-of-view, there were no crises to be solved just problems within the Newtonian paradigm, whereas the specific crises that initiated the revolution are evident from everyone's point-of-view after the revolution. This paradox is well recognized, but it seems not to be a problem and is just ignored as if it were not important or significant. Yet this discrepancy strikes at the very heart of physics and the overall progress of science. Historical conditions currently parallel the period immediately prior to the Second Scientific Revolution indicating that a new scientific revolution is approaching. When a comparison of the two periods is made, new characteristics of scientific revolutions are identified, the paradox is solved and evidence of a Zeroth Scientific Revolution emerges from the historical record.

Assessing the quality of radiographic processing in general dental practice.

PubMed

Thornley, P H; Stewardson, D A; Rout, P G J; Burke, F J T

2006-05-13

To determine if a commercial device (Vischeck) for monitoring film processing quality was a practical option in general dental practice, and to assess processing quality among a group of GDPs in the West Midlands with this device. Clinical evaluation. General dental practice, UK, 2004. Ten GDP volunteers from a practice based research group processed Vischeck strips (a) when chemicals were changed, (b) one week later, and (c) immediately before the next change of chemicals. These were compared with strips processed under ideal conditions. Additionally, a series of duplicate radiographs were produced and processed together with Vischeck strips in progressively more dilute developer solutions to compare the change in radiograph quality assessed clinically with that derived from the Vischeck. The Vischeck strips suggested that at the time chosen for change of processing chemicals, eight dentists had been processing films well beyond the point indicated for replacement. Solutions were changed after a wide range of time periods and number of films processed. The calibration of the Vischeck strip correlated closely to a clinical assessment of acceptable film quality. Vischeck strips are a useful aid to monitoring processing quality in automatic developers in general dental practice. Most of this group of GDPs were using chemicals beyond the point at which diagnostic yield would be affected.

Pharmacokinetics of Compounded Intravenous and Oral Gabapentin in Hispaniolan Amazon Parrots ( Amazona ventralis ).

PubMed

Baine, Katherine; Jones, Michael P; Cox, Sherry; Martín-Jiménez, Tomás

2015-09-01

Neuropathic pain is a manifestation of chronic pain that arises with damage to the somatosensory system. Pharmacologic treatment recommendations for alleviation of neuropathic pain are often multimodal, and the few reports communicating treatment of suspected neuropathic pain in avian patients describe the use of gabapentin as part of the therapeutic regimen. To determine the pharmacokinetics of gabapentin in Hispaniolan Amazon parrots ( Amazona ventralis ), compounded gabapentin suspensions were administered at 30 mg/kg IV to 2 birds, 10 mg/kg PO to 3 birds, and 30 mg/kg PO to 3 birds. Blood samples were collected immediately before and at 9 different time points after drug administration. Plasma samples were analyzed for gabapentin concentration, and pharmacokinetic parameters were calculated with both a nonlinear mixed-effect approach and a noncompartmental analysis. The best compartmental, oral model was used to simulate the concentration-time profiles resulting from different dosing scenarios. Mild sedation was observed in both study birds after intravenous injection. Computer simulation of different dosing scenarios with the mean parameter estimates showed that 15 mg/kg every 8 hours would be a starting point for oral dosing in Hispaniolan Amazon parrots based on effective plasma concentrations reported for human patients; however, additional studies need to be performed to establish a therapeutic dose.

PERIPHERAL IMMUNE SYSTEM SUPPRESSION IN EARLY ABSTINENT ALCOHOL DEPENDENT INDIVIDUALS: LINKS TO STRESS AND CUE-RELATED CRAVING

PubMed Central

Fox, Helen C; Milivojevic, Verica; Angarita, Gustavo A; Stowe, Raymond; Sinha, Rajita

2017-01-01

Background Peripheral immune system cytokines may play an integral role in underlying sensitized stress response and alcohol craving during early withdrawal. To date, the nature of these immune changes during early abstinence have not been examined. Methods Thirty-nine early abstinent, treatment-seeking alcohol dependent individuals and 46 socially drinking controls were exposed to three guided imageries: stress, alcohol cue and neutral. These were presented randomly across consecutive days. Plasma measures of tumor necrosis factor alpha (TNFα), tumor necrosis factor receptor 1 (TNFR1), interleukin-6 (IL-6), and interleukin-10 (IL-10), were collected at baseline, immediately after imagery and at various recovery time-points. Ratings of alcohol craving, negative mood and anxiety were also obtained at the same time-points. Results The alcohol group demonstrated decreased basal IL-10 compared with controls particularly following exposure to alcohol cue. They also showed a dampened TNFα and TNFR1 response to stress and cue, respectively, and a generalized suppression of IL-6. In the alcohol group, these immune system adaptations occurred alongside significant elevations in anxiety, negative mood and alcohol craving. Conclusions Findings demonstrate that broad immuno-suppression is still observed in alcohol dependent individuals after three weeks of abstinence and may be linked to motivation for alcohol. PMID:28675117

Using Video to Bridge the Gap Between Problem Behavior and a Delayed Time-out Procedure.

PubMed

Coppage, Sara; Meindl, James N

2017-09-01

Treatment plans focused on problem behavior often include punishment contingencies to decrease problem behavior. Immediate punishers are typically more effective than delayed punishers, but immediate delivery of a punisher is not always possible. Strategies need to be developed to increase the suppressive effects of delayed punishers. This study demonstrated the effectiveness of a treatment package involving replaying a video recording of problem behavior immediately before delivering a 15 min delayed time-out. This treatment package may prove to be an accessible and inexpensive strategy when using delayed punishers.

Users’ Workshop on Combat Stress (5th) Held at Fort Sam Houston, Texas from 9 to 13 December 1985.

DTIC Science & Technology

1986-07-01

a point that has been implicit throughout this talk, the notion of additive or cumulative aspects of stressful experiences. I have focused primarily... a tendency to dwell on the unpleasant emotion- charged events in the wake of their shooting experience. Officers report reliving and reenacting the...examined in police officers. Existing immediate observation of the link between the occurrence of stress- related symptoms and a shooting event points

Nurses' knowledge and attitudes about pain in hospitalized patients.

PubMed

Jarrett, Anna; Church, Terri; Fancher-Gonzalez, Kim; Shackelford, Jamie; Lofton, Annelle

2013-01-01

The purpose of the study was to measure knowledge and attitudes of nursing about pain management in patients before education, immediately after, and 6 months later. The end-point measure was Hospital Consumer Assessment of Healthcare Providers and Systems quarterly scores and percentile rank. This longitudinal, quasi-experimental, quantitative study used survey method with pretest and posttest scores to measure immediate learning and 6 months later to measure sustained changes in knowledge and attitudes for nurses in this facility. The setting was a 360-bed acute care community hospital in the midsouth. The sample consisted of approximately 206 bedside nurses who worked in an acute care facility and 164 final posttest participants. The survey was used in a group setting immediately prior to a didactic learning experience. Immediately after the session, a posttest survey was administered. The 6-month follow-up occurred via an online module developed by the principal investigator. A repeated-measures analysis of variance, a pairwise comparison with a paired t test, and a Bonferroni correction were performed to determine if sustained knowledge and attitudes have changed. Posttest scores were significantly higher than pretest scores on the Knowledge and Attitudes Survey Regarding Pain immediately after a didactic education session and 6 months later (P < .017). Six months later, scores remained higher than pretest or immediate posttest scores. Nurses with a stronger knowledge base may lead to better pain management, improved outcomes, and higher patient satisfaction scores.

Thermal processing of a poorly water-soluble drug substance exhibiting a high melting point: the utility of KinetiSol® Dispersing.

PubMed

Hughey, Justin R; Keen, Justin M; Brough, Chris; Saeger, Sophie; McGinity, James W

2011-10-31

Poorly water-soluble drug substances that exhibit high melting points are often difficult to successfully process by fusion-based techniques. The purpose of this study was to identify a suitable polymer system for meloxicam (MLX), a high melting point class II BCS compound, and investigate thermal processing techniques for the preparation of chemically stable single phase solid dispersions. Thermal and solution based screening techniques were utilized to screen hydrophilic polymers suitable for immediate release formulations. Results of the screening studies demonstrated that Soluplus(®)(SOL) provided the highest degree of miscibility and solubility enhancement. A hot-melt extrusion feasibility study demonstrated that high temperatures and extended residence times were required in order to render compositions amorphous, causing significant degradation of MLX. A design of experiments (DOE) was conducted on the KinetiSol(®) Dispersing (KSD) process to evaluate the effect of processing conditions on the chemical stability and amorphous character of MLX. The study demonstrated that ejection temperature significantly impacted MLX stability. All samples prepared by KSD were substantially amorphous. Dissolution analysis of the KSD processed solid dispersions showed increased dissolution rates and extent of supersaturation over the marketed generic MLX tablets. Copyright © 2011 Elsevier B.V. All rights reserved.

Comparison of joint space and end point space robotic training modalities for rehabilitation of interjoint coordination in individuals with moderate to severe impairment from chronic stroke.

PubMed

Brokaw, Elizabeth B; Holley, Rahsaan J; Lum, Peter S

2013-09-01

We have developed a novel robotic modality called Time Independent Functional Training (TIFT) that provides focused retraining of interjoint coordination after stroke. TIFT was implemented on the ARMin III exoskeleton and provides joint space walls that resist movement patterns that are inconsistent with the targeted interjoint coordination pattern. In a single test session, ten moderate to severely impaired individuals with chronic stroke practiced synchronous shoulder abduction and elbow extension in TIFT and also in a comparison mode commonly used in robotic therapy called end point tunnel training (EPTT). In EPTT, error is limited by forces applied to the hand that are normal to the targeted end point trajectory. The completion percentage of the movements was comparable between modes, but the coordination patterns used by subjects differed between modes. In TIFT, subjects performed the targeted pattern of synchronous shoulder abduction and elbow extension, while in EPTT, movements were completed with compensatory strategies that incorporated the flexor synergy (shoulder abduction with elbow flexion) or the extensor synergy (shoulder adduction with elbow extension). There were immediate effects on free movements, with TIFT resulting in larger improvements in interjoint coordination than EPTT. TIFT's ability to elicit normal coordination patterns merits further investigation into the effects of longer duration training.

A paradoxical improvement of misreaching in optic ataxia: new evidence for two separate neural systems for visual localization.

PubMed

Milner, A D; Paulignan, Y; Dijkerman, H C; Michel, F; Jeannerod, M

1999-11-07

We tested a patient (A. T.) with bilateral brain damage to the parietal lobes, whose resulting 'optic ataxia' causes her to make large pointing errors when asked to locate single light emitting diodes presented in her visual field. We report here that, unlike normal individuals, A. T.'s pointing accuracy improved when she was required to wait for 5 s before responding. This counter-intuitive result is interpreted as reflecting the very brief time-scale on which visuomotor control systems in the superior parietal lobe operate. When an immediate response was required, A. T.'s damaged visuomotor system caused her to make large errors; but when a delay was required, a different, more flexible, visuospatial coding system--presumably relatively intact in her brain--came into play, resulting in much more accurate responses. The data are consistent with a dual processing theory whereby motor responses made directly to visual stimuli are guided by a dedicated system in the superior parietal and premotor cortices, while responses to remembered stimuli depend on perceptual processing and may thus crucially involve processing within the temporal neocortex.

[Recent developments on the European ban on animal experiments for cosmetics].

PubMed

Ruhdel, I W

2001-01-01

For the second time the European Commission has postponed the sales ban on cosmetics products that have been developed and tested in animal experiments now until 2002. In the meantime the Commission wants to adopt the Seventh Amendment of the EU Cosmetics Directive. In its draft the Commission proposes to scrap the sales ban and replace it with an animal testing ban. This change would avoid possible conflicts with the WTO, however, from the animal welfare point of view would result in animal testing moving into third countries instead of avoiding them. This is because cosmetics products tested on animals outside the EU could be sold in the EU without any restrictions. As a consequence this measure would take the pressure from authorities and industry to further develop and adopt alternative methods. Other proposed measures are not acceptable from the animal welfare point of view, e.g. because they contradict Directive 86/609 and would result in a delay of the application of validated alternative methods. The Deutscher Tierschutzbund therefore still demands an immediate and complete sales ban in connection with an animal testing ban within the EU.

GASNet-EX Performance Improvements Due to Specialization for the Cray Aries Network

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

Hargrove, Paul H.; Bonachea, Dan

This document is a deliverable for milestone STPM17-6 of the Exascale Computing Project, delivered by WBS 2.3.1.14. It reports on the improvements in performance observed on Cray XC-series systems due to enhancements made to the GASNet-EX software. These enhancements, known as “specializations”, primarily consist of replacing network-independent implementations of several recently added features with implementations tailored to the Cray Aries network. Performance gains from specialization include (1) Negotiated-Payload Active Messages improve bandwidth of a ping-pong test by up to 14%, (2) Immediate Operations reduce running time of a synthetic benchmark by up to 93%, (3) non-bulk RMA Put bandwidth ismore » increased by up to 32%, (4) Remote Atomic performance is 70% faster than the reference on a point-to-point test and allows a hot-spot test to scale robustly, and (5) non-contiguous RMA interfaces see up to 8.6x speedups for an intra-node benchmark and 26% for inter-node. These improvements are available in the GASNet-EX 2018.3.0 release.« less

Realtime Gas Emission Monitoring at Hazardous Sites Using a Distributed Point-Source Sensing Infrastructure

PubMed Central

Manes, Gianfranco; Collodi, Giovanni; Gelpi, Leonardo; Fusco, Rosanna; Ricci, Giuseppe; Manes, Antonio; Passafiume, Marco

2016-01-01

This paper describes a distributed point-source monitoring platform for gas level and leakage detection in hazardous environments. The platform, based on a wireless sensor network (WSN) architecture, is organised into sub-networks to be positioned in the plant’s critical areas; each sub-net includes a gateway unit wirelessly connected to the WSN nodes, hence providing an easily deployable, stand-alone infrastructure featuring a high degree of scalability and reconfigurability. Furthermore, the system provides automated calibration routines which can be accomplished by non-specialized maintenance operators without system reliability reduction issues. Internet connectivity is provided via TCP/IP over GPRS (Internet standard protocols over mobile networks) gateways at a one-minute sampling rate. Environmental and process data are forwarded to a remote server and made available to authenticated users through a user interface that provides data rendering in various formats and multi-sensor data fusion. The platform is able to provide real-time plant management with an effective; accurate tool for immediate warning in case of critical events. PMID:26805832

Water-Related Infrastructure in a Region of Post-Earthquake Haiti: High Levels of Fecal Contamination and Need for Ongoing Monitoring

PubMed Central

Widmer, Jocelyn M.; Weppelmann, Thomas A.; Alam, Meer T.; Morrissey, B. David; Redden, Edsel; Rashid, Mohammed H.; Diamond, Ulrica; Ali, Afsar; De Rochars, Madsen Beau; Blackburn, Jason K.; Johnson, Judith A.; Morris, J. Glenn

2014-01-01

We inventoried non-surface water sources in the Leogane and Gressier region of Haiti (approximately 270 km2) in 2012 and 2013 and screened water from 345 sites for fecal coliforms and Vibrio cholerae. An international organization/non-governmental organization responsible for construction could be identified for only 56% of water points evaluated. Sixteen percent of water points were non-functional at any given time; 37% had evidence of fecal contamination, with spatial clustering of contaminated sites. Among improved water sources (76% of sites), 24.6% had fecal coliforms versus 80.9% in unimproved sources. Fecal contamination levels increased significantly from 36% to 51% immediately after the passage of Tropical Storm Sandy in October of 2012, with a return to 34% contamination in March of 2013. Long-term sustainability of potable water delivery at a regional scale requires ongoing assessment of water quality, functionality, and development of community-based management schemes supported by a national plan for the management of potable water. PMID:25071005

Water-related infrastructure in a region of post-earthquake Haiti: high levels of fecal contamination and need for ongoing monitoring.

PubMed

Widmer, Jocelyn M; Weppelmann, Thomas A; Alam, Meer T; Morrissey, B David; Redden, Edsel; Rashid, Mohammed H; Diamond, Ulrica; Ali, Afsar; De Rochars, Madsen Beau; Blackburn, Jason K; Johnson, Judith A; Morris, J Glenn

2014-10-01

We inventoried non-surface water sources in the Leogane and Gressier region of Haiti (approximately 270 km(2)) in 2012 and 2013 and screened water from 345 sites for fecal coliforms and Vibrio cholerae. An international organization/non-governmental organization responsible for construction could be identified for only 56% of water points evaluated. Sixteen percent of water points were non-functional at any given time; 37% had evidence of fecal contamination, with spatial clustering of contaminated sites. Among improved water sources (76% of sites), 24.6% had fecal coliforms versus 80.9% in unimproved sources. Fecal contamination levels increased significantly from 36% to 51% immediately after the passage of Tropical Storm Sandy in October of 2012, with a return to 34% contamination in March of 2013. Long-term sustainability of potable water delivery at a regional scale requires ongoing assessment of water quality, functionality, and development of community-based management schemes supported by a national plan for the management of potable water. © The American Society of Tropical Medicine and Hygiene.

Spatial distribution of pollutants in the area of the former CHP plant

NASA Astrophysics Data System (ADS)

Cichowicz, Robert

2018-01-01

The quality of atmospheric air and level of its pollution are now one of the most important issues connected with life on Earth. The frequent nuisance and exceedance of pollution standards often described in the media are generated by both low emission sources and mobile sources. Also local organized energy emission sources such as local boiler houses or CHP plants have impact on air pollution. At the same time it is important to remember that the role of local power stations in shaping air pollution immission fields depends on the height of emitters and functioning of waste gas treatment installations. Analysis of air pollution distribution was carried out in 2 series/dates, i.e. 2 and 10 weeks after closure of the CHP plant. In the analysis as a reference point the largest intersection of streets located in the immediate vicinity of the plant was selected, from which virtual circles were drawn every 50 meters, where 31 measuring points were located. As a result, the impact of carbon dioxide, hydrogen sulfide and ammonia levels could be observed and analyzed, depending on the distance from the street intersection.

Percutaneous Radiofrequency Ablation of Painful Spinal Tumors Adjacent to the Spinal Cord with Real-Time Monitoring of Spinal Canal Temperature: A Prospective Study

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

Nakatsuka, Atsuhiro, E-mail: nakatuka@clin.medic.mie-u.ac.jp; Yamakado, Koichiro; Takaki, Haruyuki

2009-01-15

PurposeTo prospectively evaluate the feasibility, safety, and clinical utility of bone radiofrequency (RF) ablation with real-time monitoring of the spinal canal temperature for the treatment of spinal tumors adjacent to the spinal cord.Materials and MethodsOur Institutional Review Board approved this study. Patients gave informed consent. The inclusion criteria were (a) a painful spinal metastasis and (b) a distance of 1 cm or less between the metastasis and the spinal cord. The thermocouple was placed in the spinal canal under CT fluoroscopic guidance. When the spinal canal temperature reached 45{sup o}C, RF application was immediately stopped. RF ablation was considered technicallymore » successful when the procedure was performed without major complications. Clinical success was defined as a fall in the visual analogue scale score of at least 2 points.ResultsTen patients with spinal tumors measuring 3-8 cm (mean, 4.9 {+-} 1.5 cm) were enrolled. The distance between the tumor and the spinal cord was 1-6 mm (mean, 2.4 {+-} 1.6 mm). All procedures were judged technically successful (100%). The spinal canal temperature did not exceed 45{sup o}C in 9 of the 10 patients (90%). In the remaining patient, the temperature rose to 48{sup o}C, resulting in transient neural damage, although RF application was immediately stopped when the temperature reached 45{sup o}C. Clinical success was achieved within 1 week in all patients (100%).ConclusionBone RF ablation with real-time monitoring of the spinal canal temperature is feasible, safe, and clinically useful for the treatment of painful spinal metastases adjacent to the spinal cord.« less

High temporal discounters overvalue immediate rewards rather than undervalue future rewards: an event-related brain potential study.

PubMed

Cherniawsky, Avital S; Holroyd, Clay B

2013-03-01

Impulsivity is characterized in part by heightened sensitivity to immediate relative to future rewards. Although previous research has suggested that "high discounters" in intertemporal choice tasks tend to prefer immediate over future rewards because they devalue the latter, it remains possible that they instead overvalue immediate rewards. To investigate this question, we recorded the reward positivity, a component of the event-related brain potential (ERP) associated with reward processing, with participants engaged in a task in which they received both immediate and future rewards and nonrewards. The participants also completed a temporal discounting task without ERP recording. We found that immediate but not future rewards elicited the reward positivity. High discounters also produced larger reward positivities to immediate rewards than did low discounters, indicating that high discounters relatively overvalued immediate rewards. These findings suggest that high discounters may be more motivated than low discounters to work for monetary rewards, irrespective of the time of arrival of the incentives.

Reduction of VSC and salivary bacteria by a multibenefit mouthrinse.

PubMed

Boyd, T; Vazquez, J; Williams, M

2008-03-01

To evaluate the effectiveness of a multibenefit mouthrinse containing 0.05% cetylpyridinium chloride (CPC) and 0.025% sodium fluoride in reducing volatile sulfur compound (VSC) levels and total cultivable salivary bacteria, at both 4 h and overnight. In vitro analysis of efficacy was performed using saliva-coated hydroxyapatite disc substrates first treated with the mouthrinse, then exposed to whole human saliva, followed by overnight incubation in air-tight vials. Headspace VSC was quantified by gas chromatography (GC). A clinical evaluation was conducted with 14 subjects using a crossover design. After a seven-day washout period, baseline clinical measurement of VSC was performed by GC analysis of mouth air sampled in the morning prior to eating, drinking or performing any oral hygiene. A 10 mL saline rinse was used to sample and enumerate cultivable salivary bacterial levels via serial dilution and plating. Subjects were instructed to use the treatment rinse twice daily in combination with a controlled brushing regimen. After one week the subjects returned in the morning prior to eating, drinking or performing oral hygiene to provide samples of overnight mouth air and salivary bacteria. The subjects were then immediately rinsed with the test product, and provided additional mouth air and saliva rinse samples 4 h later. A multibenefit rinse containing 0.05% CPC and 0.025% sodium fluoride was found to reduce VSC in vitro by 52%. The rinse also demonstrated a significant clinical reduction in breath VSC (p < 0.05) of 55.8% at 4 h and 23.4% overnight relative to baseline VSC levels. At both time points, the multibenefit rinse was more effective than the control; this difference was statistically significant at the overnight time point (p < 0.05). Total cultivable salivary bacteria levels were also reduced significantly (p < 0.05) at 4 h and overnight by this mouthrinse compared to baseline levels and the control. A multibenefit mouthrinse was shown to reduce in vitro VSC levels via headspace analysis and clinically at the 4 h and overnight time points. A significant reduction in total cultivable salivary bacteria was also observed at all time points, supporting the VSC data.

The effect of water and shampooing on the efficacy of fluralaner spot-on solution against Ixodes ricinus and Ctenocephalides felis infestations in dogs.

PubMed

Taenzler, Janina; Gale, Boyd; Zschiesche, Eva; Roepke, Rainer K A; Heckeroth, Anja R

2016-05-31

Fluralaner spot-on solution provides immediate and persistent efficacy against tick and flea infestations in dogs and cats for 12-weeks following topical administration. The active ingredient fluralaner is distributed systemically following transdermal absorption. Therefore, this study tested the hypothesis whether water-immersion or shampooing of dogs following administration of fluralaner spot-on solution has an impact on subsequent tick and flea efficacy. Thirty-two Beagle dogs were allocated to four study groups of 8 dogs each. On day 0, dogs in the 2 treatment groups received topical administration of fluralaner (Bravecto™ spot-on solution) according to label instructions. Dogs in the 2 corresponding control groups remained untreated. On days 3, 21, 49, and 77 dogs in one treatment group and control group were water-immersed for 2-5 min, while dogs in the other treatment group and control group were shampooed 6-8 min with a commercial foaming micro-emulsion, unscented product. On days 4, 28, 56, and 84 all dogs were co-infested with 50 ± 2 female and 10 ± 2 male Ixodes ricinus and 100 ± 4 Ctenocephalides felis, with tick and flea removal and counts 48 ± 2 h post-infestation. Efficacy against ticks and fleas was calculated for each assessment time point. No treatment-related adverse event was observed in any of the 16 dogs treated with fluralaner spot-on solution during the study. Efficacy against ticks at each assessment time point was between 99.7 and 100 % in the water-immersed group and between 99.2 and 100 % in the shampooed group. Efficacy against fleas was 100 % at each assessment time point as well in the water-immersed as the shampooed group. Tick and flea reduction in both treatment groups was significant at all assessment time points (p < 0.0001). Neither water-immersion nor shampooing after single topical administration of fluralaner spot-on solution had an impact on the excellent tick and flea efficacy over the 12-week recommended re-treatment interval.

Linking Tree Growth Response to Measured Microclimate - A Field Based Approach

NASA Astrophysics Data System (ADS)

Martin, J. T.; Hoylman, Z. H.; Looker, N. T.; Jencso, K. G.; Hu, J.

2015-12-01

The general relationship between climate and tree growth is a well established and important tenet shaping both paleo and future perspectives of forest ecosystem growth dynamics. Across much of the American west, water limits growth via physiological mechanisms that tie regional and local climatic conditions to forest productivity in a relatively predictable way, and these growth responses are clearly evident in tree ring records. However, within the annual cycle of a forest landscape, water availability varies across both time and space, and interacts with other potentially growth limiting factors such as temperature, light, and nutrients. In addition, tree growth responses may lag climate drivers and may vary in terms of where in a tree carbon is allocated. As such, determining when and where water actually limits forest growth in real time can be a significant challenge. Despite these challenges, we present data suggestive of real-time growth limitation driven by soil moisture supply and atmospheric water demand reflected in high frequency field measurements of stem radii and cell structure across ecological gradients. The experiment was conducted at the Lubrecht Experimental Forest in western Montana where, over two years, we observed intra-annual growth rates of four dominant conifer species: Douglas fir, Ponderosa Pine, Engelmann Spruce and Western Larch using point dendrometers and microcores. In all four species studied, compensatory use of stored water (inferred from stem water deficit) appears to exhibit a threshold relationship with a critical balance point between water supply and demand. The occurrence of this point in time coincided with a decrease in stem growth rates, and the while the timing varied up to one month across topographic and elevational gradients, the onset date of growth limitation was a reliable predictor of overall annual growth. Our findings support previous model-based observations of nonlinearity in the relationship between climate and annual ring formation, and suggest a rather immediate growth response to critical micro-meteorological conditions occurring at different times across the landscape by linking the timing and magnitude of tree growth responses to in situ measurements of environmental conditions.

A Cost-Utility Analysis of 5 Strategies for the Management of Acute Otitis Media in Children.

PubMed

Shaikh, Nader; Dando, Emily E; Dunleavy, Mark L; Curran, Dorothy L; Martin, Judith M; Hoberman, Alejandro; Smith, Kenneth J

2017-10-01

To assess whether antimicrobial therapy in young children with acute otitis media reduces time to resolution of symptoms, overall symptom burden, and persistence of otoscopic evidence of infection. We used a cost-utility model to evaluate whether immediate antimicrobial treatment seems to be worthwhile, and if so, which antimicrobial agent is most cost effective. We compared the cost per quality-adjusted life-day of 5 treatment regimens in children younger than 2 years of age with acute otitis media: immediate amoxicillin/clavulanate, immediate amoxicillin, immediate cefdinir, watchful waiting, and delayed prescription (DP) for antibiotic. The 5 treatment regimens, listed in order from least effective to most effective were DP, watchful waiting, immediate cefdinir, immediate amoxicillin, and immediate amoxicillin/clavulanate. Listed in order from least costly to most costly, the regimens were DP, immediate amoxicillin, watchful waiting, immediate amoxicillin/clavulanate, and immediate cefdinir. The incremental cost-utility ratio of immediate amoxicillin compared with DP was $101.07 per quality-adjusted life-day gained. The incremental cost-utility ratio of immediate amoxicillin/clavulanate compared with amoxicillin was $2331.28 per quality-adjusted life-day gained. In children younger than 2 years of age with acute otitis media and no recent antibiotic exposure, immediate amoxicillin seems to be the most cost-effective initial treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

QRS detection based ECG quality assessment.

PubMed

Hayn, Dieter; Jammerbund, Bernhard; Schreier, Günter

2012-09-01

Although immediate feedback concerning ECG signal quality during recording is useful, up to now not much literature describing quality measures is available. We have implemented and evaluated four ECG quality measures. Empty lead criterion (A), spike detection criterion (B) and lead crossing point criterion (C) were calculated from basic signal properties. Measure D quantified the robustness of QRS detection when applied to the signal. An advanced Matlab-based algorithm combining all four measures and a simplified algorithm for Android platforms, excluding measure D, were developed. Both algorithms were evaluated by taking part in the Computing in Cardiology Challenge 2011. Each measure's accuracy and computing time was evaluated separately. During the challenge, the advanced algorithm correctly classified 93.3% of the ECGs in the training-set and 91.6 % in the test-set. Scores for the simplified algorithm were 0.834 in event 2 and 0.873 in event 3. Computing time for measure D was almost five times higher than for other measures. Required accuracy levels depend on the application and are related to computing time. While our simplified algorithm may be accurate for real-time feedback during ECG self-recordings, QRS detection based measures can further increase the performance if sufficient computing power is available.

Real-Time Continuous Response Spectra Exceedance Calculation

NASA Astrophysics Data System (ADS)

Vernon, Frank; Harvey, Danny; Lindquist, Kent; Franke, Mathias

2017-04-01

A novel approach is presented for near real-time earthquake alarms for critical structures at distributed locations using real-time estimation of response spectra obtained from near free-field motions. Influential studies dating back to the 1980s identified spectral response acceleration as a key ground motion characteristic that correlates well with observed damage in structures. Thus, monitoring and reporting on exceedance of spectra-based thresholds are useful tools for assessing the potential for damage to facilities or multi-structure campuses based on input ground motions only. With as little as one strong-motion station per site, this scalable approach can provide rapid alarms on the damage status of remote towns, critical infrastructure (e.g., hospitals, schools) and points of interests (e.g., bridges) for a very large number of locations enabling better rapid decision making during critical and difficult immediate post-earthquake response actions. Real-time calculation of PSA exceedance and alarm dissemination are enabled with Bighorn, a module included in the Antelope software package that combines real-time spectral monitoring and alarm capabilities with a robust built-in web display server. Examples of response spectra from several M 5 events recorded by the ANZA seismic network in southern California will be presented.

77 FR 24750 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-25

... Change Amending NYSE Arca Equities Rule 7.31 To Specify How the Immediate-or-Cancel Time-in-Force... Change The Exchange proposes to amend NYSE Arca Equities Rule 7.31 to specify how the immediate-or-cancel... part as soon as such order is received, and the portion not so executed is to be treated as cancelled...

42 CFR 83.12 - How will NIOSH notify petitioners, the Board, and the public of petitions that have been selected...

Code of Federal Regulations, 2010 CFR

2010-10-01

... at any point in the evaluation process under §§ 83.13 and 83.14, NIOSH finds such petitions represent... work to evaluate a petition immediately, prior to presenting the petition and evaluation plan to the...

15 CFR Appendix A to Subpart C of... - Certification Application Templates

Code of Federal Regulations, 2011 CFR

2011-01-01

... Contact E-Mail Address This is a request for the above named company or individual (hereinafter referred... Distributor prior to submitting the application. (1) Correspondence and applications/requests for... contact (995.10 (d)). Distributor agrees to immediately notify the Government of any changes to point of...

Up & Strumming

ERIC Educational Resources Information Center

Perlmutter, Adam

2011-01-01

At this point, it's pretty much indisputable: The guitar is a cool instrument. For many years, it's appealed to students because of its prominence in popular music. Lightweight, portable, and inexpensive, it makes a more immediate impact than most other instruments--players can begin to make satisfying music on guitar with just a few easy chord…

40 CFR 141.71 - Criteria for avoiding filtration.

Code of Federal Regulations, 2010 CFR

2010-07-01

... PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Filtration and Disinfection § 141.71... developed under section 1428 of the Safe Drinking Water Act may be used, if the State deems it appropriate... representative sample of the source water immediately prior to the first or only point of disinfection...

Thermal energy storage effort at JPL

NASA Technical Reports Server (NTRS)

Young, D. L.

1980-01-01

The technical, operational, and economic readiness of parabolic dish systems for electric and thermal applications was investigated. A parabolic dish system was then developed to the point at which subsequent commercialization activities can lead to successful market penetration. The immediate possible applications of the dish system to thermal energy storage are discussed.

The Role of Nuclear Power in Reducing Greenhouse Gas Emissions

EPA Science Inventory

For Frank Princiotta’s book, Global Climate Change—The Technology Challenge As this chapter will point out, nuclear energy is a low greenhouse gas emitter and is capable of providing large amounts of power using proven technology. In the immediate future, it can contribute to gr...

75 FR 65534 - Immediate Disaster Assistance Program (IDAP)

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-25

... frequency at which the interest rate adjustment will occur (the ``adjustment period''), and such adjustments... adjustment period, plus one percentage point. The change in interest rate is effective on that day whether or... without the written agreement of the borrower. Any future change to interest rates on IDAP Loans will be...

Pilot implementation of a technologically advanced system for the optimization of pre-hospital, trauma patient care.

PubMed

Vagianos, Constantine E; Dimopoulou, Efi; Tsiftsis, Dimitrios; Spyropoulos, Charalambos; Spyrakopoulos, Panagiotis; Vagenas, Konstantinos

2010-07-01

Cooperation between medical informatics, wireless communication and pre-hospital emergency services is essential for the optimal pre-hospital patient treatment. The use of technological innovations improves medical care in the pre-hospital setting with regard to the organization of an integrated center, which coordinates all parties involved for the patient's best interest. A dispatch center was developed in the city of Patras, in southwestern Greece, equipped with a Geographic Information System (GIS), which immediately points out the location of emergency vehicles (EVs) on a digital map depicting the city plan. Additionally, three ambulances of the National Center of Immediate Aid (NCIA) were equipped with a decentralized traffic management system for the vehicle's traffic priority at signaled junctions. The system consisted of a cellular-based (GSM) telemedicine module, a Global Positioning System (GPS) and a web camera system in the vehicle cabin. The aforementioned system provided considerable assistance to the pre-hospital treatment first by selecting the ambulance closest to the accident's location and then by pinpointing the optimum route to the hospital, thus significantly reducing the overall transportation time. The project's objective to coordinate emergency hospital departments involved in the treatment of trauma patients with other emergency services by utilizing high technology was achieved within this interdisciplinary effort.

Nonstandard Advance Directives in Emergency Medicine: What Should We Do?

PubMed

Iserson, Kenneth V

2018-07-01

Critically ill or injured emergency department or prehospital patients who lack decision-making capacity sometimes present with a non-standard advance directive, such as a "Do Not Resuscitate" tattoo or medallion. Emergency clinicians must immediately address the question of whether to withhold treatment based on what may or may not be a valid patient directive. Advance directives have been standardized for a good reason. Emergency department or prehospital healthcare providers must be able to immediately interpret and act on them without needing a legal interpretation. When faced with non-standard directives, physicians can follow them, ignore them, or simply use them as an additional piece of information about the individual's wishes for some situations at one point in his or her life. Absent the patient's input or that of aknowledgeable surrogate, both the patient's initial reasons for their non-standard directive and his or her present wishes concerning resuscitation cannot be independently known. Therefore, healthcare providers must initiate treatment while they buy time, attempt to return the patient to lucidity, and search for probative information regarding their current wishes concerning medical treatment. Without such additional information, the moral weight will always favor initiating treatment, since withholding treatment is often irreversible and any treatment instituted can later be withdrawn. Copyright © 2018 Elsevier Inc. All rights reserved.

Volcanic and nonvolcanic rifted margins of the Red Sea and Gulf of Aden: Crustal cooling and margin evolution in Yemen

NASA Astrophysics Data System (ADS)

Menzies, Martin; Gallagher, Kerry; Yelland, Andrew; Hurford, Anthony J.

1997-06-01

New apatite fission track (AFT) data from the southern Red Sea volcanic and the Gulf of Aden nonvolcanic margins provide important constraints on the timing of crustal cooling relative to periods of volcanism and lithosphere extension. The AFT data define several regions of extension immediately adjacent to the Red Sea margin with AFT ages < 25 Ma and track-length distributions consistent with rapid cooling. Elevated Precambrian basement highs on the rift shoulder have AFT ages ≫ 100 Ma and track-length distributions indicative of a complex pre-rift history. An intervening area along the Red Sea and Gulf of Aden margins, and inland along the Balhaf graben (Jurassic rift), has AFT ages of 25-100 Ma. and track-length distributions indicative of rapid cooling. Elevated Precambrian basement highs are juxtaposed against topographically lower extended coastal terranes with sharp contrasts in AFT ages and track-length distributions, pointing to possible reactivation in the Tertiary of lineaments of Precambrian and Jurassic age. Integration of field observations with AFT data and 40Ar/ 39Ar data indicates that, on the Red Sea volcanic margin, surface uplift was initiated immediately prior to volcanism and that cooling was synchronous with widespread extension and an apparent hiatus in voluminous volcanic activity.

Laser injury and in vivo multimodal imaging using a mouse model

NASA Astrophysics Data System (ADS)

Pocock, Ginger M.; Boretsky, Adam; Gupta, Praveena; Oliver, Jeff W.; Motamedi, Massoud

2011-03-01

Balb/c wild type mice were used to perform in vivo experiments of laser-induced thermal damage to the retina. A Heidelberg Spectralis HRA confocal scanning laser ophthalmoscope with a spectral domain optical coherence tomographer was used to obtain fundus and cross-sectional images of laser induced injury in the retina. Sub-threshold, threshold, and supra-threshold lesions were observed using optical coherence tomography (OCT), infrared reflectance, red-free reflectance, fluorescence angiography, and autofluorescence imaging modalities at different time points post-exposure. Lesions observed using all imaging modalities, except autofluorescence, were not visible immediately after exposure but did resolve within an hour and grew in size over a 24 hour period. There was a decrease in fundus autofluorescence at exposure sites immediately following exposure that developed into hyper-fluorescence 24-48 hours later. OCT images revealed threshold damage that was localized to the RPE but extended into the neural retina over a 24 hour period. Volumetric representations of the mouse retina were created to visualize the extent of damage within the retina over a 24 hour period. Multimodal imaging provides complementary information regarding damage mechanisms that may be used to quantify the extent of the damage as well as the effectiveness of treatments without need for histology.

Magnesium alloy covered stent for treatment of a lateral aneurysm model in rabbit common carotid artery: An in vivo study

NASA Astrophysics Data System (ADS)

Wang, Wu; Wang, Yong-Li; Chen, Mo; Chen, Liang; Zhang, Jian; Li, Yong-Dong; Li, Ming-Hua; Yuan, Guang-Yin

2016-11-01

Magnesium alloy covered stents have rarely been used in the common carotid artery (CCA). We evaluated the long-term efficacy of magnesium alloy covered stents in a lateral aneurysm model in rabbit CCA. Magnesium alloy covered stents (group A, n = 7) or Willis covered stents (group B, n = 5) were inserted in 12 New Zealand White rabbits and they were followed up for 12 months. The long-term feasibility for aneurysm occlusion was studied through angiograms; the changes in vessel area and lumen area were assessed with IVUS. Complete aneurysmal occlusion was achieved in all aneurysms. Angiography showed that the diameter of the stented CCA in group A at 6 and 12 months was significantly greater than the diameter immediately after stent placement. On intravascular ultrasound (IVUS) examination, the mean lumen area of the stented CCA in group A was significantly greater at 6 and 12 months than that immediately after stent placement; the mean lumen area was also significantly greater in group A than in group B at the same time points. The magnesium alloy covered stents proved to be an effective approach for occlusion of lateral aneurysm in the rabbit CCA; it provides distinct advantages that are comparable to that obtained with the Willis covered stent.

Slide shows vs graphic tablet live drawing for anatomy teaching.

PubMed

Alsaid, B

2016-12-01

Blackboard drawing is the traditional and still widely learned method for anatomy teachers. However, for practical reasons, more and more lessons are done using slide shows. New digital learning tools are developed to create a more attractive teaching method. The objective of this study was to compare the use of graphic tablet live drawing versus slide shows. Sixty-five second-year students of the Faculty of Medicine participated in this study during their first semester of 2013-2014 academic year. The selected lecture dealt about neuroanatomy; two brain sections were taught: median sagittal and transverse. The sagittal section was presented via a slide show. The transverse section was taught using a graphics tablet using drawing software. Students were evaluated three times: before the lecture, immediately after the lecture and 8 weeks later. Means were compared using a t-test. Scores were significantly higher immediately after the lecture and 8 weeks later tests in comparing the transverse section (using the graphics tablet) versus the sagittal section (using PowerPoint ® ). Student satisfaction regarding the use of the tablet was high. The graphics tablet is a usable and efficient drawing tool in anatomy teaching. This tool requires a specific teacher training and preparation. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Pain Associated With Hysteroscopic Sterilization

PubMed Central

Levy, Jenna; Childers, Meredith E.

2007-01-01

Background and Objectives: The safety and efficacy of female hysteroscopic sterilization using the Essure system has been well documented. Given the marked differences in the execution of hysteroscopic and laparoscopic sterilization, the objective of this study was to assess the experience of pain postprocedure between the 2. Secondary end-points included postoperative pain medication, time to return to normal activities, postprocedure bleeding, and patient satisfaction. Methods: Twenty cases each of laparoscopic sterilization (LS) and hysteroscopic sterilization (HS) were performed. Patients were surveyed regarding their experience of pain immediately postoperatively, 1 week, and 4 weeks post-procedure. Results: The average pain score immediately postprocedure was significantly lower among HS patients than among LS patients (t=−8.17, P<.0001). One-week post-procedure, none of the patients in the HS group reported any pain, while the average pain score among the LS patients was 2.65 (t =−9.67, P<.0001). Four weeks post-procedure, women in the HS group continued to report no pain, 35% of the LS group continued to report some pain (t=−3.04, P=.004). Conclusions: Hysteroscopic sterilization offers a minimally invasive, less painful, equally efficacious modality for sterilization than laparoscopic sterilization and should be available to all women seeking permanent birth control. PMID:17651558

Childbirth and symptoms of postpartum depression and anxiety: a prospective birth cohort study

PubMed Central

Bell, A. F.; Carter, C. S.; Davis, J. M.; Golding, J.; Adejumo, O.; Pyra, M.; Connelly, J. J.; Rubin, L. H.

2016-01-01

We investigated associations between aspects of childbirth and elevated postpartum symptoms of depression and anxiety. We employed secondary analysis of perinatal data (N=4657–4946) from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort. Multivariable logistic regression models (adjusted for covariates) examined predictors of elevated symptoms of postpartum depression and anxiety. Predictors included the following: type of delivery (normal physiological vs. interventive non-physiological), immediate postpartum complications, and maternal perception of the recent birth experience. The Edinburgh Postnatal Depression Scale assessed elevated symptoms of depression (score≥13), and the Crown-Crisp Experiential Index assessed elevated symptoms of anxiety (score≥9) at 2 and 8 months after delivery. A more negative perception of the recent birth experience was associated with elevated symptoms of anxiety at 2 months [odds ratio (OR) 1.52, 95 % confidence interval (CI) 1.25–1.85] and 8 months (OR 1.30, 95 % CI 1.06–1.60) postpartum but was not associated with elevated symptoms of depression at either time point. Type of delivery (physiological vs. non-physiological) and immediate postpartum complications were not associated with elevated symptoms of depression or anxiety. Our findings suggest that improving women's childbirth experience may decrease the likelihood of postpartum anxiety, but not postpartum depression. PMID:26202722

Modification and preliminary use of the five-minute speech sample in the postpartum: associations with postnatal depression and posttraumatic stress.

PubMed

Iles, Jane; Spiby, Helen; Slade, Pauline

2014-10-01

Little is known about what constitutes key components of partner support during the childbirth experience. This study modified the five minute speech sample, a measure of expressed emotion (EE), for use with new parents in the immediate postpartum. A coding framework was developed to rate the speech samples on dimensions of couple support. Associations were explored between these codes and subsequent symptoms of postnatal depression and posttraumatic stress. 372 couples were recruited in the early postpartum and individually provided short speech samples. Posttraumatic stress and postnatal depression symptoms were assessed via questionnaire measures at six and thirteen weeks. Two hundred and twelve couples completed all time-points. Key elements of supportive interactions were identified and reliably categorised. Mothers' posttraumatic stress was associated with criticisms of the partner during childbirth, general relationship criticisms and men's perception of helplessness. Postnatal depression was associated with absence of partner empathy and any positive comments regarding the partner's support. The content of new parents' descriptions of labour and childbirth, their partner during labour and birth and their relationship within the immediate postpartum may have significant implications for later psychological functioning. Interventions to enhance specific supportive elements between couples during the antenatal period merit development and evaluation.

Alterations of Vertical Jump Mechanics after a Half-Marathon Mountain Running Race

PubMed Central

Rousanoglou, Elissavet N.; Noutsos, Konstantinos; Pappas, Achilleas; Bogdanis, Gregory; Vagenas, Georgios; Bayios, Ioannis A.; Boudolos, Konstantinos D.

2016-01-01

The fatiguing effect of long-distance running has been examined in the context of a variety of parameters. However, there is scarcity of data regarding its effect on the vertical jump mechanics. The purpose of this study was to investigate the alterations of countermovement jump (CMJ) mechanics after a half-marathon mountain race. Twenty-seven runners performed CMJs before the race (Pre), immediately after the race (Post 1) and five minutes after Post 1 (Post 2). Instantaneous and ensemble-average analysis focused on jump height and, the maximum peaks and time-to-maximum peaks of: Displacement, vertical force (Fz), anterior-posterior force (Fx), Velocity and Power, in the eccentric (tECC) and concentric (tCON) phase of the jump, respectively. Repeated measures ANOVAs were used for statistical analysis (p ≤ 0.05). The jump height decrease was significant in Post 2 (-7.9%) but not in Post 1 (-4.1%). Fx and Velocity decreased significantly in both Post 1 (only in tECC) and Post 2 (both tECC and tCON). Α timing shift of the Fz peaks (earlier during tECC and later during tCON) and altered relative peak times (only in tECC) were also observed. Ensemble-average analysis revealed several time intervals of significant post-race alterations and a timing shift in the Fz-Velocity loop. An overall trend of lowered post-race jump output and mechanics was characterised by altered jump timing, restricted anterior-posterior movement and altered force-velocity relations. The specificity of mountain running fatigue to eccentric muscle work, appears to be reflected in the different time order of the post-race reductions, with the eccentric phase reductions preceding those of the concentric one. Thus, those who engage in mountain running should particularly consider downhill training to optimise eccentric muscular action. Key points The 4.1% reduction of jump height immediately after the race is not statistically significant The eccentric phase alterations of jump mechanics precede those of the concentric ones. Force-velocity alterations present a timing shift rather than a change in force or velocity magnitude. PMID:27274665

Alterations of Vertical Jump Mechanics after a Half-Marathon Mountain Running Race.

PubMed

Rousanoglou, Elissavet N; Noutsos, Konstantinos; Pappas, Achilleas; Bogdanis, Gregory; Vagenas, Georgios; Bayios, Ioannis A; Boudolos, Konstantinos D

2016-06-01

The fatiguing effect of long-distance running has been examined in the context of a variety of parameters. However, there is scarcity of data regarding its effect on the vertical jump mechanics. The purpose of this study was to investigate the alterations of countermovement jump (CMJ) mechanics after a half-marathon mountain race. Twenty-seven runners performed CMJs before the race (Pre), immediately after the race (Post 1) and five minutes after Post 1 (Post 2). Instantaneous and ensemble-average analysis focused on jump height and, the maximum peaks and time-to-maximum peaks of: Displacement, vertical force (Fz), anterior-posterior force (Fx), Velocity and Power, in the eccentric (tECC) and concentric (tCON) phase of the jump, respectively. Repeated measures ANOVAs were used for statistical analysis (p ≤ 0.05). The jump height decrease was significant in Post 2 (-7.9%) but not in Post 1 (-4.1%). Fx and Velocity decreased significantly in both Post 1 (only in tECC) and Post 2 (both tECC and tCON). Α timing shift of the Fz peaks (earlier during tECC and later during tCON) and altered relative peak times (only in tECC) were also observed. Ensemble-average analysis revealed several time intervals of significant post-race alterations and a timing shift in the Fz-Velocity loop. An overall trend of lowered post-race jump output and mechanics was characterised by altered jump timing, restricted anterior-posterior movement and altered force-velocity relations. The specificity of mountain running fatigue to eccentric muscle work, appears to be reflected in the different time order of the post-race reductions, with the eccentric phase reductions preceding those of the concentric one. Thus, those who engage in mountain running should particularly consider downhill training to optimise eccentric muscular action. Key pointsThe 4.1% reduction of jump height immediately after the race is not statistically significantThe eccentric phase alterations of jump mechanics precede those of the concentric ones.Force-velocity alterations present a timing shift rather than a change in force or velocity magnitude.

Point process analyses of variations in smoking rate by setting, mood, gender, and dependence

PubMed Central

Shiffman, Saul; Rathbun, Stephen L.

2010-01-01

The immediate emotional and situational antecedents of ad libitum smoking are still not well understood. We re-analyzed data from Ecological Momentary Assessment using novel point-process analyses, to assess how craving, mood, and social setting influence smoking rate, as well as assessing the moderating effects of gender and nicotine dependence. 304 smokers recorded craving, mood, and social setting using electronic diaries when smoking and at random nonsmoking times over 16 days of smoking. Point-process analysis, which makes use of the known random sampling scheme for momentary variables, examined main effects of setting and interactions with gender and dependence. Increased craving was associated with higher rates of smoking, particularly among women. Negative affect was not associated with smoking rate, even in interaction with arousal, but restlessness was associated with substantially higher smoking rates. Women's smoking tended to be less affected by negative affect. Nicotine dependence had little moderating effect on situational influences. Smoking rates were higher when smokers were alone or with others smoking, and smoking restrictions reduced smoking rates. However, the presence of others smoking undermined the effects of restrictions. The more sensitive point-process analyses confirmed earlier findings, including the surprising conclusion that negative affect by itself was not related to smoking rates. Contrary to hypothesis, men's and not women's smoking was influenced by negative affect. Both smoking restrictions and the presence of others who are not smoking suppress smoking, but others’ smoking undermines the effects of restrictions. Point-process analyses of EMA data can bring out even small influences on smoking rate. PMID:21480683

Educational video and story as effective interventions reducing epilepsy-related stigma among children.

PubMed

Brabcová, Dana; Kohout, Jiří; Weberová, Veronika; Komárek, Vladimír

2017-04-01

Stigma has been related to epilepsy since ancient times. Despite the importance of this issue, only a few interventions focusing on the reduction of epilepsy-related stigma may be found in the literature. Thus, the aim of this study is to evaluate the effectiveness of two interventions focused on the reduction of epilepsy-related stigma in children aged 9-11years. The first group of children involved in the study (n 1 =89) completed the 23-item Czech version of the SSE (Stigma Scale of Epilepsy) questionnaire and an 11-item multiple-choice knowledge test, then watched a video and completed the same questionnaire and test immediately after the intervention. The same procedure was used for the second group (n 2 =93) where a story was read by an instructor. Both groups were retested 6months later using the same methods. Both interventions resulted in long-term decrease of epilepsy-related stigma - the average value on SSE decreased from 55.15 points at baseline testing to 43.28 points in the 6-month follow-up for the case of the video (p<0.001) and from 48.68 points to 36.97 points for the case of the story (p<0.001). Knowledge about epilepsy was also significantly improved with the average result in the knowledge test increasing from 6.58 to 9.09 points in case of the video (p<0.001) and from 6.88 to 8.99 points in case of the story (p<0.001). The results showed that both aforementioned interventions were significant and effective ways to reduce epilepsy-related stigma in the given age group. Copyright © 2017 Elsevier Inc. All rights reserved.

Proactive therapeutic drug monitoring of infliximab: a comparative study of a new point-of-care quantitative test with two established ELISA assays.

PubMed

Afonso, J; Lopes, S; Gonçalves, R; Caldeira, P; Lago, P; Tavares de Sousa, H; Ramos, J; Gonçalves, A R; Ministro, P; Rosa, I; Vieira, A I; Dias, C C; Magro, F

2016-10-01

Therapeutic drug monitoring is a powerful strategy known to improve the clinical outcomes and to optimise the healthcare resources in the treatment of autoimmune diseases. Currently, most of the methods commercially available for the quantification of infliximab (IFX) are ELISA-based, with a turnaround time of approximately 8 h, and delaying the target dosage adjustment to the following infusion. To validate the first point-of-care IFX quantification device available in the market - the Quantum Blue Infliximab assay (Buhlmann, Schonenbuch, Switzerland) - by comparing it with two well-established methods. The three methods were used to assay the IFX concentration of spiked samples and of the serum of 299 inflammatory bowel diseases (IBD) patients undergoing IFX therapy. The point-of-care assay had an average IFX recovery of 92%, being the most precise among the tested methods. The Intraclass Correlation Coefficients of the point-of-care IFX assay vs. the two ELISA-based established methods were 0.889 and 0.939. Moreover, the accuracy of the point-of-care IFX compared with each of the two reference methods was 77% and 83%, and the kappa statistics revealed a substantial agreement (0.648 and 0.738). The Quantum Blue IFX assay can successfully replace the commonly used ELISA-based IFX quantification kits. This point-of-care IFX assay is able to deliver the results within 15 min makes it ideal for an immediate target concentration adjusted dosing. Moreover, it is a user-friendly desktop device that does not require specific laboratory facilities or highly specialised personnel. © 2016 John Wiley & Sons Ltd.

Effects of the Introduction of Intranasal Fentanyl on Reduction of Pain Severity Score in Children: An Interrupted Time-Series Analysis.

PubMed

Lord, Bill; Jennings, Paul A; Smith, Karen

2017-12-01

Children are at risk of inadequate analgesia due to paramedics' inexperience in assessing children and challenges in administering analgesics when the patient is distressed and uncooperative. This study reports on the outcome of a change to practice guidelines that added intranasal fentanyl and intramuscular morphine within a large statewide ambulance service. This retrospective study included patients younger than 15 years treated by paramedics between January 2008 and December 2011. The primary outcome of interest was the proportion of patients having a 2/10 or greater reduction in pain severity score using an 11-point Verbal Numeric Rating Scale before and after the intervention. Segmented regression analysis was used to estimate the effect of the intervention over time. A multiple regression model calculated odds ratios with 95% confidence intervals. A total of 92,378 children were transported by paramedics during the study period, with 9833 cases included in the analysis. The median age was 11 years; 61.6% were male. Before the intervention, 88.1% (n = 3114) of children receiving analgesia had a reduction of pain severity of 2 or more points, with 94.2% (n = 5933) achieving this benchmark after intervention (P < 0.0001). The odds of a reduction in pain of 2 or more points increased by 1.01 per month immediately before the intervention and 2.33 after intervention (<0.0001). This large study of a system-wide clinical practice guideline change has demonstrated a significant improvement in the outcome of interest. However, a proportion of children with moderate to severe pain did not receive analgesia.

Effects of pre-surgical nasoalveolar moulding on maxillary arch and nasal form in unilateral cleft lip and palate before lip surgery.

PubMed

Fuchigami, T; Kimura, N; Kibe, T; Tezuka, M; Amir, M S; Suga, H; Takemoto, Y; Hashiguchi, M; Maeda-Iino, A; Nakamura, N

2017-11-01

To investigate the effects of pre-surgical nasoalveolar moulding (PNAM) on the maxillary arch and nasal form in patients with unilateral cleft lip and palate (UCLP). This is a retrospective case series study. The subjects were infants with complete UCLP who were treated with PNAM (n = 18) at Kagoshima University Medical and Dental Hospital (Japan) between 2006 and 2013. Maxillary dental casts and facial photographs were taken at the time of the first visit and immediately prior to lip surgery to evaluate the maxillary arch and nasal form changes. The dental casts were scanned with a laser scanner, and changes in the 3-Dimensional coordinates of anatomical landmarks and alveolar cleft width were analysed. Moreover, we investigated the correlation between the changes in the maxillary alveolar arch and nasal form. Regarding the maxillary alveolar arch form, the anterior points of the major segment had moved significantly to the cleft side just prior to the time of lip repair, and the alveolar cleft width was significantly decreased. For nasal form, the inclination and displacement of the columella were significantly improved. The improvement of columella inclination was moderately correlated with the posterior movement of the anterior points of the major segment. These findings indicate that PNAM for infants with UCLP enhanced symmetry in the maxillary alveolar arch and nasolabial form. In addition, the posterior movement of the anterior points of the maxillary alveolar arch was correlated with the improvement of columella deformation. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Biomechanical and Histologic Evaluation of LifeMesh™: A Novel Self-Fixating Mesh Adhesive.

PubMed

Shahan, Charles P; Stoikes, Nathaniel N; Roan, Esra; Tatum, James; Webb, David L; Voeller, Guy R

2018-04-01

Mesh fixation with the use of adhesives results in an immediate and total surface area adhesion of the mesh, removing the need for penetrating fixation points. The purpose of this study was to evaluate LifeMesh™, a prototype mesh adhesive technology which coats polypropylene mesh. The strength of the interface between mesh and tissue, inflammatory responses, and histology were measured at varying time points in a swine model, and these results were compared with sutures. Twenty Mongrel swine underwent implantation of LifeMesh™ and one piece of bare polypropylene mesh secured with suture (control). One additional piece of either LifeMesh™ or control was used for histopathologic evaluation. The implants were retrieved at 3, 7, and 14 days. Only 3- and 7-day specimens underwent lap shear testing. On Day 3, LifeMesh™ samples showed considerably less contraction than sutured samples. The interfacial strength of Day 3 LifeMesh™ samples was similar to that of sutured samples. At seven days, LifeMesh™ samples continued to show significantly less contraction than sutured samples. The strength of fixation at seven days was greater in the control samples. The histologic findings were similar in LifeMesh™ and control samples. LifeMesh™ showed significantly less contraction than sutured samples at all measured time points. Although fixation strength was similar at three days, the interfacial strength of LifeMesh™ remained unchanged, whereas sutured controls increased by day 7. With histologic equivalence, considerably less contraction, and similar early fixation strength, LifeMesh™ is a viable mesh fixation technology.

Impact of PACS on dictation turnaround time and productivity.

PubMed

Lepanto, Luigi; Paré, Guy; Aubry, David; Robillard, Pierre; Lesage, Jacques

2006-03-01

This study was conducted to measure the impact of PACS on dictation turnaround time and productivity. The radiology information system (RIS) database was interrogated to calculate the time interval between image production and dictation for every exam performed during three 90-day periods (the 3 months preceding PACS implementation, the 3 months immediately following PACS deployment, and a 3-month period 1 year after PACS implementation). Data were obtained for three exam types: chest radiographs, abdominal CT, and spine MRI. The mean dictation turnaround times obtained during the different pre- and post-PACS periods were compared using analysis of variance (ANOVA). Productivity was also determined for each period and for each exam type, and was expressed as the number of studies interpreted per full-time equivalent (FTE) radiologist. In the immediate post-PACS period, dictation turnaround time decreased 20% (p < 0.001) for radiography, but increased 13% (ns) for CT and 28% (p < 0.001) for MRI. One year after PACS was implemented, dictation turnaround time decreased 45% (p < 0.001) for radiography and 36% (p < 0.001) for MRI. For CT, 1 year post-PACS, turnaround times returned to pre-PACS levels. Productivity in the immediate post-PACS period increased 3% and 38% for radiography and CT, respectively, whereas a 6% decrease was observed for MRI. One year after implementation, productivity increased 27%, 98%, and 19% in radiography, CT, and MRI, respectively. PACS benefits, namely, shortened dictation turnaround time and increased productivity, are evident 1 year after PACS implementation. In the immediate post-PACS period, results vary with the different imaging modalities.

Beneficial effects of early hemostasis on spinal cord injury in the rat

PubMed Central

Fan, H; Chen, K; Duan, L; Wang, Y-Z; Ju, G

2016-01-01

Study design: Experimental study. Objectives: To investigate the effect of early hemostasis on spinal cord injury (SCI). Setting: Fourth Military Medical University, Xi'an, China. Methods: Sprague Dawley rats were used. Hematoxylin and eosin (HE) staining was performed to observe hemorrhage at different time points (2, 6, 12, 24 and 48 h) after SCI to determine the time window of hemostatic drug administration (n=3 per time point). Three different concentrations of Etamsylate (0.025, 0.05 and 0.1 g kg−1) were administered immediately and 5 and 10 h after SCI to evaluate the effective dosage (n=6 per group). Another 82 rats were then randomly divided into two groups, Etamsylate group (0.1 g kg−1, n=41) and glucose control group (n=41). Nissl staining was performed to observe neurons at 10 days post injury. Immunohistochemistry, western blot and quantitative real-time PCR were performed to detect tissue necrosis at 7 d.p.i., the activation of astrocytes and microglia/macrophages and lesion cavity at 10 d.p.i. Basso–Beattie–Bresnahan scoring and rump height index assay were used to examine locomotion recovery. Results: Early hemostasis reduced the lesion area and tissue necrosis, enhanced neuronal survival, alleviated the activation of microglia/macrophages and astrocytes and facilitated functional recovery after spinal cord contusion in rats. Early hemostasis decreased hemorrhage area and lesion area after spinal cord transection in rats. Conclusion: The present study demonstrated that early hemostasis has beneficial effects on SCI in the rat. It has the potential to be translated into clinical practice. PMID:27137123

Patient expectations and costs of immediate reporting of screening mammography: talk isn't cheap.

PubMed

Raza, S; Rosen, M P; Chorny, K; Mehta, T S; Hulka, C A; Baum, J K

2001-09-01

Our purpose was to determine whether patients prefer immediate or delayed results of screening mammography and to determine the cost of immediate reporting at our institution. A survey was anonymously and randomly distributed to 129 women who were 35-70 years old during a visit to their primary care physician, asking the women's preference for receiving mammography results by one of two systems: by letter with a return visit for any additional tests; or by speaking at once with the radiologist, with the option of additional tests being performed during the same visit. Patients' willingness to pay for the latter service was also determined. A cost identification model was constructed using commercially available software. We considered the impact on radiologists' and technologists' time and the need for additional equipment and space, and we analyzed the effect on the cost of immediate reporting. One hundred twenty (93%) surveys were completed. Eighty women (67%) preferred immediate reporting, and 62 (78%) of these 80 patients would wait 30-60 min. The additional cost of immediate reporting is $28.22 per patient. Only 11% of patients were willing to pay this additional cost. When new equipment and space were not required, the cost would increase by $4.38. This cost was most influenced by the time required to give patients normal results. Most surveyed patients preferred speaking with a radiologist immediately but were unwilling to pay additional fees. Radiologists, hospital administrators, and health care planners must be aware of the costs of immediate reporting and must factor these costs into any change in hospital or national policy.

 Liver transplantation in the critically ill: donation after cardiac death compared to donation after brain death grafts.

PubMed

Taner, C Burcin; Bulatao, Ilynn G; Arasi, Lisa C; Perry, Dana K; Willingham, Darrin L; Sibulesky, Lena; Rosser, Barry G; Canabal, Juan M; Nguyen, Justin H; Kramer, David J

2012-01-01

 Patients with end stage liver disease may become critically ill prior to LT requiring admission to the intensive care unit (ICU). The high acuity patients may be thought too ill to transplant; however, often LT is the only therapeutic option. Choosing the correct liver allograft for these patients is often difficult and it is imperative that the allograft work immediately. Donation after cardiac death (DCD) donors provide an important source of livers, however, DCD graft allocation remains a controversial topic, in critically ill patients. Between January 2003-December 2008, 1215 LTs were performed: 85 patients at the time of LT were in the ICU. Twelve patients received DCD grafts and 73 received donation after brain dead (DBD) grafts. After retransplant cases and multiorgan transplants were excluded, 8 recipients of DCD grafts and 42 recipients of DBD grafts were included in this study. Post-transplant outcomes of DCD and DBD liver grafts were compared. While there were differences in graft and survival between DCD and DBD groups at 4 month and 1 year time points, the differences did not reach statistical significance. The graft and patient survival rates were similar among the groups at 3-year time point. There is need for other large liver transplant programs to report their outcomes using liver grafts from DCD and DBD donors. We believe that the experience of the surgical, medical and critical care team is important for successfully using DCD grafts for critically ill patients.

Magnetic nanobeads present during enzymatic amplification and labeling for a simplified DNA detection protocol based on AC susceptometry

NASA Astrophysics Data System (ADS)

Bejhed, Rebecca S.; Strømme, Maria; Svedlindh, Peter; Ahlford, Annika; Strömberg, Mattias

2015-12-01

Magnetic biosensors are promising candidates for low-cost point-of-care biodiagnostic devices. For optimal efficiency it is crucial to minimize the time and complexity of the assay protocol including target recognition, amplification, labeling and read-out. In this work, possibilities for protocol simplifications for a DNA biodetection principle relying on hybridization of magnetic nanobeads to rolling circle amplification (RCA) products are investigated. The target DNA is recognized through a padlock ligation assay resulting in DNA circles serving as templates for the RCA process. It is found that beads can be present during amplification without noticeably interfering with the enzyme used for RCA (phi29 polymerase). As a result, the bead-coil hybridization can be performed immediately after amplification in a one-step manner at elevated temperature within a few minutes prior to read-out in an AC susceptometer setup, i.e. a combined protocol approach. Moreover, by recording the phase angle ξ = arctan(χ″/χ'), where χ and χ″ are the in-phase and out-of-phase components of the AC susceptibility, respectively, at one single frequency the total assay time for the optimized combined protocol would be no more than 1.5 hours, often a relevant time frame for diagnosis of cancer and infectious disease. Also, applying the phase angle method normalization of AC susceptibility data is not needed. These findings are useful for the development of point-of-care biodiagnostic devices relying on bead-coil binding and magnetic AC susceptometry.

Time perspectives and convenience food consumption among teenagers in Vietnam: The dual role of hedonic and healthy eating values.

PubMed

Olsen, Svein Ottar; Tuu, Ho Huy

2017-09-01

This study uses the subscales of Consideration of Future Consequences (CFC) to explore the effects of future (CFC-future) and immediate (CFC-immediate) on convenience food consumption among teenagers in Vietnam. Furthermore, we investigate the mediating and dual role of hedonic and healthy eating values in the relationships between CFCs and convenience food consumption. Survey data from 451 teenagers in Central Vietnam and structural equation modelling were used to test the relationships in a proposed theoretical model. The results indicate that while CFC-immediate and hedonic eating value has a positive direct effect, CFC-future and healthy eating value has a negative direct effect on convenience food consumption. The findings also reveal that both CFC-immediate and CFC-future have positive effects on hedonic and healthy eating values. However, this study argues and tests the relative importance of the direct (asymmetric) effects of time perspectives on eating values, and finds that while CFC-future dominate in explaining healthy eating values, CFC-immediate dominate in explaining hedonic eating values. Copyright © 2017 Elsevier Ltd. All rights reserved.

Safety of disclosing amyloid status in cognitively normal older adults.

PubMed

Burns, Jeffrey M; Johnson, David K; Liebmann, Edward P; Bothwell, Rebecca J; Morris, Jill K; Vidoni, Eric D

2017-09-01

Disclosing amyloid status to cognitively normal individuals remains controversial given our lack of understanding the test's clinical significance and unknown psychological risk. We assessed the effect of amyloid status disclosure on anxiety and depression before disclosure, at disclosure, and 6 weeks and 6 months postdisclosure and test-related distress after disclosure. Clinicians disclosed amyloid status to 97 cognitively normal older adults (27 had elevated cerebral amyloid). There was no difference in depressive symptoms across groups over time. There was a significant group by time interaction in anxiety, although post hoc analyses revealed no group differences at any time point, suggesting a minimal nonsustained increase in anxiety symptoms immediately postdisclosure in the elevated group. Slight but measureable increases in test-related distress were present after disclosure and were related to greater baseline levels of anxiety and depression. Disclosing amyloid imaging results to cognitively normal adults in the clinical research setting with pre- and postdisclosure counseling has a low risk of psychological harm. Copyright © 2017 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Eye-Head Coordination in 31 Space Shuttle Astronauts during Visual Target Acquisition.

PubMed

Reschke, Millard F; Kolev, Ognyan I; Clément, Gilles

2017-10-27

Between 1989 and 1995, NASA evaluated how increases in flight duration of up to 17 days affected the health and performance of Space Shuttle astronauts. Thirty-one Space Shuttle pilots participating in 17 space missions were tested at 3 different times before flight and 3 different times after flight, starting within a few hours of return to Earth. The astronauts moved their head and eyes as quickly as possible from the central fixation point to a specified target located 20°, 30°, or 60° off center. Eye movements were measured with electro-oculography (EOG). Head movements were measured with a triaxial rate sensor system mounted on a headband. The mean time to visually acquire the targets immediately after landing was 7-10% (30-34 ms) slower than mean preflight values, but results returned to baseline after 48 hours. This increase in gaze latency was due to a decrease in velocity and amplitude of both the eye saccade and head movement toward the target. Results were similar after all space missions, regardless of length.

Effect of immediate and delayed cold water immersion after a high intensity exercise session on subsequent run performance.

PubMed

Brophy-Williams, Ned; Landers, Grant; Wallman, Karen

2011-01-01

The purpose of the study was to determine the effects of cold water immersion (CWI) performed immediately or 3 h after a high intensity interval exercise session (HIIS) on next-day exercise performance. Eight male athletes performed three HIIS at 90%VO2max velocity followed by either a passive recovery (CON), CWI performed immediately post-exercise (CWI(0)) or CWI performed 3 h post-exercise (CWI(3)). Recovery trials were performed in a counter balanced manner. Participants then returned 24 h later and completed a muscle soreness and a totally quality recovery perception (TQRP) questionnaire, which was then followed by the Yoyo Intermittent Recovery Test [level 1] (YRT). Venous blood samples were collected pre-HIIS and pre-YRT to determine C-Reactive Protein (CRP) levels. Significantly more shuttles were performed during the YRT following CWI(0) compared to the CON trial (p=0.017, ES = 0. 8), while differences between the CWI(3) and the CON trials approached significance (p = 0.058, ES = 0.5). Performance on the YRT between the CWI(0) and CWI(3) trials were similar (p = 0.147, ES = 0. 3). Qualitative analyses demonstrated a 98% and 92% likely beneficial effect of CWI(0) and CWI(3) on next day performance, compared to CON, respectively, while CWI(0) resulted in a 79% likely benefit when compared to CWI(3). CRP values were significantly lower pre-YRT, compared to baseline, following CWI(0) (p = 0.0.36) and CWI(3) (p = 0.045), but were similar for CON (p = 0.157). Muscle soreness scores were similar between trials (p = 1.10), while TQRP scores were significantly lower for CON compared to CWI(0) (p = 0.002 ) and CWI(3) (p = 0.024). Immediate CWI resulted in superior next-day YRT performance compared to CON, while delayed (3 h) CWI was also likely to be beneficial. Qualitative analyses suggested that CWI(0) resulted in better performance than CWI(3). These results are important for athletes who do not have immediate access to CWI following exercise. Key pointsPerformance of cold water immersion as a recovery procedure following exercise is better than performing no recovery procedureAthletes, coaches and sport trainers should implement cold water immersion post-exercise irrespective of the time of administration.Where possible, cold water immersion should be performed immediately post-exercise to gain maximal recovery benefits.

General Movements in preterm infants undergoing craniosacral therapy: a randomised controlled pilot-trial.

PubMed

Raith, Wolfgang; Marschik, Peter B; Sommer, Constanze; Maurer-Fellbaum, Ute; Amhofer, Claudia; Avian, Alexander; Löwenstein, Elisabeth; Soral, Susanne; Müller, Wilhelm; Einspieler, Christa; Urlesberger, Berndt

2016-01-13

The objective of this study was to investigate neurological short-term effects of craniosacral therapy as an ideal form of osteopathic manipulative treatment (OMT) due to the soft kinaesthetic stimulation. Included were 30 preterm infants, with a gestational age between 25 and 33 weeks, who were admitted to the neonatal intensive care unit of the University Hospital of Graz, Austria. The infants were randomized either into the intervention group (IG) which received standardised craniosacral therapy, or the control group (CG) which received standard care. To guarantee that only preterm infants with subsequent normal neurodevelopment were included, follow up was done regularly at the corrected age (= actual age in weeks minus weeks premature) of 12 and 24 months. After 2 years 5 infants had to be excluded (IG; n = 12; CG: n = 13). General Movements (GMs) are part of the spontaneous movement repertoire and are present from early fetal life onwards until the end of the first half year of life. To evaluate the immediate result of such an intervention, we selected the General Movement Assessment (GMA) as an appropriate tool. Besides the global GMA (primary outcome) we used as detailed GMA, the General Movement Optimality Score (GMOS- secondary outcome), based on Prechtl's optimality concept. To analyse GMOS (secondary outcome) a linear mixed model with fixed effects for session, time point (time point refers to the comparisons of the measurements before vs. after each session) and intervention (IG vs. CG), random effect for individual children and a first order autoregressive covariance structure was used for calculation of significant differences between groups and interactions. Following interaction terms were included in the model: session*time point, session*intervention, time point*intervention and session*time point*intervention. Exploratory post hoc analyses (interaction: session*time point*intervention) were performed to determine group differences for all twelve measurement (before and after all 6 sessions) separately. Between groups no difference in the global GMA (primary outcome) could be observed. The GMOS (secondary outcome) did not change from session to session (main effect session: p = 0.262) in the IG or the CG. Furthermore no differences between IG and CG (main effect group: p = 0.361) and no interaction of time*session could be observed (p = 0.658). Post hoc analysis showed a trend toward higher values before (p = 0.085) and after (p = 0.075) the first session in CG compared to IG. At all other time points GMOS were not significantly different between groups. We were able to indicate that a group of "healthy" preterm infants undergoing an intervention with craniosacral therapy (IG) showed no significant changes in GMs compared to preterm infants without intervention (CG). In view of the fact that the global GMA (primary outcome) showed no difference between groups and the GMOS (detailed GMA-secondary outcome) did not deteriorate in the IG, craniosacral therapy seems to be safe in preterm infants. German Clinical Trials Register DRKS00004258 .

Self-Blame and PTSD Following Sexual Assault: A Longitudinal Analysis.

PubMed

Kline, Nora K; Berke, Danielle S; Rhodes, Charla A; Steenkamp, Maria M; Litz, Brett T

2018-04-01

Sexual assault is a prevalent trauma associated with high rates of posttraumatic stress disorder (PTSD). Social cognitive theories posit that behavioral self-blame (i.e., attributing the cause of the assault to personal peri-event behavior) contributes to the etiology and maintenance of PTSD symptoms. Yet the direction of the association between self-blame and PTSD symptoms in the acute aftermath of sexual assault is unknown. This study evaluated temporal pathways between behavioral self-blame and PTSD symptom severity in an epidemiological sample of sexual assault survivors ( n = 126) assessed at four time points in the months immediately following the assault. Results of cross-lagged panel modeling revealed that reports of behavioral self-blame at the first assessment following sexual assault predicted PTSD symptom severity at Time 2. However, there was no association between behavioral self-blame at Time 2 and PTSD symptom severity at Time 3, nor was there an association between behavioral self-blame at Time 3 and PTSD symptom severity at Time 4. Instead, PTSD symptom severity predicted behavioral self-blame at Times 3 and 4. Findings suggest that behavioral self-blame following sexual assault may be particularly relevant to the onset of PTSD symptoms, while PTSD symptoms themselves appear to intensify subsequent perceptions of behavioral self-blame. Clinical implications and limitations are discussed.

Mindfulness-based Cognitive Therapy (MBCT) in bipolar disorder: Preliminary evaluation of immediate effects on between-episode functioning

PubMed Central

Williams, J.M.G.; Alatiq, Y.; Crane, C.; Barnhofer, T.; Fennell, M.J.V.; Duggan, D.S.; Hepburn, S.; Goodwin, G.M.

2008-01-01

Background Bipolar disorder is highly recurrent and rates of comorbidity are high. Studies have pointed to anxiety comorbidity as one factor associated with risk of suicide attempts and poor overall outcome. This study aimed to explore the feasibility and potential benefits of a new psychological treatment (Mindfulness-based Cognitive Therapy: MBCT) for people with bipolar disorder focusing on between-episode anxiety and depressive symptoms. Methods The study used data from a pilot randomized trial of MBCT for people with bipolar disorder in remission, focusing on between-episode anxiety and depressive symptoms. Immediate effects of MBCT versus waitlist on levels of anxiety and depression were compared between unipolar and bipolar participants. Results The results suggest that MBCT led to improved immediate outcomes in terms of anxiety which were specific to the bipolar group. Both bipolar and unipolar participants allocated to MBCT showed reductions in residual depressive symptoms relative to those allocated to the waitlist condition. Limitations Analyses were based on a small sample, limiting power. Additionally the study recruited participants with suicidal ideation or behaviour so the findings cannot immediately be generalized to individuals without these symptoms. Conclusions The study, although preliminary, suggests an immediate effect of MBCT on anxiety and depressive symptoms among bipolar participants with suicidal ideation or behaviour, and indicates that further research into the use of MBCT with bipolar patients may be warranted. PMID:17884176

Graduating med-peds residents' interest in part-time employment.

PubMed

Fix, Amy L; Kaelber, David C; Melgar, Thomas A; Chamberlain, John; Cull, William; Robbins, Brett W

2011-01-01

As part-time work is becoming more popular among the primary care specialties, we examined the demographic descriptors of med-peds residents seeking and finding part-time employment upon completion of residency training. As part of the 2006 annual American Academy of Pediatrics (AAP) Graduating Med-Peds Residents Survey, we surveyed the graduating residents of all med-peds programs about their interest in and plans for part-time employment. A total of 199 (60%) of the residents responded. Of the resident respondents applying for nonfellowship jobs, 19% sought part-time positions and 10% actually accepted a part-time position. Female residents were significantly more likely than male residents to apply for part-time jobs (26% vs. 7%, P = .034). Sixty percent of female residents immediately seeking work and 58% of those going on to fellowship reported an interest in arranging a part-time or reduced-hours position at some point in the next 5 years. Part-time employment among med-peds residents applying for nonfellowship positions after graduation is similar to the current incidence of part-time employment in other fields of primary care. A much higher percentage of med-peds residents are interested in arranging part-time work within 5 years after graduation. This strong interest in part-time work has many implications for the primary care workforce. Copyright © 2011 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

A Scenario-Based Virtual Patient Program to Support Substance Misuse Education

PubMed Central

Power, Ailsa; Hill, Duncan; Chapman, Paul

2016-01-01

Objective. To evaluate virtual patient (VP) programs for injecting equipment provision (IEP) and opiate substitution therapy (OST) services with respect to confidence and knowledge among preregistration pharmacist trainees. Methods. Preregistration trainee pharmacists pilot-tested the VP programs and were invited to complete pre/post and 6-month assessments of knowledge and perceived confidence. Results. One hundred six trainees participated and completed the pre/postassessments. Forty-six (43.4%) participants repeated the assessments at six months. Scores in perceived confidence increased in all domains at both time points postprogram. Knowledge scores were greater posteducation than preeducation. Knowledge scores were also greater six months after education than preeducation. Knowledge scores at six months were lower than posteducation for both programs. Conclusion. Virtual patients programs increased preregistration pharmacists’ knowledge and confidence with regard to IEP and OST immediately after use and at six months postprogram. There was a loss of clinical knowledge over time but confidence change was sustained. PMID:27170819

Evaluating Nurses Acceptance of Hospital Information Systems: A Case Study of a Tertiary Care Hospital.

PubMed

Khalifa, Mohamed

2016-01-01

This study aims at evaluating hospital information systems (HIS) acceptance factors among nurses, in order to provide suggestions for successful HIS implementation. The study used mainly quantitative survey methods to collect data directly from nurses through a questionnaire. The availability of computers in the hospital was one of the most influential factors, with a special emphasis on the unavailability of laptop computers and computers on wheels to facilitate immediate data entry and retrieval when nurses are at the point of care. Nurses believed that HIS might frequently slow down the process of care delivery and increase the time spent by patients inside the hospital especially during slow performance and responsiveness phases. Recommendations were classified into three main areas; improving system performance and availability of computers in the hospital, increasing organizational support in the form of providing training and protected time for nurses' to learn and enhancing users' feedback by listening to their complaints and considering their suggestions.

Non-invasive prediction of bloodstain age using the principal component and a back propagation artificial neural network

NASA Astrophysics Data System (ADS)

Sun, Huimin; Meng, Yaoyong; Zhang, Pingli; Li, Yajing; Li, Nan; Li, Caiyun; Guo, Zhiyou

2017-09-01

The age determination of bloodstains is an important and immediate challenge for forensic science. No reliable methods are currently available for estimating the age of bloodstains. Here we report a method for determining the age of bloodstains at different storage temperatures. Bloodstains were stored at 37 °C, 25 °C, 4 °C, and  -20 °C for 80 d. Bloodstains were measured using Raman spectroscopy at various time points. The principal component and a back propagation artificial neural network model were then established for estimating the age of the bloodstains. The results were ideal; the square of correlation coefficient was up to 0.99 (R 2  >  0.99) and the root mean square error of the prediction at lowest reached 55.9829 h. This method is real-time, non-invasive, non-destructive and highly efficiency. It may well prove that Raman spectroscopy is a promising tool for the estimation of the age of bloodstains.

Identification of Behavior Based Safety by Using Traffic Light Analysis to Reduce Accidents

NASA Astrophysics Data System (ADS)

Mansur, A.; Nasution, M. I.

2016-01-01

This work present the safety assessment of a case study and describes an important area within the field production in oil and gas industry, namely behavior based safety (BBS). The company set a rigorous BBS and its intervention program that implemented and deployed continually. In this case, observers requested to have discussion and spread a number of determined questions related with work behavior to the workers during observation. Appraisal of Traffic Light Analysis (TLA) as one tools of risk assessment used to determine the estimated score of BBS questionnaire. Standardization of TLA appraisal in this study are based on Regulation of Minister of Labor and Occupational Safety and Health No:PER.05/MEN/1996. The result shown that there are some points under 84%, which categorized in yellow category and should corrected immediately by company to prevent existing bad behavior of workers. The application of BBS expected to increase the safety performance at work time-by-time and effective in reducing accidents.

Choice in situations of time-based diminishing returns: immediate versus delayed consequences of action.

PubMed Central

Hackenberg, T D; Hineline, P N

1992-01-01

Pigeons chose between two schedules of food presentation, a fixed-interval schedule and a progressive-interval schedule that began at 0 s and increased by 20 s with each food delivery provided by that schedule. Choosing one schedule disabled the alternate schedule and stimuli until the requirements of the chosen schedule were satisfied, at which point both schedules were again made available. Fixed-interval duration remained constant within individual sessions but varied across conditions. Under reset conditions, completing the fixed-interval schedule not only produced food but also reset the progressive interval to its minimum. Blocks of sessions under the reset procedure were interspersed with sessions under a no-reset procedure, in which the progressive schedule value increased independent of fixed-interval choices. Median points of switching from the progressive to the fixed schedule varied systematically with fixed-interval value, and were consistently lower during reset than during no-reset conditions. Under the latter, each subject's choices of the progressive-interval schedule persisted beyond the point at which its requirements equaled those of the fixed-interval schedule at all but the highest fixed-interval value. Under the reset procedure, switching occurred at or prior to that equality point. These results qualitatively confirm molar analyses of schedule preference and some versions of optimality theory, but they are more adequately characterized by a model of schedule preference based on the cumulated values of multiple reinforcers, weighted in inverse proportion to the delay between the choice and each successive reinforcer. PMID:1548449

Photobiomodulation in the Prevention of Tooth Sensitivity Caused by In-Office Dental Bleaching. A Randomized Placebo Preliminary Study.

PubMed

Calheiros, Andrea Paiva Corsetti; Moreira, Maria Stella; Gonçalves, Flávia; Aranha, Ana Cecília Correa; Cunha, Sandra Ribeiro; Steiner-Oliveira, Carolina; Eduardo, Carlos de Paula; Ramalho, Karen Müller

2017-08-01

Analyze the effect of photobiomodulation in the prevention of tooth sensitivity after in-office dental bleaching. Tooth sensitivity is a common clinical consequence of dental bleaching. Therapies for prevention of sensitivity have been investigated in literature. This study was developed as a randomized, placebo blind clinical trial. Fifty patients were selected (n = 10) and randomly divided into five groups: (1) control, (2) placebo, (3) laser before bleaching, (4) laser after bleaching, and (5) laser before and after bleaching. Irradiation was performed perpendicularly, in contact, on each tooth during 10 sec per point in two points. The first point was positioned in the middle of the tooth crown and the second in the periapical region. Photobiomodulation was applied using the following parameters: 780 nm, 40 mW, 10 J/cm 2 , 0.4 J per point. Pain was analyzed before, immediately after, and seven subsequent days after bleaching. Patients were instructed to report pain using the scale: 0 = no tooth sensitivity, 1 = gentle sensitivity, 2 = moderate sensitivity, 3 = severe sensitivity. There were no statistical differences between groups at any time (p > 0.05). More studies, with others parameters and different methods of tooth sensitivity analysis, should be performed to complement the results found. Within the limitation of the present study, the laser parameters of photobiomodulation tested in the present study were not efficient in preventing tooth sensitivity after in-office bleaching.

[Extracorporeal shock wave therapy in chronic prostatitis].

PubMed

Kul'chavenya, E V; Shevchenko, S Yu; Brizhatyuk, E V

2016-04-01

Chronic prostatitis is a prevalent urologic disease, but treatment outcomes are not always satisfactory. As a rule, chronic prostatitis results in chronic pelvic pain syndrome, significantly reducing the patient's quality of life. Open pilot prospective non-comparative study was conducted to test the effectiveness of extracorporeal shock wave therapy (ESWT) using Aries (Dornier) machine in patients with chronic prostatitis (CP) of IIIb category. A total of 27 patients underwent ESWL as monotherapy, 2 times a week for a course of 6 sessions. Exposure settings: 5-6 energy level (by sensation), the frequency of 5 Hz, 2000 pulses per session; each patient received a total energy up to 12000 mJ. per procedure. Treatment results were evaluated using NIH-CPSI (National Institute of Health Chronic Prostatitis Symptom Index) upon completing the 3 week course of 6 treatments and at 1 month after ESWT. Immediately after the ESWT course positive trend was not significant: pain index decreased from 9.1 to 7.9, urinary symptom score remained almost unchanged (4.2 at baseline, 4.1 after treatment), quality of life index also showed a slight improvement, dropping from 7.2 points to 6.0. Total NIH-CPSI score decreased from 20.5 to 18.0. One month post-treatment pain significantly decreased to 3.2 points, the urinary symptom score fell to 2.7 points, the average quality of life score was 3.9 points. ESWT, performed on Aries (Dornier) machine, is highly effective as monotherapy in patients with category IIIb chronic prostatitis.

Equipment-free nucleic acid extraction and amplification on a simple paper disc for point-of-care diagnosis of rotavirus A.

PubMed

Ye, Xin; Xu, Jin; Lu, Lijuan; Li, Xinxin; Fang, Xueen; Kong, Jilie

2018-08-14

The use of paper-based methods for clinical diagnostics is a rapidly expanding research topic attracting a great deal of interest. Some groups have attempted to realize an integrated nucleic acid test on a single microfluidic paper chip, including extraction, amplification, and readout functions. However, these studies were not able to overcome complex modification and fabrication requirements, long turn-around times, or the need for sophisticated equipment like pumps, thermal cyclers, or centrifuges. Here, we report an extremely simple paper-based test for the point-of-care diagnosis of rotavirus A, one of the most common pathogens that causes pediatric gastroenteritis. This paper-based test could perform nucleic acid extraction within 5 min, then took 25 min to amplify the target sequence, and the result was visible to the naked eye immediately afterward or quantitative by the UV-Vis absorbance. This low-cost method does not require extra equipment and is easy to use either in a lab or at the point-of-care. The detection limit for rotavirus A was found to be 1 × 10 3 copies/mL. In addition, 100% sensitivity and specificity were achieved when testing 48 clinical stool samples. In conclusion, the present paper-based test fulfills the main requirements for a point-of-care diagnostic tool, and has the potential to be applied to disease prevention, control, and precision diagnosis. Copyright © 2018 Elsevier B.V. All rights reserved.

Effects of BCAA, arginine and carbohydrate combined drink on post-exercise biochemical response and psychological condition.

PubMed

Hsu, Mei-Chich; Chien, Kuei-Yu; Hsu, Cheng-Chen; Chung, Chia-Jung; Chan, Kuei-Hui; Su, Borcherng

2011-04-30

This study investigated the effects of BCAA, arginine and carbohydrate combined beverage (BCAA Drink) on biochemical responses and psychological conditions during recovery after a single bout of exhaustive exercise. Fourteen healthy males were assigned to drink either BCAA Drink (BA trial) or placebo (PL trial) on two sessions separated by 2 weeks. Blood samples of each subject were collected before exercise, 0, 10, 20, 40, 60, 120 min and 24 h after exercise. No significant differences in the levels of lactate, ammonia, creatine kinase and glycerol between the two groups were observed at any of the time points. However, the levels of glucose and insulin were significantly higher in the BA trial as compared to those in the PL trial at the 40 and 60 min recovery points. Furthermore, the testosterone-to-cortisol ratio at the 120 min recovery point was significantly higher in the BA trial as compared to that in the PL trial. The results indicate the occurrence of anabolic response during the recovery period. The benefit of BCAA Drink was also performed by Profile of Mood States to assess the psychological condition. Fatigue score increased immediately at exhaustion in both groups, but the decrease in the fatigue score at 120 min recovery point was significant only in BA trial. These data indicate that a single bout of exhaustive exercise enhanced the feeling of fatigue. The detrimental consequence was reduced by an ingestion of BCAA Drink.

Unilateral pulmonary oedema after minimally invasive mitral valve surgery: a single-centre experience.

PubMed

Renner, Jochen; Lorenzen, Ulf; Borzikowsky, Christoph; Schoeneich, Felix; Cremer, Jochen; Haneya, Assad; Hensler, Johannes; Panholzer, Bernd; Huenges, Katharina; Broch, Ole

2018-04-01

Unilateral pulmonary oedema (UPE) is a rare but potentially life-threatening complication that has been described after minimally invasive mitral valve surgery (MICS). Over the last 8 years, we have witnessed, in our institution, several cases of severe UPE requiring immediate postoperative extracorporeal life support after MICS. Reviewing the available literature, data regarding this complication after MICS are rare. Consequently, we decided to retrospectively analyse patients scheduled for MICS in our institution. After approval by our institutional review board, 256 MICS patients were analysed. As a primary end-point, we defined a newly developed UPE, radiographically evident within the first 24 h postoperatively. Secondary end-points were length of stay in the intensive care unit, length of stay in the hospital and in-hospital mortality. Chest radiographs were analysed by an independent consultant of radiology. Fifty-one (19.9%) patients showed increased right-sided pulmonary vascular congestion in the 1st postoperative chest radiography performed in the intensive care unit. Five (1.95%) patients immediately required extracorporeal life support after admission to the intensive care unit. Cardiopulmonary bypass time was significantly longer in the UPE group [UPE vs non-UPE 213 (49) vs 196 (43) min; P = 0.013]. More patients with UPE showed a preoperative increase of C-reactive protein >0.4265 mg/dl (P = 0.05). Logistic regression analysis identified a preoperative increase in C-reactive protein >0.4265 mg/dl as well as a prolonged cardiopulmonary bypass time (odds ratio 1.009, 95% confidence level 1.002-1.016; P = 0.014) independent risk factors, significantly associated with the development of UPE (odds ratio 2.583, 95% confidence interval 1.275-5.233; P = 0.008), a prolonged cardiopulmonary bypass time (odds ratio 1.009, 95% confidence interval 1.002-1.016; P = 0.014). The presence of pulmonary hypertension (odds ratio 0.273, 95% confidence interval 0.08-0.84; P = 0.02) seemed to be a protective factor regarding the genesis of UPE. In accordance with the rarely available literature regarding UPE after MICS, our analysis led us to hypothesize the possibility of an inflammatory disposition for UPE. The role of pulmonary hypertension remains unclear in our patient population. NCT02655094.

Impact on smoking of England's 2012 partial tobacco point of sale display ban: a repeated cross-sectional national study.

PubMed

Kuipers, Mirte A G; Beard, Emma; Hitchman, Sara C; Brown, Jamie; Stronks, Karien; Kunst, Anton E; McNeill, Ann; West, Robert

2017-03-01

A partial tobacco point of sale (PoS) display ban was introduced in large shops (>280 m 2 floor area) in England on 6 April 2012. The aim of this study was to assess the medium-term effects of the partial tobacco PoS display ban on smoking in England. Data were used from 129 957 respondents participating in monthly, cross-sectional household surveys of representative samples of the English adult population aged 18+ years from January 2009 to February 2015. Interrupted-time series regression models assessed step changes in the level of current smoking and cigarette consumption in smokers and changes in the trends postban compared with preban. Models were adjusted for sociodemographic variables and e-cigarette use, seasonality and autocorrelation. Potential confounding by cigarette price was accounted for by time, as price was almost perfectly correlated with time. Following the display ban, there was no immediate step level change in smoking (-3.69% change, 95% CI -7.94 to 0.75, p=0.102) or in cigarette consumption (β -0.183, 95% CI -0.602 to 0.236). There was a significantly steeper decline in smoking post display ban (-0.46% change, 95% CI -0.72 to -0.20, p=0.001). This effect was demonstrated by respondents in manual occupations (-0.62% change, 95% CI -0.72 to -0.20, p=0.001), but not for those in non-manual occupations (-0.42, 95% CI -0.90 to 0.06, p=0.084). Cigarette consumption declined preban period (β -0.486, 95% CI -0.633 to -0.339, p<0.001), but no significant change in cigarette consumption trend was observed (β 0.019, 95% CI -0.006 to 0.042, p=0.131). The partial tobacco PoS display ban introduced in England in April 2012 did not lead to an immediate decline in smoking, but was followed by a decline in the trend of smoking prevalence that could not be accounted for by seasonal factors, e-cigarette use or price changes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Negativization rates of IgE radioimmunoassay and basophil activation test in immediate reactions to penicillins.

PubMed

Fernández, T D; Torres, M J; Blanca-López, N; Rodríguez-Bada, J L; Gomez, E; Canto, G; Mayorga, C; Blanca, M

2009-02-01

Skin test sensitivity in patients with immediate allergy to penicillins tends to decrease over time, but no information is available concerning in vitro tests. We analysed the negativization rates of two in vitro methods that determine specific immunoglobulin E (IgE) antibodies, the basophil activation test using flow cytometry (BAT) and the radioallergosorbent test (RAST), in immediate allergic reactions to penicillins. Forty-one patients with immediate allergic reactions to amoxicillin were followed up over a 4-year period. BAT and RAST were performed at 6-month intervals. Patients were randomized into groups: Group I, skin tests carried out at regular intervals; Group II, skin tests made only at the beginning of the study. Differences were observed between RAST and BAT (P < 0.01), the latter showing earlier negativization. Considering different haptens, significant differences for the rate of negativization were only found for amoxicillin (P < 0.05). Comparisons between Groups I (n = 10) and II (n = 31) showed a tendency to become negative later in Group I with RAST. Levels of specific IgE antibodies tended to decrease over time in patients with immediate allergic reactions to amoxicillin. Conversion to negative took longer for the RAST assay, although the differences were only detected with the amoxicillin hapten. Skin testing influenced the rate of negativization of the RAST assay, contributing to maintenance of in vitro sensitivity. Because of the loss of sensitivity over time, the determination of specific IgE antibodies to penicillins in patients with immediate allergic reactions must be done as soon as possible after the reaction.

[Application of high-frequency ultrasound in dermabrasion of patients with deep partial-thickness burns].

PubMed

Zang, C Y; Cao, Y Q; Xue, W J; Zhao, R; Zhang, M; Zhang, Y H; Feng, Z; Wang, Y B

2017-02-20

Objective: To investigate the application of high-frequency ultrasound in dermabrasion of patients with deep partial-thickness burns. Methods: Twenty-six patients with deep partial-thickness burns conforming to the study criteria were hospitalized in our unit from March 2015 to March 2016. Patients were all performed with dermabrasion. The structure of skin tissue and blood flow signals of uninjured side and wounds before dermabrasion, and those of wounds immediately post dermabrasion and on post dermabrasion day (PDD) 1, 3, 5, 7, 10, 14, and 21 were detected with high-frequency ultrasound, and the percentage of blood flow signals was calculated. According to the results of comparison between percentage of blood flow signals of wounds and that of normal skin before dermabrasion, patients were divided into no significant decrease group (NSD, n =19) and significant decrease group (SD, n =7). Wound healing time of patients in two groups was recorded. Data were processed with analysis of variance of repeated measurement, LSD test, t test and Chi-square test. The correlation between the percentage of blood flow signals of wounds before dermabrasion and wound healing time of 26 patients were analyzed by Spearman correlation analysis. Results: (1) Epidermis of normal skin of patients in two groups before dermabrasion showed continuous smooth linear hyperecho, which was stronger than that of dermis, and boundary of dermis and subcutaneous tissue showed stronger discontinuous linear echo than that of dermis, which gradually transited to subcutaneous tissue. In group NSD, epidermis of wound of patients before dermabrasion showed intermittent rough linear echo, which was weaker than that of normal skin epidermis, and there was no obvious abnormity of boundary between dermis and subcutaneous tissue. Immediately post dermabrasion and on PDD 1, no linear hyperecho of epidermis was observed, showing complete attrition of epidermis, and the echo of dermis and subcutaneous tissue had no obvious change as compared with that before dermabrasion, with flat surface of dermis and partly abraded superficial-dermis but relatively well preserved dermal tissue in whole. The epidermis showed discontinuous linear hyperecho, and epidermis was discontinuously regenerated on PDD 3 and 5. Partial continuous linear hyperecho was detected in the epidermis, showing partial continuous regeneration of epidermis on PDD 7 and 10. The regenerated epidermis was thicker than normal skin epidermis and showed rough linear hyperecho with non-uniform thickness on PDD 14. The regenerated epidermis was thicker than normal skin epidermis and showed rather smooth linear hyperecho with uniform thickness on PDD 21. In group SD, the structure of epidermis and dermis of wound of patients before dermabrasion, immediately post dermabrasion, and on PDD 1 was similar to that in group NSD, but the echo of boundary of dermis and subcutaneous tissue was weakened in different degrees. There was no linear hyperecho of epidermis, showing no epidermis was regenerated on PDD 3 and 5. Intermittent regeneration of epidermis appeared on PDD 7 and 10 with intermittent linear hyperecho. Partial continuous linear hyperecho was detected in the epidermis, showing partial continuous regeneration of epidermis on PDD 14 and 21. (2) The percentages of blood flow signals of wounds of patients in group NSD before dermabrasion, immediately post dermabrasion, and on PDD 1 were (3.1±1.3)%, (6.5±2.0)%, and (5.3±1.9)% respectively, higher than those in group SD [(0.9±1.1)%, (3.5±1.3)%, and (3.6±0.9)% respectively, P <0.05 or P <0.01]. The percentages of blood flow signals of wounds of patients in two groups were similar at the other time points (with P values above 0.05). Compared with the percentage of normal skin in the same group [(3.2±0.7)%], the percentages of blood flow signals of wounds of patients in group NSD were significantly increased immediately post dermabrasion and on PDD 1 (with P values below 0.01) but had no significant change at the other time points (with P values above 0.05). The percentage of blood flow signals of wounds of patients before dermabrasion in group SD was significantly lower than that of normal skin in the same group [(2.8±0.6)%, P <0.01]. The percentage of blood flow signals of wounds of patients in group SD was close to that of normal skin in the same group at each time point post dermabrasion (with P values above 0.05). (3) The wound healing time of patients in group NSD was (16.2±2.5) d, lower than that in group SD [(30.9±2.9) d, t =12.67, P <0.01]. There was obvious negative correlation between the percentage of blood flow signals of wounds before dermabrasion and wound healing time of 26 patients ( r =-0.77, P <0.01). Conclusions: High-frequency ultrasound is a good way to observe the imaging features of wounds in patients with deep partial-thickness burns before and after dermabrasion, and it can provide objective imaging evidence for the performance of dermabrasion in patients with deep partial-thickness burns.

Delayed versus immediate pushing in second stage of labor.

PubMed

Kelly, Mary; Johnson, Eileen; Lee, Vickie; Massey, Liz; Purser, Debbie; Ring, Karen; Sanderson, Stephanye; Styles, Juanita; Wood, Deb

2010-01-01

Comparison of two different methods for management of second stage of labor: immediate pushing at complete cervical dilation of 10 cm and delayed pushing 90 minutes after complete cervical dilation. This study was a randomized clinical trial in a labor and delivery unit of a not-for-profit community hospital. A sample of 44 nulliparous mothers with continuous epidural anesthesia were studied after random assignment to treatment groups. Subjects were managed with either immediate or delayed pushing during the second stage of labor at the time cervical dilation was complete. The primary outcome measure was the length of pushing during second stage of labor. Secondary outcomes included length of second stage of labor, maternal fatigue and perineal injuries, and fetal heart rate decelerations. Two-tailed, unpaired Student's t-tests and Chi-square analysis were used for data analysis. Level of significance was set at p < .01 following a Bonferroni correction for multiple t-tests. A total of 44 subjects received the study intervention (N = 28 immediate pushing; N = 16 delayed pushing). The delayed pushing group had significantly shorter amount of time spent in pushing compared with the immediate pushing group (38.9 +/- 6.9 vs. 78.7 +/- 7.9 minutes, respectively, p = .002). Maternal fatigue scores, perineal injuries, and fetal heart rate decelerations were similar for both groups. Delaying pushing for up to 90 minutes after complete cervical dilation resulted in a significant decrease in the time mothers spent pushing without a significant increase in total time in second stage of labor.In clinical practice, healthcare providers sometimes resist delaying the onset of pushing after second stage of labor has begun because of a belief it will increase labor time. This study's finding of a 51% reduction in pushing time when mothers delay pushing for up to 90 minutes, with no significant increase in overall time for second stage of labor, disputes that concern.

Comparison of valvar and right ventricular function following transcatheter and surgical pulmonary valve replacement.

PubMed

Li, Wendy F; Pollard, Heidi; Karimi, Mohsen; Asnes, Jeremy D; Hellenbrand, William E; Shabanova, Veronika; Weismann, Constance G

2018-01-01

Trans-catheter (TC) pulmonary valve replacement (PVR) has become common practice for patients with right ventricular outflow tract obstruction (RVOTO) and/or pulmonic insufficiency (PI). Our aim was to compare PVR and right ventricular (RV) function of patients who received TC vs surgical PVR. Retrospective review of echocardiograms obtained at three time points: before, immediately after PVR, and most recent. Sixty-two patients (median age 19 years, median follow-up 25 months) following TC (N = 32) or surgical (N = 30) PVR at Yale-New Haven Hospital were included. Pulmonary valve and right ventricular function before, immediately after, and most recently after PVR. At baseline, the TC group had predominant RVOTO (74% vs 10%, P < .001), and moderate-severe PI was less common (61% vs 100%, P < .001). Immediate post-procedural PVR function was good throughout. At last follow-up, the TC group had preserved valve function, but the surgical group did not (moderate RVOTO: 6% vs 41%, P < .001; >mild PI: 0% vs 24%, P = .003). Patients younger than 17 years at surgical PVR had the highest risk of developing PVR dysfunction, while PVR function in follow-up was similar in adults. Looking at RV size and function, both groups had a decline in RV size following PVR. However, while RV function remained stable in the TC group, there was a transient postoperative decline in the surgical group. TC PVR in patients age <17 years is associated with better PVR function in follow-up compared to surgical valves. There was a transient decline in RV function following surgical but not TC PVR. TC PVR should therefore be the first choice in children who are considered for PVR, whenever possible. © 2017 Wiley Periodicals, Inc.

The low incidence of bacteremia after esophageal endoscopic submucosal dissection (ESD) obviates the need for prophylactic antibiotics in esophageal ESD.

PubMed

Kawata, Noboru; Tanaka, Masaki; Kakushima, Naomi; Takizawa, Kohei; Imai, Kenichiro; Hotta, Kinichi; Matsubayashi, Hiroyuki; Tsukahara, Mika; Kawamura, Ichiro; Kurai, Hanako; Ono, Hiroyuki

2016-11-01

Although a high incidence of bacteremia after esophageal endoscopic procedures has been reported, the incidence of bacteremia associated with esophageal endoscopic submucosal dissection (ESD) remains unknown. Therefore, we investigated the incidence of bacteremia associated with esophageal ESD. From April 2013 to March 2014, patients who underwent esophageal ESD were enrolled prospectively. Two sets of blood cultures were collected from patients at the following time points: (1) immediately after ESD; (2) the next morning; and (3) when fever ≥38 °C was present after ESD. A total of 424 blood culture sets were collected from 101 patients. Six patients had positive blood cultures immediately after ESD (4 %, 7/202 sets). Another patient had a positive blood culture the next morning (0.5 %, 1/202 sets). Ten patients (10 %) developed a post-ESD fever ≥38 °C, and blood cultures from these patients were all negative (0/20 sets). The seven patients with positive blood cultures had no post-ESD fever or infectious symptoms. Growth of Bacteroides thetaiotaomicron was only observed in one patient (1 %) with positive blood cultures immediately after ESD, and this patient was diagnosed with transient bacteremia. The other six patients were considered to have contaminants in their blood cultures. Thus, the incidence of bacteremia after esophageal ESD was 1 % [95 % confidence interval (CI) 0-5 %]. No patient had infectious symptoms, and none required antibiotics after ESD. The incidence of bacteremia after esophageal ESD was low and post-ESD fever was not associated with bacteremia. We conclude that use of routine prophylactic antibiotics to patients undergoing esophageal ESD is unnecessary. UMIN000012908.

[Primary Study on Predicting the Termination of Paroxysmal Atrial Fibrillation Based on a Novel RdR RR Intervals Scatter Plot].

PubMed

Lu, Hongwei; Zhang, Chenxi; Sun, Ying; Hao, Zhidong; Wang, Chunfang; Tian, Jiajia

2015-08-01

Predicting the termination of paroxysmal atrial fibrillation (AF) may provide a signal to decide whether there is a need to intervene the AF timely. We proposed a novel RdR RR intervals scatter plot in our study. The abscissa of the RdR scatter plot was set to RR intervals and the ordinate was set as the difference between successive RR intervals. The RdR scatter plot includes information of RR intervals and difference between successive RR intervals, which captures more heart rate variability (HRV) information. By RdR scatter plot analysis of one minute RR intervals for 50 segments with non-terminating AF and immediately terminating AF, it was found that the points in RdR scatter plot of non-terminating AF were more decentralized than the ones of immediately terminating AF. By dividing the RdR scatter plot into uniform grids and counting the number of non-empty grids, non-terminating AF and immediately terminating AF segments were differentiated. By utilizing 49 RR intervals, for 20 segments of learning set, 17 segments were correctly detected, and for 30 segments of test set, 20 segments were detected. While utilizing 66 RR intervals, for 18 segments of learning set, 16 segments were correctly detected, and for 28 segments of test set, 20 segments were detected. The results demonstrated that during the last one minute before the termination of paroxysmal AF, the variance of the RR intervals and the difference of the neighboring two RR intervals became smaller. The termination of paroxysmal AF could be successfully predicted by utilizing the RdR scatter plot, while the predicting accuracy should be further improved.

Common influences of non-competitive NMDA receptor antagonists on the consolidation and reconsolidation of cocaine-cue memory.

PubMed

Alaghband, Yasaman; Marshall, John F

2013-04-01

Environmental stimuli or contexts previously associated with rewarding drugs contribute importantly to relapse among addicts, and research has focused on neurobiological processes maintaining those memories. Much research shows contributions of cell surface receptors and intracellular signaling pathways in maintaining associations between rewarding drugs (e.g., cocaine) and concurrent cues/contexts; these memories can be degraded at the time of their retrieval through reconsolidation interference. Much less studied is the consolidation of drug-cue memories during their acquisition. The present experiments use the cocaine-conditioned place preference (CPP) paradigm in rats to directly compare, in a consistent setting, the effects of N-methyl-D-aspartate (NMDA) glutamate receptor antagonists MK-801 and memantine on the consolidation and reconsolidation of cocaine-cue memories. For the consolidation studies, animals were systemically administered MK-801 or memantine immediately following training sessions. To investigate the effects of these NMDA receptor antagonists on the retention of previously established cocaine-cue memories, animals were systemically administered MK-801 or memantine immediately after memory retrieval. Animals given either NMDA receptor antagonist immediately following training sessions did not establish a preference for the cocaine-paired compartment. Post-retrieval administration of either NMDA receptor antagonist attenuated the animals' preference for the cocaine-paired compartment. Furthermore, animals given NMDA receptor antagonists post-retrieval showed a blunted response to cocaine-primed reinstatement. Using two distinct NMDA receptor antagonists in a common setting, these findings demonstrate that NMDA receptor-dependent processes contribute both to the consolidation and reconsolidation of cocaine-cue memories, and they point to the potential utility of treatments that interfere with drug-cue memory reconsolidation.

The effects of intravenous anesthetics on QT interval during anesthetic induction with sevoflurane.

PubMed

Terao, Yoshiaki; Higashijima, Ushio; Toyoda, Tomomi; Ichinomiya, Taiga; Fukusaki, Makoto; Hara, Tetsuya

2016-12-01

Sevoflurane is known to prolong the QT interval. This study aimed to determine the effect of the interaction between intravenous anesthetics and sevoflurane on the QT interval. The study included 48 patients who underwent lumbar spine surgery. Patients received 3 μg/kg fentanyl and were then randomly allocated to either Group T, in which they received 5 mg/kg thiamylal, or Group P, in which they received 1.5 mg/kg propofol, at 2 min after administration of fentanyl injection for anesthetic induction. Vecuronium (1.5 mg/kg) and sevoflurane (3 % inhaled concentration) were administered immediately after loss of consciousness and tracheal intubation was performed 3 min after vecuronium injection. Heart rate (HR), mean arterial pressure (MAP), bispectral index score (BIS), and the heart rate-corrected QT (QTc) interval on a 12-lead electrocardiogram were recorded immediately before fentanyl administration (T1), 2 min after fentanyl injection (T2), immediately before intubation (T3), and 2 min after intubation (T4). There were no significant differences between the two groups in baseline patient characteristics. BIS and MAP significantly decreased after anesthesia induction in both groups. At T3, MAP in Group T was higher than in Group P, while HR had reduced in both groups. The QTc interval was prolonged after anesthesia induction in Group T, but did not change at any time point in Group P. The QTc interval after anesthesia induction in Group T was longer than in Group P. We concluded that an injection of propofol could counteract QTc interval prolongation associated with sevoflurane anesthesia induction.

The physiological response to cold-water immersion following a mixed martial arts training session.

PubMed

Lindsay, Angus; Carr, Sam; Cross, Sean; Petersen, Carl; Lewis, John G; Gieseg, Steven P

2017-05-01

Combative sport is one of the most physically intense forms of exercise, yet the effect of recovery interventions has been largely unexplored. We investigated the effect of cold-water immersion on structural, inflammatory, and physiological stress biomarkers following a mixed martial arts (MMA) contest preparation training session in comparison with passive recovery. Semiprofessional MMA competitors (n = 15) were randomly assigned to a cold-water immersion (15 min at 10 °C) or passive recovery protocol (ambient air) completed immediately following a contest preparation training session. Markers of muscle damage (urinary myoglobin), inflammation/oxidative stress (urinary neopterin + total neopterin (neopterin + 7,8-dihydroneopterin)), and hypothalamic-pituitary axis (HPA) activation (saliva cortisol) were determined before, immediately after, and 1, 2, and 24 h postsession. Ratings of perceived soreness and fatigue, counter movement jump, and gastrointestinal temperature were also measured. Concentrations of all biomarkers increased significantly (p < 0.05) postsession. Cold water immersion attenuated increases in urinary neopterin (p < 0.05, d = 0.58), total neopterin (p < 0.05, d = 0.89), and saliva cortisol after 2 h (p < 0.05, d = 0.68) and urinary neopterin again at 24 h (p < 0.01, d = 0.57) in comparison with passive recovery. Perceived soreness, fatigue, and gastrointestinal temperatures were also lower for the cold-water immersion group at several time points postsession whilst counter movement jump did not differ. Combative sport athletes who are subjected to impact-induced stress may benefit from immediate cold-water immersion as a simple recovery intervention that reduces delayed onset muscle soreness as well as macrophage and HPA activation whilst not impairing functional performance.

Personality and Cognitive Decline in the Baltimore Epidemiologic Catchment Area Follow-up Study

PubMed Central

Hock, Rebecca S.; Lee, Hochang Benjamin; Bienvenu, O. Joseph; Nestadt, Gerald; Samuels, Jack F.; Parisi, Jeanine M.; Costa, Paul T.; Spira, Adam P.

2013-01-01

Objective To determine the association between personality domains and 11-year cognitive decline in a sample from a population-based study. Method Data from Waves 3 (1993–1996) and 4 (2003–2004) of the Baltimore cohort of the Epidemiologic Catchment Area (ECA) study were used for analyses. The sample included 561 adults (mean age ±SD = 45.2 ±10.78 years) who completed the NEO Personality Inventory-Revised (NEO PI-R) prior to Wave 4. Participants also completed the Mini-Mental State Examination (MMSE) and immediate and delayed word recall tests at Wave 3, and at Wave 4 10.9 ±0.6 years later. Results In models adjusted for baseline cognitive performance, demographic characteristics, medical conditions, depressive symptoms, and psychotropic medication use, each 10-point increase in Neuroticism T-scores was associated with a 0.15-point decrease in MMSE scores (B = −0.15 95% confidence interval (CI) −0.30, −0.01), whereas each 10-point increase in Conscientiousness T-scores was associated with a 0.18-point increase on the MMSE (B = 0.18, 95% CI 0.04, 0.32) and a 0.21-point increase in immediate recall (B = 0.21, 95% CI 0.003, 0.41) between baseline and follow-up. Conclusion Findings suggest that greater Neuroticism is associated with decline, and greater Conscientiousness is associated with improvement in performance on measures of general cognitive function, and memory in adults. Further studies are needed to determine the extent to which personality traits in midlife are associated with clinically significant cognitive outcomes in older adults, such as mild cognitive impairment and dementia, and to identify potential mediators of the association between personality and cognitive trajectories. PMID:23759291

Personality and cognitive decline in the Baltimore Epidemiologic Catchment Area follow-up study.

PubMed

Hock, Rebecca S; Lee, Hochang Benjamin; Bienvenu, O Joseph; Nestadt, Gerald; Samuels, Jack F; Parisi, Jeanine M; Costa, Paul T; Spira, Adam P

2014-09-01

To determine the association between personality domains and 11-year cognitive decline in a sample from a population-based study. Data from Waves 3 (1993-1996) and 4 (2003-2004) of the Baltimore cohort of the Epidemiologic Catchment Area (ECA) study were used for analyses. The sample included 561 adults (mean age ± SD: 45.2 ± 10.78 years) who completed the NEO Personality Inventory-Revised prior to Wave 4. Participants also completed the Mini-Mental State Examination (MMSE) and immediate and delayed word recall tests at Wave 3, and at Wave 4, 10.9 ± 0.6 years later. In models adjusted for baseline cognitive performance, demographic characteristics, medical conditions, depressive symptoms, and psychotropic medication use, each 10-point increase in Neuroticism T-scores was associated with a 0.15-point decrease in MMSE scores (B = -0.15, 95% confidence interval [CI]: -0.30, -0.01), whereas each 10-point increase in Conscientiousness T-scores was associated with a 0.18-point increase on the MMSE (B = 0.18, 95% CI: 0.04, 0.32) and a 0.21-point increase in immediate recall (B = 0.21, 95% CI: 0.003, 0.41) between baseline and follow-up. Findings suggest that greater Neuroticism is associated with decline, and greater Conscientiousness is associated with improvement in performance on measures of general cognitive function and memory in adults. Further studies are needed to determine the extent to which personality traits in midlife are associated with clinically significant cognitive outcomes in older adults, such as mild cognitive impairment and dementia, and to identify potential mediators of the association between personality and cognitive trajectories. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

[Improving myocardial mechanics parameters of severe burn rabbits with oral fluid resuscitation].

PubMed

Ruan, Jing; Zhang, Bing-qian; Wang, Guang; Luo, Zhong-hua; Zheng, Qing-yi; Zheng, Jian-sheng; Huang, Yue-sheng; Xiao, Rong

2008-08-01

To investigate the protective effect of oral fluid resuscitation on cardiac function in severe burn rabbits. One hundred and fifty rabbits were randomly divided into normal control group (NC group, n = 6, without treatment), burn group (B group, n = 42, without fluid therapy), immediate oral fluid resuscitation group (C group, n = 42), delayed oral fluid resuscitation group (D group, n = 30) and delayed and rapid oral fluid resuscitation group (E group, n = 30). The rabbits in B, C, D, E groups were subjected to 40% TBSA full-thickness burn, then were treated with fluid therapy immediately after burn (C group), at 6 hour after burn (D, E groups). The myocardial mechanics parameters including mean arterial pressure (MAP), left ventricular systolic pressure (LVSP), left ventricular end diastolic pressure (LVEDP), LV +/- dp/dt max were observed at 2, 6, 8, 12, 24, 36 and 48 post burn hour (PBH). Urine output was also examined. The level of LVSP, LV +/- dp/dt max in B roup were significantly lower than those in NC group. The level of LVSP, LV +/- dp/dt max in the C and E group were singnificantly increased during 24 hour after burn. The level of LV + dp/dt max and LV-dp/dt max in C group peaked at 8 PBH (892 +/- 116 kPa/s) and at 6PBH (724 +/- 149 kPa/s) respectively. The levels of LV +/- dp/dt max, LVSP in D group at each time point were similar to B group (P > 0.05). Both the levels of LV +/- dp/dt max in E group peaked at 8 PBH. The level of LVEDP was no obvious difference between B and other groups at each time point (P > 0.05). The changes of MAP and urine output on 24 PBH in each group were similar to above indices. Effective oral fluid therapy in severe burn rabbits during 24 hours after burn can ameliorate myocardial mechanics parameters. The amount of fluid resuscitation can be estimated according to relevant formula for delayed fluid resuscitation in burn rabbits.

Osteoblastic phenotype of rat marrow stromal cells cultured in the presence of dexamethasone, beta-glycerolphosphate, and L-ascorbic acid

NASA Technical Reports Server (NTRS)

Peter, S. J.; Liang, C. R.; Kim, D. J.; Widmer, M. S.; Mikos, A. G.; McIntire, L. V. (Principal Investigator)

1998-01-01

We investigated the effects of the time course of addition of osteogenic supplements dexamethasone, beta-glycerolphosphate, and L-ascorbic acid to rat marrow stromal cells, and the exposure time on the proliferation and differentiation of the cells. It was the goal of these experiments to determine the time point for supplement addition to optimize marrow stromal cell proliferation and osteoblastic differentiation. To determine this, two studies were performed; one study was based on the age of the cells from harvest, and the other study was based on the duration of exposure to supplemented medium. Cells were seen to proliferate rapidly at early time points in the presence and absence of osteogenic supplements as determined by 3H-thymidine incorporation into the DNA of replicating cells. These results were supported by cell counts ascertained through total DNA analysis. Alkaline phosphatase (ALP) activity and osteocalcin production at 21 days were highest for both experimental designs when the cells were exposed to supplemented medium immediately upon harvest. The ALP levels at 21 days were six times greater for cells maintained in supplements throughout than for control cells cultured in the absence of supplements for both studies, reaching an absolute value of 75 x 10(-7) micromole/min/cell. Osteocalcin production reached 20 x 10(-6) ng/cell at 21 days in both studies for cells maintained in supplemented medium throughout the study, whereas the control cells produced an insignificant amount of osteocalcin. These results suggest that the addition of osteogenic supplements to marrow-derived cells early in the culture period did not inhibit proliferation and greatly enhanced the osteoblastic phenotype of cells in a rat model.

Can a school-based sleep education programme improve sleep knowledge, hygiene and behaviours using a randomised controlled trial.

PubMed

Rigney, Gabrielle; Blunden, Sarah; Maher, Carol; Dollman, James; Parvazian, Somayeh; Matricciani, Lisa; Olds, Timothy

2015-06-01

The present study investigated the effectiveness of a school-based sleep education programme in improving key sleep behaviours, sleep knowledge, and sleep hygiene. A cross-sectional cluster-randomised controlled trial with two groups (Intervention and Control) and three assessment time points [baseline, immediately post intervention (6 weeks post baseline) and follow-up (18 weeks post baseline)] was employed. A total of 296 students (mean age = 12.2 ± 0.6 years; 59% female) from 12 schools in Adelaide, South Australia, were recruited, with 149 participants in the Intervention group and 147 in the Control group. The intervention consisted of four classroom lessons delivered at weekly intervals, followed by a group project on sleep topics, which students presented at a parental information evening. Sleep patterns were assessed objectively (actigraphy, n = 175) and subjectively (time-use recall, n = 251) at three time points. Sleep knowledge and sleep hygiene (n = 296) were also measured. Generalised estimating equations were used to compare changes in the Intervention and Control groups. The programme increased time in bed by 10 min (p = 0.03) for the Intervention group relative to the Control group, due to a 10-min delay in wake time (p = 0.00). These changes were not sustained at follow-up. There was no impact on sleep knowledge or sleep hygiene. Investment in the sleep health of youth through sleep education is important but changes to sleep patterns are difficult to achieve. More intensive programmes, programmes with a different focus or programmes targeting different age groups may be more effective. Copyright © 2015 Elsevier B.V. All rights reserved.

Intramedullary pressure changes in rats after spinal cord injury.

PubMed

Dong, X; Yang, D; Li, J; Liu, C; Yang, M; Du, L; Gu, R; Hu, A; Zhang, H

2016-11-01

The objectives of this study were to explore the change of intramedullary pressure over time in rats after different degrees of spinal cord contusion injury and to verify the hypothesis that the more serious the injury, the higher the intramedullary pressure. The control group rats underwent laminectomy only, whereas the rats in the three experimental groups were subjected to mild, moderate or severe 10th thoracic cord (T10) contusion injury after laminectomy. In addition, an intramedullary pressure of T10 was measured by a Millar Mikro-Tip pressure catheter (Millar Incorporated Company, Houston, TX, USA) immediately in the control group or at different time points after injury in the experimental groups. The average intramedullary pressure of the rats in the control group was 6.88±1.67 mm Hg, whereas that of the rats in any injury group was significantly higher (P=0.000). There was statistical difference among the different time points in the mild or moderate injury group (P=0.007/0.017), but no in the severe (P=0.374). The curves of intramedullary pressure over time in the mild and moderate injury group were bimodal, peaking at 1 and 48 h after the injury. The intramedullary pressure after injury was positively correlated with the injury degree (r=0.438, P=0.000). The intramedullary pressure of the rats increased after traumatic spinal cord injury. If the injury was not serious, the intramedullary pressure fluctuated with time and peaked at 1 and 48 h after injury. If the injury was serious, the intramedullary pressure remained high. The more serious the injury, the higher the intramedullary pressure.

Health-related quality of life for immediate versus delayed androgen-deprivation therapy in patients with asymptomatic, non-curable prostate cancer (TROG 03.06 and VCOG PR 01-03 [TOAD]): a randomised, multicentre, non-blinded, phase 3 trial.

PubMed

Duchesne, Gillian M; Woo, Henry H; King, Madeleine; Bowe, Steven J; Stockler, Martin R; Ames, Alice; D'Este, Catherine; Frydenberg, Mark; Loblaw, Andrew; Malone, Shawn; Millar, Jeremy; Tai, Keen Hun; Turner, Sandra

2017-09-01

Androgen-deprivation therapy in patients with prostate cancer who have relapsed with rising prostate-specific antigen concentration only (PSA-only relapse), or with non-curable but asymptomatic disease at diagnosis, could adversely affect quality of life at a time when the disease itself does not. We aimed to compare the effect of immediate versus delayed androgen-deprivation therapy on health-related quality of life over 5 years in men enrolled in the TOAD (Timing of Androgen Deprivation) trial. This randomised, multicentre, open-label, phase 3 trial done in 29 public and private cancer centres across Australia, New Zealand, and Canada compared immediate with delayed androgen-deprivation therapy in men with PSA-only relapse after definitive treatment, or de-novo non-curable disease. Patients were randomly assigned (1:1) with a database-embedded, dynamically balanced algorithm to immediate androgen-deprivation therapy (immediate therapy group) or to delayed androgen-deprivation therapy (delayed therapy group). Any type of androgen-deprivation therapy was permitted, as were intermittent or continuous schedules. The European Organisation for Research and Treatment of Cancer (EORTC) quality-of-life questionnaires QLQ-C30 and PR25 were completed before randomisation, every 6 months for 2 years, and annually for a further 3 years. The primary outcome of the trial, reported previously, was overall survival, with global health-related quality of life at 2 years as a secondary endpoint. Here we report prespecified secondary objectives of the quality-of-life endpoint. Analysis was by intention to treat. Statistical significance was set at p=0·0036. The trial was registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12606000301561, and ClinicalTrials.gov, number NCT00110162. Between Sept 3, 2004, and July 13, 2012, 293 men were recruited and randomly assigned; 151 to the delayed therapy group and 142 to the immediate therapy group. There was no difference between the two groups in global health-related quality of life over 2 years from randomisation. There were no statistically significant differences in global quality of life, physical functioning, role functioning, or emotional functioning, fatigue, dyspnoea, insomnia, or feeling less masculine over the entire 5 years after randomisation. Sexual activity was lower in the immediate therapy group than in the delayed group at 6 and 12 months (at 6 months mean score 29·20 [95% CI 24·59-33·80] in the delayed group vs 10·40 [6·87-13·93] in the immediate group, difference 18·80 [95% CI 13·00-24·59], p<0·0001; at 12 months 28·63 [24·07-33·18] vs 13·76 [9·94-17·59], 14·86 [8·95-20·78], p<0·0001), with the differences exceeding the clinically significant threshold of 10 points until beyond 2 years. The immediate therapy group also had more hormone-treatment-related symptoms at 6 and 12 months (at 6 months mean score 8·48 [95% CI 6·89-10·07] in the delayed group vs 15·97 [13·92-18·02] in the immediate group, difference -7·49 [-10·06 to -4·93], p<0·0001; at 12 months 9·32 [7·59-11·05] vs 17·07 [14·75-19·39], -7·75 [-10·62 to -4·89], p<0·0001), but with differences below the threshold of clinical significance. For the individual symptoms, hot flushes were clinically significantly higher in the immediate group (adjusted proportion 0·31 for delayed therapy vs 0·55 for immediate therapy, adjusted odds ratio 2·87 [1·96-4·21], p<0·0001) over the 5-year period, as were nipple or breast symptoms (0·06 vs 0·14, 2·64 [1·61-4·34], p=0·00013). Immediate use of androgen-deprivation therapy was associated with early detriments in specific hormone-treatment-related symptoms, but with no other demonstrable effect on overall functioning or health-related quality of life. This evidence can be used to help decision making about treatment initiation for men at this disease stage. Australian National Health and Medical Research Council and Cancer Councils, The Royal Australian and New Zealand College of Radiologists, Mayne Pharma Australia, Tolmar Australia. Copyright © 2017 Elsevier Ltd. All rights reserved.

Real-time determination of the worst tsunami scenario based on Earthquake Early Warning

NASA Astrophysics Data System (ADS)

Furuya, Takashi; Koshimura, Shunichi; Hino, Ryota; Ohta, Yusaku; Inoue, Takuya

2016-04-01

In recent years, real-time tsunami inundation forecasting has been developed with the advances of dense seismic monitoring, GPS Earth observation, offshore tsunami observation networks, and high-performance computing infrastructure (Koshimura et al., 2014). Several uncertainties are involved in tsunami inundation modeling and it is believed that tsunami generation model is one of the great uncertain sources. Uncertain tsunami source model has risk to underestimate tsunami height, extent of inundation zone, and damage. Tsunami source inversion using observed seismic, geodetic and tsunami data is the most effective to avoid underestimation of tsunami, but needs to expect more time to acquire the observed data and this limitation makes difficult to terminate real-time tsunami inundation forecasting within sufficient time. Not waiting for the precise tsunami observation information, but from disaster management point of view, we aim to determine the worst tsunami source scenario, for the use of real-time tsunami inundation forecasting and mapping, using the seismic information of Earthquake Early Warning (EEW) that can be obtained immediately after the event triggered. After an earthquake occurs, JMA's EEW estimates magnitude and hypocenter. With the constraints of earthquake magnitude, hypocenter and scaling law, we determine possible multi tsunami source scenarios and start searching the worst one by the superposition of pre-computed tsunami Green's functions, i.e. time series of tsunami height at offshore points corresponding to 2-dimensional Gaussian unit source, e.g. Tsushima et al., 2014. Scenario analysis of our method consists of following 2 steps. (1) Searching the worst scenario range by calculating 90 scenarios with various strike and fault-position. From maximum tsunami height of 90 scenarios, we determine a narrower strike range which causes high tsunami height in the area of concern. (2) Calculating 900 scenarios that have different strike, dip, length, width, depth and fault-position. Note that strike is limited with the range obtained from 90 scenarios calculation. From 900 scenarios, we determine the worst tsunami scenarios from disaster management point of view, such as the one with shortest travel time and the highest water level. The method was applied to a hypothetical-earthquake, and verified if it can effectively search the worst tsunami source scenario in real-time, to be used as an input of real-time tsunami inundation forecasting.

Integrating Point-of-Care Testing into a Community Emergency Department: A Mixed-Methods Evaluation.

PubMed

Pines, Jesse M; Zocchi, Mark S; Carter, Caitlin; Marriott, Charles Z; Bernard, Matthew; Warner, Leah H

2018-05-13

Point-of-care testing (POCT) is a commonly used technology that hastens the time to laboratory results in emergency departments (ED). We evaluated an ED-based POCT program on ED length of stay and time to care, coupled with qualitative interviews of local ED stakeholders. We conducted a mixed-methods study (2012-16) to examine the impact of point-of-care testing in a single, community ED. The quantiative analysis involved an observational before-after study comparing time to laboratory test result (POC troponin or POC chemistry) and ED length of stay after implementation of POCT, using a propensity-weighted interrupted time series analysis (ITSA). A complementary qualitative analysis involved five semi-structured interviews with staff using grounded theory on the benefits and challenges to ED POCT. A total of 47,399 ED visits were included in the study (24,705 in pre-intervention period and 22,694 in post-intervention). After POCT implementation, overall laboratory testing increased marginally from 61 to 62%. Central laboratory troponin and chemistry declined by >50% and was replaced by POCT. Prior to POCT implementation, time to troponin and chemistry had declined steadily due to other improvements in laboratory efficiency. After POCT implementation, there was an immediate 20 minute further decline (p<0.001) in both time to troponin and time to chemistry results using the propensity-weighted comparisons. However, the declining trend observed prior to POCT implementation did not continue at the same rate post implementation. Similarly, prior to POCT implementation, ED length of stay (LOS) declined due to other quality improvements. After POCT implementation, LOS continued declined at a similar rate. Because of this prior trend, the ITSA did not show a significant decline in LOS attributable to POCT. Common benefits of POCT perceived by staff in qualitative interviews included improved quality of care (64%), and reductions in time to test results (44%). Common challenges included concerns over POCT accuracy (32%), and technical barriers (29%). In the study ED, implementation of POCT was associated with a reduction in time to test result for both troponin and chemistry. Local staff felt that faster time to test result improved quality of care; however, concerns were raised with POCT accuracy. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

[Medical accidents and defense activities against criminal investigation--the attorney's point of view].

PubMed

Goto, Sadato

2012-09-01

Even after the criminal investigation has begun on a medical accident, immediate defense activities can prevent false indictment. On appointing a lawyer, one has to be careful of "conflicts of interests". Defense lawyers try to reconstruct what happened on the scene with the records and the comments of the persons involved. Meanwhile, they try to nail down the medical standards in the particular case by scrutinizing medical bibliography. If they succeed in pointing out to the authorities the possibilities of not guilty verdict, arrest or indictment can be avoided.

Critical behavior of modulus of gel

NASA Astrophysics Data System (ADS)

Tokita, Masayuki; Niki, Ryoya; Hikichi, Kunio

1985-09-01

The critical behavior of the shear modulus of casein gel is studied. The shear modulus of casein gel scales with the conductivity exponent in the immediate vicinity of the sol-gel transition point. The asymptotic behavior of the modulus in the region far above the transition point is governed by a different exponent which is much larger than the conductivity exponent. These results are explainable by the crossover behavior of the percolation process. This study shows that the gelation of the casein micelle solution is a realization of the percolation process.

Immediate two-stage prosthetic breast reconstruction failure: radiation is not the only culprit.

PubMed

Lam, Thomas C; Borotkanics, Robert; Hsieh, Frank; Salinas, James; Boyages, John

2018-03-15

Immediate prosthetic breast reconstruction produces a satisfactory aesthetic result with high levels of patient satisfaction. However, with the broader indication for post-mastectomy adjuvant radiation, many patients are advised against immediate breast reconstruction because of concerns of implant loss and infection particularly as most patients also require chemotherapy. This retrospective cohort study examines outcomes for patients who underwent immediate two-stage prosthetic breast reconstruction after mastectomy with or without adjuvant chemotherapy or radiotherapy (RT). Between 1998 and 2010, 452 patients undergoing two-stage prosthetic immediate breast reconstruction involving a total of 562 breasts were included in this study. Stage one was defined as insertion of the temporary expander and stage two insertion of the final silicone implant. Post-operative adjuvant radiotherapy was recommended with tissue expander in-situ for 114 patients. Complications, including loss of prosthesis, seroma and infection were recorded and analysed. Cosmetic result was assessed using a 4-point scale. Post-operative prosthesis loss was 2.7%, 5.3% for patients undergoing adjuvant chemotherapy increasing to 11.3% for patients receiving chemotherapy+RT. Chemotherapy and radiotherapy independently were the main, statistically significant, risk factors for expander or implant loss; IRR: 13.85 (p=0.012) and 2.23 (p=0.027), respectively. Prosthesis loss for patients undergoing combination chemotherapy+RT was also significant; IRR: 4.791 (p<0.001). These findings serve to better inform patients on risk in weighing treatment options. Post-mastectomy radiation doubles the risk of prosthesis loss over and above adjuvant chemotherapy but is an acceptable option following immediate prosthetic breast reconstruction in a multidisciplinary setting.

Immediate effects of foot orthoses on pain during functional tasks in people with patellofemoral osteoarthritis: A cross-over, proof-of-concept study.

PubMed

Collins, Natalie J; Hinman, Rana S; Menz, Hylton B; Crossley, Kay M

2017-01-01

The purpose of the study was to determine whether prefabricated foot orthoses immediately reduce pain during functional tasks in people with patellofemoral osteoarthritis, compared to flat insoles and shoes alone. Eighteen people with predominant lateral patellofemoral osteoarthritis (nine women; mean [SD] age 59 [10]years; body mass index 27.9 [3.2]kg/m 2 ) performed functional tasks wearing running sandals, and then wearing foot orthoses and flat insoles (random order). Participants rated knee pain during each task (11-point numerical rating scales), ease of performance and knee stability (five-point Likert scales), and comfort (100mm visual analogue scales). Compared to shoes alone, foot orthoses (p=0.002; median difference 1.5 [IQR 3]) and flat insoles (p<0.001; 2 [3]) significantly reduced pain during step-downs; foot orthoses reduced pain during walking (p=0.008; 1 [1.25]); and flat insoles reduced pain during stair ambulation (p=0.001; 1 [1.75]). No significant differences between foot orthoses and flat insoles were observed for pain severity, ease of performance or knee stability. Foot orthoses were less comfortable than flat insoles and shoes alone (p<0.05). In people with patellofemoral osteoarthritis, immediate pain-relieving effects of prefabricated, contoured foot orthoses are equivalent to flat insoles. Further studies should investigate whether similar outcomes occur with longer-term wear or different orthosis designs. Copyright © 2016 Elsevier B.V. All rights reserved.

Batch statistical process control of a fluid bed granulation process using in-line spatial filter velocimetry and product temperature measurements.

PubMed

Burggraeve, A; Van den Kerkhof, T; Hellings, M; Remon, J P; Vervaet, C; De Beer, T

2011-04-18

Fluid bed granulation is a batch process, which is characterized by the processing of raw materials for a predefined period of time, consisting of a fixed spraying phase and a subsequent drying period. The present study shows the multivariate statistical modeling and control of a fluid bed granulation process based on in-line particle size distribution (PSD) measurements (using spatial filter velocimetry) combined with continuous product temperature registration using a partial least squares (PLS) approach. Via the continuous in-line monitoring of the PSD and product temperature during granulation of various reference batches, a statistical batch model was developed allowing the real-time evaluation and acceptance or rejection of future batches. Continuously monitored PSD and product temperature process data of 10 reference batches (X-data) were used to develop a reference batch PLS model, regressing the X-data versus the batch process time (Y-data). Two PLS components captured 98.8% of the variation in the X-data block. Score control charts in which the average batch trajectory and upper and lower control limits are displayed were developed. Next, these control charts were used to monitor 4 new test batches in real-time and to immediately detect any deviations from the expected batch trajectory. By real-time evaluation of new batches using the developed control charts and by computation of contribution plots of deviating process behavior at a certain time point, batch losses or reprocessing can be prevented. Immediately after batch completion, all PSD and product temperature information (i.e., a batch progress fingerprint) was used to estimate some granule properties (density and flowability) at an early stage, which can improve batch release time. Individual PLS models relating the computed scores (X) of the reference PLS model (based on the 10 reference batches) and the density, respectively, flowabililty as Y-matrix, were developed. The scores of the 4 test batches were used to examine the predictive ability of the model. Copyright © 2011 Elsevier B.V. All rights reserved.

Immediate placement of endosseous implants into the extraction sockets.

PubMed

Ebenezer, Vijay; Balakrishnan, K; Asir, R Vigil Dev; Sragunar, Banu

2015-04-01

Implant by definition "means any object or material, such as an alloplastic substance or other tissue, which is partial or completely inserted into the body for therapeutic, diagnostic, prosthetic, or experimental purpose." The placement of a dental implant in an extraction socket at the time of extraction or explantation is known as immediate implant placement whereas delayed placement of implant signifies the implant placement in edentulous areas where healing has completed with new bone formation after the loss of tooth/teeth. Recent idea goes by "why late when it can be done immediately." There are several advantages of immediate placement of implants, and lots of studies have been done. In this article, the advantages and disadvantages of immediate versus delayed placement of implants have been reviewed.

Implications of high-velocity interstellar H I absorption features

NASA Technical Reports Server (NTRS)

Cowie, L.; York, D. G.; Laurent, C.; Vidal-Madjar, A.

1979-01-01

Contributions to the interstellar H I column density at high velocities from immediate postshock gas and from the cooling gas behind a shock are compared. The detection of high-velocity H I in L-epsilon and L-delta for Iota Ori is reported and interpreted as cooling gas behind a shock of 100 km/s velocity. The immediate postshock gas should be observable for shock velocities greater than 200 km/s and permits direct determination of the velocities of adiabatic shocks in the interstellar medium. It is pointed out that interstellar L-alpha and L-beta lines may not have purely Lorentzian profiles if high-velocity H I is a widespread phenomenon.

A 5-year comparison of marginal bone level following immediate loading of single-tooth implants placed in healed alveolar ridges and extraction sockets in the maxilla

PubMed Central

Berberi, Antoine N.; Sabbagh, Joseph M.; Aboushelib, Moustafa N.; Noujeim, Ziad F.; Salameh, Ziad A.

2014-01-01

Purpose: The aim of present investigation was to evaluate marginal bone level after 5-year follow-up of implants placed in healed ridges and fresh extraction sockets in maxilla with immediate loading protocol. Materials and Methods: Thirty-six patients in need of a single-tooth replacement in the anterior maxilla received 42 Astra Tech implants (Astra Tech Implant system™, Dentsply Implants, Mölndal, Sweden). Implants were placed either in healed ridges (group I) or immediately into fresh extraction sockets (group II). Implants were restored and placed into functional loading immediately by using a prefabricated abutment. Marginal bone level relative to the implant reference point was recorded at implant placement, crown cementation, 12, 36, and 60 months following loading using intra-oral radiographs. Measurements were made on the mesial and distal sides of each implant. Results: Overall, two implants were lost from the group II, before final crown cementation: they were excluded from the study. The mean change in marginal bone loss (MBL) after implant placement was 0.26 ± 0.161 mm for 1 year, and 0.26 ± 0.171 mm for 3 years, and 0.21 ± 0.185 mm for 5 years in extraction sockets and was 0.26 ± 0.176 mm for 1 year and 0.21 ± 0.175 mm for 3 years, and 0.19 ± 0.172 mm for 5 years in healed ridges group. Significant reduction of marginal bone was more pronounced in implants inserted in healed ridges (P < 0.041) compared to fresh surgical extraction sockets (P < 0.540). Significant MBL was observed on the mesial side of the implant after cementation of the provisional (P < 0.007) and after 12 months (P < 0.034) compared to the distal side which remained stable for 3 and 5 years observation period. Conclusions: Within the limitations of this study, responses of local bone to immediately loaded implants placed either in extraction sockets or healed ridges were similar. Functional loading technique by using prefabricated abutment placed during the surgery time seems to maintain marginal bone around implant in both healed and fresh extraction sites. PMID:24550840

Increased alpha-Amylase Response to an Acute Psychosocial Stress Challenge in Healthy Adults with Childhood Adversity

PubMed Central

Kuras, Yuliya I.; McInnis, Christine M.; Thoma, Myriam V.; Chen, Xuejie; Hanlin, Luke; Gianferante, Danielle; Rohleder, Nicolas

2017-01-01

Childhood adversity is highly prevalent and linked to lasting psychological and physiological consequences. A potential mechanism for negative health outcomes is altered stress reactivity. While previous research has addressed associations of childhood adversity with stress system reactivity, sympathetic nervous system (SNS) stress reactivity is understudied. We therefore set out here to examing salivary alpha-amylase (sAA) reactivity in relation with childhood adversity. Forty-one healthy adult subjects (n=24 male; n=17 female) aged 18-34 years underwent the Trier Social Stress Test (TSST) and completed the Childhood Trauma Questionnaire (CTQ). Saliva for measurement of sAA was collected at three time points; before the TSST, immediately after, and 10 minutes post-TSST. We found that those with childhood trauma had a higher overall sAA response to the TSST, as seen in a repeated measures ANOVA (CTQ by time interaction: F(1.8,71.5)=6.46, p=.01) and an independent samples t-test indicating higher sAA baseline to peak response (t=3.22, p=.003). There was also a positive correlation between sAA reactivity and the CTQ subscales of childhood physical abuse (r=.46, p=.005) and emotional abuse (r=.37, p=.024). Healthy adults with low-to-moderate childhood adversity had a heightened sAA response immediately following the stressor. Higher SNS reactivity could be a link to negative health outcomes in adults with early adversity. Future research should address whether altered sAA reactivity is predictive of negative health outcomes in those with childhood adversity. PMID:27577885

Weather conditions: a neglected factor in human salivary cortisol research?

NASA Astrophysics Data System (ADS)

Milas, Goran; Šupe-Domić, Daniela; Drmić-Hofman, Irena; Rumora, Lada; Klarić, Irena Martinović

2018-02-01

There is ample evidence that environmental stressors such as extreme weather conditions affect animal behavior and that this process is in part mediated through the elevated activity of the hypothalamic pituitary adrenal axis which results in an increase in cortisol secretion. This relationship has not been extensively researched in humans, and weather conditions have not been analyzed as a potential confounder in human studies of stress. Consequently, the goal of this paper was to assess the relationship between salivary cortisol and weather conditions in the course of everyday life and to test a possible moderating effect of two weather-related variables, the climate region and timing of exposure to outdoors conditions. The sample consisted of 903 secondary school students aged 18 to 21 years from Mediterranean and Continental regions. Cortisol from saliva was sampled in naturalistic settings at three time points over the course of a single day. We found that weather conditions are related to salivary cortisol concentration and that this relationship may be moderated by both the specific climate and the anticipation of immediate exposure to outdoors conditions. Unpleasant weather conditions are predictive for the level of salivary cortisol, but only among individuals who anticipate being exposed to it in the immediate future (e.g., in students attending school in the morning shift). We also demonstrated that isolated weather conditions or their patterns may be relevant in one climate area (e.g., Continental) while less relevant in the other (e.g., Mediterranean). Results of this study draw attention to the importance of controlling weather conditions in human salivary cortisol research.

Neuromuscular fatigue and recovery dynamics following prolonged continuous run at anaerobic threshold.

PubMed

Skof, B; Strojnik, V

2006-03-01

The aim of this study was to determine the influence of intensive aerobic running on some muscle contractile characteristics and the dynamics of their recovery during a 2 hour period afterwards. Seven well trained runners performed a 6 km run at anaerobic threshold (V(OBLA)). Knee torque during single twitch, low and high frequency electrical stimulation (ES), maximum voluntary knee extension, and muscle activation level test of the quadriceps femoris muscles were measured before and immediately after the run, and at several time points during a 120 minute interval that followed the run. After exercise, the mean (SE) maximum twitch torque (T(TW)) and torque at ES with 20 Hz (low frequency ES; T(F20)) dropped by 14.1 (5.1)% (p<0.05) and 20.6 (7.9)% (p<0.05) respectively, while torque at stimulation with 100 Hz (high frequency ES; T(F100)), maximum isometric knee extension torque (maximum voluntary contraction torque; T(MVC)), and activation level did not change significantly. Twitch contraction time was shortened by 8 (2)% (p<0.05). Ten minutes after the run, T(TW) was 40% higher than immediately after the run and 10% (p<0.05) higher than before the run. T(F20), T(F100), and T(MVC) remained lower for 60 minutes (p<0.05) than before the run. A 6 km continuous run at V(OBLA) caused peripheral fatigue by impairing excitation-contraction coupling. Twitch torque recovered very quickly. However, the process of torque restoration at maximum isometric knee extension torque and at high and low frequency ES took much longer.

Dose-response relationships between exercise intensity, cravings, and inhibitory control in methamphetamine dependence: An ERPs study.

PubMed

Wang, Dongshi; Zhou, Chenglin; Zhao, Min; Wu, Xueping; Chang, Yu-Kai

2016-04-01

The present study integrated behavioral and neuroelectric approaches for determining the dose-response relationships between exercise intensity and methamphetamine (MA) craving and between exercise intensity and inhibitory control in individuals with MA dependence. Ninety-two individuals with MA dependence were randomly assigned to an exercise group (light, moderate, or vigorous intensity) or to a reading control group. The participants then completed a craving self-report at four time points: before exercise, during exercise, immediately after exercise, and 50 min after exercise. Event-related potentials were also recorded while the participants completed a standard Go/NoGo task and an MA-related Go/NoGo task approximately 20 min after exercise cessation. The reduction in self-reported MA craving scores of the moderate and vigorous intensity groups was greater than that of the light intensity and control groups during acute exercise as well as immediately and 50 min following exercise termination. Additionally, an inverted-U-shaped relationship between exercise intensity and inhibitory control was generally observed for the behavioral and neuroelectric indices, with the moderate intensity group exhibiting shorter Go reaction times, increased NoGo accuracy, and larger NoGo-N2 amplitudes. Acute exercise may provide benefits for MA-associated craving and inhibitory control in MA-dependent individuals, as revealed by behavioral and neuroelectric measures. Moderate-intensity exercise may be associated with more positive effects, providing preliminary evidence for the establishment of an exercise prescription regarding intensity for MA dependence. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Using a quality improvement model to enhance providers' performance in maternal and newborn health care: a post-only intervention and comparison design.

PubMed

Ayalew, Firew; Eyassu, Gizachew; Seyoum, Negash; van Roosmalen, Jos; Bazant, Eva; Kim, Young Mi; Tekleberhan, Alemnesh; Gibson, Hannah; Daniel, Ephrem; Stekelenburg, Jelle

2017-04-12

The Standards Based Management and Recognition (SBM-R © ) approach to quality improvement has been implemented in Ethiopia to strengthen routine maternal and newborn health (MNH) services. This evaluation assessed the effect of the intervention on MNH providers' performance of routine antenatal care (ANC), uncomplicated labor and delivery and immediate postnatal care (PNC) services. A post-only evaluation design was conducted at three hospitals and eight health centers implementing SBM-R and the same number of comparison health facilities. Structured checklists were used to observe MNH providers' performance on ANC (236 provider-client interactions), uncomplicated labor and delivery (226 provider-client interactions), and immediate PNC services in the six hours after delivery (232 provider-client interactions); observations were divided equally between intervention and comparison groups. Main outcomes were provider performance scores, calculated as the percentage of essential tasks in each service area completed by providers. Multilevel analysis was used to calculate adjusted mean percentage performance scores and standard errors to compare intervention and comparison groups. There was no statistically significant difference between intervention and comparison facilities in overall mean performance scores for ANC services (63.4% at intervention facilities versus 61.0% at comparison facilities, p = 0.650) or in any specific ANC skill area. MNH providers' overall mean performance score for uncomplicated labor and delivery care was 11.9 percentage points higher in the intervention than in the comparison group (77.5% versus 65.6%; p = 0.002). Overall mean performance scores for immediate PNC were 22.2 percentage points higher at intervention than at comparison facilities (72.8% versus 50.6%; p = 0.001); and there was a significant difference of 22 percentage points between intervention and comparison facilities for each PNC skill area: care for the newborn and health check for the mother. The SBM-R quality improvement intervention made a significant positive impact on MNH providers' performance during labor and delivery and immediate PNC services, but not during ANC services. Scaling up the intervention to other facilities and regions may increase the availability of good quality MNH services across Ethiopia. The findings will also guide implementation of the government's five-year (2015-2020) health sector transformation plan and health care quality strategies needed to meet the country's MNH goals.

China's Immediate Future: Renewed Cultural Borrowing.

ERIC Educational Resources Information Center

Price, R. F.

In the years following the Eleventh Party Congress of 1977, China's leadership has shown a renewed interest in cultural borrowing and, subsequently, points of cultural contact with other countries have greatly increased. Many students and scholars have been sent abroad, and many foreign teachers have been invited to China. Between 1978 and 1980,…

78 FR 34687 - Self-Regulatory Organizations; NYSE MKT LLC; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-10

... To Amend Rule 1000-- Equities To Revise the Manner by Which the Exchange Will Phase Out the... Exchange will phase out the functionality associated with liquidity replenishment points (``LRPs'') in... Exchange filed to amend Rule 1000--Equities to provide that it would phase out the functionality associated...

Pre-Class Coming Attractions: Interest and Program Awareness in the Classroom

ERIC Educational Resources Information Center

Nadler, Joel T.; Clark, M. H.

2010-01-01

Slides similar to "Coming Attractions" shown in cinemas were displayed prior to classes at a mid-western university over three semesters. More than 140 PowerPoint slides, featuring humor, psychology content, and department/faculty information were presented immediately prior to undergraduate psychology class lectures. The primary goals were to…

A Feminine and Poststructural Extension of Cosmopolitan Ethics in Music Education

ERIC Educational Resources Information Center

Richerme, Lauren Kapalka

2017-01-01

The interconnected nature of 21st-century life demands that music educators and students consider those beyond their immediate communities in their ethical deliberations. While Appiah's cosmopolitan ethical principles of universal concern and respect for legitimate difference may serve as a starting point for global ethical considerations in music…

College English Writing Affect: Self-Efficacy and Anxiety

ERIC Educational Resources Information Center

Woodrow, Lindy

2011-01-01

This article describes a research project into the self-efficacy and anxiety of college English students at four universities in China. A total of 738 participants completed a questionnaire measuring self-efficacy and anxiety in writing in English. This was immediately followed by a writing task. The questionnaire used a seven point Likert type…

Encounters with Authority: Tactics and Negotiations at the Periphery of Participatory Platforms

ERIC Educational Resources Information Center

Mugar, Gabriel

2017-01-01

Digital participatory platforms like Wikipedia are often celebrated as projects that allow anyone to contribute. Any user can sign up and start contributing immediately. Similarly, projects that engage volunteers in the production of scientific knowledge create easy points of entry to make contributions. These low barriers to entry are a hallmark…

49 CFR 572.18 - Thorax.

Code of Federal Regulations, 2010 CFR

2010-10-01

... plane. The joints of the limbs are adjusted at any setting between 1g and 2g, which just supports the... chest midsagittal plane so that it is 1.5 inches below the longitudinal centerline of the bolt that... plane at the surface on the thorax immediately adjacent to the designated impact point is vertical and...

Immediate use steam sterilization: moving beyond current policy.

PubMed

Seavey, Rose

2013-05-01

Immediate-use steam sterilization (IUSS) is steam sterilization intended for immediate use. IUSS may cause an increased risk of infection to patients because of stress and time constraints placed on staff. When IUSS is used, it is vital to properly carry out the complete multistep process according to the manufacturer's written validated instructions for use. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Project Stride: An Equine-Assisted Intervention to Reduce Symptoms of Social Anxiety in Young Women.

PubMed

Alfonso, Sarah V; Alfonso, Lauren A; Llabre, Maria M; Fernandez, M Isabel

2015-01-01

Although there is evidence supporting the use of equine-assisted activities to treat mental disorders, its efficacy in reducing signs and symptoms of social anxiety in young women has not been examined. We developed and pilot tested Project Stride, a brief, six-session intervention combining equine-assisted activities and cognitive-behavioral strategies to reduce symptoms of social anxiety. A total of 12 women, 18-29 years of age, were randomly assigned to Project Stride or a no-treatment control. Participants completed the Liebowitz Social Anxiety Scale at baseline, immediate-post, and 6 weeks after treatment. Project Stride was highly acceptable and feasible. Compared to control participants, those in Project Stride had significantly greater reductions in social anxiety scores from baseline to immediate-post [decrease of 24.8 points; t (9) = 3.40, P = .008)] and from baseline to follow-up [decrease of 31.8 points; t (9) = 4.12, P = .003)]. These findings support conducting a full-scale efficacy trial of Project Stride. Copyright © 2015 Elsevier Inc. All rights reserved.

An amino acid-electrolyte beverage may increase cellular rehydration relative to carbohydrate-electrolyte and flavored water beverages.

PubMed

Tai, Chih-Yin; Joy, Jordan M; Falcone, Paul H; Carson, Laura R; Mosman, Matt M; Straight, Justen L; Oury, Susie L; Mendez, Carlos; Loveridge, Nick J; Kim, Michael P; Moon, Jordan R

2014-05-26

In cases of dehydration exceeding a 2% loss of body weight, athletic performance can be significantly compromised. Carbohydrate and/or electrolyte containing beverages have been effective for rehydration and recovery of performance, yet amino acid containing beverages remain unexamined. Therefore, the purpose of this study is to compare the rehydration capabilities of an electrolyte-carbohydrate (EC), electrolyte-branched chain amino acid (EA), and flavored water (FW) beverages. Twenty men (n = 10; 26.7 ± 4.8 years; 174.3 ± 6.4 cm; 74.2 ± 10.9 kg) and women (n = 10; 27.1 ± 4.7 years; 175.3 ± 7.9 cm; 71.0 ± 6.5 kg) participated in this crossover study. For each trial, subjects were dehydrated, provided one of three random beverages, and monitored for the following three hours. Measurements were collected prior to and immediately after dehydration and 4 hours after dehydration (3 hours after rehydration) (AE = -2.5 ± 0.55%; CE = -2.2 ± 0.43%; FW = -2.5 ± 0.62%). Measurements collected at each time point were urine volume, urine specific gravity, drink volume, and fluid retention. No significant differences (p > 0.05) existed between beverages for urine volume, drink volume, or fluid retention for any time-point. Treatment x time interactions existed for urine specific gravity (USG) (p < 0.05). Post hoc analysis revealed differences occurred between the FW and EA beverages (p = 0.003) and between the EC and EA beverages (p = 0.007) at 4 hours after rehydration. Wherein, EA USG returned to baseline at 4 hours post-dehydration (mean difference from pre to 4 hours post-dehydration = -0.0002; p > 0.05) while both EC (-0.0067) and FW (-0.0051) continued to produce dilute urine and failed to return to baseline at the same time-point (p < 0.05). Because no differences existed for fluid retention, urine or drink volume at any time point, yet USG returned to baseline during the EA trial, an EA supplement may enhance cellular rehydration rate compared to an EC or FW beverage in healthy men and women after acute dehydration of around 2% body mass loss.

Pointing at targets by children with congenital and transient blindness.

PubMed

Gaunet, Florence; Ittyerah, Miriam; Rossetti, Yves

2007-04-01

The study investigated pointing at memorized targets in reachable space in congenitally blind (CB) and blindfolded sighted (BS) children (6, 8, 10 and 12 years; ten children in each group). The target locations were presented on a sagittal plane by passive positioning of the left index finger. A go signal for matching the target location with the right index finger was provided 0 or 4 s after demonstration. An age effect was found only for absolute distance errors and the surface area of pointing was smaller for the CB children. Results indicate that early visual experience and age are not predictive factors for pointing in children. The delay was an important factor at all ages and for both groups, indicating distinct spatial representations such as egocentric and allocentric frames of reference, for immediate and delayed pointing, respectively. Therefore, the CB like the BS children are able to use both ego- and allocentric frames of reference.

A New Method to Develop Human Dental Pulp Cells and Platelet-rich Fibrin Complex.

PubMed

He, Xuan; Chen, Wen-Xia; Ban, Guifei; Wei, Wei; Zhou, Jun; Chen, Wen-Jin; Li, Xian-Yu

2016-11-01

Platelet-rich fibrin (PRF) has been used as a scaffold material in various tissue regeneration studies. In the previous methods to combine seed cells with PRF, the structure of PRF was damaged, and the manipulation time in vitro was also increased. The objective of this in vitro study was to explore an appropriate method to develop a PRF-human dental pulp cell (hDPC) complex to maintain PRF structure integrity and to find out the most efficient part of PRF. The PRF-hDPC complex was developed at 3 different time points during PRF preparation: (1) the before centrifugation (BC) group, the hDPC suspension was added to the venous blood before blood centrifugation; (2) the immediately after centrifugation (IAC) group, the hDPC suspension was added immediately after blood centrifugation; (3) the after centrifugation (AC) group, the hDPC suspension was added 10 minutes after blood centrifugation; and (4) the control group, PRF without hDPC suspension. The prepared PRF-hDPC complexes were cultured for 7 days. The samples were fixed for histologic, immunohistochemistry, and scanning electron microscopic evaluation. Real-time polymerase chain reaction was performed to evaluate messenger RNA expression of alkaline phosphatase and dentin sialophosphoprotein. Enzyme-linked immunosorbent assay quantification for growth factors was performed within the different parts of the PRF. Histologic, immunohistochemistry, and scanning electron microscopic results revealed that hDPCs were only found in the BC group and exhibited favorable proliferation. Real-time polymerase chain reaction revealed that alkaline phosphatase and dentin sialophosphoprotein expression increased in the cultured PRF-hDPC complex. The lower part of the PRF released the maximum quantity of growth factors. Our new method to develop a PRF-hDPCs complex maintained PRF structure integrity. The hDPCs were distributed in the buffy coat, which might be the most efficient part of PRF. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Time course of scopolamine effect on memory consolidation and forgetting in rats.

PubMed

Popović, Miroljub; Giménez de Béjar, Verónica; Popović, Natalija; Caballero-Bleda, María

2015-02-01

The effect of scopolamine on the consolidation and forgetting of emotional memory has not been completely elucidated yet. The aim of the present study was to investigate the time course of scopolamine effect on consolidation and forgetting of passive avoidance response. In a first experiment of the present study, we tested the effect of scopolamine (1mg/kg, i.p., immediately after acquisition), on 24h and 48h retention performance of the step-through passive avoidance task, in adult male Wistar rats. On the 24h retested trial, the latency of the passive avoidance response was significantly lower, while on the 48h retested trial it was significantly higher in scopolamine than in the saline-treated group. In a second experiment, we assessed the 24h time course of scopolamine (1mg/kg) effect on memory consolidation in passive avoidance task. We found that scopolamine administration only within the first six and half hours after acquisition improved memory consolidation in 48h retention performance. Finally, a third experiment was performed on the saline- and scopolamine-treated rats (given immediately after acquisition) that on the 48h retention test did not step through into the dark compartment during the cut-off time. These animals were retested weekly for up to first three months, and after that, every three months until the end of experiment (i.e., 15 months after acquisition). The passive avoidance response in the saline treated group lasted up to 6 weeks after acquisition, while in the scopolamine treated group 50% of animals conserved the initial level of passive avoidance response until the experiment end point. In conclusion, the present data suggest that (1) improving or impairment effect of scopolamine given in post-training periods depends on delay of retention trial, (2) memory consolidation process could be modify by scopolamine within first six and half hours after training and (3) scopolamine could delay forgetting of emotional memory. Copyright © 2014 Elsevier Inc. All rights reserved.

Effects of a Knee Brace With a Patellar Hole Versus Without a Patellar Hole in Patients With Knee Osteoarthritis: A Double-Blind, Randomized Controlled Trial.

PubMed

Added, Marco Aurélio Nemitalla; Added, Caroline; Kasawara, Karina Tamy; Rotta, Viviane Perez; de Freitas, Diego Galace

2017-01-01

The objective of this study was to observe the immediate effect of a knee brace with a patellar hole versus without a patellar hole on pain perception in patients with knee osteoarthritis. To accomplish this, a double-blind, randomized controlled trial enrolled 108 patients divided into two groups (knee brace with a patellar hole or without a patellar hole). Patients were evaluated by the Visual Analogue Scale (VAS) in order to measure their pain sensation, the Timed Up and Go (TUG) test was used to evaluate their ability to walk, and the 8-m walking test (8MWT) was used to estimate their walking speed. Both groups presented significant reduction in pain perception, higher function of the lower extremities, and greater mobility while wearing a knee brace. However, the patients who wore a knee brace without a patellar hole presented more favorable results than those who wore a knee brace with a patellar hole: a 1.6-point reduction was found versus 1.1 points in the VAS, the patients presented 0.7 s less time versus 0.4 s in the TUG, and the speed was reduced by 1.4 s versus 0.8 s in the 8MWT. Therefore, the knee brace without a patellar hole presented more favorable results when compared with the knee brace with a patellar hole.

Temporal analysis of the spontaneous baroreceptor reflex during mild emotional stress in the rat.

PubMed

Bajić, Dragana; Loncar-Turukalo, Tatjana; Stojicić, Sonja; Sarenac, Olivera; Bojić, Tijana; Murphy, David; Paton, Julian F R; Japundzić-Zigon, Nina

2010-03-01

The effect of emotional stress on the spontaneous baroreceptor reflex (sBRR) in freely moving rats was investigated. Six male Wistar rats equipped with an intra-arterial polyethylene catheter were exposed to a 2-min air-jet stress. For time course analysis of the sBRR response to stress, the records of systolic blood pressure (SBP) and pulse interval (PI) were divided into five regions: baseline (BASELINE), acute exposure to air-jet stress (STRESS), immediate recovery (IMMED. RECOVERY), remaining recovery (RECOVERY), and delayed response (DELAYED RESPONSE). In addition to sBRR sensitivity and effectiveness, we introduce the sequence coverage area and its median for evaluation of the sBRR operating range and set point. During exposure to STRESS and IMMED. RECOVERY, sBRR sensitivity was preserved, its effectiveness was decreased, its operating range was enlarged, and the set point was shifted towards higher SBP and lower PI values. According to the joint symbolic dynamics analysis, the SBP and PI relationship became less predictable hence more prone to respond to stress. In RECOVERY the parameters regained baseline values and DELAYED RESPONSE occurred during which re-setting of sBRR was noted. It follows that emotional stress modulates sBRR differentially during the time course of stress and recovery, affecting both linearity and unpredictability of the BP and PI relationship.

Using single-case experimental design methodology to evaluate the effects of the ABC method for nursing staff on verbal aggressive behaviour after acquired brain injury.

PubMed

Winkens, Ieke; Ponds, Rudolf; Pouwels, Climmy; Eilander, Henk; van Heugten, Caroline

2014-01-01

The ABC method is a basic and simplified form of behavioural modification therapy for use by nurses. ABC refers to the identification of Antecedent events, target Behaviours, and Consequent events. A single-case experimental AB design was used to evaluate the effects of the ABC method on a woman diagnosed with olivo-ponto-cerebellar ataxia. Target behaviour was verbal aggressive behaviour during ADL care, assessed at 9 time points immediately before implementation of the ABC method and at 36 time points after implementation. A randomisation test showed a significant treatment effect between the baseline and intervention phases (t = .58, p = .03; ES [Nonoverlap All Pairs] = .62). Visual analysis, however, showed that the target behaviour was still present after implementation of the method and that on some days the nurses even judged the behaviour to be more severe than at baseline. Although the target behaviour was still present after treatment, the ABC method seems to be a promising tool for decreasing problem behaviour in patients with acquired brain injury. It is worth investigating the effects of this method in future studies. When interpreting single-subject data, both visual inspection and statistical analysis are needed to determine whether treatment is effective and whether the effects lead to clinically desirable results.

Formation of cortical plasticity in older adults following tDCS and motor training

PubMed Central

Goodwill, Alicia M.; Reynolds, John; Daly, Robin M.; Kidgell, Dawson J.

2013-01-01

Neurodegeneration accompanies the process of natural aging, reducing the ability to perform functional daily activities. Transcranial direct current stimulation (tDCS) alters neuronal excitability and motor performance; however its beneficial effect on the induction of primary motor cortex (M1) plasticity in older adults is unclear. Moreover, little is known as to whether the tDCS electrode arrangement differentially affects M1 plasticity and motor performance in this population. In a double-blinded, cross-over trial, we compared unilateral, bilateral and sham tDCS combined with visuomotor tracking, on M1 plasticity and motor performance of the non-dominant upper limb, immediately post and 30 min following stimulation. We found (a) unilateral and bilateral tDCS decreased tracking error by 12–22% at both time points; with sham decreasing tracking error by 10% at 30 min only, (b) at both time points, motor evoked potentials (MEPs) were facilitated (38–54%) and short-interval intracortical inhibition was released (21–36%) for unilateral and bilateral conditions relative to sham, (c) there were no differences between unilateral and bilateral conditions for any measure. These findings suggest that tDCS modulated elements of M1 plasticity, which improved motor performance irrespective of the electrode arrangement. The results provide preliminary evidence indicating that tDCS is a safe non-invasive tool to preserve or improve neurological function and motor control in older adults. PMID:24367333

White-crowned sparrow males show immediate flexibility in song amplitude but not in song minimum frequency in response to changes in noise levels in the field.

PubMed

Derryberry, Elizabeth P; Gentry, Katherine; Derryberry, Graham E; Phillips, Jennifer N; Danner, Raymond M; Danner, Julie E; Luther, David A

2017-07-01

The soundscape acts as a selective agent on organisms that use acoustic signals to communicate. A number of studies document variation in structure, amplitude, or timing of signal production in correspondence with environmental noise levels thus supporting the hypothesis that organisms are changing their signaling behaviors to avoid masking. The time scale at which organisms respond is of particular interest. Signal structure may evolve across generations through processes such as cultural or genetic transmission. Individuals may also change their behavior during development (ontogenetic change) or in real time (i.e., immediate flexibility). These are not mutually exclusive mechanisms, and all must be investigated to understand how organisms respond to selection pressures from the soundscape. Previous work on white-crowned sparrows ( Zonotrichia leucophrys ) found that males holding territories in louder areas tend to sing higher frequency songs and that both noise levels and song frequency have increased over time (30 years) in urban areas. These previous findings suggest that songs are changing across generations; however, it is not known if this species also exhibits immediate flexibility. Here, we conducted an exploratory, observational study to ask whether males change the minimum frequency of their song in response to immediate changes in noise levels. We also ask whether males sing louder, as increased minimum frequency may be physiologically linked to producing sound at higher amplitudes, in response to immediate changes in environmental noise. We found that territorial males adjust song amplitude but not minimum frequency in response to changes in environmental noise levels. Our results suggest that males do not show immediate flexibility in song minimum frequency, although experimental manipulations are needed to test this hypothesis further. Our work highlights the need to investigate multiple mechanisms of adaptive response to soundscapes.

The immediate effect of long-distance running on T2 and T2* relaxation times of articular cartilage of the knee in young healthy adults at 3.0 T MR imaging

PubMed Central

Welsch, Goetz H; Laqmani, Azien; Henes, Frank O; Kaul, Michael G; Schoen, Gerhard; Adam, Gerhard; Regier, Marc

2016-01-01

Objective: To quantitatively assess the immediate effect of long-distance running on T2 and T2* relaxation times of the articular cartilage of the knee at 3.0 T in young healthy adults. Methods: 30 healthy male adults (18–31 years) who perform sports at an amateur level underwent an initial MRI at 3.0 T with T2 weighted [16 echo times (TEs): 9.7–154.6 ms] and T2* weighted (24 TEs: 4.6–53.6 ms) relaxation measurements. Thereafter, all participants performed a 45-min run. After the run, all individuals were immediately re-examined. Data sets were post-processed using dedicated software (ImageJ; National Institute of Health, Bethesda, MD). 22 regions of interest were manually drawn in segmented areas of the femoral, tibial and patellar cartilage. For statistical evaluation, Pearson product–moment correlation coefficients and confidence intervals were computed. Results: Mean initial values were 35.7 ms for T2 and 25.1 ms for T2*. After the run, a significant decrease in the mean T2 and T2* relaxation times was observed for all segments in all participants. A mean decrease of relaxation time was observed for T2 with 4.6 ms (±3.6 ms) and for T2* with 3.6 ms (±5.1 ms) after running. Conclusion: A significant decrease could be observed in all cartilage segments for both biomarkers. Both quantitative techniques, T2 and T2*, seem to be valuable parameters in the evaluation of immediate changes in the cartilage ultrastructure after running. Advances in knowledge: This is the first direct comparison of immediate changes in T2 and T2* relaxation times after running in healthy adults. PMID:27336705

The immediate effect of long-distance running on T2 and T2* relaxation times of articular cartilage of the knee in young healthy adults at 3.0 T MR imaging.

PubMed

Behzadi, Cyrus; Welsch, Goetz H; Laqmani, Azien; Henes, Frank O; Kaul, Michael G; Schoen, Gerhard; Adam, Gerhard; Regier, Marc

2016-08-01

To quantitatively assess the immediate effect of long-distance running on T2 and T2* relaxation times of the articular cartilage of the knee at 3.0 T in young healthy adults. 30 healthy male adults (18-31 years) who perform sports at an amateur level underwent an initial MRI at 3.0 T with T2 weighted [16 echo times (TEs): 9.7-154.6 ms] and T2* weighted (24 TEs: 4.6-53.6 ms) relaxation measurements. Thereafter, all participants performed a 45-min run. After the run, all individuals were immediately re-examined. Data sets were post-processed using dedicated software (ImageJ; National Institute of Health, Bethesda, MD). 22 regions of interest were manually drawn in segmented areas of the femoral, tibial and patellar cartilage. For statistical evaluation, Pearson product-moment correlation coefficients and confidence intervals were computed. Mean initial values were 35.7 ms for T2 and 25.1 ms for T2*. After the run, a significant decrease in the mean T2 and T2* relaxation times was observed for all segments in all participants. A mean decrease of relaxation time was observed for T2 with 4.6 ms (±3.6 ms) and for T2* with 3.6 ms (±5.1 ms) after running. A significant decrease could be observed in all cartilage segments for both biomarkers. Both quantitative techniques, T2 and T2*, seem to be valuable parameters in the evaluation of immediate changes in the cartilage ultrastructure after running. This is the first direct comparison of immediate changes in T2 and T2* relaxation times after running in healthy adults.

Combustion of bulk titanium in oxygen

NASA Technical Reports Server (NTRS)

Clark, A. F.; Moulder, J. C.; Runyan, C. C.

1975-01-01

The combustion of bulk titanium in one atmosphere oxygen is studied using laser ignition and several analytical techniques. These were high-speed color cinematography, time and space resolved spectra in the visible region, metallography (including SEM) of specimens quenched in argon gas, X-ray and chemical product analyses, and a new optical technique, the Hilbert transform method. The cinematographic application of this technique for visualizing phase objects in the combustion zone is described. The results indicate an initial vapor phase reaction immediately adjacent to the molten surface but as the oxygen uptake progresses the evaporation approaches the point of congruency and a much reduced evaporation rate. This and the accumulation of the various soluble oxides soon drive the reaction zone below the surface where gas formation causes boiling and ejection of particles. The buildup of rutile cuts off the oxygen supply and the reaction ceases.

Interactive Tools to Access the HELCATS Catalogues

NASA Astrophysics Data System (ADS)

Rouillard, Alexis; Plotnikov, Illya; Pinto, Rui; Génot, Vincent; Bouchemit, Myriam; Davies, Jackie

2017-04-01

The propagation tool is a web-based interface written in java that allows users to propagate Coronal Mass Ejections (CMEs), Corotating Interaction Regions (CIRs) and Solar Energetic Particles (SEPs) in the inner heliosphere. The tool displays unique datasets and catalogues through a 2-D visualisation of the trajectories of these heliospheric structures in relation to the orbital position of probes/planets and the pointing direction and extent of different imaging instruments. Summary plots of in-situ data or images of the solar corona and planetary aurorae stored at the CDPP, MEDOC and APIS databases, respectively, can be used to verify the presence of heliospheric structures at the estimated launch or impact times. A great novelty of the tool is the immediate visualisation of J-maps and the possibility to superpose on these maps the HELCATS CME and CIR catalogues.

Interactive Tools to Access the HELCATS Catalogues

NASA Astrophysics Data System (ADS)

Rouillard, A.; Génot, V.; Bouchemit, M.; Pinto, R.

2017-09-01

The propagation tool is a web-based interface written in java that allows users to propagate Coronal Mass Ejections (CMEs), Corotating Interaction Regions (CIRs) and Solar Energetic Particles (SEPs) in the inner heliosphere. The tool displays unique datasets and catalogues through a 2-D visualisation of the trajectories of these heliospheric structures in relation to the orbital position of probes/planets and the pointing direction and extent of different imaging instruments. Summary plots of in-situ data or images of the solar corona and planetary aurorae stored at the CDPP, MEDOC and APIS databases, respectively, can be used to verify the presence of heliospheric structures at the estimated launch or impact times. A great novelty of the tool is the immediate visualisation of J-maps and the possibility to superpose on these maps the HELCATS CME and CIR catalogues.

Venetian Rule and Control of Plague Epidemics on the Ionian Islands during 17th and 18th Centuries

PubMed Central

Konstantinidou, Katerina; Mantadakis, Elpis; Sardi, Thalia; Samonis, George

2009-01-01

During the 17th and 18th centuries, measures were taken by the Venetian administration to combat plague on the Ionian Islands. At that time, although the scientific basis of plague was unknown, the Venetians recognized its infectious nature and successfully decreased its spread by implementing an information network. Additionally, by activating a system of inspection that involved establishing garrisons along the coasts, the Venetians were able to control all local movements in plague-infested areas, which were immediately isolated. In contrast, the neighboring coast of mainland Greece, which was under Ottoman rule, was a plague-endemic area during the same period. We conclude that even in the absence of scientific knowledge, close observation and social and political measures can effectively restrain infectious outbreaks to the point of disappearance. PMID:19116047

Venetian rule and control of plague epidemics on the Ionian Islands during 17th and 18th centuries.

PubMed

Konstantinidou, Katerina; Mantadakis, Elpis; Falagas, Matthew E; Sardi, Thalia; Samonis, George

2009-01-01

During the 17th and 18th centuries, measures were taken by the Venetian administration to combat plague on the Ionian Islands. At that time, although the scientific basis of plague was unknown, the Venetians recognized its infectious nature and successfully decreased its spread by implementing an information network. Additionally, by activating a system of inspection that involved establishing garrisons along the coasts, the Venetians were able to control all local movements in plague-infested areas, which were immediately isolated. In contrast, the neighboring coast of mainland Greece, which was under Ottoman rule, was a plague-endemic area during the same period. We conclude that even in the absence of scientific knowledge, close observation and social and political measures can effectively restrain infectious outbreaks to the point of disappearance.