Oculomotor Deficits after Chemotherapy in Childhood

PubMed Central

Einarsson, Einar-Jón; Patel, Mitesh; Petersen, Hannes; Wiebe, Thomas; Magnusson, Måns; Moëll, Christian; Fransson, Per-Anders

2016-01-01

Advances in the diagnosis and treatment of pediatric malignancies have substantially increased the number of childhood cancer survivors. However, reports suggest that some of the chemotherapy agents used for treatment can cross the blood brain barrier which may lead to a host of neurological symptoms including oculomotor dysfunction. Whether chemotherapy at young age causes oculomotor dysfunction later in life is unknown. Oculomotor performance was assessed with traditional and novel methods in 23 adults (mean age 25.3 years, treatment age 10.2 years) treated with chemotherapy for a solid malignant tumor not affecting the central nervous system. Their results were compared to those from 25 healthy, age-matched controls (mean age 25.1 years). Correlation analysis was performed between the subjective symptoms reported by the chemotherapy treated subjects (CTS) and oculomotor performance. In CTS, the temporal control of the smooth pursuit velocity (velocity accuracy) was markedly poorer (p<0.001) and the saccades had disproportionally shorter amplitude than normal for the associated saccade peak velocity (main sequence) (p = 0.004), whereas smooth pursuit and saccade onset times were shorter (p = 0.004) in CTS compared with controls. The CTS treated before 12 years of age manifested more severe oculomotor deficits. CTS frequently reported subjective symptoms of visual disturbances (70%), unsteadiness, light-headedness and that things around them were spinning or moving (87%). Several subjective symptoms were significantly related to deficits in oculomotor performance. To conclude, chemotherapy in childhood or adolescence can result in severe oculomotor dysfunctions in adulthood. The revealed oculomotor dysfunctions were significantly related to the subjects’ self-perception of visual disturbances, dizziness, light-headedness and sensing unsteadiness. Assessments of oculomotor function may, thus, offer an objective method to track and rate the level of neurological complications following chemotherapy. PMID:26815789

Could what that ESCO sales rep said really be true? Savings realization rates in ESPC versus bid-to-spec projects

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

Coleman, Philip; Earni, Shankar; Williams, Charles

2014-08-11

Claims that savings realization is greater in energy savings performance contracts (ESPCs) are rampant at least among energy service company representatives and other ESPC cheerleaders. But hard supporting evidence for these claims has been virtually non-existent. The Department of Energy's Federal Energy Management Program uses its Compliance Tracking System (CTS) database to document the performance of federal buildings and projects towards meeting various federal energy-saving goals. This paper focuses on preliminary analysis from CTS to understand and compare the performance of federal ESPCs with projects that have been implemented with more conventional government appropriations funding. The authors have found preliminarymore » evidence using CTS that shows markedly higher savings realization rates among ESPC projects than appropriations-funded ones. There are numerous caveats to the data comparison that clamor for further study, but the difference is still intriguing. If borne out, this finding will provide concrete support to the idea that ESPCs guarantees and measurement and verification, long touted by energy service companies (ESCOs) as offering savings assurance, may truly yield substantial benefits. If ESPCs actually do perform better (i.e., have higher realization rates and savings persistence) than conventional bid-to-spec projects, the perceived premium for conducting them may look like a very good deal after all.« less

Misreporting behaviour in iterated prisoner's dilemma game with combined trust strategy

NASA Astrophysics Data System (ADS)

Chen, Bo; Zhang, Bin; Wu, Hua-qing

2015-01-01

Effects of agents' misreporting behaviour on system cooperation are studied in a multi-agent iterated prisoner's dilemma game. Agents, adopting combined trust strategy (denoted by CTS) are classified into three groups, i.e., honest CTS, positive-reporting CTS and negative-reporting CTS. The differences of cooperation frequency and pay-off under three different systems, i.e., system only with honest CTS, system with honest CTS and positive-reporting CTS and system with honest CTS and negative-reporting CTS, are compared. Furthermore, we also investigate the effects of misreporting behaviour on an exploiter who adopts an exploiting strategy (denoted by EXPL) in a system with two CTSs and one EXPL. At last, numerical simulations are performed for understanding the effects of misreporting behaviour on CTS. The results reveal that positive-reporting behaviour can strengthen system cooperation, while negative-reporting behaviour cannot. When EXPL exists in a system, positive-reporting behaviour helps the exploiter in reducing its exploiting cost and encourages agents to adopt exploiting strategy, but hurts other agents' interests.

Promising Practices in CTS.

ERIC Educational Resources Information Center

Alberta Dept. of Education, Edmonton. Curriculum Standards Branch.

This document contains 85 articles taken from previously published issues of the "CTS Communication Network Update," a publication about the career and technology studies (CTS) program of career education designed for Alberta, Canada, high school juniors and seniors. Following an introductory section and a section on general CTS, the…

Carpal tunnel syndrome among laboratory technicians in relation to personal and ergonomic factors at work.

PubMed

El-Helaly, Mohamed; Balkhy, Hanan H; Vallenius, Laura

2017-11-25

Work-related carpal tunnel syndrome (CTS) has been reported in different occupations, including laboratory technicians, so this study was carried out to determine the prevalence and the associated personal and ergonomic factors for CTS among laboratory technicians. A cross-sectional study was conducted among 279 laboratory technicians at King Fahd Hospital, Saudi Arabia, who filled in a self-administered questionnaire, including questions regarding their demographic criteria, occupational history, job tasks, workplace tools, ergonomic factors at work, and symptoms suggestive of CTS. Physical examinations and electrodiagnostic studies were carried out for those who had symptoms suggestive of CTS to confirm the diagnosis. Univariate and multivariate analysis were performed for both personal and physical factors in association with confirmed CTS among laboratory technicians. The prevalence of CTS among the laboratory technicians was 9.7% (27/279). The following were the statistically significant risk factors for CTS among them: gender (all cases of CTS were female, P=0.00), arm/hand exertion (OR: 7.96; 95% CI: 1.84-34.33), pipetting (OR: 7.27; 95% CI: 3.15-16.78), repetitive tasks (OR: 4.60; 95% CI: 1.39-15.70), using unadjustable chairs or desks (OR: 3.35; 95% CI: 1.23-9.15), and working with a biosafety cabinet (OR: 2.49; 95% CI: 1.11-5.59). CTS cases had significant longer work duration (17.9 ± 5.6 years) than CTS non-case (11.5 ± 7.4 yeas) with low OR (1.108). This study demonstrates some personal and ergonomic factors associated with CTS among the laboratory technicians, including female gender, arm/hand exertion, pipetting, repetitive tasks, working with a biosafety cabinet, and an unadjusted workstation.

Carpal tunnel syndrome among laboratory technicians in relation to personal and ergonomic factors at work

PubMed Central

El-Helaly, Mohamed; Balkhy, Hanan H.; Vallenius, Laura

2017-01-01

Objectives: Work-related carpal tunnel syndrome (CTS) has been reported in different occupations, including laboratory technicians, so this study was carried out to determine the prevalence and the associated personal and ergonomic factors for CTS among laboratory technicians. Methods: A cross-sectional study was conducted among 279 laboratory technicians at King Fahd Hospital, Saudi Arabia, who filled in a self-administered questionnaire, including questions regarding their demographic criteria, occupational history, job tasks, workplace tools, ergonomic factors at work, and symptoms suggestive of CTS. Physical examinations and electrodiagnostic studies were carried out for those who had symptoms suggestive of CTS to confirm the diagnosis. Univariate and multivariate analysis were performed for both personal and physical factors in association with confirmed CTS among laboratory technicians. Results: The prevalence of CTS among the laboratory technicians was 9.7% (27/279). The following were the statistically significant risk factors for CTS among them: gender (all cases of CTS were female, P=0.00), arm/hand exertion (OR: 7.96; 95% CI: 1.84-34.33), pipetting (OR: 7.27; 95% CI: 3.15-16.78), repetitive tasks (OR: 4.60; 95% CI: 1.39-15.70), using unadjustable chairs or desks (OR: 3.35; 95% CI: 1.23-9.15), and working with a biosafety cabinet (OR: 2.49; 95% CI: 1.11-5.59). CTS cases had significant longer work duration (17.9 ± 5.6 years) than CTS non-case (11.5 ± 7.4 yeas) with low OR (1.108). Conclusion: This study demonstrates some personal and ergonomic factors associated with CTS among the laboratory technicians, including female gender, arm/hand exertion, pipetting, repetitive tasks, working with a biosafety cabinet, and an unadjusted workstation. PMID:28855446

Associations Between Body Anthropometric Measures and Severity of Carpal Tunnel Syndrome.

PubMed

Mondelli, Mauro; Curti, Stefania; Mattioli, Stefano; Aretini, Alessandro; Ginanneschi, Federica; Greco, Giuseppe; Farioli, Andrea

2016-09-01

To assess the associations between carpal tunnel syndrome (CTS) severity and selected anthropometric and obesity indexes. We performed a case-control study. Clinical and electrophysiological severity of CTS was classified as mild, moderate, or severe based on validated scales. Body and hand anthropometric characteristics were measured at the time of the electrodiagnostic study. We estimated the relative risk ratios (RRRs) of CTS severity by fitting multinomial logistic regression models adjusted by age and sex. In addition, we fitted multivariable models, including age, sex, wrist ratio, hand ratio, body mass index (BMI), and waist/stature ratio. Electromyography laboratories. Consecutive patients (N=1087), those with CTS (n=340) and those without CTS (n=747), were enrolled. Not applicable. Associations between CTS severity and selected anthropometric and obesity indexes. We observed associations between many anthropometric indexes and CTS severity. Among obesity indexes, the waist/stature ratio, and among hand anthropometric indexes, the wrist/palm ratio, showed the highest RRRs for the clinical and electrophysiological severity scales. The RRRs of severe CTS (adjusted for age and sex) for the wrist/palm ratio were 3.5 for the clinical scale and 2.4 for the electrophysiological scale. The RRRs of severe CTS for the waist/stature ratio were 2.3 for the clinical scale and 2.0 for the electrophysiological scale. In the multivariable models, both BMI and the waist/stature ratio were associated with the outcomes. Different configurations of the body and, in particular, the hand and wrist system may influence the occurrence and severity of CTS. Multiple obesity indexes, possibly including the waist/stature ratio, should be considered when investigating the association between body composition and CTS. Future studies should determine whether in obese subjects with CTS the weight and waist circumference loss produces an improvement in CTS symptoms and recovery of distal conduction velocity of the median nerve. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

The impact of cash transfers on social determinants of health and health inequalities in sub-Saharan Africa: a systematic review.

PubMed

Owusu-Addo, Ebenezer; Renzaho, Andre M N; Smith, Ben J

2018-06-01

Cash transfers (CTs) are now high on the agenda of most governments in low- and middle-income countries. Within the field of health promotion, CTs constitute a healthy public policy initiative as they have the potential to address the social determinants of health (SDoH) and health inequalities. A systematic review was conducted to synthesise the evidence on CTs' impacts on SDoH and health inequalities in sub-Saharan Africa, and to identify the barriers and facilitators of effective CTs. Twenty-one electronic databases and the websites of 14 key organizations were searched in addition to grey literature and hand searching of selected journals for quantitative and qualitative studies on CTs' impacts on SDoH and health outcomes. Out of 182 full texts screened for eligibility, 79 reports that reported findings from 53 studies were included in the final review. The studies were undertaken within 24 CTs comprising 11 unconditional CTs (UCTs), 8 conditional CTs (CCTs) and 5 combined UCTs and CCTs. The review found that CTs can be effective in tackling structural determinants of health such as financial poverty, education, household resilience, child labour, social capital and social cohesion, civic participation, and birth registration. The review further found that CTs modify intermediate determinants such as nutrition, dietary diversity, child deprivation, sexual risk behaviours, teen pregnancy and early marriage. In conjunction with their influence on SDoH, there is moderate evidence from the review that CTs impact on health and quality of life outcomes. The review also found many factors relating to intervention design features, macro-economic stability, household dynamics and community acceptance of programs that could influence the effectiveness of CTs. The external validity of the review findings is strong as the findings are largely consistent with those from Latin America. The findings thus provide useful insights to policy makers and managers and can be used to optimise CTs to reduce health inequalities.

Chitosan /Zeolite Y/Nano ZrO2 nanocomposite as an adsorbent for the removal of nitrate from the aqueous solution.

PubMed

Teimouri, Abbas; Nasab, Shima Ghanavati; Vahdatpoor, Niaz; Habibollahi, Saeed; Salavati, Hossein; Chermahini, Alireza Najafi

2016-12-01

In the present study, a series of chitosan/Zeolite Y/Nano Zirconium oxide (CTS/ZY/Nano ZrO 2 ) nanocomposites were made by controlling the molar ratio of chitosan (CTS) to Zeolite Y/Nano Zirconium oxide in order to remove nitrate (NO 3 - ) ions in the aqueous solution. The nanocomposite adsorbents were characterized by XRD, FTIR, BET, SEM and TEM. The influence of different molar ratios of CTS to ZY/Nano ZrO 2 , the initial pH value of the nitrate solution, contact time, temperature, the initial concentration of nitrate and adsorbent dose was studied. The adsorption isotherms and kinetics were also analyzed. It was attempted to describe the sorption processes by the Langmuir equation and the theoretical adsorption capacity (Q 0 ) was found to be 23.58mg nitrate per g of the adsorbent. The optimal conditions for nitrate removal were found to be: molar ratio of CTS/ZY/Nano ZrO 2 : 5:1; pH: 3; 0.02g of adsorbent and temperature: 35°C, for 60min. The adsorption capacities of CTS, ZY, Nano ZrO 2 , CTS/Nano ZrO 2 , CTS/ZY and CTS/ZY/Nano ZrO 2 nanocomposites for nitrate removal were compared, showing that the adsorption ability of CTS/ZY/Nano ZrO 2 nanocomposite was higher than the average values of those of CTS (1.95mg/g for nitrate removal), ZY, Nano ZrO 2 , CTS/Nano ZrO 2, and CTS/ZY. Copyright © 2016. Published by Elsevier B.V.

Isolation, activity and immunological characterisation of a secreted aspartic protease, CtsD, from Aspergillus fumigatus.

PubMed

Vickers, Imelda; Reeves, Emer P; Kavanagh, Kevin A; Doyle, Sean

2007-05-01

Aspergillus fumigatus is an opportunistic fungal pathogen that infects immunocompromised patients. A putative aspartic protease gene (ctsD; 1425 bp; intron-free) was identified and cloned. CtsD is evolutionarily distinct from all previously identified A. fumigatus aspartic proteases. Recombinant CtsD was expressed in inclusion bodies in Escherichia coli (0.2mg/g cells) and subjected to extensive proteolysis in the baculovirus expression system. Activation studies performed on purified, refolded, recombinant CtsD resulted in protease activation with a pH(opt)4.0 and specific activity=10 U/mg. Pepstatin A also inhibited recombinant CtsD activity by up to 72% thereby confirming classification as an aspartic protease. Native CtsD was also immunologically identified in culture supernatants and purified from fungal cultures using pepstatin-agarose affinity chromatography (7.8 microg CtsD/g mycelia). In A. fumigatus, semi-quantitative RT-PCR analysis revealed expression of ctsD in minimal and proteinaceous media only. Expression of ctsD was absent under nutrient-rich conditions. Expression of ctsD was also detected, in vivo, in the Galleria mellonella virulence model following A. fumigatus infection.

Resonance Rayleigh scattering method for highly sensitive detection of chitosan using aniline blue as probe

NASA Astrophysics Data System (ADS)

Zhang, Weiai; Ma, Caijuan; Su, Zhengquan; Bai, Yan

2016-11-01

This paper describes a highly sensitive and accurate approach using aniline blue (AB) (water soluble) as a probe to determine chitosan (CTS) through Resonance Rayleigh scattering (RRS). Under optimum experimental conditions, the intensities of RRS were linearly proportional to the concentration of CTS in the range from 0.01 to 3.5 μg/mL, and the limit of detection (LOD) was 6.94 ng/mL. Therefore, a new and highly sensitive method based on RRS for the determination of CTS has been developed. Furthermore, the effect of molecular weight of CTS and the effect of the degree of deacetylation of CTS on the accurate quantification of CTS was studied. The experimental data was analyzed by linear regression analysis, which indicated that the molecular weight and the degree of deacetylation of CTS had no statistical significance and this method could be used to determine CTS accurately. Meanwhile, this assay was applied for CTS determination in health products with satisfactory results.

Employees' Knowledge of Carpal Tunnel Syndrome.

ERIC Educational Resources Information Center

Gandy-Goldston, Terrie M.

A study examined employees' knowledge of the causes of carpal tunnel syndrome (CTS), its prevention, and their legal rights after being diagnosed with CTS. A 24-item questionnaire was administered to a random sample of 30 Chicago-area employees who had been afflicted with CTS. Of those surveyed, 99% considered their CTS injury related to their…

Preparation and characterization of the graft copolymer of chitosan with poly[rosin-(2-acryloyloxy)ethyl ester].

PubMed

Duan, Wengui; Chen, Chunhong; Jiang, Linbin; Li, Guang Hua

2008-09-05

Graft copolymerization of rosin-(2-acryloyloxy)ethyl ester (RAEE) onto chitosan (Cts) was carried out under microwave irradiation using potassium persulfate as an initiator. The structures, morphology, and thermal properties of the Cts graft copolymer (Cts-g-PRAEE) were characterized by means of FT-IR, XRD, SEM, and TG. Also, Cts and Cts-g-PRAEE copolymer were used as carriers of fenoprofen calcium (FC), and their controlled release behavior in artificial intestinal juice were studied. The results show that the rate of release of fenoprofen calcium from the carrier of Cts-g-PRAEE copolymer becomes very slower than that of Cts in artificial intestinal juice. Copyright © 2008. Published by Elsevier Ltd.

Prevalence, incidence and risk factors of carpal tunnel syndrome in a large footwear factory.

PubMed

Roquelaure, Y; Mariel, J; Dano, C; Fanello, S; Penneau-Fontbonne, D

2001-01-01

The study was conducted to assess the prevalence and incidence of carpal tunnel syndrome (CTS) in a large modern footwear factory and to identify factors predictive of CTS. To this end, 199 workers were examined in 1996, and 162 of them were re-examined in 1997. Ergonomic and psychosocial risk factors of CTS were assessed by workpost analysis and self-administered questionnaire. The prevalence of CTS at baseline in 1996 and in 1997 was 16.6% (95%CI: 11.4-21.7) and 11.7% (95%CI: 6.7-16.8), respectively. The incidence rate of CTS in 1997 was 11.7% (95%CI: 6.7-7.8). No specific type of job performance was associated with CTS. Obesity (OR = 4.4; 95%CI: 1.1-17.1) and psychological distress at baseline (OR = 4.3; 95%CI: 1.0-18.6) were strongly predictive of CTS. Rapid trigger movements of the fingers were also predictive of CTS (OR = 3.8; 95%CI: 1.0-17.2). A strict control of thework by superiors was negatively associatedwith CTS (OR = 0.5; 95%CI: 0.2-1.3). The prevalence and incidence of CTS in this workforce were largely higher than in the general population and numerous industries. The study highlights the role of psychological distress in workers exposed to a high level of physical exposure and psychological demand.

Carpal tunnel syndrome and prediabetes: is there a true association?

PubMed

Sousa Vasconcelos, José Tupinambá; Freitas Paiva, Ângela Maria; Cavalcanti, Mauro Furtado; de Carvalho, Jozélio Freire; Bonfá, Eloisa; Borba, Eduardo Ferreira

2015-10-01

Carpal tunnel syndrome (CTS) is probably associated with diabetes mellitus, but its link to prediabetes (PD) is unknown. To determine prevalence of PD and others risk factors in CTS. A cross-sectional study including 115 idiopathic CTS patients and 115 age-, gender-and body mass index (BMI)-matched controls was performed. Clinical, laboratory and neurophysiological evaluations were conducted in all subjects to confirm CTS diagnosis. CTS severity was graded on a standardized neurophysiological scale. PD was defined using strict criteria. The prevalence of PD was similar in CTS and control groups (27% vs. 21.7%, respectively P=0.44). Nocturnal symptoms (91.3%) and moderate CTS (58.3%) were most frequently observed in CTS patients. In logistic regression analysis, PD was significantly correlated with age (odds ratio [OR] 1.05, 95% confidence interval [CI] 1.01-1.09; P=0.006) and BMI (OR 1.08. 95% CI 1.01-1.16; P=0.026), but not with CTS (OR 0.82, 95% CI 0.43-1.53; P=0.537). CTS patients with PD had a significantly higher mean age compared to those without PD (53.8±10.2 vs. 49.5±8.6 years, respectively P=0.027). The frequency of age >60 years was significantly higher in CTS with PD than in CTS without PD (29.0% vs. 8.3%, respectively P=0.04) as was BMI >30kg/m(2) (64.5% vs. 33.3%, respectively P=0.03). No significant differences were observed between the two CTS groups with respect to gender, BMI, symptoms, and neurophysiological severity of CTS. Our findings indicated that CTS is not associated with PD, but that PD is closely linked to age and overweight. Copyright © 2015 Elsevier B.V. All rights reserved.

Individual risk factors for carpal tunnel syndrome: an evaluation of body mass index, wrist index and hand anthropometric measurements.

PubMed

Boz, Cavit; Ozmenoglu, Mehmet; Altunayoglu, Vildan; Velioglu, Sibel; Alioglu, Zekeriya

2004-09-01

In this study we aimed to identify the role of the body mass index (BMI), wrist index and hand anthropometric measures as risk factors for carpal tunnel syndrome (CTS) in both genders. Based on clinical and electrophysiologic diagnostic criteria, 154 female and 44 male CTS patients, as well as 150 female and 44 male age-matched control subjects, were selected. BMI, wrist index, hand shape index, digit index and hand length/height ratio were compared between the CTS patients and the control subjects for each gender separately. Mean BMI was found to be a significant risk factor for CTS in both genders. The wrist index was found to be higher in female (P < 0.001) and in male (P = 0.034) CTS groups than in the respective control groups. Logistic regression analysis revealed the wrist index to be an independent risk factor in females, but not in males. Shape and digit indices were significantly higher in female CTS patients than in corresponding control subjects, and regression analysis showed the shape and digit indices to be independent risk factors for CTS. In the male CTS group, the shape and digit indices did not significantly differ from their controls. Differences in the hand length/height ratio were not statistically significant in female and male CTS patients compared to their controls and it was not found to be an independent risk factor for CTS. Our study confirmed BMI as an independent risk factor for CTS in both genders. Hand and wrist anthropometrics were found to be independent risk factors for CTS in females, but not in males.

[Etiological factors for developing carpal tunnel syndrome in people who work with computers].

PubMed

Lewańska, Magdalena; Wagrowska-Koski, Ewa; Walusiak-Skorupa, Jolanta

2013-01-01

Carpal tunnel syndrome (CTS) is the most frequent mononeuropathy of upper extremities. From the early 1990's it has been suggested that intensive work with computers can result in CTS development, however, this relationship has not as yet been proved. The aim of the study was to evaluate occupational and non-occupational risk factors for developing CTS in the population of computer-users. The study group comprised 60 patients (58 women and 2 men; mean age: 53.8 +/- 6.35 years) working with computers and suspected of occupational CTS. A survey as well as both median and ulnar nerve conduction examination (NCS) were performed in all the subjects. The patients worked with use of computer for 6.43 +/- 1.71 h per day. The mean latency between the beginning of employment and the occurrence of first CTS symptoms was 12.09 +/- 5.94 years. All patients met the clinical and electrophysiological diagnostic criteria of CTS. In the majority of patients etiological factors for developing CTS were non-occupational: obesity, hypothyroidism, oophorectomy, past hysterectomy, hormonal replacement therapy or oral contraceptives, recent menopause, diabetes, tendovaginitis. In 7 computer-users etiological factors were not identified. The results of our study show that CTS is usually generated by different causes not related with using computers at work.

Neuromuscular ultrasound in patients with carpal tunnel syndrome and normal nerve conduction studies.

PubMed

Aseem, Fazila; Williams, Jessica W; Walker, Francis O; Cartwright, Michael S

2017-06-01

Nerve conduction studies (NCS) are sensitive for carpal tunnel syndrome (CTS), but a small proportion of patients with clinical CTS have normal NCS. This retrospective study was designed to assess the neuromuscular ultrasound findings in a group of CTS patients. The electronic medical record was reviewed by a neurologist to identify patients who had a diagnosis of CTS with normal NCS, including either mixed median-ulnar comparison or transcarpal sensory studies, and complete neuromuscular ultrasound evaluation for CTS. Fourteen individuals (22 wrists) met all criteria. A total of 92.3% had median nerve cross-sectional area enlargement at the wrist (mean 16.3 mm 2 ), 100% had increased wrist-to-forearm median nerve area ratio (mean 2.4), 82.4% had decreased median nerve echogenicity, 75.0% had decreased median nerve mobility, and 7.1% had increased median nerve vascularity. A large proportion of patients with clinical CTS but normal NCS have abnormal neuromuscular ultrasound findings. Muscle Nerve 55: 913-915, 2017. © 2016 Wiley Periodicals, Inc.

Evaluation of Radiographic Instability of the Trapeziometacarpal Joint in Women With Carpal Tunnel Syndrome.

PubMed

Kim, Jeong Hwan; Gong, Hyun Sik; Kim, Youn Ho; Rhee, Seung Hwan; Kim, Jihyoung; Baek, Goo Hyun

2015-07-01

To determine whether median nerve dysfunction measured by electrophysiologic studies in carpal tunnel syndrome (CTS) is associated with thumb trapeziometacarpal (TMC) joint instability. We evaluated 71 women with CTS and 31 asymptomatic control women. Patients with generalized laxity or TMC joint osteoarthritis were excluded. We classified the electrophysiologic severity of CTS based on nerve conduction time and amplitude and assessed radiographic instability of the TMC joint based on TMC joint stress radiographs. We compared subluxation ratio between patients with CTS and controls and performed correlation analysis of the relationship between the electrophysiologic grade and subluxation ratio. Thirty-one patients were categorized into the mild CTS subgroup and 41 into the severe CTS subgroup. There was no significant difference in subluxation ratio between the control group and CTS patients or between the control group and CTS subgroup patients. Furthermore, there was no significant correlation between electrophysiologic grade and subluxation ratio. This study demonstrated that patients with CTS did not have greater radiographic TMC joint instability compared with controls, and suggests that TMC joint stability is not affected by impaired median nerve function. Further studies could investigate how to better evaluate proprioceptive function of TMC joint and whether other nerves have effects on TMC joint motor/proprioceptive function, to elucidate the relationship between neuromuscular control of the TMC joint, its stability, and its progression to osteoarthritis. Diagnostic II. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Message passing with a limited number of DMA byte counters

DOEpatents

Blocksome, Michael [Rochester, MN; Chen, Dong [Croton on Hudson, NY; Giampapa, Mark E [Irvington, NY; Heidelberger, Philip [Cortlandt Manor, NY; Kumar, Sameer [White Plains, NY; Parker, Jeffrey J [Rochester, MN

2011-10-04

A method for passing messages in a parallel computer system constructed as a plurality of compute nodes interconnected as a network where each compute node includes a DMA engine but includes only a limited number of byte counters for tracking a number of bytes that are sent or received by the DMA engine, where the byte counters may be used in shared counter or exclusive counter modes of operation. The method includes using rendezvous protocol, a source compute node deterministically sending a request to send (RTS) message with a single RTS descriptor using an exclusive injection counter to track both the RTS message and message data to be sent in association with the RTS message, to a destination compute node such that the RTS descriptor indicates to the destination compute node that the message data will be adaptively routed to the destination node. Using one DMA FIFO at the source compute node, the RTS descriptors are maintained for rendezvous messages destined for the destination compute node to ensure proper message data ordering thereat. Using a reception counter at a DMA engine, the destination compute node tracks reception of the RTS and associated message data and sends a clear to send (CTS) message to the source node in a rendezvous protocol form of a remote get to accept the RTS message and message data and processing the remote get (CTS) by the source compute node DMA engine to provide the message data to be sent.

Evaluation of median nerve T2 signal changes in patients with surgically treated carpal tunnel syndrome.

PubMed

Samanci, Yavuz; Karagöz, Yeşim; Yaman, Mehmet; Atçı, İbrahim Burak; Emre, Ufuk; Kılıçkesmez, Nuri Özgür; Çelik, Suat Erol

2016-11-01

To determine the accuracy of median nerve T2 evaluation and its relation with Boston Questionnaire (BQ) and nerve conduction studies (NCSs) in pre-operative and post-operative carpal tunnel syndrome (CTS) patients in comparison with healthy volunteers. Twenty-three CTS patients and 24 healthy volunteers underwent NCSs, median nerve T2 evaluation and self-administered BQ. Pre-operative and 1st year post-operative median nerve T2 values and cross-sectional areas (CSAs) were compared both within pre-operative and post-operative CTS groups, and with healthy volunteers. The relationship between MRI findings and BQ and NCSs was analyzed. The ROC curve analysis was used for determining the accuracy. The comparison of pre-operative and post-operative T2 values and CSAs revealed statistically significant improvements in the post-operative patient group (p<0.001 for all parameters). There were positive correlations between T2 values at all levels and BQ values, and positive and negative correlations were also found regarding T2 values and NCS findings in CTS patients. The receiver operating characteristic curve analysis for defined cut-off levels of median nerve T2 values in hands with severe CTS yielded excellent accuracy at all levels. However, this accuracy could not be demonstrated in hands with mild CTS. This study is the first to analyze T2 values in both pre-operative and post-operative CTS patients. The presence of increased T2 values in CTS patients compared to controls and excellent accuracy in hands with severe CTS indicates T2 signal changes related to CTS pathophysiology and possible utilization of T2 signal evaluation in hands with severe CTS. Copyright © 2016 Elsevier B.V. All rights reserved.

The impact of cash transfers on social determinants of health and health inequalities in sub-Saharan Africa: a systematic review

PubMed Central

Renzaho, Andre M N; Smith, Ben J

2018-01-01

Abstract Cash transfers (CTs) are now high on the agenda of most governments in low- and middle-income countries. Within the field of health promotion, CTs constitute a healthy public policy initiative as they have the potential to address the social determinants of health (SDoH) and health inequalities. A systematic review was conducted to synthesise the evidence on CTs’ impacts on SDoH and health inequalities in sub-Saharan Africa, and to identify the barriers and facilitators of effective CTs. Twenty-one electronic databases and the websites of 14 key organizations were searched in addition to grey literature and hand searching of selected journals for quantitative and qualitative studies on CTs’ impacts on SDoH and health outcomes. Out of 182 full texts screened for eligibility, 79 reports that reported findings from 53 studies were included in the final review. The studies were undertaken within 24 CTs comprising 11 unconditional CTs (UCTs), 8 conditional CTs (CCTs) and 5 combined UCTs and CCTs. The review found that CTs can be effective in tackling structural determinants of health such as financial poverty, education, household resilience, child labour, social capital and social cohesion, civic participation, and birth registration. The review further found that CTs modify intermediate determinants such as nutrition, dietary diversity, child deprivation, sexual risk behaviours, teen pregnancy and early marriage. In conjunction with their influence on SDoH, there is moderate evidence from the review that CTs impact on health and quality of life outcomes. The review also found many factors relating to intervention design features, macro-economic stability, household dynamics and community acceptance of programs that could influence the effectiveness of CTs. The external validity of the review findings is strong as the findings are largely consistent with those from Latin America. The findings thus provide useful insights to policy makers and managers and can be used to optimise CTs to reduce health inequalities. PMID:29762708

The Quality Changes of Postharvest Mulberry Fruit Treated by Chitosan-g-Caffeic Acid During Cold Storage.

PubMed

Yang, Caifeng; Han, Beibei; Zheng, Yu; Liu, Lili; Li, Changlong; Sheng, Sheng; Zhang, Jian; Wang, Jun; Wu, Fuan

2016-04-01

This study aimed to characterize the effects of chitosan-g-caffeic acid (CTS-g-CA) on improving the quality and extending the shelf life of postharvest mulberry fruit during storage at 4 °C for 18 d. CTS-g-CA was enzymatically synthesized using laccase from Pleurotus ostreatus as a catalyst. The synergistic effects of CTS-g-CA treatment on mulberry fruit were evaluated using a co-toxicity factor (cf). The results showed that the rotting rate of CTS-g-CA-treated fruit was 37.67% (compared with that of the control at 97.67%) on day 18. The weight loss and malondialdehyde (MDA) contents of the CTS-g-CA-treated mulberry fruit were significantly lower (P < 0.05) than those of the control, CA, CTS, and CA+CTS treatments. Moreover, the DPPH and ABTS radical scavenging activities of the CTS-g-CA treatment were both higher than those of the control. Furthermore, the CTS-g-CA treatment also maintained higher levels of main active substances, such as anthocyanins, ascorbic acid, polyphenols and flavones, in mulberry fruit than the other treatments. Therefore, CTS-g-CA could be used to improve the quality and extend the shelf life of postharvest mulberry fruit during cold storage. © 2016 Institute of Food Technologists®

Analyzing functional brain connectivity by means of commute times: a new approach and its application to track event-related dynamics.

PubMed

Dimitriadis, S I; Laskaris, N A; Tzelepi, A; Economou, G

2012-05-01

There is growing interest in studying the association of functional connectivity patterns with particular cognitive tasks. The ability of graphs to encapsulate relational data has been exploited in many related studies, where functional networks (sketched by different neural synchrony estimators) are characterized by a rich repertoire of graph-related metrics. We introduce commute times (CTs) as an alternative way to capture the true interplay between the nodes of a functional connectivity graph (FCG). CT is a measure of the time taken for a random walk to setout and return between a pair of nodes on a graph. Its computation is considered here as a robust and accurate integration, over the FCG, of the individual pairwise measurements of functional coupling. To demonstrate the benefits from our approach, we attempted the characterization of time evolving connectivity patterns derived from EEG signals recorded while the subject was engaged in an eye-movement task. With respect to standard ways, which are currently employed to characterize connectivity, an improved detection of event-related dynamical changes is noticeable. CTs appear to be a promising technique for deriving temporal fingerprints of the brain's dynamic functional organization.

Quantitative Muscle Ultrasonography in Carpal Tunnel Syndrome.

PubMed

Lee, Hyewon; Jee, Sungju; Park, Soo Ho; Ahn, Seung-Chan; Im, Juneho; Sohn, Min Kyun

2016-12-01

To assess the reliability of quantitative muscle ultrasonography (US) in healthy subjects and to evaluate the correlation between quantitative muscle US findings and electrodiagnostic study results in patients with carpal tunnel syndrome (CTS). The clinical significance of quantitative muscle US in CTS was also assessed. Twenty patients with CTS and 20 age-matched healthy volunteers were recruited. All control and CTS subjects underwent a bilateral median and ulnar nerve conduction study (NCS) and quantitative muscle US. Transverse US images of the abductor pollicis brevis (APB) and abductor digiti minimi (ADM) were obtained to measure muscle cross-sectional area (CSA), thickness, and echo intensity (EI). EI was determined using computer-assisted, grayscale analysis. Inter-rater and intra-rater reliability for quantitative muscle US in control subjects, and differences in muscle thickness, CSA, and EI between the CTS patient and control groups were analyzed. Relationships between quantitative US parameters and electrodiagnostic study results were evaluated. Quantitative muscle US had high inter-rater and intra-rater reliability in the control group. Muscle thickness and CSA were significantly decreased, and EI was significantly increased in the APB of the CTS group (all p<0.05). EI demonstrated a significant positive correlation with latency of the median motor and sensory NCS in CTS patients (p<0.05). These findings suggest that quantitative muscle US parameters may be useful for detecting muscle changes in CTS. Further study involving patients with other neuromuscular diseases is needed to evaluate peripheral muscle change using quantitative muscle US.

Carpal Tunnel Syndrome in Behçet's Disease.

PubMed

Lee, Jungsoo; Cho, Suhyun; Kim, Do Young; Zheng, Zhenlong; Park, Hoon; Bang, Dongsik

2015-07-01

Behçet's disease (BD) is a chronic inflammatory disease characterized by orogenital ulcers, skin and ocular lesions, in addition to articular, vascular, and neurologic symptoms. Carpal tunnel syndrome (CTS), can also occur in BD patients secondary to inflammation in the connective tissues, vessels, and tendons, as well as nerve involvement in BD itself. However, reports of patients who have CTS in BD are rare. The aim of this study was to evaluate the clinical characteristics of CTS in BD patients. Retrospective analysis of the medical records of 1750 BD patients, and 14 (0.8%) BD patients who were diagnosed with CTS was performed at the BD Specialty Clinic of Severance Hospital. Patient demographics, disease activity/severity for both diseases, and the clinical characteristics of CTS in BD were recorded and analyzed. All 14 BD patients with CTS were women. Twelve patients (85.7%) were diagnosed with active BD. The CTS was mild in 8 patients (57.2%), moderate in 3 patients (21.4%), and severe in 3 patients (21.4%). Ten patients (71.4%) had BD prior to the diagnosis of CTS, and these 10 patients all had active BD. CTS can occur as a result of the inflammation associated with BD and can also be the presenting symptom of nerve involvement in BD. CTS can also develop as the initial symptom of BD. Therefore, a higher degree of suspicion should be maintained for CTS in patients with BD and vice versa; however, the exact relationship is uncertain.

Modeling the cost-benefit of nerve conduction studies in pre-employment screening for carpal tunnel syndrome.

PubMed

Evanoff, Bradley; Kymes, Steve

2010-06-01

The aim of this study was to evaluate the costs associated with pre-employment nerve conduction testing as a screening tool for carpal tunnel syndrome (CTS) in the workplace. We used a Markov decision analysis model to compare the costs associated with a strategy of screening all prospective employees for CTS and not hiring those with abnormal nerve conduction, versus a strategy of not screening for CTS. The variables included in our model included employee turnover rate, the incidence of CTS, the prevalence of median nerve conduction abnormalities, the relative risk of developing CTS conferred by abnormal nerve conduction screening, the costs of pre-employment screening, and the worker's compensation costs to the employer for each case of CTS. In our base case, total employer costs for CTS from the perspective of the employer (cost of screening plus costs for workers' compensation associated with CTS) were higher when screening was used. Median costs per employee position over five years were US$503 for the screening strategy versus US$200 for a no-screening strategy. A sensitivity analysis showed that a strategy of screening was cost-beneficial from the perspective of the employer only under a few circumstances. Using Monte Carlo simulation varying all parameters, we found a 30% probability that screening would be cost-beneficial. A strategy of pre-employment screening for CTS should be carefully evaluated for yield and social consequences before being implemented. Our model suggests such screening is not appropriate for most employers.

Poly(hydroxybutyrate)/chitosan Aligned Electrospun Scaffold as a Novel Substrate for Nerve Tissue Engineering.

PubMed

Karimi, Afarin; Karbasi, Saeed; Razavi, Shahnaz; Zargar, Elham Naghash

2018-01-01

Reconstruction of nervous system is a great challenge in the therapeutic medical field. Nerve tissue engineering is a novel method to regenerate nervous system in human health care. Tissue engineering has introduced novel approaches to promote and guide peripheral nerve regeneration using submicron and nanoscale fibrous scaffolds. In this study, 9 wt% poly(3-hydroxybutyrate) (PHB) solutions with two different ratios of chitosan (CTS) (15%, and 20%) were mixed in trifluoroacetic acid as a cosolvent. Thereafter, random and aligned PHB/CTS scaffolds were fabricated by electrospinning method in an appropriate condition. Average diameters for aligned PHB, PHB/CTS 85:15 and PHB/CTS 80:20 were obtained as 675 nm, 740.3 nm, and 870.74 nm, which was lesser than random fibers. The solution components entity authenticity was approved by Fourier transform infrared. The addition of CTS decreased both water droplet contact angle from 124.79° to 43.14° in random and 110.87° to 33.49° in aligned PHB/CTS fibrous scaffold. Moreover, alignment of fibers causes tremendous increase in hydrophilicity of fibrous PHB/CTS substrate. Tensile strength increased from 6.41 MPa for random to 8.73 MPa for aligned PHB/CTS 85:15. Our results indicated that aligned PHB/CTS 85:15 nanofibers are the desired scaffold than the random PHB/CTS nanofibers for application in nerve tissue regeneration.

Repeated application of composted tannery sludge affects differently soil microbial biomass, enzymes activity, and ammonia-oxidizing organisms.

PubMed

Araújo, Ademir Sérgio Ferreira; Lima, Luciano Moura; Santos, Vilma Maria; Schmidt, Radomir

2016-10-01

Repeated application of composted tannery sludge (CTS) changes the soil chemical properties and, consequently, can affect the soil microbial properties. The aim of this study was to evaluate the responses of soil microbial biomass and ammonia-oxidizing organisms to repeated application of CTS. CTS was applied repeatedly during 6 years, and, at the sixth year, the soil microbial biomass, enzymes activity, and ammonia-oxidizing organisms were determined in the soil. The treatments consisted of 0 (without CTS application), 2.5, 5, 10, and 20 t ha(-1) of CTS (dry basis). Soil pH, EC, SOC, total N, and Cr concentration increased with the increase in CTS rate. Soil microbial biomass did not change significantly with the amendment of 2.5 Mg ha(-1), while it decreased at the higher rates. Total and specific enzymes activity responded differently after CTS application. The abundance of bacteria did not change with the 2.5-Mg ha(-1) CTS treatment and decreased after this rate, while the abundance of archaea increased significantly with the 2.5-Mg ha(-1) CTS treatment. Repeated application of different CTS rates for 6 years had different effects on the soil microbial biomass and ammonia-oxidizing organisms as a response to changes in soil chemical properties.

Workplace and individual risk factors for carpal tunnel syndrome.

PubMed

Burt, Susan; Crombie, Ken; Jin, Yan; Wurzelbacher, Steve; Ramsey, Jessica; Deddens, James

2011-12-01

To quantify the relationship between workplace physical factors, particularly hand activity level (HAL) and forceful exertion and carpal tunnel syndrome (CTS), while taking into account individual factors. To compare quantitative exposure assessment measures with more practical ratings-based measures. In a group of healthcare and manufacturing workers, each study participant's job tasks were evaluated for HAL, forceful exertion and other physical stressors and videotaped for further analysis, including frequency and duration of exertion and postural deviation. Electrodiagnostic testing of median and ulnar nerves and questionnaires were administered to all participants. A CTS case required median mononeuropathy and symptoms on hand diagrams in fingers 1-3. Multiple logistic regression models were used to analyse associations between job and individual factors and CTS. Of 477 workers studied, 57 (11.9%) were dominant hand CTS cases. Peak force ≥70% maximum voluntary contraction versus <20% maximum voluntary contraction resulted in an OR of 2.74 (1.32-5.68) for CTS. Among those with a body mass index ≥30, the OR for ≥15 exertions per minute was 3.35 (1.14-9.87). Peak worker ratings of perceived exertion increased the odds for CTS by 1.14 (1.01-1.29) for each unit increase on the 10-point scale. The odds for CTS increased by 1.38 (1.05-1.81) for each unit increase on the HAL 10-point scale among men, but not women. Combined force and HAL values above the ACGIH TLV for HAL resulted in an OR of 2.96 (1.51-5.80) for CTS. Quantitative and ratings-based job exposure measures were each associated with CTS. Obesity increased the association between frequency of exertion and CTS.

Primary somatosensory/motor cortical thickness distinguishes paresthesia-dominant from pain-dominant carpal tunnel syndrome.

PubMed

Maeda, Yumi; Kettner, Norman; Kim, Jieun; Kim, Hyungjun; Cina, Stephen; Malatesta, Cristina; Gerber, Jessica; McManus, Claire; Libby, Alexandra; Mezzacappa, Pia; Mawla, Ishtiaq; Morse, Leslie R; Audette, Joseph; Napadow, Vitaly

2016-05-01

Paresthesia-dominant and pain-dominant subgroups have been noted in carpal tunnel syndrome (CTS), a peripheral neuropathic disorder characterized by altered primary somatosensory/motor (S1/M1) physiology. We aimed to investigate whether brain morphometry dissociates these subgroups. Subjects with CTS were evaluated with nerve conduction studies, whereas symptom severity ratings were used to allocate subjects into paresthesia-dominant (CTS-paresthesia), pain-dominant (CTS-pain), and pain/paresthesia nondominant (not included in further analysis) subgroups. Structural brain magnetic resonance imaging data were acquired at 3T using a multiecho MPRAGE T1-weighted pulse sequence, and gray matter cortical thickness was calculated across the entire brain using validated, automated methods. CTS-paresthesia subjects demonstrated reduced median sensory nerve conduction velocity (P = 0.05) compared with CTS-pain subjects. In addition, cortical thickness in precentral and postcentral gyri (S1/M1 hand area) contralateral to the more affected hand was significantly reduced in CTS-paresthesia subgroup compared with CTS-pain subgroup. Moreover, in CTS-paresthesia subjects, precentral cortical thickness was negatively correlated with paresthesia severity (r(34) = -0.40, P = 0.016) and positively correlated with median nerve sensory velocity (r(36) = 0.51, P = 0.001), but not with pain severity. Conversely, in CTS-pain subjects, contralesional S1 (r(9) = 0.62, P = 0.042) and M1 (r(9) = 0.61, P = 0.046) cortical thickness were correlated with pain severity, but not median nerve velocity or paresthesia severity. This double dissociation in somatotopically specific S1/M1 areas suggests a neuroanatomical substrate for symptom-based CTS subgroups. Such fine-grained subgrouping of CTS may lead to improved personalized therapeutic approaches, based on superior characterization of the linkage between peripheral and central neuroplasticity.

Value of F-wave inversion in diagnosis of carpal tunnel syndrome and it's relation with anthropometric measurements.

PubMed

Komurcu, Hatice Ferhan; Kilic, Selim; Anlar, Omer

2015-01-01

The clinical importance of F-wave inversion in the diagnosis of Carpal Tunnel Syndrome (CTS) is not yet well known. This study aims to investigate the value of F-wave inversion in diagnosing CTS, and to evaluate the relationship of F-wave inversion with age, gender, diabetes mellitus, body mass index (BMI), wrist or waist circumferences. Patients (n=744) who were considered to have CTS with clinical findings were included in the study. In order to confirm the diagnosis of CTS, standard electrophysiological parameters were studied with electroneuromyography. In addition, median nerve F-wave measurements were done and we determined if F-wave inversion was present or not. Sensitivity and specificity of F-wave inversion were investigated for its value in showing CTS diagnosed by electrophysiological examination. CTS diagnosis was confirmed by routine electrophysiological parameters in 307 (41.3%) patients. The number of the patients with the presence of F-wave inversion was 243 (32.7%). Sensitivity of F-wave inversion was found as 56% and specificity as 83.8%. BMI and wrist circumference values were significantly higher in patients with F-wave inversion present than those with F-wave inversion absent (p=0.0033, p=0.025 respectively). F-wave inversion can be considered as a valuable electrophysiological measurement for screening of CTS.

Reliability and construct validity of the Spanish version of the 6-item CTS symptoms scale for outcomes assessment in carpal tunnel syndrome.

PubMed

Rosales, Roberto S; Martin-Hidalgo, Yolanda; Reboso-Morales, Luis; Atroshi, Isam

2016-03-03

The purpose of this study was to assess the reliability and construct validity of the Spanish version of the 6-item carpal tunnel syndrome (CTS) symptoms scale (CTS-6). In this cross-sectional study 40 patients diagnosed with CTS based on clinical and neurophysiologic criteria, completed the standard Spanish versions of the CTS-6 and the disabilities of the arm, shoulder and hand (QuickDASH) scales on two occasions with a 1-week interval. Internal-consistency reliability was assessed with the Cronbach alpha coefficient and test-retest reliability with the intraclass correlation coefficient, two way random effect model and absolute agreement definition (ICC2,1). Cross-sectional precision was analyzed with the Standard Error of the Measurement (SEM). Longitudinal precision for test-retest reliability coefficient was assessed with the Standard Error of the Measurement difference (SEMdiff) and the Minimal Detectable Change at 95 % confidence level (MDC95). For assessing construct validity it was hypothesized that the CTS-6 would have a strong positive correlation with the QuickDASH, analyzed with the Pearson correlation coefficient (r). The standard Spanish version of the CTS-6 presented a Cronbach alpha of 0.81 with a SEM of 0.3. Test-retest reliability showed an ICC of 0.85 with a SRMdiff of 0.36 and a MDC95 of 0.7. The correlation between CTS-6 and the QuickDASH was concordant with the a priori formulated construct hypothesis (r 0.69) CONCLUSIONS: The standard Spanish version of the 6-item CTS symptoms scale showed good internal consistency, test-retest reliability and construct validity for outcomes assessment in CTS. The CTS-6 will be useful to clinicians and researchers in Spanish speaking parts of the world. The use of standardized outcome measures across countries also will facilitate comparison of research results in carpal tunnel syndrome.

Association between wrist ratio and carpal tunnel syndrome: Effect modification by body mass index.

PubMed

Thiese, Matthew S; Merryweather, Andrew; Koric, Alzina; Ott, Ulrike; Wood, Eric M; Kapellusch, Jay; Foster, James; Garg, Arun; Deckow-Schaefer, Gwen; Tomich, Suzanna; Kendall, Richard; Drury, David L; Wertsch, Jacqueline; Hegmann, Kurt T

2017-12-01

Previous studies have reported higher wrist ratios (WR) related to carpal tunnel syndrome (CTS) but have not assessed effect modification by obesity and may have inadequately controlled for confounders. Baseline data of a multicenter prospective cohort study were analyzed. CTS was defined by nerve conduction study (NCS) criteria and symptoms. Among the 1,206 participants, a square-shaped wrist was associated with CTS after controlling for confounders (prevalence ratio = 2.27; 95% confidence interval [95% CI], 1.33-3.86). Body mass index (BMI) was a strong effect modifier on the relationship between WR and both CTS and abnormal NCS results, with normal weight strata of rectangular versus square wrists = 8.18 (95% CI, 1.63-49.96) and 7.12 (95% CI, 2.19-23.16), respectively. A square wrist is significantly associated with CTS after controlling for confounders. Effect modification by high BMI masked the eightfold magnitude adjusted relationship seen between WR and CTS among normal weight participants. Muscle Nerve 56: 1047-1053, 2017. © 2017 Wiley Periodicals, Inc.

Long-term symptomatic, functional, and work outcomes of carpal tunnel syndrome among construction workers.

PubMed

Evanoff, Bradley; Gardner, Bethany T; Strickland, Jaime R; Buckner-Petty, Skye; Franzblau, Alfred; Dale, Ann Marie

2016-05-01

The long-term outcomes of carpal tunnel syndrome (CTS) including symptoms, functional status, work disability, and economic impact are unknown. We conducted a retrospective study of 234 active construction workers with medical claims for CTS and 249 workers without CTS claims; non-cases were matched on age, trade, and insurance eligibility. We conducted telephone interviews with cases and non-cases and collected administrative data on work hours. Compared to non-cases, CTS cases were more likely to report recurrent hand symptoms, decreased work productivity/quality, decreased performance of physical work demands, and greater functional limitations. Surgical cases showed larger improvements on multiple outcomes than non-surgical cases. Minimal differences in paid work hours were seen between cases and non-cases in the years preceding and following CTS claims. Persistent symptoms and functional impairments were present several years after CTS diagnosis. Long-term functional limitations shown by this and other studies indicate the need for improved prevention and treatment. © 2016 Wiley Periodicals, Inc.

Carpal tunnel syndrome in the Turkish steel industry.

PubMed

Gedizlioglu, Muhtesem; Arpaci, Esra; Cevher, Demet; Ce, Pinar; Kulan, Can Ahmet; Colak, Ilhan; Duzgun, Baran

2008-05-01

Certain occupations are reported to be associated with a high risk for carpal tunnel syndrome (CTS). In this study, we investigated the development of CTS in iron-steel industry workers. Subjects were recruited from a factory of 650 workers and assessed by means of history, physical examination and electrophysiological testing. Seventy-nine subjects from the factory and 53 healthy controls with occupations unrelated to heavy physical work were assessed. None of the worker group had electrophysiological evidence of CTS. One subject in the control group has electrophysiological evidence of CTS. In the worker group, all sensory nerve conduction velocities and ulnar nerve action potential amplitudes in both hands and distal motor latencies were statistically different. In our study, among a group of heavy labourers, no cases of CTS were detected. However, all electrophysiologic parameters of workers were different from controls. Our results point to a diffuse, but subclinical injury of peripheral nerves under heavy physical work conditions, instead of a local effect such as CTS.

Incidence of carpal tunnel syndrome in the US military population.

PubMed

Wolf, Jennifer Moriatis; Mountcastle, Sally; Owens, Brett D

2009-09-01

Carpal tunnel syndrome (CTS) is a common disease. Its epidemiology has been evaluated previously, mostly in regional populations or in working groups, with an incidence between 1.5 and 3.5 per 1,000 person-years. We studied this diagnosis in the US military population, with the hypothesis that this young population would have a lower incidence of CTS than previously reported in general populations. The Defense Medical Epidemiology Database notes all medical encounters for all US military personnel and maintains the number of all personnel on active duty each year. We queried the database using the International Classification of Diseases, ninth revision, code 354.0 (CTS) and analyzed the personnel presenting for initial visits for the years 1998-2006. Multivariate Poisson analysis was performed, controlling for rank, gender, age, and race. The raw incidence of CTS in the US military was 3.98 per 1,000 person-years, in a population of 12,298,088 person-years. Females had a significantly higher incidence of CTS than males, with an adjusted incidence rate ratio of 3.29. CTS incidence increased by age, with the age group > or = 40 years having a significantly higher incidence. Additionally, military rank was found to be an independent risk factor for CTS, with rates higher in senior officer and enlisted groups. This suggests that occupational requirements have an effect on CTS within the military. We showed a comparable incidence of CTS between the US military and general population, with a significantly higher female cohort with a diagnosis of CTS. Increased age and advanced rank were risk factors for CTS.

Continuous Traumatic Situations in the Face of Ongoing Political Violence: The Relationship Between CTS and PTSD.

PubMed

Nuttman-Shwartz, Orit; Shoval-Zuckerman, Yael

2016-12-01

This article presents a literature review of the concept of continuous traumatic situations (CTS), which relates to residents living in ongoing situations of political violence and national security threats. The first aim of this review is to narrow the gap regarding knowledge about the concept of CTS by presenting findings from studies that have assessed the effects of CTS on civilian populations. The second aim is to describe CTS in a way that highlights the differences and similarities between posttraumatic stress disorder and responses to CTS. This distinction is a necessary precondition for examining CTS, as is a careful clinical analysis of the development and course of symptoms. This literature review also highlights the importance of adopting a supplementary perspective for understanding the psychological impact of ongoing exposure to real threats, which can be used as a basis for developing intervention strategies that are appropriate for coping with life in the context of persistent violence. CTS can be manifested as emotions, behaviors, and perceptions among individuals, families, communities, and societies. The nature of the proposed model of CTS is a circular one, combining past and future perceptions and emotional reactions that have resulted from continuous and repeated traumatic experiences over an extended period of time. This wider understanding reflects the complexity of the CTS phenomenon. Various micro and macro interventions relating to CTS as the result of political violence situations and national security threats are presented, and recommendations for practice, policy, and future research are offered. © The Author(s) 2015.

Electrospun biomimetic scaffold of hydroxyapatite/chitosan supports enhanced osteogenic differentiation of mMSCs

NASA Astrophysics Data System (ADS)

Peng, Hongju; Yin, Zi; Liu, Huanhuan; Chen, Xiao; Feng, Bei; Yuan, Huihua; Su, Bo; Ouyang, Hongwei; Zhang, Yanzhong

2012-12-01

Engaging functional biomaterial scaffolds to regulate stem cell differentiation has drawn a great deal of attention in the tissue engineering and regenerative medicine community. In this study, biomimetic composite nanofibrous scaffolds of hydroxyapatite/chitosan (HAp/CTS) were prepared to investigate their capacity for inducing murine mesenchymal stem cells (mMSCs) to differentiate into the osteogenic lineage, in the absence and presence of an osteogenic supplementation (i.e., ascorbic acid, β-glycerol phosphate, and dexamethasone), respectively. Using electrospun chitosan (CTS) nanofibrous scaffolds as the control, cell morphology, growth, specific osteogenic genes expression, and quantified proteins secretion on the HAp/CTS scaffolds were sequentially examined and assessed. It appeared that the HAp/CTS scaffolds supported better attachment and proliferation of the mMSCs. Most noteworthy was that in the absence of the osteogenic supplementation, expression of osteogenic genes including collagen I (Col I), runt-related transcription factor 2 (Runx2), alkaline phosphatase (ALP), and osteocalcin (OCN) were significantly upregulated in mMSCs cultured on the HAp/CTS nanofibrous scaffolds. Also increased secretion of the osteogenesis protein markers of alkaline phosphatase and collagen confirmed that the HAp/CTS nanofibrous scaffold markedly promoted the osteogenic commitment in the mMSCs. Moreover, the presence of osteogenic supplementation proved an enhanced efficacy of mMSC osteogenesis on the HAp/CTS nanofibrous scaffolds. Collectively, this study demonstrated that the biomimetic nanofibrous HAp/CTS scaffolds could support and enhance the adhesion, proliferation, and particularly osteogenic differentiation of the mMSCs. It also substantiated the potential of using biomimetic nanofibrous scaffolds of HAp/CTS for functional bone repair and regeneration applications.

Time-dependent effect of composted tannery sludge on the chemical and microbial properties of soil.

PubMed

de Sousa, Ricardo Silva; Santos, Vilma Maria; de Melo, Wanderley Jose; Nunes, Luis Alfredo Pinheiro Leal; van den Brink, Paul J; Araújo, Ademir Sérgio Ferreira

2017-12-01

Composting has been suggested as an efficient method for tannery sludge recycling before its application to the soil. However, the application of composted tannery sludge (CTS) should be monitored to evaluate its effect on the chemical and microbial properties of soil. This study evaluated the time-dependent effect of CTS on the chemical and microbial properties of soil. CTS was applied at 0, 2.5, 5, 10, and 20 Mg ha -1 and the soil chemical and microbial properties were evaluated at 0, 45, 75, 150, and 180 days. Increased CTS rates increased the levels of Ca, Cr, and Mg. While Soil pH, organic C, and P increased with the CTS rates initially, this effect decreased over time. Soil microbial biomass, respiration, metabolic quotient, and dehydrogenase increased with the application of CTS, but decreased over time. Analysis of the Principal Response Curve showed a significant effect of CTS rate on the chemical and microbial properties of the soil over time. The weight of each variable indicated that all soil properties, except β-glucosidase, dehydrogenase and microbial quotient, increased due to the CTS application. However, the highest weights were found for Cr, pH, Ca, P, phosphatase and total organic C. The application of CTS in the soil changed the chemical and microbial properties over time, indicating Cr, pH, Ca, phosphatase, and soil respiration as the more responsive chemical and microbial variables by CTS application.

Poly(hydroxybutyrate)/chitosan Aligned Electrospun Scaffold as a Novel Substrate for Nerve Tissue Engineering

PubMed Central

Karimi, Afarin; Karbasi, Saeed; Razavi, Shahnaz; Zargar, Elham Naghash

2018-01-01

Background: Reconstruction of nervous system is a great challenge in the therapeutic medical field. Nerve tissue engineering is a novel method to regenerate nervous system in human health care. Tissue engineering has introduced novel approaches to promote and guide peripheral nerve regeneration using submicron and nanoscale fibrous scaffolds. Materials and Methods: In this study, 9 wt% poly(3-hydroxybutyrate) (PHB) solutions with two different ratios of chitosan (CTS) (15%, and 20%) were mixed in trifluoroacetic acid as a cosolvent. Thereafter, random and aligned PHB/CTS scaffolds were fabricated by electrospinning method in an appropriate condition. Results: Average diameters for aligned PHB, PHB/CTS 85:15 and PHB/CTS 80:20 were obtained as 675 nm, 740.3 nm, and 870.74 nm, which was lesser than random fibers. The solution components entity authenticity was approved by Fourier transform infrared. The addition of CTS decreased both water droplet contact angle from 124.79° to 43.14° in random and 110.87° to 33.49° in aligned PHB/CTS fibrous scaffold. Moreover, alignment of fibers causes tremendous increase in hydrophilicity of fibrous PHB/CTS substrate. Tensile strength increased from 6.41 MPa for random to 8.73 MPa for aligned PHB/CTS 85:15. Conclusions: Our results indicated that aligned PHB/CTS 85:15 nanofibers are the desired scaffold than the random PHB/CTS nanofibers for application in nerve tissue regeneration. PMID:29657929

Annual Surveillance Summary: Escherichia coli (E. coli) Infections in the Military Health System (MHS), 2016

DTIC Science & Technology

2017-06-01

Department of Defense (DOD) active duty (AD) service members, and the DMDC Contingency Tracking System (CTS) to determine Department of the Navy (DON...and the Department of Defense (DOD) active duty (AD) population increased above the weighted historic IR; however, all of the 2016 rates remained...infections among young, otherwise healthy, sexually active women. 5 Screening practices may also contribute to higher rates of E. coli infections among

Korean Cancer Patients’ Awareness of Clinical Trials, Perceptions on the Benefit and Willingness to Participate

PubMed Central

Lim, Yoojoo; Lim, Jee Min; Jeong, Won Jae; Lee, Kyung-Hun; Keam, Bhumsuk; Kim, Tae-Yong; Kim, Tae Min; Han, Sae-Won; Oh, Do Youn; Kim, Dong-Wan; Kim, Tae-You; Heo, Dae Seog; Bang, Yung-Jue; Im, Seock-Ah

2017-01-01

Purpose The purpose of this study was to assess current levels of awareness of clinical trials (CTs), perceptions regarding their benefits and willingness to participate to CTs among Korean cancer patients. Materials and Methods From December 2012 to August 2015, we distributed questionnaires to cancer patients receiving systemic anti-cancer therapy at Seoul National University Hospital, Seoul, Korea. Results A total of 397 out of 520 requested patients (76.3%) responded to the survey. Among the 397 patients, 62.5% were female and the median age was 52 years. Overall, 97.4% (387/397) answered that they have at least heard of CTs. When asked about their level of awareness, 23.8% (92/387) answered that they could more than roughly explain about CTs. The average visual analogue scale score of CT benefit in all patients was 6.43 (standard deviation, 2.20). Patients who were only familiar with the term without detailed knowledge of the contents had the least expectation of benefit from CTs (p=0.015). When asked about their willingness to participate in CTs, 56.7% (225/397) answered positively. Patients with higher levels of awareness of CTs showed higher willingness to participate (p < 0.001). Heavily treated patients and patients with previous experience regarding CTs also showed a higher willingness to participate (p < 0.001). The perceived benefit of CTs was higher in the group willing to participate (p=0.026). Conclusion The patient’s level of awareness regarding CTs was positively related to the positive perception and willingness to participate. Although the general awareness of CTs was high, a relatively large proportion of patients did not have accurate knowledge; therefore, proper and accurate patient education is necessary. PMID:28392549

Korean Cancer Patients' Awareness of Clinical Trials, Perceptions on the Benefit and Willingness to Participate.

PubMed

Lim, Yoojoo; Lim, Jee Min; Jeong, Won Jae; Lee, Kyung-Hun; Keam, Bhumsuk; Kim, Tae-Yong; Kim, Tae Min; Han, Sae-Won; Oh, Do Youn; Kim, Dong-Wan; Kim, Tae-You; Heo, Dae Seog; Bang, Yung-Jue; Im, Seock-Ah

2017-10-01

The purpose of this study was to assess current levels of awareness of clinical trials (CTs), perceptions regarding their benefits and willingness to participate to CTs among Korean cancer patients. From December 2012 to August 2015, we distributed questionnaires to cancer patients receiving systemic anti-cancer therapy at Seoul National University Hospital, Seoul, Korea. A total of 397 out of 520 requested patients (76.3%) responded to the survey. Among the 397 patients, 62.5% were female and the median age was 52 years. Overall, 97.4% (387/397) answered that they have at least heard of CTs. When asked about their level of awareness, 23.8% (92/387) answered that they could more than roughly explain about CTs. The average visual analogue scale score of CT benefit in all patients was 6.43 (standard deviation, 2.20). Patients who were only familiar with the term without detailed knowledge of the contents had the least expectation of benefit from CTs (p=0.015). When asked about their willingness to participate in CTs, 56.7% (225/397) answered positively. Patients with higher levels of awareness of CTs showed higher willingness to participate (p < 0.001). Heavily treated patients and patients with previous experience regarding CTs also showed a higher willingness to participate (p < 0.001). The perceived benefit of CTs was higher in the group willing to participate (p=0.026). The patient's level of awareness regarding CTs was positively related to the positive perception and willingness to participate. Although the general awareness of CTs was high, a relatively large proportion of patients did not have accurate knowledge; therefore, proper and accurate patient education is necessary.

The accelerating effect of chitosan-silica hybrid dressing materials on the early phase of wound healing.

PubMed

Park, Ji-Ung; Jung, Hyun-Do; Song, Eun-Ho; Choi, Tae-Hyun; Kim, Hyoun-Ee; Song, Juha; Kim, Sukwha

2017-10-01

Commercialized dressing materials with or without silver have played a passive role in early-phase wound healing, protecting the skin defects from infections, absorbing exudate, and preventing dehydration. Chitosan (CTS)-based sponges have been developed in pure or hybrid forms for accelerating wound healing, but their wound-healing capabilities have not been extensively compared with widely used commercial dressing materials, providing limited information in a practical aspect. In this study, we have developed CTS-silica (CTS-Si) hybrid sponges with water absorption, flexibility, and mechanical behavior similar to those of CTS sponges. In vitro and in vivo tests were performed to compare the CTS-Si sponges with three commercial dressing materials [gauze, polyurethane (PU), and silver-containing hydrofiber (HF-Ag)] in addition to CTS sponges. Both in vitro and in vivo tests showed that CTS-Si sponges promoted fibroblast proliferation, leading to accelerated collagen synthesis, whereas the CTS sponges did not exhibit significant differences in fibroblast proliferation and collagen synthesis from gauze, PU, and HF-Ag sponges. In case of CTS-Si, the inflammatory cells were actively recruited to the wound by the influence of the released silicon ions from CTS-Si sponges, which, in return, led to an enhanced secretion of growth factors, particularly TGF-β during the early stage. The higher level of TGF-β likely improved the proliferation of fibroblasts, and as a result, collagen synthesis by fibroblasts became remarkably productive, thereby increasing collagen density at the wound site. Therefore, the CTS-Si hybrid sponges have considerable potential as a wound-dressing material for accelerating wound healing. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1828-1839, 2017. © 2016 Wiley Periodicals, Inc.

Influence of vacuum annealing on the properties of Cu2SnS3 thin films using low cost ultrasonic spray pyrolysis

NASA Astrophysics Data System (ADS)

Rahaman, Sabina; Sunil, M. Anantha; Shaik, Habibuddin; Ghosh, Kaustab

2018-05-01

Deposition of Cu2SnS3 (CTS) thin films is successfully carried out on soda lime glass substrate using low cost ultrasonic spray pyrolysis technique. Vacuum annealing of CTS films is carried out at different temperatures 350°C, 400°C and 450°C. The present work is to study the effect of annealing temperature on the crystal structure, surface morphology and optical properties of CTS thin films. Structural studies confirm the formation of CTS phase. Raman analysis is carried out to study presence of defects with annealing temperature. Optical studies confirm that film prepared at 450°C temperature is suitable as absorber material for photovoltaic applications.

Australian men with cancer practice complementary therapies (CTs) as a coping strategy.

PubMed

Klafke, Nadja; Eliott, Jaklin A; Olver, Ian N; Wittert, Gary A

2014-11-01

The aim of this study was to explore how and why Australian men with cancer practice complementary therapies (CTs) and how their significant others (SOs) contribute to the regular uptake of CTs. This qualitative study employed semi-structured interviews with 26 male cancer patients and 24 SOs. Participants were purposefully sampled from a preceding Australian survey investigating the use of CTs in men with cancer (94% response rate and 86% consent rate for follow-up interview). Interviews were conducted in a metropolitan location, and the 43 interview transcripts were analyzed thematically. Three core themes were identified: men used CTs as (a) problem-focused coping (e.g., diet modification), (b) emotion-focused coping (e.g., meditation), and (c) meaning-based coping (e.g., prayer). Practicing CTs helped men to cope with physical, emotional, and spiritual concerns, although some men spoke of difficulties with practicing meditation to regulate their emotions. SOs were supportive of men's coping strategies but were only rarely involved in men's emotion-focused coping. Complementary therapies have the potential to facilitate coping with cancer, independent of any measurable physiological benefit. Our findings suggest that when clinicians engage in conversations about CTs use, they should consider the type of coping strategy employed by their patient. Such information may enhance the efficacy of some interventions (e.g., meditation) and also provide for an opportunity to discuss patients' expectations concerning CTs. Copyright © 2014 John Wiley & Sons, Ltd.

Prevalence, course and determinants of carpal tunnel syndrome symptoms during pregnancy: a prospective study.

PubMed

Meems, M; Truijens, Sem; Spek, V; Visser, L H; Pop, V J M

2015-07-01

To investigate the prevalence, severity and relation to fluid retention of self-reported pregnancy-related carpal tunnel syndrome (CTS) symptoms in a large sample of pregnant women. A prospective longitudinal cohort study. Dutch women who became pregnant between January 2013 and January 2014 in the southeast of The Netherlands. A total of 639 Dutch pregnant women. Baseline characteristics were assessed at 12 weeks' gestation. CTS symptoms were assessed using the Boston Carpal Tunnel Questionnaire (BCTQ) at 32 weeks and during the first postpartum week regarding the last weeks of pregnancy. Fluid retention, sleeping problems and depressive symptoms (using the Edinburgh Depression Scale) were assessed at several time points during pregnancy. BCTQ scores, fluid retention and sleeping problems. Of the 639 women, 219 (34%) reported CTS symptoms during pregnancy. Total mean scores on the BCTQ were significantly higher after 32 weeks' than up to 32 weeks' gestation. Most women experienced mild to moderate symptoms. Pregnant women with CTS symptoms reported significantly higher levels of fluid retention during gestation compared with pregnant women without CTS symptoms [F = 60.6, df (1598), P < 0.001], adjusted for body mass index (BMI), age, parity, and depression scores. Higher scores on fluid retention throughout the pregnancy were significantly related to CTS (OR = 1.8, 95%CI 1.5, 2.1, P < 0.001). Finally, the occurrence of CTS was independently related to sleeping problems. Although the severity of symptoms and functional impairment of CTS were relatively mild, health care professionals should be aware of the high prevalence. The occurrence of CTS symptoms is significantly higher in women who report fluid retention during gestation and it can contribute to sleeping problems. © 2015 Royal College of Obstetricians and Gynaecologists.

Carpal Tunnel Syndrome: Symptoms, Causes and Treatment Options. Literature Reviev.

PubMed

Zamborsky, Radoslav; Kokavec, Milan; Simko, Lukas; Bohac, Martin

2017-01-26

Carpal Tunnel Syndrome (CTS) is the most common form of entrapment neuropathy. Several authors have investigated the anatomical and pathophysiological features of CTS and have identified several parameters that, in combination, play a significant role in its pathophysiology. Advancement in biological research on CTS has enabled the advent of efficient diagnostic techniques such as provocative tests and nerve conduction studies. Sophisticated technologies, such as magnetic resonance imaging (MRI) and ultrasonography (US), have facilitated the diagnosis of CTS. This review article aims at consolidating the relevant medical literature pertaining to the symptoms, pathophysiology, clinical diagnosis and treatment strategies of CTS. It also compares the various methods of diagnosis and discusses their benefits and disadvantages. Finally, it sheds light on the conservative vs. surgical approach to treatment and compares them. While the surgical approach has proved to be more efficient relative to the conservative methods of steroid injections and splinting, many studies have demonstrated both advantages and adverse effects of the surgical methods. Surgical options and complications are discussed in detail. This article comprehensively summarizes all medical aspects of CTS to update medical professionals' knowledge regarding the disease.

Seasonal regulation of condensed tannin consumption by free-ranging goats in a semi-arid savanna

PubMed Central

Heitkӧnig, Ignas M. A.; Scogings, Peter F.; Hattas, Dawood; Dziba, Luthando E.; Prins, Herbert H. T.; de Boer, Willem F.

2018-01-01

Although condensed tannins (CTs) are known to reduce forage intake by mammalian herbivores in controlled experiments, few studies have tested these effects in the field. Thus the role of CTs on foraging ecology of free-ranging herbivores is inadequately understood. To investigate the effects of CTs under natural savanna conditions, we pre-dosed groups of goats with polyethylene glycol (PEG, a CT-neutralising chemical), CT powder or water before observing their foraging behaviour. While accounting for the effects of season and time of the day, we tested the hypothesis that herbivores forage in ways that reduce the intake rate (g DM per minute) of CTs. We expected pre-dosing goats with CTs to reduce CT intake rates by (1) consuming diets low in CTs, (2) reducing bite rates, (3) increasing the number of foraging bouts, or (4) reducing the length of foraging bouts. Lastly, (5) expected CT to have no influence the number of dietary forage species. In both wet and dry seasons, pre-dosing goats with CTs resulted in lower CT consumption rates compared to PEG goats which seemed relieved from the stress associated with CT consumption. During dry season, the number of dietary forage species was similar across treatments, although goats that were dosed with PEG significantly increased this number in the wet season. Dosing goats with PEG increased the number and length of browsing bouts compared to goats from the other treatments. Pre-loading goats with PEG also tended to increase bite rates on browse forages, which contributed to increased consumption rates of CTs. Based on the behavioural adjustments made by goats in this study and within the constraints imposed by chemical complexity in savanna systems, we concluded that herbivores under natural conditions foraged in ways that minimised CTs consumption. More research should further elucidate the mechanism through which CTs regulated feeding behaviour. PMID:29293513

Transport of cryptotanshinone, a major active triterpenoid in Salvia miltiorrhiza Bunge widely used in the treatment of stroke and Alzheimer's disease, across the blood-brain barrier.

PubMed

Yu, Xi-Yong; Lin, Shu-Guang; Chen, Xiao; Zhou, Zhi-Wei; Liang, Jun; Duan, Wei; Chowbay, Balram; Wen, Jing-Yuan; Chan, Eli; Cao, Jie; Li, Chun-Guang; Zhou, Shu-Feng

2007-05-01

Cryptotanshinone (CTS), a major constituent from the roots of Salvia miltiorrhiza (Danshen), is widely used in the treatment of coronary heart disease, stroke and less commonly Alzheimer's disease. Our recent study indicates that CTS is a substrate for P-glycoprotein (PgP/MDR1/ABCB1). This study has investigated the nature of the brain distribution of CTS across the brain-blood barrier (BBB) using several in vitro and in vivo rodent models. A polarized transport of CTS was found in rat primary microvascular endothelial cell (RBMVEC) monolayers, with facilitated efflux from the abluminal side to luminal side. Addition of a PgP (e.g. verapamil and quinidine) or multi-drug resistance protein 1/2 (MRP1/2) inhibitor (e.g. probenecid and MK-571) in both luminal and abluminal sides attenuated the polarized transport. In a bilateral in situ brain perfusion model, the uptake of CTS into the cerebrum increased from 0.52 +/- 0.1% at 1 min to 11.13 +/- 2.36 ml/100 g tissue at 30 min and was significantly greater than that of sucrose. Co-perfusion of a PgP/MDR1 (e.g. verapamil) or MRP1/2 inhibitor (e.g. probenecid) significantly increased the brain distribution of CTS by 35.1-163.6%. The brain levels of CTS were only about 21% of those in plasma, and were significantly increased when coadministered with verapamil or probenecid in rats. The brain levels of CTS in rats subjected to middle cerebral artery occlusion and rats treated with quinolinic acid (a neurotoxin) were about 2- to 2.5-fold higher than the control rats. Moreover, the brain levels in mdr1a(-/-) and mrp1(-/-) mice were 10.9- and 1.5-fold higher than those in the wild-type mice, respectively. Taken collectively, these findings indicate that PgP and Mrp1 limit the brain penetration of CTS in rodents, suggesting a possible role of PgP and MRP1 in limiting the brain penetration of CTS in patients and causing drug resistance to Danshen therapy and interactions with conventional drugs that are substrates of PgP and MRP1. Further studies are needed to explore the role of other drug transporters in restricting the brain penetration of CTS and the clinical relevance.

Relationship of Coronary Calcium on Standard Chest CT Scans With Mortality.

PubMed

Hughes-Austin, Jan M; Dominguez, Arturo; Allison, Matthew A; Wassel, Christina L; Rifkin, Dena E; Morgan, Cindy G; Daniels, Michael R; Ikram, Umaira; Knox, Jessica B; Wright, C Michael; Criqui, Michael H; Ix, Joachim H

2016-02-01

The aim of this study was to determine the correlation between coronary artery calcium (CAC) scores on 3 mm electrocardiography (ECG)-gated computed tomography (CT) scans and standard 6 mm chest CT scans, and to compare relative strength of associations of CAC on each scan type with mortality risk. Coronary artery calcification predicts cardiovascular disease (CVD) and all-cause mortality, and is typically measured on ECG-gated 3 mm CT scans. Patients undergo standard 6 mm chest CTs for various clinical indications much more frequently, but CAC is not usually quantified. To better understand the usefulness of standard chest CTs to quantify CAC, we conducted a case-control study among persons who had both scan types. Between 2000 and 2003, 4,544 community-living individuals self- or physician-referred for "whole-body" CT scans, had 3 mm ECG-gated CTs and standard 6 mm chest CTs, and were followed for mortality through 2009. In this nested case-control study, we identified 157 deaths and 494 controls frequency matched (1:3) on age and sex. The Agatston method quantified CAC on both scan types. Unconditional logistic regression determined associations with mortality, accounting for CVD risk factors. Participants were 68 ± 11 years of age and 63% male. The Spearman correlation of CAC scores between the 2 scan types was 0.93 (p < 0.001); median CAC scores were lower on 6 mm CTs compared to 3 mm CTs (22 vs.104 Agatston units, p < 0.001). Adjusted for traditional CVD risk factors, each standard deviation higher CAC score on 6 mm CTs was associated with 50% higher odds of death (odds ratio: 1.5; 95% confidence interval: 1.2 to 1.9), similar to 50% higher odds on the 3 mm ECG-gated CTs (odds ratio: 1.5; 95% confidence interval: 1.1 to 1.9). CAC scores on standard 6 mm chest CTs are strongly correlated with 3 mm ECG-gated CTs and similarly predict mortality in community-living individuals. Chest CTs performed for other clinical indications may provide an untapped resource to garner CVD risk information without additional radiation exposure or expense. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

The Effects of Low Intensity Laser on Clinical and Electrophysiological Parameters of Carpal Tunnel Syndrome

PubMed Central

Rayegani, Seyed Mansoor; Bahrami, Mohammad Hasan; Eliaspour, Darisuh; Raeissadat, Seyed Ahmad; Shafi Tabar Samakoosh, Mostafa; Sedihgipour, Leyla; Kargozar, Elham

2013-01-01

Introduction: Carpal Tunnel Syndrome (CTS) is the most common type of entrapment neuropathy. Conservative therapy is usually considered as the first step in the management of CTS. Low Level Laser Therapy (LLLT) is among the new physical modalities, which has shown therapeutic effects in CTS. The aim of the present study was to compare the effects of applying LASER and splinting together with splinting alone in patients with CTS. Methods: Fifty patients with mild and moderate CTS who met inclusion criteria were included in this study. The disease was confirmed by electrodiagnostic study (EDx) and clinical findings. Patients were randomly divided into 3 groups. Group A received LLLT and splinting. Group B received sham LLLT+ splinting and group C received only splints. Group A received LLLT (50 mw and 880nm with total dose of 6 joule/cm2). Clinical and EDx parameters were evaluated before and after treatment (3 weeks and 2 months later). Results: Electrophysiologic parameters and clinical findings including CTS provocative tests, Symptoms severity score (SSS), Functional Severity Score (FSS) and Visual Analogue Score (VAS) were improved in all three groups at 3 weeks and 2 months after treatment. No significant changes were noticed between the three groups regarding clinical and EDX parameters. Conclusion: We found no superiority in applying Low Intensity Laser accompanying splinting to traditional treatment which means splinting alone in patients with CTS. However, future studies investigating LLLT with parameters other than the one used in this study may reveal different results in favor of LLLT. PMID:25606328

Controlled-release biodegradable nanoparticles: From preparation to vaginal applications.

PubMed

Martínez-Pérez, Beatriz; Quintanar-Guerrero, David; Tapia-Tapia, Melina; Cisneros-Tamayo, Ricardo; Zambrano-Zaragoza, María L; Alcalá-Alcalá, Sergio; Mendoza-Muñoz, Néstor; Piñón-Segundo, Elizabeth

2018-03-30

This study aimed to prepare poly (d,l-lactide-co-glycolide) (PLGA) nanoparticles (NPs) with chitosan (CTS) surface modification to be used as a vaginal delivery system for antimycotic drugs. Clotrimazole was encapsulated with entrapment efficiencies of 86.1 and 68.9% into Clotrimazole-PLGA-NPs (CLT-PLGA-NPs) and PLGA-NPs with CTS-modified surface (CLT-PLGA-CTS-NPs), respectively. The later NPs exhibited a larger size and higher positive zeta potential (Z potential) in comparison to unmodified NPs. In vitro release kinetic studies indicated that Clotrimazole was released in percentages of >98% from both nanoparticulate systems after 18days. Antifungal activity and mucoadhesive properties of NPs were enhanced when CTS was added onto the surface. In summary, these results suggested that Clotrimazole loaded into PLGA-CTS-NPs has great potential for vaginal applications in treating vaginal infections generated by Candida albicans. Copyright © 2018 Elsevier B.V. All rights reserved.

Biomechanical risk factors for carpal tunnel syndrome: a pooled study of 2474 workers

PubMed Central

Harris-Adamson, Carisa; Eisen, Ellen A; Kapellusch, Jay; Garg, Arun; Hegmann, Kurt T; Thiese, Matthew S; Dale, Ann Marie; Evanoff, Bradley; Burt, Susan; Bao, Stephen; Silverstein, Barbara; Merlino, Linda; Gerr, Fred; Rempel, David

2015-01-01

Background Between 2001 and 2010, five research groups conducted coordinated prospective studies of carpal tunnel syndrome (CTS) incidence among US workers from various industries and collected detailed subject-level exposure information with follow-up of symptoms, electrophysiological measures and job changes. Objective This analysis examined the associations between workplace biomechanical factors and incidence of dominant-hand CTS, adjusting for personal risk factors. Methods 2474 participants, without CTS or possible polyneuropathy at enrolment, were followed up to 6.5 years (5102 person-years). Individual workplace exposure measures of the dominant hand were collected for each task and included force, repetition, duty cycle and posture. Task exposures were combined across the workweek using time-weighted averaging to estimate job-level exposures. CTS case-criteria were based on symptoms and results of electrophysiological testing. HRs were estimated using Cox proportional hazard models. Results After adjustment for covariates, analyst (HR=2.17; 95% CI 1.38 to 3.43) and worker (HR=2.08; 95% CI 1.31 to 3.39) estimated peak hand force, forceful repetition rate (HR=1.84; 95% CI 1.19 to 2.86) and per cent time spent (eg, duty cycle) in forceful hand exertions (HR=2.05; 95% CI 1.34 to 3.15) were associated with increased risk of incident CTS. Associations were not observed between total hand repetition rate, per cent duration of all hand exertions, or wrist posture and incident CTS. Conclusions In this prospective multicentre study of production and service workers, measures of exposure to forceful hand exertion were associated with incident CTS after controlling for important covariates. These findings may influence the design of workplace safety programmes for preventing work-related CTS. PMID:25324489

Personal and workplace psychosocial risk factors for carpal tunnel syndrome: a pooled study cohort.

PubMed

Harris-Adamson, Carisa; Eisen, Ellen A; Dale, Ann Marie; Evanoff, Bradley; Hegmann, Kurt T; Thiese, Matthew S; Kapellusch, Jay M; Garg, Arun; Burt, Susan; Bao, Stephen; Silverstein, Barbara; Gerr, Fred; Merlino, Linda; Rempel, David

2013-08-01

Between 2001 and 2010, six research groups conducted coordinated multiyear, prospective studies of carpal tunnel syndrome (CTS) incidence in US workers from various industries and collected detailed subject-level exposure information with follow-up symptom, physical examination, electrophysiological measures and job changes. This analysis of the pooled cohort examined the incidence of dominant-hand CTS in relation to demographic characteristics and estimated associations with occupational psychosocial factors and years worked, adjusting for confounding by personal risk factors. 3515 participants, without baseline CTS, were followed-up to 7 years. Case criteria included symptoms and an electrodiagnostic study consistent with CTS. Adjusted HRs were estimated in Cox proportional hazard models. Workplace biomechanical factors were collected but not evaluated in this analysis. Women were at elevated risk for CTS (HR=1.30; 95% CI 0.98 to 1.72), and the incidence of CTS increased linearly with both age and body mass index (BMI) over most of the observed range. High job strain increased risk (HR=1.86; 95% CI 1.11 to 3.14), and social support was protective (HR=0.54; 95% CI 0.31 to 0.95). There was an inverse relationship with years worked among recent hires with the highest incidence in the first 3.5 years of work (HR=3.08; 95% CI 1.55 to 6.12). Personal factors associated with an increased risk of developing CTS were BMI, age and being a woman. Workplace risk factors were high job strain, while social support was protective. The inverse relationship between CTS incidence and years worked among recent hires suggests the presence of a healthy worker survivor effect in the cohort.

Personal and workplace psychosocial risk factors for carpal tunnel syndrome: a pooled study cohort

PubMed Central

Harris-Adamson, Carisa; Eisen, Ellen A; Dale, Ann Marie; Evanoff, Bradley; Hegmann, Kurt T; Thiese, Matthew S; Kapellusch, Jay M; Garg, Arun; Burt, Susan; Bao, Stephen; Silverstein, Barbara; Gerr, Fred; Merlino, Linda; Rempel, David

2015-01-01

Background Between 2001 and 2010, six research groups conducted coordinated multiyear, prospective studies of carpal tunnel syndrome (CTS) incidence in US workers from various industries and collected detailed subject-level exposure information with follow-up symptom, physical examination, electrophysiological measures and job changes. Objective This analysis of the pooled cohort examined the incidence of dominant-hand CTS in relation to demographic characteristics and estimated associations with occupational psychosocial factors and years worked, adjusting for confounding by personal risk factors. Methods 3515 participants, without baseline CTS, were followed-up to 7 years. Case criteria included symptoms and an electrodiagnostic study consistent with CTS. Adjusted HRs were estimated in Cox proportional hazard models. Workplace biomechanical factors were collected but not evaluated in this analysis. Results Women were at elevated risk for CTS (HR=1.30; 95% CI 0.98 to 1.72), and the incidence of CTS increased linearly with both age and body mass index (BMI) over most of the observed range. High job strain increased risk (HR=1.86; 95% CI 1.11 to 3.14), and social support was protective (HR=0.54; 95% CI 0.31 to 0.95). There was an inverse relationship with years worked among recent hires with the highest incidence in the first 3.5 years of work (HR=3.08; 95% CI 1.55 to 6.12). Conclusions Personal factors associated with an increased risk of developing CTS were BMI, age and being a woman. Workplace risk factors were high job strain, while social support was protective. The inverse relationship between CTS incidence and years worked among recent hires suggests the presence of a healthy worker survivor effect in the cohort. PMID:23645610

Time Is Money: Opportunity Cost and Physicians' Provision of Charity Care 1996–2005

PubMed Central

Wright, David Bradley

2010-01-01

Objective To test whether physicians' provision of charity care depends on their hourly wage. Data Sources Secondary data from four rounds of the Community Tracking Study (CTS) Physician Survey (1996–2005). Data are nationally representative of nonfederal office- and hospital-based physicians spending at least 20 hours per week on patient care. Study Design A two-part model with site-level fixed effects, time trend variables, and site–year interactions is used to model the relationship between physicians' hourly wage and both their decision to provide any charity care and the amount of charity care provided. Salaried and nonsalaried physicians are modeled separately. Data Collection/Extraction Methods Data from each round of the CTS were merged into a single cross-sectional file with 38,087 physician-year observations. Principal Findings The association between physician's hourly wage and the likelihood of providing charity care is positive for salaried physicians and negative for nonsalaried physicians. Among physicians providing any charity care, hourly wage is positively associated with the amount of charity care provided regardless of salaried status. Practice characteristics are also significant. Conclusions The financial considerations of salaried physicians differ significantly from those of nonsalaried physicians in the decision to provide charity care, but factor similarly into the amount of charity care provided. PMID:20662946

Beyond Critical Thinking Skills: Investigating the Relationship between Critical Thinking Skills and Dispositions through Different Online Instructional Strategies

ERIC Educational Resources Information Center

Yang, Ya-Ting C.; Chou, Heng-An

2008-01-01

The purpose of this study was to investigate (1) the relationship between critical thinking skills (CTS) and critical thinking dispositions (CTD), and (2) the effectiveness of different levels of instructional strategy (asynchronous online discussions (AODs), CTS instruction via AODs, and CTS instruction with CTD cultivation via AODs) in improving…

Diagnosis from functional perspectives: usefulness of a manual tactile test for predicting precision pinch performance and disease severity in subjects with carpal tunnel syndrome.

PubMed

Hsu, Hsiu-Yun; Kuo, Yao-Lung; Jou, I-Ming; Su, Fong-Chin; Chiu, Haw-Yen; Kuo, Li-Chieh

2014-04-01

To investigate how the severity levels revealed in a nerve conduction study (NCS) affect the results of the Manual Tactile Test (MTT) for patients with carpal tunnel syndrome (CTS), and to examine the relationships between the results of the MTT and precision pinch performance. Case-control studies. Hospital and local community. Patients with CTS (N=70) with 119 affected hands were studied. A control group matched by age, sex, and hand dominance was also recruited. Not applicable. CTS severity was determined based on NCS findings. The MTT, traditional sensory tests, and precision pinch performance were used to examine the functional sensory status of the hand from different perspectives. The patients with CTS exhibited deterioration in all of the sensibility tests (P<.001). The results showed that the MTT could classify subgroups of severity in CTS (P<.001). A moderate correlation was found between the results of the MTT and precision pinch performance (r=.526-.585, P<.001). Multiple linear regression analysis showed that the MTT results were useful indicators for predicting precision pinch performance and differentiating severity in subjects with CTS (r(2)=.376 and .323, respectively). The findings indicate that the MTT could be a valid and useful assessment for hand sensibility and prehensile pinch performance in patients with CTS. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Seasonal distribution and demographical characteristics of carpal tunnel syndrome in 1039 patients.

PubMed

Gomes, Irênio; Becker, Jefferson; Ehlers, João Arthur; Kapczinski, Flávio; Nora, Daniel Bocchese

2004-09-01

To describe the demographic characteristics of gender, age, and presence of repetitive movements, intake of alcohol and non-steroid anti-inflammatories (NSAI), medical specialties that referred patients to nerve conduction studies and electromyography (NCS-EMG), school attainment, and seasonal distribution in patients with a neurophysiological diagnosis of carpal tunnel syndrome (CTS) in the State of Rio Grande do Sul, Brazil. A series of 1039 patients (1549 hands) with neurophysiologically defined CTS was studied. Patients were referred for NCS-EMG in 3 universities and 2 private services, from August 2001 to January 2003. All patients completed a questionnaire containing demographic information. The diagnosis of CTS was established following a pre-established protocol, with defined diagnostic criteria. Around one fourth of patients had already performed NCS-EMG; the greatest frequency of CTS was observed in women (5.6:1) and in patients above the age of 40. Most patients reported performing repetitive movements in their daily routine (69.7%); 12.9% reported use of NSAI and 14.9% regular intake of alcoholic beverages. A greater frequency of CTS was observed in the months of July and August, when compared to the other months of the year. Around 2/3 of the study population had completed at least secondary school. Most requests of nerve conduction studies did not provide a diagnostic hypothesis (59.9%) and neurophysiologic studies were requested mostly by traumatology/orthopedics (71.1%). We have concluded that, in our environment, CTS shows some demographical characteristics that are similar to what the literature describes. Also, we have found that most of our sample concluded at least secondary school, and was referred to neurophysiologic studies by orthopedists. To be pointed out is the seasonal distribution of CTS, which demonstrates a significant association with winter months.

Direct Determination of Lean Body Mass by CT in F-18 FDG PET/CT Studies: Comparison with Estimates Using Predictive Equations.

PubMed

Kim, Chang Guhn; Kim, Woo Hyoung; Kim, Myoung Hyoun; Kim, Dae-Weung

2013-06-01

The purpose of this study was to estimate lean body mass (LBM) using CT (LBM CTs) and compare the results with LBM estimates of four different predictive equations (LBM PEs) to assess whether LBM CTs and LBM PEs can be used interchangeably for SUV normalization. Whole-body F-18 FDG PET/CT studies were conducted on 392 patients. LBM CT1 is modified adipose tissue-free body mass, and LBM CT2 is adipose tissue-free body mass. Four different PEs were used for comparison (LBM PE1-4). Agreement between the two measurement methods was assessed by Bland-Altman analysis. We calculated the difference between two methods (bias), the percentage of difference, and the limits of agreement, expressed as a percentage. For LBM CTs vs. LBM PEs, except LBM PE3, the ranges of biases and limits of agreement were -3.77 to 3.81 kg and 26.60-35.05 %, respectively, indicating the wide limits of agreement and differing magnitudes of bias. For LBM CTs vs. LBM PE3, LBM PE3 had wider limits of agreement and greater positive bias (44.28-46.19 % and 10.49 to 14.04 kg, respectively), showing unacceptably large discrepancies between LBM CTs and LBM PE3. This study demonstrated that there are substantial discrepancies between individual LBM CTs and LBM PEs, and this should be taken into account when LBM CTs and LBM PEs are used interchangeably between patients.

Impact of distal median neuropathy on handwriting performance for patients with carpal tunnel syndrome in office and administrative support occupations.

PubMed

Kuo, Li-Chieh; Hsu, Hsiao-Man; Wu, Po-Ting; Lin, Sheng-Che; Hsu, Hsiu-Yun; Jou, I-Ming

2014-06-01

This study investigates the handwriting performance of patients with carpal tunnel syndrome (CTS) and healthy controls in office and administrative support occupations, adopting both biomechanical and functional perspectives. This work also explores how surgical intervention altered the performance of the CTS patients. Fourteen CTS patients and 14 control subjects were recruited to complete a self-reported survey and participate in sensory tests, hand strength, dexterity and handwriting tasks using a custom force acquisition pen along with motion capture technology. Based on the results of these, the sensory measurements, along with functional and biomechanical parameters, were used to determine the differences between the groups and also reveal any improvements that occurred in the CTS group after surgical intervention. The CTS patients showed significantly poorer hand sensibility and dexterity than the controls, as well as excessive force exertion of the digits and pen tip, and less efficient force adjustment ability during handwriting. After surgery and sensory recovery, the hand dexterity and pen tip force of the CTS patients improved significantly. The force adjustment abilities of the digits also increased, but these changes were not statistically significant. This study provides the objective measurements and novel apparatus that can be used to determine impairments in the handwriting abilities of office or administrative workers with CTS. The results can also help clinicians or patients to better understand the sensory-related deficits in sensorimotor control of the hand related to CTS, and thus develop and implement more suitable training or adaptive protocols.

Catestatin (chromogranin A344-364) is a novel cardiosuppressive agent: inhibition of isoproterenol and endothelin signaling in the frog heart

PubMed Central

Mazza, Rosa; Gattuso, Alfonsina; Mannarino, Cinzia; Brar, Bhawanjit K.; Barbieri, Sandra Francesca; Tota, Bruno; Mahata, Sushil K.

2008-01-01

The catecholamine release-inhibitory catestatin [Cts; human chromogranin (Cg) A352-372, bovine CgA344-364] is a vasoreactive and anti-hypertensive peptide derived from CgA. Using the isolated avascular frog heart as a bioassay, in which the interactions between the endocardial endothelium and the subjacent myocardium can be studied without the confounding effects of the vascular endothelium, we tested the direct cardiotropic effects of bovine Cts and its interaction with β-adrenergic (isoproterenol, ISO) and endothelin-1 (ET-1) signaling. Cts dose-dependently decreased stroke volume and stroke work, with a threshold concentration of 11 nM, approaching the in vivo level of the peptide. Cts reduced contractility by inhibiting phosphorylation of phospholamban (PLN). Furthermore, the Cts effect was abolished by pretreatment with either nitric oxide synthase (NG-monomethyl-l-arginine) or guanylate cyclase (ODQ) inhibitors, or an ETB receptor (ETBR) antagonist (BQ-788). Cts also noncompetitively inhibited the positive inotropic action of ISO. In addition, Cts inhibited the positive inotropic effect of ET-1, mediated by ETA receptors, and did not alter the negative inotropic ET-1 influence mediated by ETBR. Cts action through ETBR was further suggested when, in the presence of BQ-788, Cts failed to inhibit the positive inotropism of both ISO and ET-1 stimulation and PLN phosphorylation. We concluded that the cardiotropic actions of Cts, including the β-adrenergic and ET-1 antagonistic effects, support a novel role of this peptide as an autocrine-paracrine modulator of cardiac function, particularly when the stressed heart becomes a preferential target of both adrenergic and ET-1 stimuli. PMID:18469147

Optimized synthesis of glycyrrhetinic acid-modified chitosan 5-fluorouracil nanoparticles and their characteristics

PubMed Central

Cheng, Mingrong; Chen, Houxiang; Wang, Yong; Xu, Hongzhi; He, Bing; Han, Jiang; Zhang, Zhiping

2014-01-01

The nanoparticle drug delivery system, which uses natural or synthetic polymeric material as a carrier to deliver drugs to targeted tissues, has a broad prospect for clinical application for its targeting, slow-release, and biodegradable properties. Here, we used chitosan (CTS) and hepatoma cell-specific binding molecule glycyrrhetinic acid to synthesize glycyrrhetinic acid-modified chitosan (GA-CTS). The synthetic product was confirmed by infrared (IR) spectra and hydrogen-1 nuclear magnetic resonance. The GA-CTS/5-fluorouracil (5-FU) nanoparticles were synthesized by combining GA-CTS and 5-FU and conjugating 5-FU onto the GA-CTS nanomaterial. The central composite design was performed to optimize the preparation process as CTS:tripolyphosphate sodium (TPP) weight ratio =5:1, 5-FU:CTS weight ratio =1:1, TPP concentration =0.05% (w/v), and cross-link time =50 minutes. GA-CTS/5-FU nanoparticles had a mean particle size of 193.7 nm, a polydispersity index of 0.003, a zeta potential of +27.4 mV, and a drug loading of 1.56%. The GA-CTS/5-FU nanoparticle had a protective effect on the drug against plasma degrading enzyme, and provided a sustained release system comprising three distinct phases of quick, steady, and slow release. Our study showed that the peak time, half-life time, mean residence time and area under the curve of GA-CTS/5-FU were longer or more than those of the 5-FU group, but the maximum concentration (Cmax) was lower. We demonstrated that the nanoparticles accumulated in the liver and have significantly inhibited tumor growth in an orthotropic liver cancer mouse model. PMID:24493926

Optimization of low cost, non toxic, earth abundant p-type Cu2SnS3 thin film for Photovoltaic application

NASA Astrophysics Data System (ADS)

Chaudhari, J. J.; Patel, S.; Joshi, U. S.

2016-09-01

Cu2SnS3 (CTS) is one of promising candidate as an absorber material for thin film solar cell. Because of relatively higher prize of Indium and hazardous environmental impact of processing of Gallium, CTS is suitable alternative candidate to Cu2SnS3 (CIGS) based solar cell as its constituent elements such as copper, tin and sulphur are abundantly available in earth's crust. CTS is ternary semiconductor and its energy band gap is 1.5eV, which is perfectly matched with solar energy spectrum for maximum transfer of solar energy into electrical energy through photovoltaic action. The primary methods for the synthesis of CTS are Thermal evaporation, electrochemical, sputtering and wet chemical methods. Here in this paper we have optimized a low cost non-vacuum solution process method for the synthesis of CTS without any external sulfurization. The X-ray diffraction studies showed the formation of phase with the peaks corresponding to (112), (220) and (312) planes. Chemical Solution Deposition (CSD) for the synthesis of CTS is suitable for large area deposition and it includes several routes like solvothermal methods, direct liquid coating and nano ink based technique. The metal Chloride salts and thiourea is used as a source of sulphur to synthesize CTS solution and homogeneous thin films of CTS deposited on glass substrate using spin coating method. Use of abrasive solvent like hydrazine and hydrogen sulphide gas which are used to synthesize CTS thin film have detrimental effect on environment, we report eco friendly solvent based approach to synthesize CTS at low temperature 200 °C.

Blaming the messenger for the bad news about partner violence by women: the methodological, theoretical, and value basis of the purported invalidity of the conflict tactics scales.

PubMed

Straus, Murray A

2012-01-01

More than 200 studies have found "gender symmetry" in perpetration of violence against a marital or dating partner in the sense that about the same percent of women as men physically assault a marital or dating partner. Most of these studies obtained the data using the Conflict Tactics Scales (CTS). However, these results have been challenged by numerous articles in the past 25 years that have asserted that the CTS is invalid. This article identifies and responds to 11 purported methodological problems of the CTS, and two other bases for the belief that the CTS is not valid. The discussion argues that the repeated assertion over the past 25 years that the CTS is invalid is not primarily about methodology. Rather it is primarily about theories and values concerning the results of research showing gender symmetry in perpetration. According to the prevailing "patriarchal dominance" theory, these results cannot be true and therefore the CTS must be invalid. The conclusion suggests that an essential part of the effort to prevent and treat violence against women and by women requires taking into account the dyadic nature of partner violence through use of instruments such as the CTS that measure violence by both partners. Copyright © 2012 John Wiley & Sons, Ltd.

Development of silver and zinc oxide decorated nanoclay containing polymeric composites for water disinfection applications

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

Motshekga, Sarah C.; Department of Chemical, Metallurgical and Materials Engineering, Tshwane University of Technology, Pretoria, 0001; Ray, Suprakas Sinha

Contaminated drinking water has serious implications to the human health that could lead to death. The rapid growth of bacterial contamination in drinking water is alarming, and yet a robust and cost effective method with less limitation has not been developed. The current study is aimed at evaluating the performance of nanoclay composites dispersed in chitosan biopolymer as an antibacterial material. The performances of the composites were evaluated using the batch kinetic studies. Three composites of Ag-CtsB, ZnO-CtsB and Ag/ZnO-CtsB were prepared and evaluated against gram negative Escherichia coli and gram positive Enterococcus faecalis bacteria. The composites were characterized bymore » powder X-ray diffraction, scanning electron microscope, energy dispersive spectroscopy and BET surface area measurements. Antibacterial activity results showed that the composites can be a potent bactericide material for water disinfection as they are highly effective against both gram negative and gram positive bacteria tested. Whereas both Ag-CtsB and ZnO-CtsB composites showed good antibacterial activity against bacteria with removal efficiency from 51%, best antibacterial activity was observed with Ag/ZnO-CtsB composite with removal efficiency from 78%. The results revealed that Ag/ZnO-CtsB composite is a promising bactericide that is highly effective against both gram negative and gram positive bacteria tested.« less

Development of silver and zinc oxide decorated nanoclay containing polymeric composites for water disinfection applications

NASA Astrophysics Data System (ADS)

Motshekga, Sarah C.; Ray, Suprakas Sinha; Onyango, Maurice S.; Momba, Maggie N. B.

2015-05-01

Contaminated drinking water has serious implications to the human health that could lead to death. The rapid growth of bacterial contamination in drinking water is alarming, and yet a robust and cost effective method with less limitation has not been developed. The current study is aimed at evaluating the performance of nanoclay composites dispersed in chitosan biopolymer as an antibacterial material. The performances of the composites were evaluated using the batch kinetic studies. Three composites of Ag-CtsB, ZnO-CtsB and Ag/ZnO-CtsB were prepared and evaluated against gram negative Escherichia coli and gram positive Enterococcus faecalis bacteria. The composites were characterized by powder X-ray diffraction, scanning electron microscope, energy dispersive spectroscopy and BET surface area measurements. Antibacterial activity results showed that the composites can be a potent bactericide material for water disinfection as they are highly effective against both gram negative and gram positive bacteria tested. Whereas both Ag-CtsB and ZnO-CtsB composites showed good antibacterial activity against bacteria with removal efficiency from 51%, best antibacterial activity was observed with Ag/ZnO-CtsB composite with removal efficiency from 78%. The results revealed that Ag/ZnO-CtsB composite is a promising bactericide that is highly effective against both gram negative and gram positive bacteria tested.

Assessing the performance of LOINC® and RadLex for coverage of CT scans across three sites in a health information exchange.

PubMed

Beitia, Anton Oscar; Kuperman, Gilad; Delman, Bradley N; Shapiro, Jason S

2013-01-01

We evaluated the performance of LOINC® and RadLex standard terminologies for covering CT test names from three sites in a health information exchange (HIE) with the eventual goal of building an HIE-based clinical decision support system to alert providers of prior duplicate CTs. Given the goal, the most important parameter to assess was coverage for high frequency exams that were most likely to be repeated. We showed that both LOINC® and RadLex provided sufficient coverage for our use case through calculations of (a) high coverage of 90% and 94%, respectively for the subset of CTs accounting for 99% of exams performed and (b) high concept token coverage (total percentage of exams performed that map to terminologies) of 92% and 95%, respectively. With trends toward greater interoperability, this work may provide a framework for those wishing to map radiology site codes to a standard nomenclature for purposes of tracking resource utilization.

Hypothyroidism and carpal tunnel syndrome: a meta-analysis.

PubMed

Shiri, Rahman

2014-12-01

This study aimed to assess the magnitude of the association between hypothyroidism and carpal tunnel syndrome (CTS). Eighteen studies were included in a random-effects meta-analysis. A meta-analysis of the studies that did not control their estimates for any confounder showed an association between a thyroid disease (hypo- or hyperthyroidism) and CTS (N = 9,573, effect size [ES] = 1.32 (95% confidence interval [CI], 1.04-1.68) and between hypothyroidism and CTS (N = 64,531, ES = 2.15 [95% CI, 1.64-2.83]). When a meta-analysis limited to the studies that controlled their estimates for some potential confounders, the association between a thyroid disease and CTS disappeared (N = 4,799, ES = 1.17 [95% CI, 0.71-1.92], I(2) = 0%), and the effect size for hypothyroidism largely attenuated (N = 71,133, ES = 1.44 [95% CI, 1.27-1.63], I(2) = 0%). Moreover, there was evidence of publication bias. This meta-analysis found only a modest association between hypothyroidism and CTS. Confounding and publication bias may still account for part of the remaining excess risk. © 2014 Wiley Periodicals, Inc.

One-year incidence of carpal tunnel syndrome in Latino poultry processing workers and other Latino manual workers.

PubMed

Cartwright, Michael S; Walker, Francis O; Newman, Jill C; Schulz, Mark R; Arcury, Thomas A; Grzywacz, Joseph G; Mora, Dana C; Chen, Haiying; Eaton, Bethany; Quandt, Sara A

2014-03-01

To determine the incidence of carpal tunnel syndrome (CTS) over 1 year in Latino poultry processing workers. Symptoms and nerve conduction studies were used to identify Latino poultry processing workers (106 wrists) and Latinos in other manual labor occupations (257 wrists) that did not have CTS at baseline, and these individuals were then evaluated in the same manner 1 year later. Based on wrists, the 1-year incidence of CTS was higher in poultry processing workers than non-poultry manual workers (19.8% vs. 11.7%, P = 0.022). Poultry workers had a higher odds (1.89; P = 0.089) of developing CTS over 1 year compared to non-poultry manual workers. Latino poultry processing workers have an incidence of CTS that is possibly higher than Latinos in other manual labor positions. Latino poultry workers' high absolute and relative risk of CTS likely results from the repetitive and strenuous nature of poultry processing work. © 2013 Wiley Periodicals, Inc.

Assessment of the Presence of Carpal Tunnel Syndrome in Patients with Diabetes Mellitus, Hypothyroidism and Acromegaly

PubMed Central

Nas, Kemal; Kilinç, Faruk; Tasdemir, Nebahat; Bozkurt, Mehtap; Yildiz, Ismail

2015-01-01

Introduction Carpal tunnel syndrome (CTS) is one of the most common entrapment neuropathies of the upper limbs. It results from compromised median nerve function of the wrist that is caused by increased pressure in the carpal tunnel. Repetitive use of the hand and wrist, obesity, pregnancy, rheumatoid diseases, trauma and endocrinopathies are some of the risk factors for CTS. Aim The purpose of this study was to find out whether patients with diabetes mellitus (DM), hypothyroidism and acromegaly have an increased incidence of carpal tunnel syndrome compared to each other and normal population. Materials and Methods Patients were assigned into three groups as follows: patients with type II DM n: 100, patients with hypothyroidism n:48 and patients with acromegaly n:36. In addition, 50 healthy individuals were included in the study as control subjects. Patients were asked if they had any pain, symptoms of paraesthesia and numbness. Patients with peripheral neuropathy were excluded from the study. Boston Symptom Severity Scale and Functional Capacity Scale were used to assess symptom severity and functional capacity. CTS was investigated by performing electrophysiological study for both hands. Results The incidence of CTS was significantly higher in all three groups compared to the control group (p>0.05). In addition, the incidence of CTS was significantly higher in the DM group compared to the hypothyroid and acromegaly groups (p<0.001). The incidence of bilateral CTS in the DM group was significantly higher compared to both hypothyroid and acromegaly groups and the control group (p<0.001). Conclusion CTS has a higher incidence in DM, hypothyroid and acromegaly patients compared to healthy individuals. Clinicians should be careful about development of CTS in DM, hypothyroidism and acromegaly. They should adopt a multidisciplinary approach and co-operate with the psychiatrist. PMID:26266148

Importance of Recognizing Carpal Tunnel Syndrome for Neurosurgeons: A Review

PubMed Central

YUNOKI, Masatoshi; KANDA, Takahiro; SUZUKI, Kenta; UNEDA, Atsuhito; HIRASHITA, Koji; YOSHINO, Kimihiro

2017-01-01

Idiopathic carpal tunnel syndrome (CTS) is a common complaint, reflecting entrapment neuropathy of the upper extremity. CTS produces symptoms similar to those of other conditions, such as cervical spondylosis or ischemic or neoplastic intracranial disease. Because of these overlaps, patients with CTS are often referred to a neurosurgeon. Surgical treatment of CTS was started recently in our department. Through this experience, we realized that neurosurgeons should have an increased awareness of this condition so they can knowledgeably assess patients with a differential diagnosis that includes CTS and cervical spinal and cerebral disease. We conducted a literature review to gain the information needed to summarize current knowledge on the clinical, pathogenetic, and therapeutic aspects of CTS. Because the optimal diagnostic criteria for this disease are still undetermined, its diagnosis is based on the patient’s history and physical examination, which should be confirmed by nerve conduction studies and imaging modalities such as magnetic resonance imaging and ultrasonography. Treatment methods include observation, medication, splinting, steroid injections, and surgical intervention. Understanding the clinical features and pathogenesis of CTS, as well as the therapeutic options available to treat it, is important for neurosurgeons if they are to provide the correct management of patients with this disease. PMID:28154344

Importance of Recognizing Carpal Tunnel Syndrome for Neurosurgeons: A Review.

PubMed

Yunoki, Masatoshi; Kanda, Takahiro; Suzuki, Kenta; Uneda, Atsuhito; Hirashita, Koji; Yoshino, Kimihiro

2017-04-15

Idiopathic carpal tunnel syndrome (CTS) is a common complaint, reflecting entrapment neuropathy of the upper extremity. CTS produces symptoms similar to those of other conditions, such as cervical spondylosis or ischemic or neoplastic intracranial disease. Because of these overlaps, patients with CTS are often referred to a neurosurgeon. Surgical treatment of CTS was started recently in our department. Through this experience, we realized that neurosurgeons should have an increased awareness of this condition so they can knowledgeably assess patients with a differential diagnosis that includes CTS and cervical spinal and cerebral disease. We conducted a literature review to gain the information needed to summarize current knowledge on the clinical, pathogenetic, and therapeutic aspects of CTS. Because the optimal diagnostic criteria for this disease are still undetermined, its diagnosis is based on the patient's history and physical examination, which should be confirmed by nerve conduction studies and imaging modalities such as magnetic resonance imaging and ultrasonography. Treatment methods include observation, medication, splinting, steroid injections, and surgical intervention. Understanding the clinical features and pathogenesis of CTS, as well as the therapeutic options available to treat it, is important for neurosurgeons if they are to provide the correct management of patients with this disease.

75 FR 26701 - Telecommunications Relay Services and Speech-to-Speech Services for Individuals With Hearing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-12

... Services (CTS), Internet Protocol (IP) CTS, IP Relay, and Video Relay Services (VRS), for the 2010-2011... comment on NECA's proposed compensation rates for TRS, STS, CTS, IP CTS, IP Relay, and VRS, for the 2010... interstate traditional TRS; $3.1566 for STS; $1.6951 for CTS and IP CTS; $1.2985 for IP Relay. Based on these...

Soil microbial properties after 5 years of consecutive amendment with composted tannery sludge.

PubMed

Araujo, Ademir Sérgio Ferreira; Miranda, Ana Roberta Lima; Oliveira, Mara Lucia Jacinto; Santos, Vilma Maria; Nunes, Luís Alfredo Pinheiro Leal; Melo, Wanderley José

2015-01-01

Composting has been recognised an alternative method to tannery sludge recycling and afterwards to be used in agriculture. As the tannery sludge contains salts and chromium, the application of composted tannery sludge (CTS) should be performed carefully to minimise negative effects on soil microbial properties. Therefore, this study evaluated the effects of 5-year repeated CTS amendment on soil microbial biomass (SMB) and enzyme activities in a tropical soil. CTS was applied during 5 years at 0, 2.5, 5, 10 and 20 Mg ha(-1), and at the fifth year, the microbial biomass C (MBC) and N (MBN), basal and substrate-induced respiration (SIR), metabolic quotient (qCO₂) and dehydrogenase (DHA) and fluorescein diacetate (FDA) hydrolysis were determined in the soil samples. Soil MBC and MBN showed the highest values with the amendment of 5 Mg ha(-1) CTS. Soil respiration increased with the increase in CTS rates, while SIR showed the highest values with the amendment of 0, 2.5 and 5 Mg ha(-1) CTS. DHA activity showed the highest values with the amendment up to 2.5 Mg ha(-1), while FDA hydrolysis increased up to the rate of 5 Mg ha(-1) CTS. The results show that after 5 years of permanent amendment of CTS, soils amended with 2.5 Mg ha(-1) have SMB and enzymatic activities similar to those in unamended soil.

A comparison of data sources for the surveillance of work-related carpal tunnel syndrome in Massachusetts.

PubMed

Davis, Letitia; Wellman, Helen; Hart, James; Cleary, Robert; Gardstein, Betsey M; Sciuchetti, Paul

2004-09-01

This study examined whether a state surveillance system for work-related carpal tunnel syndrome (WR-CTS) based on workers' compensation claims (Sentinel Event Notification System for Occupational Risks, SENSOR) and the Annual Survey of Occupational Injuries and Illnesses (SOII) identified the same industries, occupations, sources of injury, and populations for intervention. Trends in counts, rates, and female/male ratios of WR-CTS during 1994-1997, and age distributions were compared across three data sources: SENSOR, Massachusetts SOII, and National SOII. SENSOR and National SOII data on WR-CTS were compared by industry, occupation, and injury source. Due to small sample size and subsequent gaps in available information, state SOII data on WR-CTS were of little use in identifying specific industries and occupations for intervention. SENSOR and National SOII data on the frequency of WR-CTS cases identified many similar occupations and industries, and both surveillance systems pointed to computer use as a risk factor for WR-CTS. Some high rate industries identified by SENSOR were not identified using National SOII rates even when national findings were restricted to take into account the distribution of the Massachusetts workforce. Use of national SOII data on rates of WR-CTS for identifying state industry priorities for WR-CTS prevention should be undertaken with caution. Options for improving state SOII data and use of other state data systems should be pursued.

Relationship between Semmes-Weinstein Monofilaments perception Test and sensory nerve conduction studies in Carpal Tunnel Syndrome.

PubMed

Raji, Parvin; Ansari, Noureddin Nakhostin; Naghdi, Soofia; Forogh, Bijan; Hasson, Scott

2014-01-01

The Semmes-Weinstein Monofilament Test (SWMT) is a clinical widely used test to quantify the sensibility in patients with Carpal Tunnel Syndrome (CTS). No study has investigated the relationship between the SWMT and sensory nerve conduction studies (SNCS) in patients with CTS. To assess the relationship between the SWMT and SNCS findings in patients with CTS. This cross-sectional clinical measurement study included 35 patients with CTS (55 hands) with a mean age of 45 ± 12 years. The outcome measures were the SWMT and SNCS measures of distal latency (DLs), amplitude (AMPs), and nerve conduction velocity (NCV). The median innervated fingers were tested using SWMT and electrodiagnostic tests. The primary outcome was the correlations between the SWMTs and NCS measures. All of the patients/hands had abnormal NCS findings. When looking at the three digits of interest (thumb, index and middle), the thumb SWMTs had the highest number of abnormal findings (58.2%), with the middle digit having the lowest (45.5%). All NCS findings were statistically different between abnormal and normal thumb SWMTs and abnormal and normal total summed SWMTs. There were significant moderate correlations between thumb SWMT scores and all NCS outcomes. Although only approximately 50% of the CTS diagnosed through NCS are corroborated through SWMT; the significant associations between SWMT and NCS measures suggest that SWMT is a valid test for assessing sensations in patients with CTS.

Association Between Cardiovascular Risk Factors and Carpal Tunnel Syndrome in Pooled Occupational Cohorts.

PubMed

Hegmann, Kurt T; Thiese, Matthew Steven; Kapellusch, Jay; Merryweather, Andrew S; Bao, Stephen; Silverstein, Barbara; Wood, Eric M; Kendall, Richard; Wertsch, Jacqueline; Foster, James; Garg, Arun; Drury, David L

2016-01-01

The aim of the study was to ascertain if cardiovascular (CVD) risk factors are carpal tunnel syndrome (CTS) risk factors. Analysis of pooled baseline data from two large prospective cohort studies (n = 1824) assessed the relationships between a modified Framingham Heart Study CVD risk score both CTS and abnormal nerve conduction study prevalence. Quantified job exposures, personal and psychosocial confounders were statistically controlled. Odds ratio and 95% confidence intervals were calculated for individual risk scores. There was a strong relationship between CVD risk score and both CTS and abnormal nerve conduction study after adjustment for confounders, with odds ratios as high as 4.16 and 7.35, respectively. Dose responses were also observed. In this workplace population, there is a strong association between CVD risk scores and both CTS and abnormal nerve conduction study that persisted after controlling for confounders. These data suggest a potentially modifiable disease mechanism.

When exactly can carpal tunnel syndrome be considered work-related?

PubMed

Falkiner, Sonja; Myers, Stuart

2002-03-01

Carpal tunnel syndrome (CTS), compression of the median nerve at the wrist, is the most frequently encountered peripheral entrapment neuropathy. Whilst rates of all other work-related conditions have declined, the number of work-related musculoskeletal disorders (which include CTS) has not changed for the past 9 years in the USA. Median days off work are also highest for CTS: 27 compared to 20 for fractures and 18 for amputations. This results in enormous Workers Compensation and other costs to the community. Awareness of CTS as a disorder associated with repeated trauma at work is now so widespread amongst workers that many have diagnosed themselves before being medically assessed, often by means of the Internet. Surprisingly, however, a definite causal relationship has not yet been established for most occupations. Although the quality of research in this area is generally poor, CTS research studies are being used as the basis for acceptance of Workers Compensation claims, substantial expensive ergonomic workplace change and even workplace closures. The fact that the incidence of work-related musculoskeletal disorders has not changed despite these latter measures would suggest that a causal relationship is not proven and that some resources are being misdirected in CTS prevention and treatment. A literature review of 64 articles on CTS was conducted. This included those articles most frequently cited as demonstrating the relationship between CTS and work. Primary risk factors in the development of CTS are: being a woman of menopausal age, obesity or lack of fitness, diabetes or having a family history of diabetes, osteoarthritis of the carpometacarpal joint of the thumb, smoking, and lifetime alcohol intake. In most cases, work acts as the 'last straw' in CTS causation. Except in the case of work that involves very cold temperatures (possibly in conjunction with load and repetition) such as butchery, work is less likely than demographic and disease-related variables to cause CTS. To label other types of work as having caused CTS, therefore, would result in inappropriate allocation of resources. It would also relieve individuals of the responsibility of addressing correctable lifestyle factors and treatable illnesses such as obesity, diabetes, smoking and increased alcohol intake which may have contributed to their CTS more that their work. This results in both avoidable long-term health effects and ongoing costs to the community.

The versatile biopolymer chitosan: potential sources, evaluation of extraction methods and applications.

PubMed

Kaur, Surinder; Dhillon, Gurpreet Singh

2014-05-01

Among the biopolymers, chitin and its derivative chitosan (CTS) have been receiving increasing attention. Both are composed of randomly distributed β-(1-4)-linked d-glucosamine and N-acetyl glucosamine units. On commercial scale, CTS is mainly obtained from the crustacean shells. The chemical methods employed for extraction of CTS from crustacean shells are laden with many disadvantages. Waste fungal biomass represents a potential biological source of CTS, in fact with superior physico-chemical properties, such as high degree of deacetylation, low molecular weight, devoid of protein contamination and high bioactivity. Researchers around the globe are attempting to commercialize CTS production and extraction from fungal sources. Fungi are promising and environmentally benign source of CTS and they have the potential to completely replace crustacean-derived CTS. Waste fungal biomass resulting from various pharmaceutical and biotechnological industries is grown on inexpensive agro-industrial wastes and its by-products are a rich and inexpensive source of CTS. CTS is emerging as an important natural polymer having broad range of applications in different fields. In this context, the present review discusses the potential sources of CTS and their advantages and disadvantages. This review also deals with potential applications of CTS in different fields. Finally, the various attributes of CTS sought in different applications are discussed.

Cooling modifies mixed median and ulnar palmar studies in carpal tunnel syndrome.

PubMed

Araújo, Rogério Gayer Machado de; Kouyoumdjian, João Aris

2007-09-01

Temperature is an important and common variable that modifies nerve conduction study parameters in practice. Here we compare the effect of cooling on the mixed palmar median to ulnar negative peak-latency difference (PMU) in electrodiagnosis of carpal tunnel syndrome (CTS). Controls were 22 subjects (19 women, mean age 42.1 years, 44 hands). Patients were diagnosed with mild symptomatic CTS (25 women, mean age 46.6 years, 34 hands). PMU was obtained at the usual temperature, >32 degrees C, and after wrist/hand cooling to <27 degrees C in ice water. After cooling, there was a significantly greater increase in PMU and mixed ulnar palmar latency in patients versus controls. We concluded that cooling significantly modifies the PMU. We propose that the latencies of compressed nerve overreact to cooling and that this response could be a useful tool for incipient CTS electrodiagnosis. There was a significant latency overreaction of the ulnar nerve to cooling in CTS patients. We hypothesize that subclinical ulnar nerve compression is associated with CTS.

The C2 Domain Protein Cts1 Functions in the Calcineurin Signaling Circuit during High-Temperature Stress Responses in Cryptococcus neoformans ▿ †

PubMed Central

Aboobakar, Eanas F.; Wang, Xuying; Heitman, Joseph; Kozubowski, Lukasz

2011-01-01

Calcineurin is a conserved calcium/calmodulin-dependent serine/threonine-specific protein phosphatase that acts in cell stress responses. Calcineurin is essential for growth at 37°C and for virulence of the human fungal pathogen Cryptococcus neoformans, but its substrates remain unknown. The C2 domain-containing, phospholipid-binding protein Cts1 was previously identified as a multicopy suppressor of a calcineurin mutation in C. neoformans. Here we further characterize the function of Cts1 and the links between Cts1 and calcineurin. GFP-Cts1 localizes to cytoplasmic puncta and colocalizes with the endosomal marker FM4-64. The cts1Δ mutant shows a distinct FM4-64 staining pattern, suggesting involvement of Cts1 in endocytic trafficking. In large budded cells, GFP-Cts1 localizes transiently at the mother bud neck, as a single ring that undergoes contraction. mCherry-Cts1 colocalizes with the GFP-tagged calcineurin catalytic subunit Cna1 at sites of mRNA processing at 37°C, suggesting that Cts1 and calcineurin function coordinately during thermal stress. GFP-Cts1 exhibits slower electrophoretic mobility for cells grown at 37°C than for cells grown at 24°C, and the shift to a higher molecular weight is more pronounced in the presence of the calcineurin inhibitor FK506. In vitro treatment with calf intestinal alkaline phosphatase (CIP) restores faster electrophoretic mobility to GFP-Cts1, suggesting that Cts1 is phosphorylated at 37°C and may be dephosphorylated in a calcineurin-dependent manner. mCherry-Cts1 also coimmunoprecipitates with GFP-Cna1, with greater complex formation at 37°C than at 24°C. Taken together, these findings support potential roles for Cts1 in endocytic trafficking, mRNA processing, and cytokinesis and suggest that Cts1 is a substrate of calcineurin during high-temperature stress responses. PMID:22002655

Theoretical impact of simulated workplace-based primary prevention of carpal tunnel syndrome in a French region.

PubMed

Roquelaure, Yves; Fouquet, Natacha; Chazelle, Emilie; Descatha, Alexis; Evanoff, Bradley; Bodin, Julie; Petit, Audrey

2018-04-02

Carpal tunnel syndrome (CTS) is the most common nerve entrapment neuropathy in the working-age population. The reduction of CTS incidence in the workforce is a priority for policy makers due to the human, social and economic costs. To assess the theoretical impact of workplace-based primary interventions designed to reduce exposure to personal and/or work-related risk factors for CTS. Surgical CTS were assessed using regional hospital discharge records for persons aged 20-59 in 2009. Using work-related attributable fractions (AFEs), we estimated the number of work-related CTS (WR-CTS) in high-risk jobs. We simulated three theoretical scenarios of workplace-based primary prevention for jobs at risk: a mono-component work-centered intervention reducing the incidence of WR-CTS arbitrarily by 10% (10%-WI), and multicomponent global interventions reducing the incidence of all surgical CTS by 5% and 10% by targeting personal and work risk factors. A limited proportion of CTS were work-related in the region's population. WR-CTS were concentrated in nine jobs at high risk of CTS, amounting to 1603 [1137-2212] CTS, of which 906 [450-1522] were WR-CTS. The 10%-WI, 5%-GI and 10%-GI hypothetically prevented 90 [46-153], 81 [58-111] and 159 [114-223] CTS, respectively. The 10%-GI had the greatest impact regardless of the job. The impact of the 10%-WI interventions was high only in jobs at highest risk and AFEs (e.g. food industry jobs). The 10%-WI and 5%-GI had a similar impact for moderate-risk jobs (e.g. healthcare jobs). The impact of simulated workplace-based interventions suggests that prevention efforts to reduce exposure to work-related risk factors should focus on high-risk jobs. Reducing CTS rates will also require integrated strategies to reduce personal risk factors, particularly in jobs with low levels of work-related risk of CTS.

Prevalence of clinical findings of carpal tunnel syndrome in Isfahanian dentists

PubMed Central

Haghighat, Abbas; Khosrawi, Saeid; Kelishadi, Abdolmajid; Sajadieh, Sepideh; Badrian, Hamid

2012-01-01

Background: Carpal tunnel Syndrome (CTS) is the most common compression neuropathy. Jobs with frequent and repetitive hand movements are one of the risk factors for this syndrome. The aim of this study was to determine the prevalence of CTS in Isfahanian dentists. Materials and Methods: In this cross-sectional descriptive study, 240 dentists were evaluated for CTS. Diagnosis was made according to both questionnaire and clinical tests of Phalen and Tinel. Age, sex, years of experience, working hours per week and the type of procedure were considered as dependent variables. All data were analyzed by Chi-square and T-test using SPSS software 11.5 (α=0.05). Results: Among the dentists who were studied, 173 (72%) were male and 67 (28%) were female. 16.2% of males and 17.9% of females had symptoms of CTS and there wasn’t any significant difference between them (P>0.05%). the prevalence increased with advancing age. In a way that it reached to 22.2% in ages more than 55 in contrast to 6% among individuals between 25–34 years old. With increasing of experience to 15 years the risk of CTS increased but an unexpected reduction was observed with more than 15 years of experience. Conclusion: This study showed the prevalence of CTS was 16.7% among dentists and was more common in older dentists. CTS prevalence was increased with age. The dentist population with more working hours per week and more experience years were more susceptible for this syndrome. Using suitable gloves, wrist splints and short periods of resting during vigorous continuous working can decrease the symptoms of this disease. PMID:23210072

Dose calculation and verification of the Vero gimbal tracking treatment delivery

NASA Astrophysics Data System (ADS)

Prasetio, H.; Wölfelschneider, J.; Ziegler, M.; Serpa, M.; Witulla, B.; Bert, C.

2018-02-01

The Vero linear accelerator delivers dynamic tumor tracking (DTT) treatment using a gimbal motion. However, the availability of treatment planning systems (TPS) to simulate DTT is limited. This study aims to implement and verify the gimbal tracking beam geometry in the dose calculation. Gimbal tracking was implemented by rotating the reference CT outside the TPS according to the ring, gantry, and gimbal tracking position obtained from the tracking log file. The dose was calculated using these rotated CTs. The geometric accuracy was verified by comparing calculated and measured film response using a ball bearing phantom. The dose was verified by comparing calculated 2D dose distributions and film measurements in a ball bearing and a homogeneous phantom using a gamma criterion of 2%/2 mm. The effect of implementing the gimbal tracking beam geometry in a 3D patient data dose calculation was evaluated using dose volume histograms (DVH). Geometrically, the gimbal tracking implementation accuracy was  <0.94 mm. The isodose lines agreed with the film measurement. The largest dose difference of 9.4% was observed at maximum tilt positions with an isocenter and target separation of 17.51 mm. Dosimetrically, gamma passing rates were  >98.4%. The introduction of the gimbal tracking beam geometry in the dose calculation shifted the DVH curves by 0.05%-1.26% for the phantom geometry and by 5.59% for the patient CT dataset. This study successfully demonstrates a method to incorporate the gimbal tracking beam geometry into dose calculations. By combining CT rotation and MU distribution according to the log file, the TPS was able to simulate the Vero tracking treatment dose delivery. The DVH analysis from the gimbal tracking dose calculation revealed changes in the dose distribution during gimbal DTT that are not visible with static dose calculations.

An overview of the Communications Technology Satellite (CTS) project

NASA Technical Reports Server (NTRS)

Rapp, W.; Ogden, D.; Wright, D.

1982-01-01

The Communications Technology Satellite (CTS) project is reviewed. A technical description of the CTS spacecraft and its cognate hardware and operations is included. A historical treatise of the CTS project is provided. Also presented is an overview of the CTS experiments and demonstrations conducted during the course of the project.

Green synthesis of silver/montmorillonite/chitosan bionanocomposites using the UV irradiation method and evaluation of antibacterial activity

PubMed Central

Shameli, Kamyar; Ahmad, Mansor Bin; Yunus, Wan Md Zin Wan; Rustaiyan, Abdolhossein; Ibrahim, Nor Azowa; Zargar, Mohsen; Abdollahi, Yadollah

2010-01-01

In this study, silver nanoparticles (Ag-NPs) were synthesized using a green physical synthetic route into the lamellar space of montmorillonite (MMT)/chitosan (Cts) utilizing the ultraviolet (UV) irradiation reduction method in the absence of any reducing agent or heat treatment. Cts, MMT, and AgNO3 were used as the natural polymeric stabilizer, solid support, and silver precursor, respectively. The properties of Ag/MMT/Cts bionanocomposites (BNCs) were studied as the function of UV irradiation times. UV irradiation disintegrated the Ag-NPs into smaller sizes until a relatively stable size and size distribution were achieved. Meanwhile, the crystalline structure and d-spacing of the MMT interlayer, average size and size distribution, surface morphology, elemental signal peaks, functional groups, and surface plasmon resonance of Ag/MMT/Cts BNCs were determined by powder X-ray diffraction, transmission electron microscopy, scanning electron microscopy, energy dispersive X-ray fluorescence, Fourier transform infrared, and UV-visible spectroscopy. The antibacterial activity of Ag-NPs in MMT/Cts was investigated against Gram-positive bacteria, ie, Staphylococcus aureus and methicillin-resistant S. aureus and Gram-negative bacteria (ie, Escherichia coli) by the disk diffusion method on Muller–Hinton Agar at different sizes of Ag-NPs. All of the synthesized Ag/MMT/Cts BNCs were found to have high antibacterial activity. These results show that Ag/MMT/Cts BNCs can be useful in different biologic research and biomedical applications, such as surgical devices and drug delivery vehicles. PMID:21116328

Transforming growth factor-β (TGF-β) expression is increased in the subsynovial connective tissues of patients with idiopathic carpal tunnel syndrome.

PubMed

Chikenji, Takako; Gingery, Anne; Zhao, Chunfeng; Passe, Sandra M; Ozasa, Yasuhiro; Larson, Dirk; An, Kai-Nan; Amadio, Peter C

2014-01-01

Non-inflammatory fibrosis of the subsynovial connective tissue (SSCT) is a hallmark of carpal tunnel syndrome (CTS). The etiology of this finding and its relationship to the development of CTS remain poorly understood. Recent studies have found that transforming growth factor-β (TGF-β) plays a central role in fibrosis. The purpose of this study was to investigate the expression of TGF-β and connective tissue growth factor (CTGF), a downstream mediator of TGF-β, in the pathogenesis of CTS. We compared SSCT specimens from 26 idiopathic CTS patients with specimens from 10 human cadaver controls with no previous diagnosis of CTS. Immunohistochemistry was performed to determine levels TGF-β1, CTGF, collagen 1(Col1) and collagen 3 (Col3) expression. TGF-β1 (p < 0.01), CTGF (p < 0.01), and Col3 (p < 0.01) were increased in SSCT of CTS patients compared with control tissue. In addition, a strong positive correlation was found between TGF-β1 and CTGF, (R(2) = 0.80, p < 0.01) and a moderate positive correlation between Col3 and TGF-β1 (R(2) = 0.49, p < 0.01). These finding suggest that there is an increased expression of TGF-β and CTGF, a TGF-β regulated protein, and that this TGF-β activation may be responsible for SSCT fibrosis in CTS patients. © 2013 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Activation in the hypothalamic-pituitary-adrenocortical axis and sympathetic nervous system in women with carpal tunnel syndrome.

PubMed

Fernández-de-Las-Peñas, César; Díaz-Rodríguez, Lourdes; Salom-Moreno, Jaime; Galiano-Castillo, Noelia; Valverde-Herreros, Lis; Martínez-Martín, Javier; Pareja, Juan A

2014-08-01

The aim of this study is to investigate the differences in salivary cortisol (hypothalamic-pituitary-adrenocortical [HPA] axis), α-amylase activity (sympathetic nervous system [SNS]), and immunoglobulin A (IgA; immune system) concentrations between women with carpal tunnel syndrome (CTS) and healthy women. A cross-sectional study. Activation of HPA, SNS, and immune system in CTS has not been clearly determined. One hundred two women (age: 45 ± 7 years) with electrodiagnostic and clinical diagnosis of CTS and 102 matched healthy women. The intensity of the pain was assessed with a Numerical Pain Rating Scale (0-10), and disability was determined with Boston Carpal Tunnel Questionnaire. Salivary cortisol concentration, α-amylase activity, salivary flow rate, and IgA concentration were collected from nonstimulated saliva. Women with CTS exhibited lower salivary flow rate (P < 0.001) and higher α-amylase activity (P < 0.01) than controls. No significant differences for cortisol and IgA concentrations (P > 0.2) were found between groups as a total. Women with severe CTS exhibited lower salivary flow rate (P < 0.001), higher α-amylase activity (P = 0.002), and higher cortisol concentration (P = 0.03) than healthy women and than those with minimal/moderate CTS (P < 0.05). Within women with CTS, significant positive associations between α-amylase activity and the intensity of pain were found: the highest the level of pain, the higher the α-amylase activity, i.e., higher SNS activation. These results suggest that women with severe CTS exhibit changes in activation in the HPA axis and SNS but not in the humoral immune system. Activation of the SNS was associated with the intensity of pain. Future studies are needed to elucidate the direction of this relationship. Wiley Periodicals, Inc.

Chitosan-based nanocomposites for de-nitrification of water

NASA Astrophysics Data System (ADS)

Masheane, Monaheng L.; Nthunya, Lebea N.; Malinga, Soraya P.; Nxumalo, Edward N.; Mhlanga, Sabelo D.

2017-08-01

Novel chitosan (CTs) nanocomposite beads containing alumina (Al2O3, denoted as Al in the nanocomposites) and functionalized multiwalled carbon nanotubes (f-MWCNTs) (CTsAl/f-MWCNTs) were prepared using an environmentally benign phase inversion method and subsequently used for the removal of nitrates (NO3-) in water. The ellipsoidal beads with an average size of 3 mm were readily formed at room temperature and contained a small amount of Al (20 wt%) and f-MWCNTs (5%). The beads were found to adsorb nitrates effectively over a wide range of pH (pH 2 - pH 6) and showed maximum nitrates removal of 96.8% from a 50 mg/L nitrate water solution. Pure CTs beads on the other hand removed only 23% at pH 4. Kinetic studies suggested that the particle diffusion was rate controlling step for the adsorption of nitrates on CTsAl/f-MWCNT nanocomposite beads. Langmuir-Freundlich isotherms revealed that the adsorption of nitrates was on the heterogeneous surface of CTsAl/f-MWCNT beads. The Dubinin-Radushkevich (D-R) isotherm further revealed that the adsorption of nitrates was by electrostatic interaction. Thermodynamic studies suggested that the adsorption was spontaneous and exothermic. More than 70% recovery was achieved for 5 cycles of desorption-degeneration studies. Al and f-MWCNTs have shown to improve swelling and solubility of CTs.

Clinical, electrophysiological and magnetic resonance imaging findings in carpal tunnel syndrome.

PubMed

Musluoğlu, L; Celik, M; Tabak, H; Forta, H

2004-01-01

To assess magnetic resonance imaging (MRI) findings in carpal tunnel syndrome (CTS) and to compare them with electrophysiological findings. Routine motor and sensory nerve conduction examinations and needle EMG were performed in 42 hands of 22 patients, who were clinically diagnosed as having CTS in at least one wrist. Of 29 wrists with clinically and electrophysiologically confirmed CTS, MRI could detect abnormality in 18 wrists (62%). Median nerve was found to be abnormal in MRI in 1 of 2 wrists with suspected clinical symptoms and proven CTS by electrophysiological examination. MRI was abnormal in 1 of 4 wrists with normal clinical and electrophysiological examination. MRI was abnormal in 46, 7% of wrists with mild CTS, in 61.6% of moderate CTS and in 100% of severe CTS. Volar bulging of the flexor retinaculum was detected in a single wrist with severe CTS. Enlargement of median nerve was observed in 3 of 5 severe CTS. MRI could be useful in the diagnosis of unproven cases in CTS. It also provides anatomical information that correlate well with electrophysiological findings in regard of the severity of median nerve compression.

Which surgery should be offered for carpal tunnel syndrome in a patient who was previously treated for recurrence on the contralateral side? Preliminary study of 13 patients with the Canaletto® implant.

PubMed

Illuminati, I; Seigle-Murandi, F; Gouzou, S; Fabacher, T; Facca, S; Hidalgo Diaz, J J; Liverneaux, P

2017-12-01

There are no published studies on the management of carpal tunnel syndrome (CTS) patients who have already been operated for recurrent CTS on the contralateral side. The aim of this study was to evaluate 13 patients with CTS who underwent primary release using a Canaletto ® implant. The 13 patients had all been operated for recurrent CTS previously. On the contralateral side, they all had subjective signs, and two of them already had complications. All were operated with the Canaletto ® implant according to Duché's technique, in a mean of 20minutes. After a mean 19.3-month follow-up, paresthesia, pain, and QuickDASH scores were significantly improved, even in one patient who underwent revision at another facility. This preliminary study suggests that use of a Canaletto ® implant as first-line treatment for CTS in patients who already underwent revision surgery on the other side is a simple and safe technique, without worsening of symptoms. These findings should be assessed with a prospective randomized controlled trial. Copyright © 2017 SFCM. Published by Elsevier Masson SAS. All rights reserved.

Chotosan, a kampo formula, ameliorates chronic cerebral hypoperfusion-induced deficits in object recognition behaviors and central cholinergic systems in mice.

PubMed

Zhao, Qi; Murakami, Yukihisa; Tohda, Michihisa; Obi, Ryosuke; Shimada, Yutaka; Matsumoto, Kinzo

2007-04-01

We previously demonstrated that the Kampo formula chotosan (CTS) ameliorated spatial cognitive impairment via central cholinergic systems in a chronic cerebral hypoperfusion (P2VO) mouse model. In this study, the object discrimination tasks were used to determine if the ameliorative effects of CTS on P2VO-induced cognitive deficits are a characteristic pharmacological profile of this formula, with the aim of clarifying the mechanisms by which CTS enhances central cholinergic function in P2VO mice. The cholinesterase inhibitor tacrine (THA) and Kampo formula saikokeishito (SKT) were used as controls. P2VO impaired object discrimination performance in the object recognition, location, and context tests. Daily administration of CTS (750 mg/kg, p.o.) and THA (2.5 mg/kg, i.p.) improved the object discrimination deficits, whereas SKT (750 mg/kg, p.o.) did not. In ex vivo assays, tacrine but not CTS or SKT inhibited cortical cholinesterase activity. P2VO reduced the mRNA expression of m(3) and m(5) muscarinic receptors and choline acetyltransferase but not that of other muscarinic receptor subtypes in the cerebral cortex. Daily administration of CTS and THA but not SKT reversed these expression changes. These results suggest that CTS and THA improve P2VO-induced cognitive impairment by normalizing the deficit of central cholinergic systems and that the beneficial effect on P2VO-induced cognitive deficits is a distinctive pharmacological characteristic of CTS.

Hand cumulative trauma disorders in Nigerian custom tailors: the need for redesign of manual scissors.

PubMed

Adeleye, Adedoyin Abiodun; Akanbi, Olusegun Gabriel

2015-01-01

Cutting scissors are important working tools for Nigerian custom tailors (CTs) but its usage apparently does not meet the ergonomics need of these artisans. A survey was carried out amongst CTs using questionnaires to obtain their background social-occupational demographics and observation methods to study their work performance, use of scissors and any cumulative trauma disorder (CTD) in their hands. Thicknesses of various fabrics were measured and comparison between Western world's custom tailoring job and the Nigerian type was done. The results showed some CTD risk factors with finger contusions on the 71 CTs evaluated. The right-hand contusions were traced to the constant usage of unpadded manual scissors with ungloved hands. Disparity between Western and Nigerian tailoring practice may account for the high occurrence of disorders in Nigerian CTs. Since hand dimensions are crucial in the design of hand tools, it is therefore concluded that hand anthropometry of Nigerian CTs and soft padding of manual scissors may mitigate CTD burdens on CTs' hands. Cumulative trauma disorders on the hands of low-income Nigerian CTs needed investigation. This was done via self-assessment and observational methods of the artisans’ work system. Frequent usage of unpadded manual scissors with un-gloved hands cause and exacerbate the problem. Hand anthropometry of users is crucial in scissors manufacturing.

Cryptotanshinone induces cell cycle arrest and apoptosis through the JAK2/STAT3 and PI3K/Akt/NFκB pathways in cholangiocarcinoma cells.

PubMed

Ke, Fayong; Wang, Zheng; Song, Xiaoling; Ma, Qiang; Hu, Yunping; Jiang, Lin; Zhang, Yijian; Liu, Yingbin; Zhang, Yong; Gong, Wei

2017-01-01

Cholangiocarcinoma (CCA) is the most common biliary tract malignancy in the world with high resistance to current chemotherapies and extremely poor prognosis. The main objective of this study was to investigate the inhibitory effects of cryptotanshinone (CTS), a natural compound isolated from Salvia miltiorrhiza Bunge , on CCA both in vitro and in vivo and to explore the underlying mechanisms of CTS-induced apoptosis and cell cycle arrest. The anti-tumor activity of CTS on HCCC-9810 and RBE cells was assessed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) assay and colony forming assays. Cell cycle changes were detected by flow cytometric analysis. Apoptosis was detected by annexin V/propidium iodide double staining and Hoechst 33342 staining assays. The efficacy of CTS in vivo was evaluated using a HCCC-9810 xenograft model in athymic nude mice. The expression of key proteins involved in cell apoptosis and signaling pathway in vitro was analyzed by Western blot analysis. CTS induced potent growth inhibition, S-phase arrest, apoptosis, and colony-forming inhibition in HCCC-9810 and RBE cells in a dose-dependent manner. Intraperitoneal injection of CTS (0, 10, or 25 mg/kg) for 4 weeks significantly inhibited the growth of HCCC-9810 xenografts in athymic nude mice. CTS treatment induced S-phase arrest with a decrease of cyclin A1 and an increase of cyclin D1 protein level. Bcl-2 expression was downregulated remarkably, while Bax expression was increased after apoptosis occurred. Additionally, the activation of JAK2/STAT3 and PI3K/Akt/NFκB was significantly inhibited in CTS-treated CCA cells. CTS induced CCA cell apoptosis by suppressing both the JAK2/STAT3 and PI3K/Akt/NFκB signaling pathways and altering the expression of Bcl-2/Bax family, which was regulated by these two signaling pathways. CTS may serve as a potential therapeutic agent for CCA.

Prevalence of Obesity in Carpal Tunnel Syndrome Patients: A Cross-Sectional Survey.

PubMed

Mansoor, Salman; Siddiqui, Maimoona; Mateen, Farrukh; Saadat, Shoab; Khan, Zarak H; Zahid, Mehr; Khan, Hamza H; Malik, Shuja A; Assad, Salman

2017-07-26

Carpal tunnel syndrome (CTS) is the most common compressive entrapment neuropathy caused by the compression of the median nerve at the wrist space known as the carpal tunnel. The epidemiologic factors related to CTS include genetic, medical, social, vocational, and demographic factors. The common symptoms experienced include pain, paresthesia, and numbness in the median nerve distribution. If left untreated, it can lead to irreversible median nerve damage, causing a loss of hand function. Body mass index (BMI) has been attributed as a risk factor for the development of CTS. We planned to determine the frequency of obesity among CTS patients in the neurophysiology department of a tertiary care center in Islamabad, Pakistan. The survey was designed as a cross-sectional descriptive study from March 2016 to August 2016 using a consecutive nonprobability sampling technique. A total of 112 patients with a mean age of 54 ± 5 years were included in the study. In the study population, 39 patients (35 percent) were males and 73 were females (65 percent). Based on BMI, 74 patients (66 percent) had a normal weight and 38 (34 percent) were obese. The frequency of obesity in our study was 34 percent, excluding the other comorbid conditions, which is quite high. Targeted therapy in those with CTS should also include weight reduction measures because obesity poses a cause-and-effect relationship for both the severity and the pathogenesis of CTS.

Diagnostic utility of F waves in clinically diagnosed patients of carpal tunnel syndrome.

PubMed

Joshi, Anand G; Gargate, Ashwini R

2013-01-01

Sensory nerve conduction velocity (SNCV) of median nerve measured across the carpal tunnel, difference between distal sensory latencies (DSLs) of median and ulnar nerves and difference between distal motor latencies (DMLs) of median and ulnar nerves are commonly used nerve conduction parameters for diagnosis of carpal tunnel syndrome (CTS). These are having high degree of sensitivity and specificity. Study of median nerve F-wave minimal latency (FWML) and difference between F-wave minimal latencies (FWMLs) of median and ulnar nerves have also been reported to be useful parameters for diagnosis of CTS. However, there is controversy regarding superiority of F-wave study for diagnosis of CTS. So the aim of present study was to compare sensitivity and specificity of median FWML and difference between FWMLs of median and ulnar nerves with that of above mentioned electrophysiological parameters and to find out which parameters are having more sensitivity and specificity, for early diagnosis of CTS. Median and ulnar nerves sensory and motor conduction, median and ulnar nerves F-wave studies were carried out bilaterally in 125 clinically diagnosed patients of carpal tunnel syndrome. These parameters were also studied in 45 age matched controls. Difference between DSLs of median and ulnar nerves, median SNCV and difference between DMLs of median and ulnar nerves were having highest sensitivity and specificity while median FWML and difference between FWMLs of median and ulnar nerves was having lowest sensitivity and specificity for diagnosis of CTS. So in conclusion F-wave study is not superior parameter for diagnosis of CTS.

Observed Differences between Males and Females in Surgically Treated Carpal Tunnel Syndrome Among Non-manual Workers: A Sensitivity Analysis of Findings from a Large Population Study

PubMed Central

Farioli, Andrea; Curti, Stefania; Bonfiglioli, Roberta; Baldasseroni, Alberto; Spatari, Giovanna; Mattioli, Stefano; Violante, Francesco Saverio

2018-01-01

Abstract Objectives We aimed at assessing whether differences among males and females in carpal tunnel syndrome (CTS) epidemiology might be attributable to segregation with respect to occupational biomechanical exposures or differential access to care by sex. Methods We analysed surgically treated cases of CTS occurring among non-manual workers in Tuscany between 1997 and 2000. We conducted a Monte Carlo simulation to estimate the difference in occupational biomechanical exposures between males and females necessary to explain the observed incidence rate ratios. We also accounted for the sex-specific probability of receiving surgery after the diagnosis of CTS, as women were reported to be more likely to undergo surgery in a subset of our study population. We quantified the hypothetical biomechanical overload through the hand activity level (HAL) metric proposed by the American Conference of Governmental Industrial Hygienists. To quantify the effect of HAL on CTS risk, we assumed a prior distribution based on findings from two large cohort studies of industrial workers. Results After adjustment for the probability of receiving surgery, women showed a 4-fold incidence of CTS as compared with men. To explain this association among non-manual workers, women should have an average value of HAL at least 5 points higher. Conclusions Our analysis does not support the hypothesis that the difference in CTS incidence between males and females is entirely attributable to occupational risk factors or to differential access to surgery. The causal pathway between sex and CTS might include more determinants such as hormonal factors, anthropometric characteristics, and non-occupational exposure to biomechanical overload (e.g. household tasks). PMID:29579135

Severity of Carpal Tunnel Syndrome and Diagnostic Accuracy of Hand and Body Anthropometric Measures

PubMed Central

Mondelli, Mauro; Farioli, Andrea; Mattioli, Stefano; Aretini, Alessandro; Ginanneschi, Federica; Greco, Giuseppe; Curti, Stefania

2016-01-01

Objective To study the diagnostic properties of hand/wrist and body measures according to validated clinical and electrophysiological carpal tunnel syndrome (CTS) severity scales. Methods We performed a prospective case-control study. For each case, two controls were enrolled. Two five-stage clinical and electrophysiological scales were used to evaluate CTS severity. Anthropometric measurements were collected and obesity indicators and hand/wrist ratios were calculated. Area under the receiver operating characteristic curves (AUC), sensitivity, specificity, and likelihood ratios were calculated separately by gender. Results We consecutively enrolled 370 cases and 747 controls. The wrist-palm ratio, waist-hip-height ratio and waist-stature ratio showed the highest proportion of cases with abnormal values in the severe stages of CTS for clinical and electrophysiological severity scales in both genders. Accuracy tended to increase with CTS severity for females and males. In severe stage, most of the indexes presented moderate accuracy in both genders. Among subjects with severe CTS, the wrist-palm ratio presented the highest AUC for hand measures in the clinical and electrophysiological severity scales both in females (AUC 0.83 and 0.76, respectively) and males (AUC 0.91 and 0.82, respectively). Among subjects with severe CTS, the waist-stature ratio showed the highest AUC for body measures in the clinical and electrophysiological severity scales both in females (AUC 0.78 and 0.77, respectively) and males (AUC 0.84 and 0.76, respectively). The results of waist-hip-height ratio AUC were similar. Conclusions Wrist-palm ratio, waist-hip-height ratio and waist-stature ratio could contribute to support the diagnostic hypothesis of severe CTS that however has to be confirmed by nerve conduction study. PMID:27768728

Waist circumference and waist-to-hip ratio in carpal tunnel syndrome: a case-control study.

PubMed

Mondelli, Mauro; Aretini, Alessandro; Ginanneschi, Federica; Greco, Giuseppe; Mattioli, Stefano

2014-03-15

The association between carpal tunnel syndrome (CTS) and high body mass index (BMI) and some hand measures is well known. No study has been specifically focused on waist circumference (WC) and waist-to-hip-ratio (WHR). The aim of this prospective case-control study is to evaluate the association between CTS and WC, WHR and other body and hand anthropometric measures. We consecutively enrolled one "idiopathic" CTS case for two controls in 3 outpatient electromyography labs. The main anthropometric measures were BMI, WC, WHR, wrist ratio (WR) and hand ratio (HR). We performed univariate and multivariate analyses. Female cases and controls were 250 and 474 and male cases and controls were 120 and 273, respectively. At univariate analysis there were differences in many anthropometric measures between cases and controls. At multivariate logistic regression analyses high BMI, WC and WHR and abnormal HR and WR were independent risk factors for CTS. Crossing two categories between BMI, WC and WHR, the overweight subjects, especially females, were at risk only if they had very high WC or high WHR. The risk increased if they were obese. High WC/WHR doubles the risk of CTS, the risk further increased if overweight/obese subjects have also very high WC or high WHR. The obese subjects were always at risk regardless of WC and WHR values. Metabolic causes of this association with CTS were hypothesised. BMI is not the only and most powerful body predictor of "idiopathic" CTS, but also WHR and WC should be considered. These measures may not be interchangeable and it may be desirable to consider the utility of their joint use. Copyright © 2014 Elsevier B.V. All rights reserved.

The Prevalence of Carpal Tunnel Syndrome in Latino Poultry Processing Workers and Other Latino Manual Workers

PubMed Central

Cartwright, Michael S.; Walker, Francis O.; Blocker, Jill N.; Schulz, Mark R.; Arcury, Thomas A.; Grzywacz, Joseph G.; Mora, Dana; Chen, Haiying; Marín, Antonio J.; Quandt, Sara A.

2011-01-01

Objective To determine the prevalence of carpal tunnel syndrome (CTS) in Latino poultry processing workers. Methods Symptoms and nerve conduction studies were used to prospectively assess 287 Latino poultry processing workers and 226 Latinos in other manual labor occupations. Results The prevalence of CTS was higher in poultry processing (8.7%) compared to non-poultry manual workers (4.0%, p < 0.0001). The adjusted odds ratio for the prevalence of CTS in poultry workers was 2.51 (95% CI of 1.80 to 3.50) compared to non-poultry workers. Within the poultry workers, those who performed packing, sanitation, and chilling had a trend toward less CTS than those who performed tasks requiring more repetitive and strenuous hand movements. Discussion Latino poultry processing workers have a high prevalence of CTS, which likely results from the repetitive and strenuous nature of the work. PMID:22258161

Can widespread hypersensitivity in carpal tunnel syndrome be substantiated if neck and arm pain are absent?

PubMed

Schmid, A B; Soon, B T C; Wasner, G; Coppieters, M W

2012-02-01

Recent studies demonstrated that patients with carpal tunnel syndrome (CTS) have signs of thermal and mechanical hyperalgesia in extra-median territories suggesting an involvement of central pain mechanisms. As previous studies included patients with shoulder/arm symptoms or neck pain, a potential influence of these coexisting disorders cannot be excluded. This study therefore evaluated whether widespread sensory changes (hypoesthesia or hyperalgesia) are present in patients with unilateral CTS in the absence of coexisting disorders. Twenty-six patients with unilateral CTS with symptoms localised to their hand and 26 healthy controls participated in the study. A comprehensive quantitative sensory testing (QST) protocol including thermal and mechanical detection and pain thresholds was performed over the hands (median, ulnar and radial innervation area), lateral elbows, neck and tibialis anterior muscle. Patients with CTS demonstrated thermal and mechanical hypoesthesia in the hand but not at distant sites. Thermal or mechanical hyperalgesia was not identified at any location with traditional QST threshold testing. However, patients with CTS rated the pain during thermal pain testing significantly higher than healthy participants. This was especially apparent for heat pain ratings which were elevated not only in the affected hand but also in the neck and tibialis anterior muscle. In conclusion, CTS alone in the absence of coexisting neck and arm pain does not account for sensory changes outside the affected hand as determined by traditional QST threshold testing. Elevated pain ratings may however be an early indication of central pain mechanisms. © 2011 European Federation of International Association for the Study of Pain Chapters.

Theoretical study of chain transfer to solvent reactions of alkyl acrylates.

PubMed

Moghadam, Nazanin; Srinivasan, Sriraj; Grady, Michael C; Rappe, Andrew M; Soroush, Masoud

2014-07-24

This computational and theoretical study deals with chain transfer to solvent (CTS) reactions of methyl acrylate (MA), ethyl acrylate (EA), and n-butyl acrylate (n-BA) self-initiated homopolymerization in solvents such as butanol (polar, protic), methyl ethyl ketone (MEK) (polar, aprotic), and p-xylene (nonpolar). The results indicate that abstraction of a hydrogen atom from the methylene group next to the oxygen atom in n-butanol, from the methylene group in MEK, and from a methyl group in p-xylene by a live polymer chain are the most likely mechanisms of CTS reactions in MA, EA, and n-BA. Energy barriers and molecular geometries of reactants, products, and transition states are predicted. The sensitivity of the predictions to three hybrid functionals (B3LYP, X3LYP, and M06-2X) and three different basis sets (6-31G(d,p), 6-311G(d), and 6-311G(d,p)) is investigated. Among n-butanol, sec-butanol, and tert-butanol, tert-butanol has the highest CTS energy barrier and the lowest rate constant. Although the application of the conductor-like screening model (COSMO) does not affect the predicted CTS kinetic parameter values, the application of the polarizable continuum model (PCM) results in higher CTS energy barriers. This increase in the predicted CTS energy barriers is larger for butanol and MEK than for p-xylene. The higher rate constants of chain transfer to n-butanol reactions compared to those of chain transfer to MEK and p-xylene reactions suggest the higher CTS reactivity of n-butanol.

Multidimensional Ultrasound Imaging of the Wrist: Changes of Shape and Displacement of the Median Nerve and Tendons in Carpal Tunnel Syndrome

PubMed Central

Filius, Anika; Scheltens, Marjan; Bosch, Hans G.; van Doorn, Pieter A.; Stam, Henk J.; Hovius, Steven E.R.; Amadio, Peter C.; Selles, Ruud W.

2015-01-01

Dynamics of structures within the carpal tunnel may alter in carpal tunnel syndrome (CTS) due to fibrotic changes and increased carpal tunnel pressure. Ultrasound can visualize these potential changes, making ultrasound potentially an accurate diagnostic tool. To study this, we imaged the carpal tunnel of 113 patients and 42 controls. CTS severity was classified according to validated clinical and nerve conduction study (NCS) classifications. Transversal and longitudinal displacement and shape (changes) were calculated for the median nerve, tendons and surrounding tissue. To predict diagnostic value binary logistic regression modeling was applied. Reduced longitudinal nerve displacement (p≤0.019), increased nerve cross-sectional area (p≤0.006) and perimeter (p≤0.007), and a trend of relatively changed tendon displacements were seen in patients. Changes were more convincing when CTS was classified as more severe. Binary logistic modeling to diagnose CTS using ultrasound showed a sensitivity of 70-71% and specificity of 80-84%. In conclusion, CTS patients have altered dynamics of structures within the carpal tunnel. PMID:25865180

Photoelectrochemical (PEC) studies on Cu2SnS3 (CTS) thin films deposited by chemical bath deposition method.

PubMed

Shelke, H D; Lokhande, A C; Kim, J H; Lokhande, C D

2017-11-15

Cu 2 SnS 3 (CTS) thin films have been successfully deposited on a cost-effective stainless steel substrate by simple and inexpensive chemical bath deposition (CBD) method. The films are deliberated in provisos of their structural, morphological, optical and photoelectrochemical (PEC) properties before and after annealing treatment, using various physico-chemical techniques. The XRD studies showed the formation of triclinic phase of CTS films with nanocrystalline structure. Also, the crystallinity is enhanced with annealing and the secondary phase of Cu 2 S observed. Raman analysis confirmed the formation of CTS compound with secondary Cu 2 S phase. The SEM images also discovered mostly tiny spherical grains and significant progress in the size of grains after annealing. The films possess direct transitions with band gap energies of 1.35eV and 1.31eV before and after annealing, respectively. The improved photoconversion efficiency of CTS thin film based PEC cell is explained with the help of theoretical modeling of energy band diagram and correspondent circuit model of the impedance spectra. Copyright © 2017 Elsevier Inc. All rights reserved.

Risk factors for operated carpal tunnel syndrome: a multicenter population-based case-control study

PubMed Central

Mattioli, Stefano; Baldasseroni, Alberto; Bovenzi, Massimo; Curti, Stefania; Cooke, Robin MT; Campo, Giuseppe; Barbieri, Pietro G; Ghersi, Rinaldo; Broccoli, Marco; Cancellieri, Maria Pia; Colao, Anna Maria; dell'Omo, Marco; Fateh-Moghadam, Pirous; Franceschini, Flavia; Fucksia, Serenella; Galli, Paolo; Gobba, Fabriziomaria; Lucchini, Roberto; Mandes, Anna; Marras, Teresa; Sgarrella, Carla; Borghesi, Stefano; Fierro, Mauro; Zanardi, Francesca; Mancini, Gianpiero; Violante, Francesco S

2009-01-01

Background Carpal tunnel syndrome (CTS) is a socially and economically relevant disease caused by compression or entrapment of the median nerve within the carpal tunnel. This population-based case-control study aims to investigate occupational/non-occupational risk factors for surgically treated CTS. Methods Cases (n = 220) aged 18-65 years were randomly drawn from 13 administrative databases of citizens who were surgically treated with carpal tunnel release during 2001. Controls (n = 356) were randomly sampled from National Health Service registry records and were frequency matched by age-gender-specific CTS hospitalization rates. Results At multivariate analysis, risk factors were blue-collar/housewife status, BMI ≥ 30 kg/m2, sibling history of CTS and coexistence of trigger finger. Being relatively tall (cut-offs based on tertiles: women ≥165 cm; men ≥175 cm) was associated with lower risk. Blue-collar work was a moderate/strong risk factor in both sexes. Raised risks were apparent for combinations of biomechanical risk factors that included frequent repetitivity and sustained force. Conclusion This study strongly underlines the relevance of biomechanical exposures in both non-industrial and industrial work as risk factors for surgically treated CTS. PMID:19758429

Kampo formulations, chotosan, and yokukansan, for dementia therapy: existing clinical and preclinical evidence.

PubMed

Matsumoto, Kinzo; Zhao, Qi; Niu, Yimin; Fujiwara, Hironori; Tanaka, Ken; Sasaki-Hamada, Sachie; Oka, Jun-Ichiro

2013-01-01

Cognitive deficits and behavioral and psychological symptoms of dementia (BPSD) are typical features of patients with dementia such as Alzheimer's disease (AD), vascular dementia (VD), and other forms of senile dementia. Clinical evidence has demonstrated the potential usefulness of chotosan (CTS) and yokukansan (YKS), traditional herbal formulations called Kampo medicines, in the treatment of cognitive disturbance and BPSD in dementia patients, although the indications targeted by CTS and YKS in Kampo medicine differ. The availability of CTS and YKS for treating dementia patients is supported by preclinical studies using animal models of dementia that include cognitive/emotional deficits caused by aging and diabetes, dementia risk factors. These studies have led not only to the concept of a neuronal basis for the CTS- and YKS-induced amelioration of cognitive function and emotional/psychiatric symptom-related behavior in animal models, but also to a proposal that ingredient(s) of Uncariae Uncis cum Ramulus, a medicinal herb included in CTS and YKS, may play an important role in the actions of these formulae in dementia patients. Further studies are needed to clarify the active ingredients of these formulae and their target endogenous molecules implicated in the anti-dementia drug-like actions.

Chromosome territory repositioning induced by PHA-activation of lymphocytes: A 2D and 3D appraisal.

PubMed

Ioannou, Dimitrios; Kandukuri, Lakshmi; Simpson, Joe Leigh; Tempest, Helen Ghislaine

2015-01-01

Genomes and by extension chromosome territories (CTs) in a variety of organisms exhibit nonrandom organization within interphase nuclei. CTs are susceptible to movement upon induction by a variety of stimuli, including: cell differentiation, growth factors, genotoxic agents, proliferating status, and stimulants that induce novel transcription profiles. These findings suggest nuclear architecture can undergo reorganization, providing support for a functional significance of CT organization. The effect of the initiation of transcription on global scale chromatin architecture has been underexplored. This study investigates the organization of all 24 human chromosomes in lymphocytes from two individuals in resting and phytohaemagglutinin activated lymphocytes using 2D and 3D approaches. The radial organization of CTs in lymphocytes in both resting and activated lymphocytes follows a gene-density pattern. However, CT organization in activated nuclei appears less constrained exhibiting a more random organization. We report differences in the spatial relationship between homologous and heterologous CTs in activated nuclei. In addition, a reproducible radial hierarchy of CTs was identified and evidence of a CT repositioning was observed in activated nuclei using both 2D and 3D approaches. Alterations between resting and activated lymphocytes could be adaptation of CTs to the new transcription profile and possibly the formation of new neighborhoods of interest or interaction of CTs with nuclear landmarks. The increased distances between homologous and heterologous CTs in activated lymphocytes could be a reflection of a defensive mechanism to reduce potential interaction to prevent any structural chromosome abnormalities (e.g. translocations) as a result of DNA damage that increases during lymphocyte activation.

"…you earn money by suffering pain:" Beliefs About Carpal Tunnel Syndrome Among Latino Poultry Processing Workers.

PubMed

Arcury, Thomas A; Mora, Dana C; Quandt, Sara A

2015-06-01

The nature of poultry processing puts workers at risk for developing neurological injuries, particularly carpal tunnel syndrome (CTS). Many poultry processing workers are Latino immigrants. This qualitative analysis uses an explanatory models of illness (EMs) framework to describe immigrant Latino poultry processing workers' (Guatemalan and Mexican) beliefs of CTS. Understanding these workers' CTS EMs provides a foundation for recommendations to reduce the risk factors for this occupational injury. In-depth interviews were completed with 15 poultry processing workers diagnosed with CTS. Systematic qualitative analysis was used to delineate beliefs about causes, symptoms, physiology, treatments, quality-of-life and health implications of CTS. Participants' EMs largely reflect current biomedical understanding of CTS. These EMs are similar for Guatemalan and Mexican workers. Beliefs about causes include factors in the work environment (e.g., repetition, cold) and individual physical weakness. Treatments include over-the-counter medicine, as well as traditional remedies. Most know the future impact of CTS will include chronic pain. These workers know what causes CTS and that curing it would require quitting their jobs, but feel that they must endure CTS to support their families. Latino poultry processing workers, whether Guatemalan or Mexican, have a fairly complete understanding of what causes CTS, how to treat it, and what they must do to cure it. However, situational factors force them to endure CTS. Policy changes are needed to change the structure of work in poultry processing, particularly line speed and break frequency, if the prevalence of CTS is to be reduced.

Carpal tunnel syndrome in women working in tea agriculture

PubMed Central

Devrimsel, Gul; Kirbas, Serkan; Yildirim, Murat; Turkyilmaz, Aysegul Kucukali; Sahin, Nilay

2014-01-01

OBJECTIVE: The aim of this cross-sectional study was to determine the frequency of carpal tunnel syndrome (CTS) among women using tea leaf scissors and compare it with normal population. METHODS: Two hundred hands of 100 women using tea leaf scissors (tea leaf scissors group) and 112 hands of 56 healthy women (control group) were clinically and electrophysiologically evaluated for CTS. Women using tea leaf scissors were evaluated with visual analog scale (VAS) for pain and Boston Carpal Tunnel Syndrome Questionnaire for symptoms and functional status. RESULTS: Carpal tunnel syndrome was diagnosed bilaterally in 62 (62%) and unilaterally in 7 (7%) women using tea leaf scissors, whereas 2 (3.57%) bilateral and 6 (10.71%) unilateral cases of CTS was diagnosed in controls. The differences in demographic factors were not statistically significant. In women with CTS using tea leaf scissors, mean symptom severity, functional status, and VAS scores were 2.73±0.60, 2.42±0.71 and 5.19±1.84, respectively. There was statistically significant difference in the frequency of CTS between women using tea leaf scissors and the control group and the risk of having CTS among women using tea leaf scissors was approximately 12 times greater (p<0.001). CONCLUSION: In tea agriculture, working with repetitive flexions and extensions of the wrist highly increases the risk of developing CTS. PMID:28058318

Plant growth and arbuscular mycorrhizae development in oil sands processing by-products.

PubMed

Boldt-Burisch, Katja; Naeth, M Anne; Schneider, Uwe; Schneider, Beate; Hüttl, Reinhard F

2018-04-15

Soil pollutants such as hydrocarbons can induce toxic effects in plants and associated arbuscular mycorrhizal fungi (AMF). This study was conducted to evaluate if the legume Lotus corniculatus and the grass Elymus trachycaulus and arbuscular mycorrhizal fungi could grow in two oil sands processing by-products after bitumen extraction from the oil sands in northern Alberta, Canada. Substrate treatments were coarse tailings sand (CTS), a mix of dry mature fine tailings (MFT) with CTS (1:1) and Pleistocene sandy soil (hydrocarbon free); microbial treatments were without AMF, with AMF and AMF plus soil bacteria isolated from oil sands reclamation sites. Plant biomass, root morphology, leaf water content, shoot tissue phosphorus content and mycorrhizal colonization were evaluated. Both plant species had reduced growth in CTS and tailings mix relative to sandy soil. AMF frequency and intensity in roots of E. trachycaulus was not influenced by soil hydrocarbons; however, it decreased significantly over time in roots of L. corniculatus without bacteria in CTS. Mycorrhizal inoculation alone did not significantly improve plant growth in CTS and tailings mix; however, inoculation with mycorrhizae plus bacteria led to a significantly positive response of both plant species in CTS. Thus, combined inoculation with selected mycorrhizae and bacteria led to synergistic effects. Such combinations may be used in future to improve plant growth in reclamation of CTS and tailings mix. Copyright © 2017 Elsevier B.V. All rights reserved.

Effect of citric acid concentration and hydrolysis time on physicochemical properties of sweet potato starches.

PubMed

Surendra Babu, Ayenampudi; Parimalavalli, Ramanathan; Rudra, Shalini Gaur

2015-09-01

Physicochemical properties of citric acid treated sweet potato starches were investigated in the present study. Sweet potato starch was hydrolyzed using citric acid with different concentrations (1 and 5%) and time periods (1 and 11 h) at 45 °C and was denoted as citric acid treated starch (CTS1 to CTS4) based on their experimental conditions. The recovery yield of acid treated starches was above 85%. The CTS4 sample displayed the highest amylose (around 31%) and water holding capacity its melting temperature was 47.66 °C. The digestibility rate was slightly increased for 78.58% for the CTS3 and CTS4. The gel strength of acid modified starches ranged from 0.27 kg to 1.11 kg. RVA results of acid thinned starches confirmed a low viscosity profile. CTS3 starch illustrated lower enthalpy compared to all other modified starches. All starch samples exhibited a shear-thinning behavior. SEM analysis revealed that the extent of visible degradation was increased at higher hydrolysis time and acid concentration. The CTS3 satisfied the criteria required for starch to act as a fat mimetic. Overall results conveyed that the citric acid treatment of sweet potato starch with 5% acid concentration and 11h period was an ideal condition for the preparation of a fat replacer. Copyright © 2015 Elsevier B.V. All rights reserved.

Critical thinking skills in nursing students: a comparison between freshmen and senior students.

PubMed

Azizi-Fini, Ismail; Hajibagheri, Ali; Adib-Hajbaghery, Mohsen

2015-03-01

Critical thinking is one of the most important concepts in the field of education. Despite studies published on nursing students' critical thinking skills (CTS), some suggest that there is not enough evidence supporting the relationship between content of nursing education programs and nursing students' CTS. Given the existing discrepancies, this study aimed to compare the critical thinking skills of freshmen and senior nursing students. This comparative study was conducted on 150 undergraduate freshmen and senior nursing students in Kashan University of Medical Sciences, during 2012. The students in the first and the last semesters of their study in nursing were entered in the study using the census method. Data were collected using a questionnaire including questions on demographic data and the California Critical Thinking Skills Test, form B. Data analysis was performed using the SPSS v.13 software. Descriptive statistics were calculated. Moreover, independent sample t-test and Spearman and Pearson's correlation coefficients were used in the data analysis. Both the freshmen and senior nursing students had low CTS. The mean critical thinking scores were 11.79 ± 4.80 and 11.21 ± 3.17 for the freshmen and the senior students, respectively (P = 0.511). Moreover, no significant correlation was found between the students' score in CTS and their age, gender, high school grade point average (GPA), rank in university entrance examination (RUEE) and interest in the nursing profession. The students were low skilled in critical thinking and their CTS did not significantly change during their nursing degree. Thus it may be concluded that the nursing education program did not affect the CTS of its students. Longitudinal studies are suggested for assessing nursing students' critical thinking over time. Moreover, revising the curriculum and preparing nursing educators for implementing innovative and active teaching strategies are suggested.

The efficiency of acoustic radiation force impulse (ARFI) elastography in the diagnosis and staging of carpal tunnel syndrome.

PubMed

Arslan, Harun; Yavuz, Alpaslan; İlgen, Ferda; Aycan, Abdurrahman; Ozgokce, Mesut; Akdeniz, Hüseyin; Batur, Abdussamet

2018-01-12

The aim of the present study was to quantify the stiffness of the median nerve (MN) at the carpal tunnel inlet by acoustic radiation force impulse (ARFI) elastography and to evaluate whether ARFI can be used in diagnosis and staging of carpal tunnel syndrome (CTS). Sonographic examinations of 96 wrists in 50 patients were included in the study. The cross-sectional area and stiffness of the MN were quantitatively measured by B-mode ultrasonography (USG) and ARFI. The findings of CTS were assigned to four groups: (I) normal (n = 21), (II) mild (n = 39), (III) moderate (n = 38), and (IV) severe (n = 19). The differences between CTS patients and controls and the differences in electrodiagnostic tests among subgroups were statistically compared. ROC analysis was performed to determine the cut-off values between subgroups. Bilateral CTS was present in 46 patients (92 wrists) and unilateral CTS in four patients. Of the 96 nerves in the 50 symptomatic "idiopathic CTS" patients (48 women, 2 men; mean age 45.9 years, range 23-73 years), 39 (40.4%) were mild, 38 (39.8%) were moderate, and 19 (19.8%) were severely affected. When compared to controls, MN stiffness was significantly higher in the CTS group (P < 0.001); furthermore, it was higher in the severe or extreme severity group than the mild or moderate severity group (P < 0.001). A 3.250 m/s cut-off value on ARFI revealed sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 81, 82, 95.1, 50, and 82%, respectively. The MN stiffness measured by ARFI elastography is significantly higher in patients with CTS then in controls. ARFI elastography appears to be a highly efficient imaging modality for the diagnosis and staging of these patients.

A machine learning approach to identify clinical trials involving nanodrugs and nanodevices from ClinicalTrials.gov.

PubMed

de la Iglesia, Diana; García-Remesal, Miguel; Anguita, Alberto; Muñoz-Mármol, Miguel; Kulikowski, Casimir; Maojo, Víctor

2014-01-01

Clinical Trials (CTs) are essential for bridging the gap between experimental research on new drugs and their clinical application. Just like CTs for traditional drugs and biologics have helped accelerate the translation of biomedical findings into medical practice, CTs for nanodrugs and nanodevices could advance novel nanomaterials as agents for diagnosis and therapy. Although there is publicly available information about nanomedicine-related CTs, the online archiving of this information is carried out without adhering to criteria that discriminate between studies involving nanomaterials or nanotechnology-based processes (nano), and CTs that do not involve nanotechnology (non-nano). Finding out whether nanodrugs and nanodevices were involved in a study from CT summaries alone is a challenging task. At the time of writing, CTs archived in the well-known online registry ClinicalTrials.gov are not easily told apart as to whether they are nano or non-nano CTs-even when performed by domain experts, due to the lack of both a common definition for nanotechnology and of standards for reporting nanomedical experiments and results. We propose a supervised learning approach for classifying CT summaries from ClinicalTrials.gov according to whether they fall into the nano or the non-nano categories. Our method involves several stages: i) extraction and manual annotation of CTs as nano vs. non-nano, ii) pre-processing and automatic classification, and iii) performance evaluation using several state-of-the-art classifiers under different transformations of the original dataset. The performance of the best automated classifier closely matches that of experts (AUC over 0.95), suggesting that it is feasible to automatically detect the presence of nanotechnology products in CT summaries with a high degree of accuracy. This can significantly speed up the process of finding whether reports on ClinicalTrials.gov might be relevant to a particular nanoparticle or nanodevice, which is essential to discover any precedents for nanotoxicity events or advantages for targeted drug therapy.

SU-E-T-396: Dosimetric Accuracy of Proton Therapy for Patients with Metal Implants in CT Scans Using Metal Deletion Technique (MDT) Artifacts Reduction

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

Li, X; Kantor, M; Zhu, X

2014-06-01

Purpose: To evaluate the dosimetric accuracy for proton therapy patients with metal implants in CT using metal deletion technique (MDT) artifacts reduction. Methods: Proton dose accuracies under CT metal artifacts were first evaluated using a water phantom with cylindrical inserts of different materials (titanium and steel). Ranges and dose profiles along different beam angles were calculated using treatment planning system (Eclipse version 8.9) on uncorrected CT, MDT CT, and manually-corrected CT, where true Hounsfield units (water) were assigned to the streak artifacts. In patient studies, the treatment plans were developed on manually-corrected CTs, then recalculated on MDT and uncorrected CTs.more » DVH indices were compared between the dose distributions on all the CTs. Results: For water phantom study with 1/2 inch titanium insert, the proton range differences estimated by MDT CT were with 1% for all beam angles, while the range error can be up to 2.6% for uncorrected CT. For the study with 1 inch stainless steel insert, the maximum range error calculated by MDT CT was 1.09% among all the beam angles compared with maximum range error with 4.7% for uncorrected CT. The dose profiles calculated on MDT CTs for both titanium and steel inserts showed very good agreements with the ones calculated on manually-corrected CTs, while large dose discrepancies calculated using uncorrected CTs were observed in the distal end region of the proton beam. The patient study showed similar dose distribution and DVHs for organs near the metal artifacts recalculated on MDT CT compared with the ones calculated on manually-corrected CT, while the differences between uncorrected and corrected CTs were much pronounced. Conclusion: In proton therapy, large dose error could occur due to metal artifact. The MDT CT can be used for proton dose calculation to achieve similar dose accuracy as the current clinical practice using manual correction.« less

Glucose adsorption to chitosan membranes increases proliferation of human chondrocyte via mammalian target of rapamycin complex 1 and sterol regulatory element-binding protein-1 signaling.

PubMed

Chang, Shun-Fu; Huang, Kuo-Chin; Cheng, Chin-Chang; Su, Yu-Ping; Lee, Ko-Chao; Chen, Cheng-Nan; Chang, Hsin-I

2017-10-01

Osteoarthritis (OA) is currently still an irreversible degenerative disease of the articular cartilage. Recent, dextrose (d-glucose) intraarticular injection prolotherapy for OA patients has been reported to benefit the chondrogenic stimulation of damaged cartilage. However, the detailed mechanism of glucose's effect on cartilage repair remains unclear. Chitosan, a naturally derived polysaccharide, has recently been investigated as a surgical or dental dressing to control breeding. Therefore, in this study, glucose was adsorbed to chitosan membranes (CTS-Glc), and the study aimed to investigate whether CTS-Glc complex membranes could regulate the proliferation of human OA chondrocytes and to explore the underlying mechanism. Human OA and SW1353 chondrocytes were used in this study. The experiments involving the transfection of cells used SW1353 chondrocytes. A specific inhibitor and siRNAs were used to investigate the mechanism underlying the CTS-Glc-regulated proliferation of human chondrocytes. We found that CTS-Glc significantly increased the proliferation of both human OA and SW1353 chondrocytes comparable to glucose- or chitosan-only stimulation. The role of mammalian target of rapamycin complex 1 (mTORC1) signaling, including mTOR, raptor, and S6k proteins, has been demonstrated in the regulation of CTS-Glc-increased human chondrocyte proliferation. mTORC1 signaling increased the expression levels of maturated SREBP-1 and FASN and then induced the expressions of cell cycle regulators, that is, cyclin D, cyclin-dependent kinase-4 and -6 in human chondrocytes. This study elucidates the detailed mechanism behind the effect of CTS-Glc complex membranes in promoting chondrocyte proliferation and proposes a possible clinical application of the CTS-Glc complex in the dextrose intraarticular injection of OA prolotherapy in the future to attenuate the pain and discomfort of OA patients. © 2017 Wiley Periodicals, Inc.

Measurement properties of gingival biotype evaluation methods.

PubMed

Alves, Patrick Henry Machado; Alves, Thereza Cristina Lira Pacheco; Pegoraro, Thiago Amadei; Costa, Yuri Martins; Bonfante, Estevam Augusto; de Almeida, Ana Lúcia Pompéia Fraga

2018-06-01

There are numerous methods to measure the dimensions of the gingival tissue, but few have compared the effectiveness of one method over another. This study aimed to describe a new method and to estimate the validity of gingival biotype assessment with the aid of computed tomography scanning (CTS). In each patient different methods of evaluation of the gingival thickness were used: transparency of periodontal probe, transgingival, photography, and a new method of CTS). Intrarater and interrater reliability considering the categorical classification of the gingival biotype were estimated with Cohen's kappa coefficient, intraclass correlation coefficient (ICC), and ANOVA (P < .05). The criterion validity of the CTS was determined using the transgingival method as the reference standard. Sensitivity and specificity values were computed along with theirs 95% CI. Twelve patients were subjected to assessment of their gingival thickness. The highest agreement was found between transgingival and CTS (86.1%). The comparison between the categorical classifications of CTS and the transgingival method (reference standard) showed high specificity (94.92%) and low sensitivity (53.85%) for definition of a thin biotype. The new method of CTS assessment to classify gingival tissue thickness can be considered reliable and clinically useful to diagnose thick biotype. © 2018 Wiley Periodicals, Inc.

Fabrication of Cu2SnS3 thin films by ethanol-ammonium solution process by doctor-blade technique

NASA Astrophysics Data System (ADS)

Wang, Yaguang; Li, Jianmin; Xue, Cong; Zhang, Yan; Jiang, Guoshun; Liu, Weifeng; Zhu, Changfei

2017-11-01

In the present study, a low-cost and simple method is applied to fabricate Cu2SnS3 (CTS) thin films. Namely CTS thin films are prepared by a doctor-blade method with a slurry dissolving the Cu2O and SnS powders obtained from CBD reaction solution into ethanol-ammonium solvents. Series of characterization methods including XRD, Raman spectra, SEM and UV-Vis analyses are introduced to investigate the phase structure, morphology and optical properties of CTS thin films. As a result, monoclinic CTS films have been obtained with the disappearance of binary phases CuS and SnS2 while increasing the annealing temperature and time, high quality monoclinic CTS thin films consisting of compact and large grains have been successfully prepared by this ethanol-ammonium method. Moreover, the secondary phase Cu2Sn3S7 is also observed during the annealing process. In addition, the post-annealed CTS film with a band-gap about 0.89 eV shows excellent absorbance between 400 and 1200 nm, which is proper for the bottom layer in multi-junction thin film solar cells.[Figure not available: see fulltext.

Ferulic acid-coupled chitosan: thermal stability and utilization as an antioxidant for biodegradable active packaging film.

PubMed

Woranuch, Sarekha; Yoksan, Rangrong; Akashi, Mitsuru

2015-01-22

The aim of the present research was to study the thermal stability of ferulic acid after coupling onto chitosan, and the possibility of using ferulic acid-coupled chitosan (FA-CTS) as an antioxidant for biodegradable active packaging film. FA-CTS was incorporated into biodegradable film via a two-step process, i.e. compounding extrusion at temperatures up to 150°C followed by blown film extrusion at temperatures up to 175°C. Although incorporation of FA-CTS with a content of 0.02-0.16% (w/w) caused decreased water vapor barrier property and reduced extensibility, the biodegradable films possessed improved oxygen barrier property and antioxidant activity. Radical scavenging activity and reducing power of film containing FA-CTS were higher than those of film containing naked ferulic acid, by about 254% and 94%, respectively. Tensile strength and rigidity of the films were not significantly affected by the addition of FA-CTS with a content of 0.02-0.08% (w/w). The above results suggested that FA-CTS could potentially be used as an antioxidant for active packaging film. Copyright © 2014 Elsevier Ltd. All rights reserved.

[Carpal tunnel syndrome and steel industry].

PubMed

Caciari, T; Rosati, M V; Casale, T; Sancini, A; Giubilati, R; De Sio, S; Suppi, A; Tomei, G; Santoro, L; Scala, B; Nardone, N; Tomei, F

2013-01-01

The carpal tunnel syndrome (CTS) is a common working pathology. The CTS diagnosis is not so easy because neurophysiological investigations are necessary. The purpose of this study is to evaluate the working risks and the presence of CTS signs using a focused anamnestic and clinical procedure. We evaluated the working risks of CTS in a population of 65 male workers of a steel industry (average age 25.1 and seniority 2.82), performing 5 different tasks. The Borg Scale was used to evaluate the subjective muscle effort. Diurnal paresthesia (V1FG), nocturnal paresthesia (V1FN), hypersensitivity (V1IS), hypostenia (V1IT) were considered. We identified three main working risks repetitiveness of single actions, static and prolonged posture of the truck, muscle effort. 21.5% of the workers showed at least one of the three symptoms;13.8% showed one or more symptoms; the clinical objectivity was observed in 18.5%. A relation between V1FG, V1FN, clinical objective linked to the workers age of the task 1 (p =0.035) is showed. To prevent CTS, the use of the Borg Scale associated with identification of the risks and with the anamenstic-clinical investigation is useful to discriminate people at risk of CTS.

Cryptotanshinone induces cell cycle arrest and apoptosis through the JAK2/STAT3 and PI3K/Akt/NFκB pathways in cholangiocarcinoma cells

PubMed Central

Ke, Fayong; Wang, Zheng; Song, Xiaoling; Ma, Qiang; Hu, Yunping; Jiang, Lin; Zhang, Yijian; Liu, Yingbin; Zhang, Yong; Gong, Wei

2017-01-01

Background Cholangiocarcinoma (CCA) is the most common biliary tract malignancy in the world with high resistance to current chemotherapies and extremely poor prognosis. The main objective of this study was to investigate the inhibitory effects of cryptotanshinone (CTS), a natural compound isolated from Salvia miltiorrhiza Bunge, on CCA both in vitro and in vivo and to explore the underlying mechanisms of CTS-induced apoptosis and cell cycle arrest. Methods The anti-tumor activity of CTS on HCCC-9810 and RBE cells was assessed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) assay and colony forming assays. Cell cycle changes were detected by flow cytometric analysis. Apoptosis was detected by annexin V/propidium iodide double staining and Hoechst 33342 staining assays. The efficacy of CTS in vivo was evaluated using a HCCC-9810 xenograft model in athymic nude mice. The expression of key proteins involved in cell apoptosis and signaling pathway in vitro was analyzed by Western blot analysis. Results CTS induced potent growth inhibition, S-phase arrest, apoptosis, and colony-forming inhibition in HCCC-9810 and RBE cells in a dose-dependent manner. Intraperitoneal injection of CTS (0, 10, or 25 mg/kg) for 4 weeks significantly inhibited the growth of HCCC-9810 xenografts in athymic nude mice. CTS treatment induced S-phase arrest with a decrease of cyclin A1 and an increase of cyclin D1 protein level. Bcl-2 expression was downregulated remarkably, while Bax expression was increased after apoptosis occurred. Additionally, the activation of JAK2/STAT3 and PI3K/Akt/NFκB was significantly inhibited in CTS-treated CCA cells. Conclusion CTS induced CCA cell apoptosis by suppressing both the JAK2/STAT3 and PI3K/Akt/NFκB signaling pathways and altering the expression of Bcl-2/Bax family, which was regulated by these two signaling pathways. CTS may serve as a potential therapeutic agent for CCA. PMID:28670110

Organizational and psychosocial risk factors for carpal tunnel syndrome: a cross-sectional study of French workers.

PubMed

Rigouin, Pascal; Ha, Catherine; Bodin, Julie; Le Manac'h, Audrey Petit; Descatha, Alexis; Goldberg, Marcel; Roquelaure, Yves

2014-02-01

The aim of the study was to examine the organizational and psychosocial risk factors for carpal tunnel syndrome (CTS) in workers exposed to various levels of work-related constraints, with a special focus on factors related to the work organization. From 3,710 workers, representative of a French region's working population, trained occupational physicians diagnosed a total of 156 cases of CTS between 2002 and 2005. Diagnoses were established by standardized physical examination, while personal factors and work exposure were assessed by self-administered questionnaires. Statistical associations between CTS and personal and work-related factors were analyzed for each gender using logistic regression modeling. Among the factors related to work organization, working with temporary workers was associated with CTS for women (OR = 1.99, 95 % CI 1.23-3.25), but not for men. Task rotation during the job (OR = 2.45 95 % CI 1.41-4.24) and work pace dependent on quantified targets (OR = 1.93 95 % CI 1.08-3.46) were associated with CTS only for men. The work-related psychosocial factors highlighted by the logistic modeling were high psychological demand for women (OR = 1.90, 95 % CI 1.17-3.09) and low skill discretion (OR = 1.77, 95 % CI 1.01-3.11) for men. This study has identified some psychosocial factors and factors related to work organization associated with clinically diagnosed and symptom-only cases of CTS as well as personal and biomechanical factors. However, due to the cross-sectional design of the study, no causal conclusion could be drawn and longitudinal studies are necessary to confirm these results.

Examination of patients for carpal tunnel syndrome sensibility, provocative, and motor testing.

PubMed

Palumbo, Carl F; Szabo, Robert M

2002-05-01

The value of a test for carpal tunnel syndrome (CTS) depends on the purpose of performing the test. When screening a large population with a low prevalence for CTS, a test with a high sensitivity is needed so that no possible case goes undetected. However, in order to establish a diagnosis, a more specific test is required. Using a combination of physical examination techniques, including sensibility and provocative testing, the probability of correctly diagnosing CTS without relying on electrodiagnostic studies can be very high. Because CTS is a clinical syndrome, the diagnosis should be made on clinical grounds. Electrodiagnosis is extremely important, however, in its ability to objectively document median nerve slowing and eliminate other competing differential diagnoses.

Screening for Acromegaly in Patients with Carpal Tunnel Syndrome: A Prospective Study (ACROCARP).

PubMed

Zoicas, F; Kleindienst, A; Mayr, B; Buchfelder, M; Megele, R; Schöfl, C

2016-07-01

Early diagnosis of acromegaly prevents irreversible comorbidities and facilitates surgical cure. Carpal tunnel syndrome (CTS) is common in acromegaly and patients have often undergone surgery for CTS prior to the diagnosis of acromegaly. We hypothesized that screening CTS-patients for acromegaly could facilitate active case-finding. We prospectively enrolled 196 patients [135 women, 56.9 (range 23-103) years] who presented with CTS for surgery. Patients were asked about 6 symptoms suggestive of acromegaly using a questionnaire calculating a symptom score (0-6 points), and insulin-like-growth factor 1 (IGF-1) was measured. If IGF-1 was increased, IGF-1 measurement was repeated, and random growth hormone (GH) and/or an oral glucose tolerance test (OGTT) with assessment of GH-suppression were performed. The mean symptom score was 1.7±1.3 points. Three patients reported the maximal symptom score of 6 points, but none of them had an increased IGF-1. There was no correlation between the symptom score and IGF-1-SDS (standard deviation score) (r=0.026; p=0.71). Four patients had an IGF-1>2 SDS. In 2 patients acromegaly was ruled out using random GH and OGTT. One patient had normal IGF-1 and random GH at follow-up. One patient refused further diagnostics. In this prospective cohort of patients with CTS, the observed frequency of acromegaly was at most 0.51% (95% CI 0.03 to 2.83%). In this prospective study, none of the 196 patients with CTS had proven acromegaly. Thus, we see no evidence to justify general screening of patients with CTS for acromegaly. © Georg Thieme Verlag KG Stuttgart · New York.

Genome-Wide Association Mapping Reveals Multiple QTLs Governing Tolerance Response for Seedling Stage Chilling Stress in Indica Rice.

PubMed

Pandit, Elssa; Tasleem, Swaleha; Barik, Saumya R; Mohanty, Durga P; Nayak, Deepak K; Mohanty, Shakti P; Das, Sujata; Pradhan, Sharat K

2017-01-01

Rice crop is sensitive to cold stress at seedling stage. A panel of population representing 304 shortlisted germplasm lines was studied for seedling stage chilling tolerance in indica rice. Six phenotypic classes were exposed to six low temperature stress regimes under control phenotyping facility to investigate response pattern. A panel of 66 genotypes representing all phenotypic classes was used for ensuring genetic diversity, population structure and association mapping for the trait using 58 simple sequence repeat (SSR) and 2 direct trait linked markers. A moderate level of genetic diversity was detected in the panel population for the trait. Deviation of Hardy-Weinberg's expectation was detected in the studied population using Wright's F statistic. The panel showed 30% variation among population and 70% among individuals. The entire population was categorized into three sub-populations through STRUCTURE analysis. This revealed tolerance for the trait had a common primary ancestor for each sub-population with few admix individuals. The panel population showed the presence of many QTLs for cold stress tolerance in the individuals representing like genome-wide expression of the trait. Nineteen SSR markers were significantly associated at chilling stress of 8°C to 4°C for 7-21 days duration. Thus, the primers linked to the seedling stage cold tolerance QTLs namely qCTS9, qCTS-2, qCTS6.1, qSCT2, qSCT11, qSCT1a, qCTS-3.1, qCTS11.1, qCTS12.1, qCTS-1b, and CTB2 need to be pyramided for development of strongly chilling tolerant variety.

Genome-Wide Association Mapping Reveals Multiple QTLs Governing Tolerance Response for Seedling Stage Chilling Stress in Indica Rice

PubMed Central

Pandit, Elssa; Tasleem, Swaleha; Barik, Saumya R.; Mohanty, Durga P.; Nayak, Deepak K.; Mohanty, Shakti P.; Das, Sujata; Pradhan, Sharat K.

2017-01-01

Rice crop is sensitive to cold stress at seedling stage. A panel of population representing 304 shortlisted germplasm lines was studied for seedling stage chilling tolerance in indica rice. Six phenotypic classes were exposed to six low temperature stress regimes under control phenotyping facility to investigate response pattern. A panel of 66 genotypes representing all phenotypic classes was used for ensuring genetic diversity, population structure and association mapping for the trait using 58 simple sequence repeat (SSR) and 2 direct trait linked markers. A moderate level of genetic diversity was detected in the panel population for the trait. Deviation of Hardy-Weinberg's expectation was detected in the studied population using Wright's F statistic. The panel showed 30% variation among population and 70% among individuals. The entire population was categorized into three sub-populations through STRUCTURE analysis. This revealed tolerance for the trait had a common primary ancestor for each sub-population with few admix individuals. The panel population showed the presence of many QTLs for cold stress tolerance in the individuals representing like genome-wide expression of the trait. Nineteen SSR markers were significantly associated at chilling stress of 8°C to 4°C for 7–21 days duration. Thus, the primers linked to the seedling stage cold tolerance QTLs namely qCTS9, qCTS-2, qCTS6.1, qSCT2, qSCT11, qSCT1a, qCTS-3.1, qCTS11.1, qCTS12.1, qCTS-1b, and CTB2 need to be pyramided for development of strongly chilling tolerant variety. PMID:28487705

Blood Flow Changes in Subsynovial Connective Tissue on Contrast-Enhanced Ultrasonography in Patients With Carpal Tunnel Syndrome Before and After Surgical Decompression.

PubMed

Motomiya, Makoto; Funakoshi, Tadanao; Ishizaka, Kinya; Nishida, Mutsumi; Matsui, Yuichiro; Iwasaki, Norimasa

2017-11-24

Although qualitative alteration of the subsynovial connective tissue in the carpal tunnel is considered to be one of the most important factors in the pathophysiologic mechanisms of carpal tunnel syndrome (CTS), little information is available about the microcirculation in the subsynovial connective tissue in patients with CTS. The aims of this study were to use contrast-enhanced ultrasonography (US) to evaluate blood flow in the subsynovial connective tissue proximal to the carpal tunnel in patients with CTS before and after carpal tunnel release. The study included 15 volunteers and 12 patients with CTS. The blood flow in the subsynovial connective tissue and the median nerve was evaluated preoperatively and at 1, 2, and 3 months postoperatively using contrast-enhanced US. The blood flow in the subsynovial connective tissue was higher in the patients with CTS than in the volunteers. In the patients with CTS, there was a significant correlation between the blood flow in the subsynovial connective tissue and the median nerve (P = .01). The blood flow in both the subsynovial connective tissue and the median nerve increased markedly after carpal tunnel release. Our results suggest that increased blood flow in the subsynovial connective tissue may play a role in the alteration of the microcirculation within the median nerve related to the pathophysiologic mechanisms of CTS. The increase in the blood flow in the subsynovial connective tissue during the early postoperative period may contribute to the changes in intraneural circulation, and these changes may lead to neural recovery. © 2017 by the American Institute of Ultrasound in Medicine.

Fabrication of high quality Cu2SnS3 thin film solar cell with 1.12% power conversion efficiency obtain by low cost environment friendly sol-gel technique

NASA Astrophysics Data System (ADS)

Chaudhari, J. J.; Joshi, U. S.

2018-03-01

Cu2SnS3 (CTS) is an emerging ternery chalcogenide material with great potential application in thin film solar cells. We present here high quality Cu2SnS3 thin films using a facile spin coating method. The as deposited films of CTS were sulphurized in a graphite box using tubular furnace at 520 °C for 60 min at the rate of 2.83 °C min-1 in argon atmosphere. X-ray diffraction (XRD) and Raman spectroscopy studies confirm tetragonal phase and absence of any secondary phase in sulphurized CTS thin films. X-ray photoelectron spectroscopy (XPS) demonstrates that Cu and Sn are in +1 and +4 oxidation state respectively. Surface morphology of CTS films were analyzed by field emission scanning electron microscope and atomic force microscope (AFM), which revealed a smooth surface with roughness (RMS) of 6.32 nm for sulphurized CTS film. Hall measurements confirmed p-type conductivity with hole concentartion of sulphurized CTS thin film is of 6.5348 × 1020 cm-3. UV-vis spectra revealed a direct energy band gap varies from 1.45 eV to 1.01 eV for as-deposited and sulphurized CTS thin film respectively. Such band gap values are optimum for semiconductor material as an absorber layer of thin film solar cell. The CTS thin film solar cell had following structure: SLG/FTO/ZnO/CTS/Al with short circuit current density of (Jsc) of 11.6 mA cm-2, open circuit voltage (Voc) of 0.276 V, active area of 0.16 cm2, fill factor (FF) of 35% and power conversion efficiency of 1.12% under AM 1.5 (100 mW cm-2) illumination in simulated standard test conditions.

Biomechanical and psychosocial exposures are independent risk factors for carpal tunnel syndrome: assessment of confounding using causal diagrams.

PubMed

Harris-Adamson, Carisa; Eisen, Ellen A; Neophytou, Andreas; Kapellusch, Jay; Garg, Arun; Hegmann, Kurt T; Thiese, Matthew S; Dale, Ann Marie; Evanoff, Bradley; Bao, Stephen; Silverstein, Barbara; Gerr, Fred; Burt, Susan; Rempel, David

2016-11-01

Between 2001 and 2010, six research groups conducted coordinated prospective studies of carpal tunnel syndrome (CTS) incidence among US workers from various industries to estimate exposure-response relationships. This analysis examined the presence and magnitude of confounding between biomechanical and workplace psychosocial factors and incidence of dominant-hand CTS. 1605 participants, without CTS at enrolment, were followed for up to 3.5 years (2471 person-years). Demographic information, medical history and workplace psychosocial stress measures were collected at baseline. Individual workplace biomechanical exposures were collected for each task and combined across the workweek using time-weighted averaging (TWA). CTS case criteria were based on symptoms and results of electrophysiological testing. HRs were estimated with Cox proportional hazard models. Confounding was assessed using causal diagrams and an empirical criterion of 10% or greater change in effect estimate magnitude. There were 109 incident CTS cases (IR=4.41/100 person-years; 6.7% cumulative incidence). The relationships between CTS and forceful repetition rate, % time forceful hand exertion and the Threshold Limit Value for Hand Activity Level (TLV-HAL) were slightly confounded by decision latitude with effect estimates being attenuated towards the null (10-14% change) after adjustment. The risk of CTS among participants reporting high job strain was attenuated towards the null by 14% after adjusting for the HAL Scale or the % time forceful hand exertions. Although attenuation of the relationships between CTS and some biomechanical and work psychosocial exposures was observed after adjusting for confounding, the magnitudes were small and confirmed biomechanical and work psychosocial exposures as independent risk factors for incident CTS. 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/.

Chromosome territory relocation paradigm during DNA damage response: Some insights from molecular biology to physics.

PubMed

Fatakia, Sarosh N; Kulashreshtha, Mugdha; Mehta, Ishita S; Rao, Basuthkar J

2017-09-03

Among the many facets of DNA damage response (DDR), relocation of chromosome territories (CTs) is most intriguing. We have previously reported that cisplatin induced DDR in human dermal fibroblasts led to relocation of CTs 12, 15 from the nuclear periphery to its interior while CTs 19, 17 repositioned from the interior to its periphery. Studies of CT relocation remain nascent as we begin unraveling the role of key players in DDR to demonstrate its mechanistic basis. Consolidating our recent reports, we argue that γH2AX-signaling leads to enhanced recruitment of nuclear myosin 1 (NM1) to chromatin, which via its motor function, results in CT repositioning. Next, we invoke a novel systems-level theory that subsumed CTs as pairs, not solo entities, to present the physical basis for plasticity in interphase CT arrangement. Subsequently, we posited that our systems-level theory describes a unified physical basis for non-random positioning of CTs in interphase nuclei across disparate eukaryotes.

Measuring violence risk and outcomes among Mexican American adolescent females.

PubMed

Cervantes, Richard C; Duenas, Norma; Valdez, Avelardo; Kaplan, Charles

2006-01-01

Central to the development of culturally competent violence prevention programs for Hispanic youth is the development of psychometrically sound violence risk and outcome measures for this population. A study was conducted to determine the psychometric properties of two commonly used violence measures, in this case for Mexican American adolescent females. The Conflict Tactics Scales (CTS2) and the Past Feelings and Acts of Violence Scale (PFAV) were analyzed to examine their interitem reliability, criterion validity, and discriminant validity. A sample of 150 low-risk and 150 high-risk adolescent females was studied. Discriminant validity was indicated by the perpetrator negotiation scale and by the victim psychological aggression and sexual coercion scales of the CTS2 and the PFAV. Analysis indicates that the CTS2 scales and the PFAV demonstrate adequate reliability, whereas strong criterion validity was evidenced by eight of the CTS2 scales and the PFAV.

Medigap Premiums and Medicare HMO Enrollment

PubMed Central

McLaughlin, Catherine G; Chernew, Michael; Taylor, Erin Fries

2002-01-01

Objective Markets for Medicare HMOs (health maintenance organizations) and supplemental Medicare coverage are often treated separately in existing literature. Yet because managed care plans and Medigap plans both cover services not covered by basic Medicare, these markets are clearly interrelated. We examine the extent to which Medigap premiums affect the likelihood of the elderly joining managed care plans. Data Sources The analysis is based on a sample of Medicare beneficiaries drawn from the 1996–1997 Community Tracking Study (CTS) Household Survey by the Center for Studying Health System Change. Respondents span 56 different CTS sites from 30 different states. Measures of premiums for privately-purchased Medigap policies were collected from a survey of large insurers serving this market. Data for individual, market, and HMO characteristics were collected from the CTS, InterStudy, and HCFA (Health Care Financing Administration). Study Design Our analysis uses a reduced-form logit model to estimate the probability of Medicare HMO participation as a function of Medigap premiums controlling for other market- and individual-level characteristics. The logit coefficients were then used to simulate changes in Medicare participation in response to changes in Medigap premiums. Principal Findings We found that Medigap premiums vary considerably among the geographic markets included in our sample. Measures of premiums from different insurers and for different types of Medigap policies were generally highly correlated across markets. Our models consistently indicate a strong positive relationship between Medigap premiums and HMO participation. This result is robust across several specifications. Simulations suggest that a one standard deviation increase in Medigap premiums would increase HMO participation by more than 8 percentage points. Conclusions This research provides strong evidence that Medigap premiums have a significant effect on seniors' participation in Medicare HMOs. Policy initiatives aimed at lowering Medigap premiums will likely discourage enrollment in Medicare HMOs, holding other factors constant. Although the Medigap premiums are just one factor affecting the future penetration rate of Medicare HMOs, they are an important driver of HMO enrollment and should be considered carefully when creating policy related to seniors' supplemental coverage. Similarly, our results imply that reforms to the Medicare HMO market would influence the demand for Medigap policies. PMID:12546281

A model of cardiopulmonary bypass staged training integrating technical and non-technical skills dedicated to cardiac trainees.

PubMed

Fouilloux, V; Doguet, F; Kotsakis, A; Dubrowski, A; Berdah, S

2015-03-01

To develop a standardized simulation-based curriculum to teach medical knowledge and technical, communication and critical thinking skills necessary to initiate and wean from cardiopulmonary bypass (CPB) to junior cardiac trainees (CTs) in France. Performance on post-curricular tests was compared between CTs who participated in the new curriculum to those who did not. The simulation-based curriculum was developed by content and education experts. Simulations sequentially taught the skills necessary for initiating and weaning from CPB as well as managing crises by adding fidelity and complexity to scenarios. Nine CTs were randomly assigned to the new curriculum (n=5) or the traditional curriculum (n=4). Skills were assessed using tests of medical knowledge and technical, communication (GRS) and critical thinking (SCT) skills. A two-sample Wilcoxon rank-sum test compared average scores between the two groups. Alpha of 0.05 was set to indicate statistically significant differences. The resutls revealed that CTs in the new curriculum significantly outperformed CTs in the traditional curriculum on technical (18.2 vs 14.8, p=0.05) and communication (3.5 vs 2.2, p=0.013) skills. There was no significant difference between CTs in the new curriculum in the Script Concordance Test (16.5 vs 14.8, p=0.141) and knowledge tests (26.9 vs 24.6, p=0.14) compared to CTs in the traditional curriculum. Our new curriculum teaches communication and technical skills necessary for CPB. The results of this pilot study are encouraging and relevant. They give grounds for future research with a larger panel of trainees. Based on the current distribution of scores, a sample size of 12 CTs per group should yield significant results for all tests. © The Author(s) 2014.

Prevalent involvement of thenar motor fibres in vineyard workers with carpal tunnel syndrome.

PubMed

Mondelli, M; Baldasseroni, A; Aretini, A; Ginanneschi, F; Padua, L

2010-08-01

Carpal tunnel syndrome (CTS) has a high prevalence in agricultural workers, especially those engaged in vineyards. We postulated that vineyard CTS was electrophysiologically different from CTS of other subjects. We performed a retrospective cross-sectional electrophysiological study of two cohorts of consecutive patients with CTS, the first consisting of vineyard workers and the second, of other unselected types of workers, housewives and pensioners. Thirty-three vineyard workers (mean age 46.8years, 42% women) and 205 patients with other occupations (mean age 53.7years; 66% women) were enrolled. All patients underwent sensory and motor neurography of the median and ulnar nerves. Differences in demographic and electrophysiological findings between groups were calculated and multiple linear regression analysis was performed to eliminate the influence of potential confounding factors (age, sex, BMI, clinical severity of CTS) on the results of univariate difference analysis. Univariate analysis showed that DML was longer and compound muscle action potential amplitude of the median nerve, recorded from the abductor pollicis brevis muscle, was smaller in vineyard workers than in the other CTS patients. These differences remained significant after adjusting the results for confounding factors. The vineyard workers showed a different pattern of CTS than the other patients: thenar motor fibres were more affected, presumably due to chronic compression on the thenar branch. This suggests an association between "common" CTS and thenar mononeuropathy. Occupational physiologists should clarify the mechanisms of neuromuscular engagement in particular jobs and ergonomists design suitable working tools, because many "individual" risk factors are difficult to change, but workplace-related risk factors can be modified. Copyright 2010 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Co-distribution of cysteine cathepsins and matrix metalloproteases in human dentin.

PubMed

Scaffa, Polliana Mendes Candia; Breschi, Lorenzo; Mazzoni, Annalisa; Vidal, Cristina de Mattos Pimenta; Curci, Rosa; Apolonio, Fabianni; Gobbi, Pietro; Pashley, David; Tjäderhane, Leo; Tersariol, Ivarne Luis Dos Santos; Nascimento, Fábio Dupart; Carrilho, Marcela Rocha

2017-02-01

It has been hypothesized that cysteine cathepsins (CTs) along with matrix metalloproteases (MMPs) may work in conjunction in the proteolysis of mature dentin matrix. The aim of this study was to verify simultaneously the distribution and presence of cathepsins B (CT-B) and K (CT-K) in partially demineralized dentin; and further to evaluate the activity of CTs and MMPs in the same tissue. The distribution of CT-B and CT-K in sound human dentin was assessed by immunohistochemistry. A double-immunolabeling technique was used to identify, at once, the occurrence of those enzymes in dentin. Activities of CTs and MMPs in dentin extracts were evaluated spectrofluorometrically. In addition, in situ gelatinolytic activity of dentin was assayed by zymography. The results revealed the distribution of CT-B and CT-K along the dentin organic matrix and also indicated co-occurrence of MMPs and CTs in that tissue. The enzyme kinetics studies showed proteolytic activity in dentin extracts for both classes of proteases. Furthermore, it was observed that, at least for sound human dentin matrices, the activity of MMPs seems to be predominant over the CTs one. Copyright © 2016 Elsevier Ltd. All rights reserved.

A prospective study of carpal tunnel syndrome: workplace and individual risk factors.

PubMed

Burt, Susan; Deddens, James A; Crombie, Ken; Jin, Yan; Wurzelbacher, Steve; Ramsey, Jessica

2013-08-01

To quantify the risk for carpal tunnel syndrome (CTS) from workplace physical factors, particularly hand activity level and forceful exertion, while taking into account individual factors including age, gender, body mass index (BMI), and pre-existing medical conditions. Three healthcare and manufacturing workplaces were selected for inclusion on the basis of range of exposure to hand activity level and forceful exertion represented by their jobs. Each study participant's job tasks were observed and evaluated onsite and videotaped for further analysis, including frequency and duration of exertion and postural deviation. Individual health assessment entailed electrodiagnostic testing of median and ulnar nerves, physical examination and questionnaires at baseline with annual follow-up for 2 years. The incidence of dominant hand CTS during the study was 5.11 per 100 person-years (29 cases). Adjusted HRs for dominant hand CTS were as follows: working with forceful exertion ≥ 20% but <60% of the time: 2.83 (1.18, 6.79) and ≥ 60% of the time vs <20%: 19.57 (5.96, 64.24), BMI ≥ 30 kg/m(2) (obesity): 3.19 (1.28, 7.98). The American Conference for Governmental Industrial Hygienists (ACGIH) Threshold Limit Value (TLV) for hand activity level also predicted CTS, HR=1.40 (1.11, 1.78) for each unit increase in the TLV ratio, controlling for obesity and job strain. Workplace and individual risk factors both contribute to the risk for CTS. Time spent in forceful exertion can be a greater risk for CTS than obesity if the job exposure is high. Preventive workplace efforts should target forceful exertions.

Triggering of Carpal Tunnel Syndrome Symptoms in Patients Using Urban Public Transportation.

PubMed

de Saboya Lenzi, Luiz Guilherme; Fernandes, Carlos Henrique; Myiamoto Meirelles, Lia; Baptista Gomes Dos Santos, João; Faloppa, Flávio; Raduan Neto, Jorge

2016-09-01

Background: Carpal tunnel syndrome (CTS) is the most common compressive neuropathy found in clinical practice. Recent studies evaluated which external factors could be involved in the CTS symptoms, including prolonged exposure to vibration, especially in the upper limb. This study investigated signs and symptoms in patients with CTS after using urban transport on (1) both upper limbs, (2) how long before these symptoms appear, and (3) the hands position or body reaction during the act of pressing the safety bars. Methods: The study was conducted from July 2012 to April 2013. A total of 205 (178 women and 27 men) patients were evaluated. CTS was diagnosed in 285 hands. All participants answered a questionnaire formulated by the authors. The questionnaire was applied by researchers who were single-blinded and not involved in the research. Results: Most of the participants (87%) were women, but there was no statistical significance in age between groups (women = 51.24 ± 8.47 years, men = 51.10 ± 6.52 years, P > .05). The symptoms appeared significantly in the first 15 minutes after boarding when compared with patients who had no symptoms during the journey. There was no difference between hands position along the journey and the onset of symptoms. Conclusions: The onset of symptoms in patients with CTS using urban public transportation most commonly occurred in the first 15 minutes after boarding. Public transport vibration seems to be, at least in part, directly related to the development of symptoms. Questionnaires for the assessment of paresthesia symptoms during the use of public transport may be useful for CTS diagnosis.

Triggering of Carpal Tunnel Syndrome Symptoms in Patients Using Urban Public Transportation

PubMed Central

de Saboya Lenzi, Luiz Guilherme; Fernandes, Carlos Henrique; Myiamoto Meirelles, Lia; Baptista Gomes dos Santos, João; Faloppa, Flávio; Raduan Neto, Jorge

2016-01-01

Background: Carpal tunnel syndrome (CTS) is the most common compressive neuropathy found in clinical practice. Recent studies evaluated which external factors could be involved in the CTS symptoms, including prolonged exposure to vibration, especially in the upper limb. This study investigated signs and symptoms in patients with CTS after using urban transport on (1) both upper limbs, (2) how long before these symptoms appear, and (3) the hands position or body reaction during the act of pressing the safety bars. Methods: The study was conducted from July 2012 to April 2013. A total of 205 (178 women and 27 men) patients were evaluated. CTS was diagnosed in 285 hands. All participants answered a questionnaire formulated by the authors. The questionnaire was applied by researchers who were single-blinded and not involved in the research. Results: Most of the participants (87%) were women, but there was no statistical significance in age between groups (women = 51.24 ± 8.47 years, men = 51.10 ± 6.52 years, P > .05). The symptoms appeared significantly in the first 15 minutes after boarding when compared with patients who had no symptoms during the journey. There was no difference between hands position along the journey and the onset of symptoms. Conclusions: The onset of symptoms in patients with CTS using urban public transportation most commonly occurred in the first 15 minutes after boarding. Public transport vibration seems to be, at least in part, directly related to the development of symptoms. Questionnaires for the assessment of paresthesia symptoms during the use of public transport may be useful for CTS diagnosis. PMID:27698625

Perceptions and Attitudes of Cancer Patients and Caregivers Towards Enrollment in Clinical Trials in Lebanon.

PubMed

Salem, Rana; Matar, Charbel; Assi, Rita; Alameddine, Raafat; Temraz, Sally; Shamseddine, Ali; Mukherji, Deborah

2017-12-02

The rates of participation in oncology clinical trials (CTs) are relatively lower in the Middle East compared to other areas in the world. Many social and cultural factors underlie the patients' reluctance to participate. To probe the knowledge, attitudes, and perceptions of patients with cancer and their caregivers regarding participation in CTs at our tertiary referral center in Lebanon, we interviewed 210 patients and caregivers visiting the outpatient clinics in the Naef Basile Cancer Institute at the American University of Beirut. A questionnaire was derived from literature and administered in Arabic. The study was approved by the Institutional Review Board (IRB). Two hundred individuals agreed to answer the questionnaire. The majority of participants (90.5%) were Lebanese with the remaining being non-Lebanese Arabs. Eighty-nine participants (45%) were aware of the concepts of CTs. Eighty-two respondents (41%) would participate in phase I CTs. Twenty-nine individuals (14.5%) agree to be enrolled in CTs with the approval of their family members only. One hundred twenty-nine subjects (64.5%) stated that they would refuse enrollment in a CT where they might receive placebo. Eighty-eight (44%) of participants considered that medical records could be reviewed for research without consent while 54% agreed that samples collected during clinical workup could be used for research without the consent of the patient. There are several social and demographic correlates for participation in CTs. Raising awareness and overcoming barriers of misconception are keys to promote participation in CTs in Lebanon.

Physical properties of compact toroids generated by a coaxial source

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

Henins, I.; Hoida, H.W.; Jarboe, T.R.

1980-01-01

In the CTX experiments we have been studying CTs generated with a magnetized coaxial plasma gun. CTs have been generated in prolate and oblate cylindrically symmetric metallic flux conservers. The plasma and magnetic field properties are studied through the use of magnetic probes, Thomson scattering, interferometry, and spectroscopy.

Associations between workplace factors and carpal tunnel syndrome: A multi-site cross sectional study.

PubMed

Fan, Z Joyce; Harris-Adamson, Carisa; Gerr, Fred; Eisen, Ellen A; Hegmann, Kurt T; Bao, Stephen; Silverstein, Barbara; Evanoff, Bradley; Dale, Ann Marie; Thiese, Matthew S; Garg, Arun; Kapellusch, Jay; Burt, Susan; Merlino, Linda; Rempel, David

2015-05-01

Few large epidemiologic studies have used rigorous case criteria, individual-level exposure measurements, and appropriate control for confounders to examine associations between workplace psychosocial and biomechanical factors and carpal tunnel syndrome (CTS). Pooling data from five independent research studies, we assessed associations between prevalent CTS and personal, work psychosocial, and biomechanical factors while adjusting for confounders using multivariable logistic regression. Prevalent CTS was associated with personal factors of older age, obesity, female sex, medical conditions, previous distal upper extremity disorders, workplace measures of peak forceful hand activity, a composite measure of force and repetition (ACGIH Threshold Limit Value for Hand Activity Level), and hand vibration. In this cross-sectional analysis of production and service workers, CTS prevalence was associated with workplace and biomechanical factors. The findings were similar to those from a prospective analysis of the same cohort with differences that may be due to recall bias and other factors. © 2015 Wiley Periodicals, Inc.

Distribution of Legionella and bacterial community composition among regionally diverse US cooling towers

PubMed Central

Llewellyn, Anna C.; Lucas, Claressa E.; Roberts, Sarah E.; Brown, Ellen W.; Nayak, Bina S.; Winchell, Jonas M.

2017-01-01

Cooling towers (CTs) are a leading source of outbreaks of Legionnaires’ disease (LD), a severe form of pneumonia caused by inhalation of aerosols containing Legionella bacteria. Accordingly, proper maintenance of CTs is vital for the prevention of LD. The aim of this study was to determine the distribution of Legionella in a subset of regionally diverse US CTs and characterize the associated microbial communities. Between July and September of 2016, we obtained aliquots from water samples collected for routine Legionella testing from 196 CTs located in eight of the nine continental US climate regions. After screening for Legionella by PCR, positive samples were cultured and the resulting Legionella isolates were further characterized. Overall, 84% (164) were PCR-positive, including samples from every region studied. Of the PCR-positive samples, Legionella spp were isolated from 47% (78), L. pneumophila was isolated from 32% (53), and L. pneumophila serogroup 1 (Lp1) was isolated from 24% (40). Overall, 144 unique Legionella isolates were identified; 53% (76) of these were Legionella pneumophila. Of the 76 L. pneumophila isolates, 51% (39) were Lp1. Legionella were isolated from CTs in seven of the eight US regions examined. 16S rRNA amplicon sequencing was used to compare the bacterial communities of CT waters with and without detectable Legionella as well as the microbiomes of waters from different climate regions. Interestingly, the microbial communities were homogenous across climate regions. When a subset of seven CTs sampled in April and July were compared, there was no association with changes in corresponding CT microbiomes over time in the samples that became culture-positive for Legionella. Legionella species and Lp1 were detected frequently among the samples examined in this first large-scale study of Legionella in US CTs. Our findings highlight that, under the right conditions, there is the potential for CT-related LD outbreaks to occur throughout the US. PMID:29261791

Distribution of Legionella and bacterial community composition among regionally diverse US cooling towers.

PubMed

Llewellyn, Anna C; Lucas, Claressa E; Roberts, Sarah E; Brown, Ellen W; Nayak, Bina S; Raphael, Brian H; Winchell, Jonas M

2017-01-01

Cooling towers (CTs) are a leading source of outbreaks of Legionnaires' disease (LD), a severe form of pneumonia caused by inhalation of aerosols containing Legionella bacteria. Accordingly, proper maintenance of CTs is vital for the prevention of LD. The aim of this study was to determine the distribution of Legionella in a subset of regionally diverse US CTs and characterize the associated microbial communities. Between July and September of 2016, we obtained aliquots from water samples collected for routine Legionella testing from 196 CTs located in eight of the nine continental US climate regions. After screening for Legionella by PCR, positive samples were cultured and the resulting Legionella isolates were further characterized. Overall, 84% (164) were PCR-positive, including samples from every region studied. Of the PCR-positive samples, Legionella spp were isolated from 47% (78), L. pneumophila was isolated from 32% (53), and L. pneumophila serogroup 1 (Lp1) was isolated from 24% (40). Overall, 144 unique Legionella isolates were identified; 53% (76) of these were Legionella pneumophila. Of the 76 L. pneumophila isolates, 51% (39) were Lp1. Legionella were isolated from CTs in seven of the eight US regions examined. 16S rRNA amplicon sequencing was used to compare the bacterial communities of CT waters with and without detectable Legionella as well as the microbiomes of waters from different climate regions. Interestingly, the microbial communities were homogenous across climate regions. When a subset of seven CTs sampled in April and July were compared, there was no association with changes in corresponding CT microbiomes over time in the samples that became culture-positive for Legionella. Legionella species and Lp1 were detected frequently among the samples examined in this first large-scale study of Legionella in US CTs. Our findings highlight that, under the right conditions, there is the potential for CT-related LD outbreaks to occur throughout the US.

Risk assessments using the Strain Index and the TLV for HAL, Part II: Multi-task jobs and prevalence of CTS.

PubMed

Kapellusch, Jay M; Silverstein, Barbara A; Bao, Stephen S; Thiese, Mathew S; Merryweather, Andrew S; Hegmann, Kurt T; Garg, Arun

2018-02-01

The Strain Index (SI) and the American Conference of Governmental Industrial Hygienists (ACGIH) threshold limit value for hand activity level (TLV for HAL) have been shown to be associated with prevalence of distal upper-limb musculoskeletal disorders such as carpal tunnel syndrome (CTS). The SI and TLV for HAL disagree on more than half of task exposure classifications. Similarly, time-weighted average (TWA), peak, and typical exposure techniques used to quantity physical exposure from multi-task jobs have shown between-technique agreement ranging from 61% to 93%, depending upon whether the SI or TLV for HAL model was used. This study compared exposure-response relationships between each model-technique combination and prevalence of CTS. Physical exposure data from 1,834 workers (710 with multi-task jobs) were analyzed using the SI and TLV for HAL and the TWA, typical, and peak multi-task job exposure techniques. Additionally, exposure classifications from the SI and TLV for HAL were combined into a single measure and evaluated. Prevalent CTS cases were identified using symptoms and nerve-conduction studies. Mixed effects logistic regression was used to quantify exposure-response relationships between categorized (i.e., low, medium, and high) physical exposure and CTS prevalence for all model-technique combinations, and for multi-task workers, mono-task workers, and all workers combined. Except for TWA TLV for HAL, all model-technique combinations showed monotonic increases in risk of CTS with increased physical exposure. The combined-models approach showed stronger association than the SI or TLV for HAL for multi-task workers. Despite differences in exposure classifications, nearly all model-technique combinations showed exposure-response relationships with prevalence of CTS for the combined sample of mono-task and multi-task workers. Both the TLV for HAL and the SI, with the TWA or typical techniques, appear useful for epidemiological studies and surveillance. However, the utility of TWA, typical, and peak techniques for job design and intervention is dubious.

GWAS with longitudinal phenotypes: performance of approximate procedures

PubMed Central

Sikorska, Karolina; Montazeri, Nahid Mostafavi; Uitterlinden, André; Rivadeneira, Fernando; Eilers, Paul HC; Lesaffre, Emmanuel

2015-01-01

Analysis of genome-wide association studies with longitudinal data using standard procedures, such as linear mixed model (LMM) fitting, leads to discouragingly long computation times. There is a need to speed up the computations significantly. In our previous work (Sikorska et al: Fast linear mixed model computations for genome-wide association studies with longitudinal data. Stat Med 2012; 32.1: 165–180), we proposed the conditional two-step (CTS) approach as a fast method providing an approximation to the P-value for the longitudinal single-nucleotide polymorphism (SNP) effect. In the first step a reduced conditional LMM is fit, omitting all the SNP terms. In the second step, the estimated random slopes are regressed on SNPs. The CTS has been applied to the bone mineral density data from the Rotterdam Study and proved to work very well even in unbalanced situations. In another article (Sikorska et al: GWAS on your notebook: fast semi-parallel linear and logistic regression for genome-wide association studies. BMC Bioinformatics 2013; 14: 166), we suggested semi-parallel computations, greatly speeding up fitting many linear regressions. Combining CTS with fast linear regression reduces the computation time from several weeks to a few minutes on a single computer. Here, we explore further the properties of the CTS both analytically and by simulations. We investigate the performance of our proposal in comparison with a related but different approach, the two-step procedure. It is analytically shown that for the balanced case, under mild assumptions, the P-value provided by the CTS is the same as from the LMM. For unbalanced data and in realistic situations, simulations show that the CTS method does not inflate the type I error rate and implies only a minimal loss of power. PMID:25712081

The Strain Index (SI) and Threshold Limit Value (TLV) for Hand Activity Level (HAL): risk of carpal tunnel syndrome (CTS) in a prospective cohort.

PubMed

Garg, A; Kapellusch, J; Hegmann, K; Wertsch, J; Merryweather, A; Deckow-Schaefer, G; Malloy, E J

2012-01-01

A cohort of 536 workers was enrolled from 10 diverse manufacturing facilities and was followed monthly for six years. Job physical exposures were individually measured. Worker demographics, medical history, psychosocial factors, current musculoskeletal disorders (MSDs) and nerve conduction studies (NCS) were obtained. Point and lifetime prevalence of carpal tunnel syndrome (CTS) at baseline (symptoms + abnormal NCS) were 10.3% and 19.8%. During follow-up, there were 35 new CTS cases (left, right or both hands). Factors predicting development of CTS included: job physical exposure (American conference of governmental industrial hygienists Threshold Limit Value (ACGIH TLV) for Hand Activity Level (HAL) and the Strain Index (SI)), age, BMI, other MSDs, inflammatory arthritis, gardening outside of work and feelings of depression. In the adjusted models, the TLV for HAL and the SI were both significant per unit increase in exposure with hazard ratios (HR) increasing up to a maximum of 5.4 (p = 0.05) and 5.3 (p = 0.03), respectively; however, similar to other reports, both suggested lower risk at higher exposures. Data suggest that the TLV for HAL and the SI are useful metrics for estimating exposure to biomechanical stressors. This study was conducted to determine how well the TLV for HAL and the SI predict risk of CTS using a prospective cohort design with survival analysis. Both the TLV for HAL and the SI were found to predict risk of CTS when adjusted for relevant covariates.

[Socio professional impact of surgical release of carpal tunnel syndrome].

PubMed

Kraiem, Aouatef Mahfoudh; Hnia, Hajer; Bouzgarrou, Lamia; Henchi, Mohamed Adnène; Khalfallah, Taoufik

2016-01-01

The objective was studying the socio-professional impact of release surgery for carpal tunnel syndrom (CTS). We conducted a cross-sectional study of patients operated for work-related CTS; data were collected in the Occupational Health Department at the University Hospital Tahar Sfar in Mahdia, Tunisia over a period of 8 years, from 1 January 2006 to December 2013. Data collection was performed using a survey form focusing on participants' socio-professional and medical characteristics and on their professional future. We used Karasek's questionnaire to study psychosocial constraints at work. The duration of a work stoppage following release surgery for CTS was significantly related to the existence of musculoskeletal disorders other than CTS, to a statement that the carpal tunnel syndrome was work related and to job seniority. As regards the professional future of operated employees, 50.7% remained in the same position, 15.3% were given customized workstation and 33.8% were offered a different position within the same company. The professional future of these employees was related to their occupational qualifications and to the type of sensory and/or motor impairment of median nerve detected during EMG test. A number of nonlesional factors determines the duration of the work stoppage, while the professional future of patients operated for CTS essentially depends on their professional qualifications and on EMG data. Certainly much broader studies would allow to refine these results.

Computer use and carpal tunnel syndrome: A meta-analysis.

PubMed

Shiri, Rahman; Falah-Hassani, Kobra

2015-02-15

Studies have reported contradictory results on the role of keyboard or mouse use in carpal tunnel syndrome (CTS). This meta-analysis aimed to assess whether computer use causes CTS. Literature searches were conducted in several databases until May 2014. Twelve studies qualified for a random-effects meta-analysis. Heterogeneity and publication bias were assessed. In a meta-analysis of six studies (N=4964) that compared computer workers with the general population or other occupational populations, computer/typewriter use (pooled odds ratio (OR)=0.72, 95% confidence interval (CI) 0.58-0.90), computer/typewriter use ≥1 vs. <1h/day (OR=0.63, 95% CI 0.38-1.04) and computer/typewriter use ≥4 vs. <4h/day (OR=0.68, 95% CI 0.54-0.87) were inversely associated with CTS. Conversely, in a meta-analysis of six studies (N=5202) conducted among office workers, CTS was positively associated with computer/typewriter use (pooled OR=1.34, 95% CI 1.08-1.65), mouse use (OR=1.93, 95% CI 1.43-2.61), frequent computer use (OR=1.89, 95% CI 1.15-3.09), frequent mouse use (OR=1.84, 95% CI 1.18-2.87) and with years of computer work (OR=1.92, 95% CI 1.17-3.17 for long vs. short). There was no evidence of publication bias for both types of studies. Studies that compared computer workers with the general population or several occupational groups did not control their estimates for occupational risk factors. Thus, office workers with no or little computer use are a more appropriate comparison group than the general population or several occupational groups. This meta-analysis suggests that excessive computer use, particularly mouse usage might be a minor occupational risk factor for CTS. Further prospective studies among office workers with objectively assessed keyboard and mouse use, and CTS symptoms or signs confirmed by a nerve conduction study are needed. Copyright © 2014 Elsevier B.V. All rights reserved.

Glycyrrhetinic acid-modified chitosan nanoparticles enhanced the effect of 5-fluorouracil in murine liver cancer model via regulatory T-cells

PubMed Central

Cheng, Mingrong; Xu, Hongzhi; Wang, Yong; Chen, Houxiang; He, Bing; Gao, Xiaoyan; Li, Yingchun; Han, Jiang; Zhang, Zhiping

2013-01-01

Modified chitosan nanoparticles are a promising platform for drug, such as 5-fluorouracil (5-FU), gene, and vaccine delivery. Here, we used chitosan and hepatoma cell-specific binding molecule glycyrrhetinic acid (GA) to synthesize glycyrrhetinic acid-modified chitosan (GA-CTS). The synthetic product was confirmed by infrared spectroscopy and hydrogen nuclear magnetic resonance. By combining GA-CTS and 5-FU, we obtained a GA-CTS/5-FU nanoparticle, with a particle size of 193.7 nm, drug loading of 1.56%, and a polydispersity index of 0.003. The GA-CTS/5-FU nanoparticle provided a sustained-release system comprising three distinct phases of quick, steady, and slow release. In vitro data indicated that it had a dose- and time-dependent anticancer effect. The effective drug exposure time against hepatic cancer cells was increased in comparison with that observed with 5-FU. In vivo studies on an orthotropic liver cancer mouse model demonstrated that GA-CTS/5-FU significantly inhibited cancer cell proliferation, resulting in increased survival time. The antitumor mechanisms for GA-CTS/5-FU nanoparticle were possibly associated with an increased expression of regulatory T-cells, decreased expression of cytotoxic T-cell and natural killer cells, and reduced levels of interleukin-2 and interferon gamma. PMID:24187487

Facile fabrication and characterization of chitosan-based zinc oxide nanoparticles and evaluation of their antimicrobial and antibiofilm activity

NASA Astrophysics Data System (ADS)

Dhillon, Gurpreet Singh; Kaur, Surinder; Brar, Satinder Kaur

2014-06-01

The present investigation deals with the facile synthesis and characterization of chitosan (CTS)-based zinc oxide (ZnO) nanoparticles (NPs) and their antimicrobial activities against pathogenic microorganisms. ZnO-CTS NPs were synthesized through two different methods: nano spray drying and precipitation, using various organic compounds (citric acid, glycerol, starch and whey powder) as stabilizers. Both the synthesis methods were simple and were devoid of any chemical usage. The detailed characterization of the NPs was carried out using UV-Vis spectroscopy, dynamic light scattering particle size analysis, zeta potential measurements and scanning electron microscopy, which confirmed the fabrication of NPs with different shapes and sizes. Antimicrobial assay of synthesized ZnO-CTS NPs was carried out against different pathogenic microbial strains ( Candida albicans, Micrococcus luteus and Staphylococcus aureus). The significant ( p < 0.05) inhibition of growth was observed for both M. luteus and S. aureus with ZnO-CTS NPs (with a concentration ranging from 0.625 to 0.156 mg/ml) as compared to control treatment. ZnO-CTS NPs also showed significant biofilm inhibition activity ( p < 0.05) against M. luteus and S. aureus. The study demonstrated the potential of ZnO-CTS NPs as antimicrobial and antibiofilm agents.

78 FR 55696 - Request for Comment on Petition Filed by Purple Communications, Inc. Regarding the Provision of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-11

... Commission's VRS Reform Order regarding the use of Internet Protocol Captioned Telephone Service (IP CTS... requested clarification would force Purple and other IP CTS providers to cease the provision of IP CTS using... of Internet Protocol Captioned Telephone Service (IP CTS) through Web or wireless technologies...

Positional cloning of a gene responsible for the cts mutation of the silkworm, Bombyx mori.

PubMed

Ito, Katsuhiko; Kidokoro, Kurako; Katsuma, Susumu; Shimada, Toru; Yamamoto, Kimiko; Mita, Kazuei; Kadono-Okuda, Keiko

2012-07-01

The larval head cuticle and anal plates of the silkworm mutant cheek and tail spot (cts) have chocolate-colored spots, unlike the entirely white appearance of the wild-type (WT) strain. We report the identification and characterization of the gene responsible for the cts mutation. Positional cloning revealed a cts candidate on chromosome 16, designated BmMFS, based on the high similarity of the deduced amino acid sequence between the candidate gene from the WT strain and the major facilitator superfamily (MFS) protein. BmMFS likely encodes a membrane protein with 11 putative transmembrane domains, while the putative structure deduced from the cts-type allele possesses only 10-pass transmembrane domains owing to a deletion in its coding region. Quantitative RT-PCR analysis showed that BmMFS mRNA was strongly expressed in the integument of the head and tail, where the cts phenotype is observed; expression markedly increased at the molting and newly ecdysed stages. These results indicate that the novel BmMFS gene is cts and the membrane structure of its protein accounts for the cts phenotype. These expression profiles and the cts phenotype are quite similar to those of melanin-related genes, such as Bmyellow-e and Bm-iAANAT, suggesting that BmMFS is involved in the melanin synthesis pathway.

Automatic localization of cochlear implant electrodes in CTs with a limited intensity range

NASA Astrophysics Data System (ADS)

Zhao, Yiyuan; Dawant, Benoit M.; Noble, Jack H.

2017-02-01

Cochlear implants (CIs) are neural prosthetics for treating severe-to-profound hearing loss. Our group has developed an image-guided cochlear implant programming (IGCIP) system that uses image analysis techniques to recommend patientspecific CI processor settings to improve hearing outcomes. One crucial step in IGCIP is the localization of CI electrodes in post-implantation CTs. Manual localization of electrodes requires time and expertise. To automate this process, our group has proposed automatic techniques that have been validated on CTs acquired with scanners that produce images with an extended range of intensity values. However, there are many clinical CTs acquired with a limited intensity range. This limitation complicates the electrode localization process. In this work, we present a pre-processing step for CTs with a limited intensity range and extend the methods we proposed for full intensity range CTs to localize CI electrodes in CTs with limited intensity range. We evaluate our method on CTs of 20 subjects implanted with CI arrays produced by different manufacturers. Our method achieves a mean localization error of 0.21mm. This indicates our method is robust for automatic localization of CI electrodes in different types of CTs, which represents a crucial step for translating IGCIP from research laboratory to clinical use.

Conspiracy theories as quasi-religious mentality: an integrated account from cognitive science, social representations theory, and frame theory.

PubMed

Franks, Bradley; Bangerter, Adrian; Bauer, Martin W

2013-01-01

Conspiracy theories (CTs) can take many forms and vary widely in popularity, the intensity with which they are believed and their effects on individual and collective behavior. An integrated account of CTs thus needs to explain how they come to appeal to potential believers, how they spread from one person to the next via communication, and how they motivate collective action. We summarize these aspects under the labels of stick, spread, and action. We propose the quasi-religious hypothesis for CTs: drawing on cognitive science of religion, social representations theory, and frame theory. We use cognitive science of religion to describe the main features of the content of CTs that explain how they come to stick: CTs are quasi-religious representations in that their contents, forms and functions parallel those found in beliefs of institutionalized religions. However, CTs are quasi-religious in that CTs and the communities that support them, lack many of the institutional features of organized religions. We use social representations theory to explain how CTs spread as devices for making sense of sudden events that threaten existing worldviews. CTs allow laypersons to interpret such events by relating them to common sense, thereby defusing some of the anxiety that those events generate. We use frame theory to explain how some, but not all CTs mobilize collective counter-conspiratorial action by identifying a target and by proposing credible and concrete rationales for action. We specify our integrated account in 13 propositions.

Conspiracy theories as quasi-religious mentality: an integrated account from cognitive science, social representations theory, and frame theory

PubMed Central

Franks, Bradley; Bangerter, Adrian; Bauer, Martin W.

2013-01-01

Conspiracy theories (CTs) can take many forms and vary widely in popularity, the intensity with which they are believed and their effects on individual and collective behavior. An integrated account of CTs thus needs to explain how they come to appeal to potential believers, how they spread from one person to the next via communication, and how they motivate collective action. We summarize these aspects under the labels of stick, spread, and action. We propose the quasi-religious hypothesis for CTs: drawing on cognitive science of religion, social representations theory, and frame theory. We use cognitive science of religion to describe the main features of the content of CTs that explain how they come to stick: CTs are quasi-religious representations in that their contents, forms and functions parallel those found in beliefs of institutionalized religions. However, CTs are quasi-religious in that CTs and the communities that support them, lack many of the institutional features of organized religions. We use social representations theory to explain how CTs spread as devices for making sense of sudden events that threaten existing worldviews. CTs allow laypersons to interpret such events by relating them to common sense, thereby defusing some of the anxiety that those events generate. We use frame theory to explain how some, but not all CTs mobilize collective counter-conspiratorial action by identifying a target and by proposing credible and concrete rationales for action. We specify our integrated account in 13 propositions. PMID:23882235

Medigap premiums and Medicare HMO enrollment.

PubMed

McLaughlin, Catherine G; Chernew, Michael; Taylor, Erin Fries

2002-12-01

Markets for Medicare HMOs (health maintenance organizations) and supplemental Medicare coverage are often treated separately in existing literature. Yet because managed care plans and Medigap plans both cover services not covered by basic Medicare, these markets are clearly interrelated. We examine the extent to which Medigap premiums affect the likelihood of the elderly joining managed care plans. The analysis is based on a sample of Medicare beneficiaries drawn from the 1996-1997 Community Tracking Study (CTS) Household Survey by the Center for Studying Health System Change. Respondents span 56 different CTS sites from 30 different states. Measures of premiums for privately-purchased Medigap policies were collected from a survey of large insurers serving this market. Data for individual, market, and HMO characteristics were collected from the CTS, InterStudy, and HCFA (Health Care Financing Administration). Our analysis uses a reduced-form logit model to estimate the probability of Medicare HMO participation as a function of Medigap premiums controlling for other market- and individual-level characteristics. The logit coefficients were then used to simulate changes in Medicare participation in response to changes in Medigap premiums. We found that Medigap premiums vary considerably among the geographic markets included in our sample. Measures of premiums from different insurers and for different types of Medigap policies were generally highly correlated across markets. Our models consistently indicate a strong positive relationship between Medigap premiums and HMO participation. This result is robust across several specifications. Simulations suggest that a one standard deviation increase in Medigap premiums would increase HMO participation by more than 8 percentage points. This research provides strong evidence that Medigap premiums have a significant effect on seniors' participation in Medicare HMOs. Policy initiatives aimed at lowering Medigap premiums will likely discourage enrollment in Medicare HMOs, holding other factors constant. Although the Medigap premiums are just one factor affecting the future penetration rate of Medicare HMOs, they are an important driver of HMO enrollment and should be considered carefully when creating policy related to seniors' supplemental coverage. Similarly, our results imply that reforms to the Medicare HMO market would influence the demand for Medigap policies.

Service Learning: Building Commitment to Becoming Teachers

ERIC Educational Resources Information Center

Bleicher, Robert E.; Correia, Manuel G.; Buchanan, Merilyn

2006-01-01

Background: The aim of this study was to examine the effectiveness of an early field experience program for undergraduate university students called classroom tutors in this project (CTs). Purpose: This study aims to measure the effects on CTs after their participation in Willing Workers in Classrooms (WWC). A second aim was to begin to develop a…

Chemical profiling with HPLC-FTMS of exogenous and endogenous chemicals susceptible to the administration of chotosan in an animal model of type 2 diabetes-induced dementia.

PubMed

Niu, Yimin; Li, Feng; Inada, Chikako; Tanaka, Ken; Watanabe, Shiro; Fujiwara, Hironori; Sasaki-Hamada, Sachie; Oka, Jun-Ichiro; Matsumoto, Kinzo

2015-02-01

In our previous study, the daily administration of chotosan (CTS), a Kampo formula consisting of Uncaria and other 10 different crude drugs, ameliorated cognitive deficits in several animal models of dementia including type 2 diabetic db/db mice in a similar manner to tacrine, an acetylcholinesterase inhibitor. The present study investigated the metabonomics of CTS in db/db mice, a type 2 diabetes model, and m/m mice, a non-diabetes control strain, to identify the exogenous and endogenous chemicals susceptible to the administration of CTS using high performance liquid chromatography equipped with an orbitrap hybrid Fourier transform mass spectrometer. The results obtained revealed that the systemic administration of CTS for 20 days led to the distribution of Uncalia plant-derived alkaloids such as rhynchophylline, hirsuteine, and corynoxeine in the plasma and brains of db/db and m/m mice and induced alterations in four major metabolic pathways; i.e., (1) purine, (2) tryptophan, (3) cysteine and methionine, (4) glycerophospholipids in db/db mice. Moreover, glycerophosphocholine (GPC) levels in the plasma and brain were significantly higher in CTS-treated db/db mice than in vehicle-treated control animals. The results of the in vitro experiment using organotypic hippocampal slice cultures demonstrated that GPC (10-30 μM), as well as tacrine, protected hippocampal cells from N-methyl-d-aspartate-induced excitotoxicity in a manner that was reversible with the muscarinic receptor antagonist scopolamine, whereas GPC had no effect on the activity of acetylcholinesterase in vitro. Our results demonstrated that some CTS constituents with neuropharmacological activity were distributed in the plasma and brain tissue following the systemic administration of CTS and may subsequently have affected some metabolic pathways including glycerophospholipid metabolism and cognitive function in db/db mice. Moreover, the present metabonomic analysis suggested that GPC is a putative endogenous chemical that may be involved in the tacrine-like actions of CTS in the present diabetic animal model. Copyright © 2014 Elsevier B.V. All rights reserved.

78 FR 66779 - CTS Automotive LLC, a Subsidiary of CTS Corporation Including On-Site Leased Workers From Metro...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-06

... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-83,010] CTS Automotive LLC, a Subsidiary of CTS Corporation Including On- Site Leased Workers From Metro Staff and Aerotek Including Workers Whose Unemployment Insurance (UI) Wages Are Reported Through D&R Technology LLC, Carol Stream, Illinois; Amended Certification Regarding...

Increasing minority patient participation in cancer clinical trials using oncology nurse navigation.

PubMed

Holmes, Dennis Ricky; Major, Jacquelyn; Lyonga, Doris Efosi; Alleyne, Rebecca Simone; Clayton, Sheilah Marie

2012-04-01

Residential distance from an academic or cancer center is a significant barrier to minority patient participation in cancer research. Most cancer clinical trials (CTs) are only accessible at academic and cancer centers, yet most cancer patients receive treatment in their home communities where access to CTs may be limited. Oncology nurse navigation is an innovative approach for increasing minority CT participation by facilitating access to cancer CTs in communities where minority patients live. The purpose of this study was to evaluate the impact of oncology nurse navigation on community-based recruitment of black patients to breast cancer CTs at a major cancer center. We merged the roles of a traditional oncology research nurse and a professional patient navigator to create a novel health care provider role, the oncology nurse navigator. The primary duties of the oncology nurse navigator were to engage black cancer patients in the offices of their community physicians and to collaborate with community physicians to increase black patient participation in cancer research. The oncology nurse navigator played a key role in all phases of the CT participation process (e.g., screening for eligibility and completion of informed consent and clinical research forms) and guided each patient around barriers in the health care system. The accrual of eligible patients to breast cancer CTs was used to assess the impact of oncology nurse navigation on community-based recruitment of blacks to cancer CTs. Between January 2007 and December 2008, a total of 132 black breast cancer patients were screened by a single oncology nurse navigator for eligibility to University of Southern California-sponsored breast cancer CTs. Fifty-nine patients were eligible for CTs, and each was invited to participate in 1 or more CTs for which they were eligible. Fifty-one of 59 eligible black patients (86% of eligible patients) were enrolled to 1 or more research protocols. The estimated cost per enrolled patient was $5,677, nearly half the expected per patient cost of treating patients on CT at an academic or cancer center. Oncology nurse navigation is an effective outreach strategy for increasing black patient participation in cancer research and may be achieved at nearly half the cost of traditional methods of enrolling patients in CTs at cancer centers. Copyright © 2012 Elsevier Inc. All rights reserved.

[Prevalence and Co-prevalence of Complex Regional Pain Syndrome (CRPS) and Carpal Tunnel Syndrome (CTS) in Hand Rehabilitation].

PubMed

Neubrech, F; Gentzsch, T; Kotsougiani, D; Bickert, B; Kneser, U; Harhaus, L

2016-06-01

In the current literature, there are reports of associations between complex regional pain syndromes (CRPS) and carpal tunnel syndromes (CTS). The aim of this study was to determine the prevalence of both disease patterns in hand rehabilitation patients and to investigate whether there is a correlation between CTS and CRPS. Furthermore, differences in the healing process of patients with and without additional CTS, and the effectiveness of the rehabilitative therapy for both diseases, were investigated. The computerised medical records of 791 patients in the years 2009-2015 who had been in hand rehabilitation were retrospectively analysed. At the beginning and end of rehabilitation, measurements were made of pain by visual analogue scales (VAS, 0-10), grip strength and finger mobility (mean distance from finger pulp to palmar D2-D5). The clinical course was statistically analysed. CRPS diagnosis was confirmed clinically by a pain therapist, CTS diagnosis was confirmed by neurological and neurophysiological examination. Surgical therapy was performed despite CRPS diagnosis. The prevalence of CRPS was 161/1000 and of CTS 62/1000; the co-prevalence of the 2 diagnoses was 24/1000 (p<0.0001). In the CRPS group, after a mean of 8 (1-21) weeks of rehabilitative therapy, mean pain was reduced from 5 (1-10) to 3 (0-9), grip strength improved from 10 (0-39)kg to 18.5 (2.5-45.5)kg and finger mobility increased from 2.9 (0-7.6)cm to 1.8 (0-7.8)cm. In the CRPS+CTS group, after a mean of 6.8 (3-23) weeks of rehabilitative therapy, mean pain was reduced from 5 (0-8) to 2.6 (0-5), grip strength improved from 9.7 (2.4-25.5)kg to 17.4 (0.9-47.4)kg and finger mobility increased from 2.7 (0-5.3)cm to 1.7 (0-5.3)cm. Improvement over the period of rehabilitation was significant in both groups, though the period of therapy was significantly shorter in the CRPS+CTS group. CRPS and CTS are often associated. Rehabilitative therapy was effective for CRPS- and CRPS+CTS patients. © Georg Thieme Verlag KG Stuttgart · New York.

An ergonomics study on the evaluation of carpal tunnel syndrome among Chikan embroidery workers of West Bengal, India.

PubMed

Gangopadhyay, Somnath; Chakrabarty, Sabarni; Sarkar, Krishnendu; Dev, Samrat; Das, Tamal; Banerjee, Sunetra

2015-01-01

Chikan embroidery is a popular handicraft in India that involves hand-intensive stitching while seated in a static posture with the upper back curved and the head bent over the fabric. Women perform most Chikan embroidery. The aim of this study was to analyze the repetitive nature of this work among female Chikan embroiderers by measuring the prevalence of upper extremity discomfort and carpal tunnel syndrome (CTS). The Nordic musculoskeletal questionnaire was used to analyze the extent of upper extremity pain symptomology. The repetitive nature of Chikan embroidery work was evaluated using the Assessment of Repetitive Tasks of the upper limbs tool (ART). Motor nerve conduction studies of median and ulnar nerves were performed with embroidery workers and a control group to determine the risk of CTS. Among embroidery workers, the prevalence of wrist pain was 68% and forearm pain was 60%. The embroiderers also commonly reported Tingling and numbness in the hands and fingertips. The ART analysis found that Chikan embroidery is a highly repetitive task and nerve conduction studies showed that the embroidery workers were more likely to experience CTS than women in the control group. Chikan embroidery is a hand-intensive occupation involving repetitive use of hands and wrists and this study population is at risk of experiencing CTS. Future research should explore the potential benefits of ergonomics measures including incorporating breaks, stretching exercises, and the use of wrist splints to reduce repetitive strain and the probability of developing CTS.

What motivates Parkinson's disease patients to enter clinical trials?

PubMed

Valadas, Anabela; Coelho, Miguel; Mestre, Tiago; Guedes, Leonor Correia; Finisterra, Maria; Noronha, Ana; Rosa, Mário M; Sampaio, Cristina; Ferreira, Joaquim J

2011-11-01

Limited data is available regarding motivations and concerns of Parkinson's disease (PD) patients when participating in clinical trials (CTs). Knowledge of these factors may improve the recruitment and quality of future trials. To assess the motivations and concerns of PD patients concerning participation in CTs and to evaluate the extent to which patients understand informed consent materials and placebo effect concept. Cross-sectional study in PD patients enrolled in CTs between 2002 and 2007. Two questionnaires designed for placebo-controlled and active-controlled studies were mailed to patients. From the 93/127 replied questionnaires (response rate: 73.2%) 91 were evaluable. Fifty-nine percent of the participants were women with a mean age of 66.8 years. The main reasons for participating in CTs were to help the advance of science (63.7%), to gain access to a better treatment (56.0%), and to benefit others (51.6%). Risk of adverse events (49.5%) and negative effects of treatment (35.2%) were the major concerns. Ninety percent reported they had understood the informed consent. Of 80 patients included in placebo-controlled studies, 63.9% understood the placebo effect concept. Globally, 66% of patients would participate in another CT and 41.6% in a placebo-controlled trial. The main motivations of PD patients to participate in CTs were the benefit to the patient himself and to others. The major concern was safety. PD patients understood the informed consent, but more educational efforts must be made to explain the placebo effect. Most PD patients were very positive toward CTs and would participate in another trial. Copyright © 2011 Elsevier Ltd. All rights reserved.

A prospective study of carpal tunnel syndrome: workplace and individual risk factors

PubMed Central

Burt, Susan; Deddens, James A; Crombie, Ken; Jin, Yan; Wurzelbacher, Steve; Ramsey, Jessica

2015-01-01

Objectives To quantify the risk for carpal tunnel syndrome (CTS) from workplace physical factors, particularly hand activity level and forceful exertion, while taking into account individual factors including age, gender, body mass index (BMI), and pre-existing medical conditions. Methods Three healthcare and manufacturing workplaces were selected for inclusion on the basis of range of exposure to hand activity level and forceful exertion represented by their jobs. Each study participants job tasks were observed and evaluated ’ onsite and videotaped for further analysis, including frequency and duration of exertion and postural deviation. Individual health assessment entailed electrodiagnostic testing of median and ulnar nerves, physical examination and questionnaires at baseline with annual follow-up for 2 years. Results The incidence of dominant hand CTS during the study was 5.11 per 100 person-years (29 cases). Adjusted HRs for dominant hand CTS were as follows: working with forceful exertion ≥20% but <60% of the time: 2.83 (1.18, 6.79) and ≥60% of the time vs <20%: 19.57 (5.96, 64.24), BMI ≥30 kg/m2 (obesity): 3.19 (1.28, 7.98). The American Conference for Governmental Industrial Hygienists (ACGIH) Threshold Limit Value (TLV) for hand activity level also predicted CTS, HR=1.40 (1.11, 1.78) for each unit increase in the TLV ratio, controlling for obesity and job strain. Conclusions Workplace and individual risk factors both contribute to the risk for CTS. Time spent in forceful exertion can be a greater risk for CTS than obesity if the job exposure is high. Preventive workplace efforts should target forceful exertions. PMID:23788614

Exposure–response relationships for the ACGIH threshold limit value for hand-activity level: results from a pooled data study of carpal tunnel syndrome

PubMed Central

Kapellusch, Jay M; Gerr, Frederic E; Malloy, Elizabeth J; Garg, Arun; Harris-Adamson, Carisa; Bao, Stephen S; Burt, Susan E; Dale, Ann Marie; Eisen, Ellen A; Evanoff, Bradley A; Hegmann, Kurt T; Silverstein, Barbara A; Theise, Matthew S; Rempel, David M

2014-01-01

Objective This paper aimed to quantify exposure–response relationships between the American Conference of Governmental Industrial Hygienists’ (ACGIH) threshold limit value (TLV) for hand-activity level (HAL) and incidence of carpal tunnel syndrome (CTS). Methods Manufacturing and service workers previously studied by six research institutions had their data combined and re-analyzed. CTS cases were defined by symptoms and abnormal nerve conduction. Hazard ratios (HR) were calculated using proportional hazards regression after adjusting for age, gender, body mass index, and CTS predisposing conditions. Results The longitudinal study comprised 2751 incident-eligible workers, followed prospectively for up to 6.4 years and contributing 6243 person-years of data. Associations were found between CTS and TLV for HAL both as a continuous variable [HR 1.32 per unit, 95% confidence interval (95% CI) 1.11–1.57] and when categorized using the ACGIH action limit (AL) and TLV. Those between the AL and TLV and above the TLV had HR of 1.7 (95% CI 1.2–2.5) and 1.5 (95% CI 1.0–2.1), respectively. As independent variables (in the same adjusted model) the HR for peak force (PF) and HAL were 1.14 per unit (95% CI 1.05–1.25), and 1.04 per unit (95% CI 0.93–1.15), respectively. Conclusion Those with exposures above the AL were at increased risk of CTS, but there was no further increase in risk for workers above the TLV. This suggests that the current AL may not be sufficiently protective of workers. Combinations of PF and HAL are useful for predicting risk of CTS. PMID:25266844

Critical Thinking Skills in Nursing Students: a Comparison Between Freshmen and Senior Students

PubMed Central

Azizi-Fini, Ismail; Hajibagheri, Ali; Adib-Hajbaghery, Mohsen

2015-01-01

Background: Critical thinking is one of the most important concepts in the field of education. Despite studies published on nursing students’ critical thinking skills (CTS), some suggest that there is not enough evidence supporting the relationship between content of nursing education programs and nursing students’ CTS. Objectives: Given the existing discrepancies, this study aimed to compare the critical thinking skills of freshmen and senior nursing students. Patients and Methods: This comparative study was conducted on 150 undergraduate freshmen and senior nursing students in Kashan University of Medical Sciences, during 2012. The students in the first and the last semesters of their study in nursing were entered in the study using the census method. Data were collected using a questionnaire including questions on demographic data and the California Critical Thinking Skills Test, form B. Data analysis was performed using the SPSS v.13 software. Descriptive statistics were calculated. Moreover, independent sample t-test and Spearman and Pearson’s correlation coefficients were used in the data analysis. Results: Both the freshmen and senior nursing students had low CTS. The mean critical thinking scores were 11.79 ± 4.80 and 11.21 ± 3.17 for the freshmen and the senior students, respectively (P = 0.511). Moreover, no significant correlation was found between the students’ score in CTS and their age, gender, high school grade point average (GPA), rank in university entrance examination (RUEE) and interest in the nursing profession. Conclusions: The students were low skilled in critical thinking and their CTS did not significantly change during their nursing degree. Thus it may be concluded that the nursing education program did not affect the CTS of its students. Longitudinal studies are suggested for assessing nursing students’ critical thinking over time. Moreover, revising the curriculum and preparing nursing educators for implementing innovative and active teaching strategies are suggested. PMID:25830160

Factors affecting interest in cardiothoracic surgery: Survey of North American general surgery residents.

PubMed

Vaporciyan, Ara A; Reed, Carolyn E; Erikson, Clese; Dill, Michael J; Carpenter, Andrea J; Guleserian, Kristine J; Merrill, Walter

2009-05-01

Applications to cardiothoracic surgery (CTS) training programs have declined precipitously. The viewpoints of potential applicants, general surgery residents, have not yet been assessed. Their perceptions are crucial to understanding the cause and formulating appropriate changes in our educational system. An initial survey instrument was content-validated, and the final instrument was distributed electronically between March 24 and May 2, 2008 through 251 general surgery program directors to all Accreditation Council for Graduate Medical Education-accredited general surgery residents (7508). The response rate was 29% (2153 residents; 89% programs). Respondent's demographics matched existing data; 6% were committed to CTS, and 26% reported prior or current interest in CTS. Interest waned after postgraduate year 3. Interest correlated with CTS rotation duration. Of the respondents committed to CTS, 76% had mentors (71% were cardiothoracic surgeons). CTS had the most shortcomings among 9 subspecialties. Job security and availability accounted for 46% of reported shortcomings (3 to 14 times higher than other subspecialties). Work schedule accounted for 25%. Length of training was not a very important factor, although it was identified as an option to increase interest in CTS. Residents who were undecided or uninterested in CTS were twice as likely to cite the ability to balance work and personal life as important than residents who chose CTS. The dominant concern documented in the survey is job security and availability. The importance of mentorship and exposure to CTS faculty in promoting interest was also evident. Decision makers should consider these findings when planning changes in education and the specialty.

Factors affecting interest in cardiothoracic surgery: survey of North American general surgery residents.

PubMed

Vaporciyan, Ara A; Reed, Carolyn E; Erikson, Clese; Dill, Michael J; Carpenter, Andrea J; Guleserian, Kristine J; Merrill, Walter

2009-05-01

Applications to cardiothoracic surgery (CTS) training programs have declined precipitously. The viewpoints of potential applicants, general surgery residents, have not yet been assessed. Their perceptions are crucial to understanding the cause and formulating appropriate changes in our educational system. An initial survey instrument was content-validated, and the final instrument was distributed electronically between March 24 and May 2, 2008 through 251 general surgery program directors to all Accreditation Council for Graduate Medical Education-accredited general surgery residents (7,508). The response rate was 29% (2153 residents; 89% programs). Respondent's demographics matched existing data; 6% were committed to CTS, and 26% reported prior or current interest in CTS. Interest waned after postgraduate year 3. Interest correlated with CTS rotation duration. Of the respondents committed to CTS, 76% had mentors (71% were cardiothoracic surgeons). CTS had the most shortcomings among 9 subspecialties. Job security and availability accounted for 46% of reported shortcomings (3 to 14 times higher than other subspecialties). Work schedule accounted for 25%. Length of training was not a very important factor, although it was identified as an option to increase interest in CTS. Residents who were undecided or uninterested in CTS were twice as likely to cite the ability to balance work and personal life as important than residents who chose CTS. The dominant concern documented in the survey is job security and availability. The importance of mentorship and exposure to CTS faculty in promoting interest was also evident. Decision makers should consider these findings when planning changes in education and the specialty.

Transcranial direct current stimulation and cognitive training in the rehabilitation of Alzheimer disease: A case study.

PubMed

Penolazzi, Barbara; Bergamaschi, Susanna; Pastore, Massimiliano; Villani, Daniele; Sartori, Giuseppe; Mondini, Sara

2015-01-01

In the present study we tested the cognitive effects of transcranial direct current stimulation (tDCS) in a case of probable Alzheimer disease (AD). The patient (male, 60 years, mild AD) underwent two cycles of treatments, separated by 2 months. In the first cycle, active stimulation (10 sessions, 2 mA for 20 min; anode over the left dorsolateral prefrontal cortex) was followed by computerised tasks (CTs) specifically chosen to engage the most impaired cognitive processes in the patient (tDCS+CT condition). In the second cycle, which was structured as the first, CTs were administered after placebo stimulation (sham+CT condition). Effects on cognitive performance were evaluated not only by the CTs, but also by neuropsychological tests assessing global cognitive functioning. Statistical analyses revealed that whereas the tDCS+CT condition had few effects on the CTs, it induced a stability of the patient's global cognitive functioning lasting approximately 3 months, which was not achieved when the patient underwent sham+CT condition. Therefore, the synergetic use of tDCS and CTs appeared to slow down the cognitive decline of our patient. This preliminary result, although in need of further confirmation, suggests the potentiality of tDCS as an adjuvant tool for cognitive rehabilitation in AD.

Kinesiotaping as an alternative treatment method for carpal tunnel syndrome.

PubMed

Geler Külcü, Duygu; Bursali, Canan; Aktaş, İlknur; Bozkurt Alp, Selin; Ünlü Özkan, Feyza; Akpinar, Pınar

2016-06-23

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. Conservative treatment choices are not always satisfactory. The aim of this study was to investigate the effect of kinesiotaping (KT) on pain level, grip strength, and functional status compared with that of placebo KT and orthotic device (OD) in patients with CTS. In this randomized, placebo-controlled study, participants were allocated into one of three groups: an experimental KT group (Group 1), a placebo KT group (Group 2), and an OD group (Group 3). Visual analogue scale (VAS) and Douleur Neuropathique 4 (DN4) scores, dynamometric grip strength measures, and the Boston CTS questionnaire (BQ) were the outcome measures. All groups significantly improved in terms of VAS scores (P < 0.05), DN4 scores (P < 0.05), and BQ scores (P < 0.05). Grip strength improved in Group 3 (P = 0.001). There was a significant difference among the groups with respect to BQ scores (P < 0.05). KT application for the treatment of CTS should be an alternative treatment choice.

Communication network in the follicular papilla and connective tissue sheath through gap junctions in human hair follicles.

PubMed

Iguchi, Makiko; Hara, Masahiro; Manome, Hideaki; Kobayasi, Hiromi; Tagami, Hachiro; Aiba, Setsuya

2003-06-01

Epithelial-mesenchymal interactions play a crucial role in the induction of life-long cyclic transformations of hair follicles. Many studies have already demonstrated several candidates for the soluble factors secreted from the mesenchymal components of the hair follicle, i.e. the follicular papilla (FP) and connective tissue sheath (CTS), which may be responsible for hair cycling. In this paper, we focused on cell-cell contact between FP cells (FPCs), between CTS cells (CTSCs), and between FPCs and CTSCs that may allow these mesenchymal components to function as a syncytium during hair cycling. Electron microscopic examination of the FP and the CTS obtained from human scalp revealed a tri-lamellar structure of the plasma membranes, which is a characteristic of gap junctions at the cell-cell contacting area. The immunohistochemical study with anticonnexin 43 Ab using a confocal laser scanning microscope demonstrated numerous spotted positive signals scattered throughout the FP. In the CTS, spotted positive signals were arranged linearly along the basement membrane of the hair follicle. In particular, these positive spots were aggregated in the transitional region between the FP and the CTS. By Western blot analysis of total protein extracts from the cultured FPCs and neonatal human dermal fibroblasts using anticonnexin 43 antibody, a positive band corresponding to connexin 43 was detected at 43 kDa on both the FPC lane and fibroblast lane. These findings suggest that the FP and the CTS form a communicating network through gap junctions, which may play a role in controlling the dynamic structural changes of hair follicles during hair cycling.

A Machine Learning Approach to Identify Clinical Trials Involving Nanodrugs and Nanodevices from ClinicalTrials.gov

PubMed Central

de la Iglesia, Diana; García-Remesal, Miguel; Anguita, Alberto; Muñoz-Mármol, Miguel; Kulikowski, Casimir; Maojo, Víctor

2014-01-01

Background Clinical Trials (CTs) are essential for bridging the gap between experimental research on new drugs and their clinical application. Just like CTs for traditional drugs and biologics have helped accelerate the translation of biomedical findings into medical practice, CTs for nanodrugs and nanodevices could advance novel nanomaterials as agents for diagnosis and therapy. Although there is publicly available information about nanomedicine-related CTs, the online archiving of this information is carried out without adhering to criteria that discriminate between studies involving nanomaterials or nanotechnology-based processes (nano), and CTs that do not involve nanotechnology (non-nano). Finding out whether nanodrugs and nanodevices were involved in a study from CT summaries alone is a challenging task. At the time of writing, CTs archived in the well-known online registry ClinicalTrials.gov are not easily told apart as to whether they are nano or non-nano CTs—even when performed by domain experts, due to the lack of both a common definition for nanotechnology and of standards for reporting nanomedical experiments and results. Methods We propose a supervised learning approach for classifying CT summaries from ClinicalTrials.gov according to whether they fall into the nano or the non-nano categories. Our method involves several stages: i) extraction and manual annotation of CTs as nano vs. non-nano, ii) pre-processing and automatic classification, and iii) performance evaluation using several state-of-the-art classifiers under different transformations of the original dataset. Results and Conclusions The performance of the best automated classifier closely matches that of experts (AUC over 0.95), suggesting that it is feasible to automatically detect the presence of nanotechnology products in CT summaries with a high degree of accuracy. This can significantly speed up the process of finding whether reports on ClinicalTrials.gov might be relevant to a particular nanoparticle or nanodevice, which is essential to discover any precedents for nanotoxicity events or advantages for targeted drug therapy. PMID:25347075

Personal risk factors for carpal tunnel syndrome in female visual display unit workers.

PubMed

Riccò, Matteo; Cattani, Silvia; Signorelli, Carlo

2016-11-18

Carpal tunnel syndrome (CTS) is the most common nerve entrapment syndrome, which since the beginning of the seventies has been linked to the keyboard and visual display unit (VDU). The objective of this study was to investigate the prevalence and personal factors associated with CTS in female VDU workers in Italy. Participants in this study were female adult subjects, working ≥ 20 h/week (N = 631, mean age 38.14±7.81 years, mean working age 12.9±7.24 years). Signs and symptoms were collected during compulsory occupational medical surveillance. The binary logistic regression was used to estimate adjusted odds ratios for the factors of interest. Diagnosis of CTS was reported in 48 cases (7.6%, 11 of them or 1.7% after a surgical correction) for the incidence of 5.94/1000 person-years. In general, signs and symptoms of CTS were associated with the following demographic factors: previous trauma of upper limb (adjusted odds ratio (ORa) = 8.093, 95% confidence interval (CI): 2.347-27.904), history (> 5 years) of oral contraceptives therapy/hormone replacement therapy (ORa = 3.77, 95% CI: 1.701-8.354) and cervical spine signs/symptoms (ORa = 4.565, 95% CI: 2.281-9.136). The prevalence of CTS was similar to the estimates for the general population of Italy. Among personal risk factors, hormone therapy, previous trauma of the upper limb and signs/symptoms of the cervical spine appeared to be associated with a higher risk of CTS syndrome. Eventually, the results reinforce interpretation of CTS in VDU workers as a work-related musculoskeletal disorder rather than a classical occupational disease. Int J Occup Med Environ Health 2016;29(6):927-936. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Community Health. Career & Technology Studies. Guide to Standards and Implementation. Interim 1996 (September 1996-September 1997).

ERIC Educational Resources Information Center

Alberta Dept. of Education, Edmonton. Curriculum Standards Branch.

This document contains materials for teachers to use in presenting the community health strand of the career and technology studies (CTS) program that has been approved for secondary schools in Alberta, Canada. The first three sections outline the philosophy/rationale, organization, and curriculum and assessment standards of the CTS program in…

A Study on Critical Thinking Assessment System of College English Writing

ERIC Educational Resources Information Center

Dong, Tian; Yue, Lu

2015-01-01

This research attempts to discuss the validity of introducing the evaluation of students' critical thinking skills (CTS) into the assessment system of college English writing through an empirical study. In this paper, 30 College English Test Band 4 (CET-4) writing samples were collected and analyzed. Students' CTS and the final scores of collected…

Current interest in careers in surgery and cardiothoracic surgery from the millennial generation.

PubMed

Ghannam, Michael; Zhao, Lili; Reddy, Rishindra M

2014-01-01

Interest in cardiothoracic surgery (CTS) as a career has decreased over the past decade. Anecdotal evidence suggests that many surgeons develop an interest in CTS before medical school and even before college. This study evaluates the interest of high-school students at a magnet high school, with regard to careers in medicine, in surgery, and in CTS. A survey assessing career interests and values was conducted among junior and senior high-school students. Students were given a 1-hour presentation by a cardiothoracic (CT) surgeon on the postgraduate training process and then completed a postpresentation survey. A magnet math and science high school, the Kalamazoo Area Mathematics and Science Center. Of 128 students, 117 (91% response rate) completed the survey. Overall, 38% of students reported having a high interest in medicine; of this group, 58% reported a high interest in surgery and 36% reported having a high interest in CTS. Men were more likely than women were to have a high interest in surgery and CTS (p < 0.001). Students with at least 1 family member as a physician vs those without were more likely to be interested in medicine, surgery, and CTS and also have a higher level of concern for postgraduation debt (p < 0.01). Women were more likely than men were to have a high level of concern about postgraduation debt (p = 0.018). After a presentation by a CT surgeon, students showed no changes in interest in medicine careers but did report an increased level of knowledge about the process of becoming a CT surgeon, going from 31% to 72%. There exists a large interest in both surgery and CTS at the high-school level, but there may be a need for more active outreach to maintain and foster their interest in surgery and CTS through undergraduate and medical school. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Application of a computed tomography based cystic fibrosis scoring system to chest tomosynthesis

NASA Astrophysics Data System (ADS)

Söderman, Christina; Johnsson, Åse; Vikgren, Jenny; Rystedt, Hans; Ivarsson, Jonas; Rossi Norrlund, Rauni; Nyberg Andersson, Lena; Bâth, Magnus

2013-03-01

In the monitoring of progression of lung disease in patients with cystic fibrosis (CF), recurrent computed tomography (CT) examinations are often used. The relatively new imaging technique chest tomosynthesis (CTS) may be an interesting alternative in the follow-up of these patients due to its visualization of the chest in slices at radiation doses and costs significantly lower than is the case with CT. A first step towards introducing CTS imaging in the diagnostics of CF patients is to establish a scoring system appropriate for evaluating the severity of CF pulmonary disease based on findings in CTS images. Previously, several such CF scoring systems based on CT imaging have been published. The purpose of the present study was to develop a CF scoring system for CTS, by starting from an existing scoring system dedicated for CT images and making modifications regarded necessary to make it appropriate for use with CTS images. In order to determine any necessary changes, three thoracic radiologists independently used a scoring system dedicated for CT on both CT and CTS images from CF patients. The results of the scoring were jointly evaluated by all the observers, which lead to suggestions for changes to the scoring system. Suggested modifications include excluding the scoring of air trapping and doing the scoring of the findings in quadrants of the image instead of in each lung lobe.

Hydroxyapatite-chitosan based bioactive hybrid biomaterials with improved mechanical strength

NASA Astrophysics Data System (ADS)

Zima, A.

2018-03-01

Composites consisting of hydroxyapatite (HA) and chitosan (CTS) have recently been intensively studied. In this work, a novel inorganic-organic (I/O) HA/CTS materials in the form of granules were prepared through a simple solution-based chemical method. During the synthesis of these hybrids, the electrostatic complexes between positively charged, protonated amine groups of chitosan and the negative phosphate species (HPO42 - and H2PO4-) were formed. Our biocomposites belong to the class I of hybrids, which was confirmed by FTIR studies. XRD analysis revealed that the obtained materials consisted of hydroxyapatite as the only crystalline phase. Homogeneous dispersion of the components in HA/CTS composites was confirmed. The use of 17 wt% and 23 wt% of chitosan resulted in approximately 12-fold and 16-fold increase in the compressive strength of HA/CTS as compared to the non-modified HA material. During incubation of the studied materials in SBF, pH of the solution remained close to the physiological one. Formation of apatite layer on their surfaces indicated bioactive nature of the developed biomaterials.

Level-2 Milestone 5213. CTS-1 Contract Award Completed

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

Leininger, Matt

2015-09-24

This report documents the fact that the first commodity technology (CT) system contract award, CTS-1, has been completed. The description of the milestone is: Based on Tri-Lab CTS-1 process and review, LLNL successfully awards the procurement for the next-generation Tri-Lab Linux CTS-1. The milestone completion criterion is: Signed contract. The milestone was completed on September 24th. 2015.

The influence of non-rigid anatomy and patient positioning on endoscopy-CT image registration in the head and neck.

PubMed

Ingram, W Scott; Yang, Jinzhong; Wendt, Richard; Beadle, Beth M; Rao, Arvind; Wang, Xin A; Court, Laurence E

2017-08-01

To assess the influence of non-rigid anatomy and differences in patient positioning between CT acquisition and endoscopic examination on endoscopy-CT image registration in the head and neck. Radiotherapy planning CTs and 31-35 daily treatment-room CTs were acquired for nineteen patients. Diagnostic CTs were acquired for thirteen of the patients. The surfaces of the airways were segmented on all scans and triangular meshes were created to render virtual endoscopic images with a calibrated pinhole model of an endoscope. The virtual images were used to take projective measurements throughout the meshes, with reference measurements defined as those taken on the planning CTs and test measurements defined as those taken on the daily or diagnostic CTs. The influence of non-rigid anatomy was quantified by 3D distance errors between reference and test measurements on the daily CTs, and the influence of patient positioning was quantified by 3D distance errors between reference and test measurements on the diagnostic CTs. The daily CT measurements were also used to investigate the influences of camera-to-surface distance, surface angle, and the interval of time between scans. Average errors in the daily CTs were 0.36 ± 0.61 cm in the nasal cavity, 0.58 ± 0.83 cm in the naso- and oropharynx, and 0.47 ± 0.73 cm in the hypopharynx and larynx. Average errors in the diagnostic CTs in those regions were 0.52 ± 0.69 cm, 0.65 ± 0.84 cm, and 0.69 ± 0.90 cm, respectively. All CTs had errors heavily skewed towards 0, albeit with large outliers. Large camera-to-surface distances were found to increase the errors, but the angle at which the camera viewed the surface had no effect. The errors in the Day 1 and Day 15 CTs were found to be significantly smaller than those in the Day 30 CTs (P < 0.05). Inconsistencies of patient positioning have a larger influence than non-rigid anatomy on projective measurement errors. In general, these errors are largest when the camera is in the superior pharynx, where it sees large distances and a lot of muscle motion. The errors are larger when the interval of time between CT acquisitions is longer, which suggests that the interval of time between the CT acquisition and the endoscopic examination should be kept short. The median errors found in this study are comparable to acceptable levels of uncertainty in deformable CT registration. Large errors are possible even when image alignment is very good, indicating that projective measurements must be made carefully to avoid these outliers. © 2017 American Association of Physicists in Medicine.

Is the Control of Applied Digital Forces During Natural Five-digit Grasping Affected by Carpal Tunnel Syndrome?

PubMed

Chen, Po-Tsun; Jou, I-Ming; Lin, Chien-Ju; Chieh, Hsiao-Feng; Kuo, Li-Chieh; Su, Fong-Chin

2015-07-01

The impaired sensory function of the hand induced by carpal tunnel syndrome (CTS) is known to disturb dexterous manipulations. However, force control during daily grasping configuration among the five digits has not been a prominent focus of study. Because grasping is so important to normal function and use of a hand, it is important to understand how sensory changes in CTS affect the digit force of natural grasp. We therefore examined the altered patterns of digit forces applied during natural five-digit grasping in patients with CTS and compared them with those seen in control subjects without CTS. We hypothesized that the patients with CTS will grasp by applying larger forces with lowered pair correlations and more force variability of the involved digits than the control subjects. Specifically, we asked: (1) Is there a difference between patients with CTS and control subjects in applied force by digits during lift-hold-lower task? (2) Is there a difference in force correlation coefficient of the digit pairs? (3) Are there force variability differences during the holding phase? We evaluated 15 female patients with CTS and 15 control subjects matched for age, gender, and hand dominance. The applied radial forces (Fr) of the five digits were recorded by respective force transducers on a cylinder simulator during the lift-hold-lower task with natural grasping. The movement phases of the task were determined by a video-based motion capture system. The applied forces of the thumb in patients with CTS (7 ± 0.8 N; 95% CI, 7.2-7.4 N) versus control subjects (5 ± 0.8 N; 95% CI, 5.1-5.3 N) and the index finger in patients with CTS (3 ± 0.3 N; 95% CI, 3.2-3.3 N) versus control subjects (2 ± 0.3 N; 95% CI, 2.2-2.3 N) observed throughout most of the task were larger in the CTS group (p ranges 0.035-0.050 for thumb and 0.016-0.050 for index finger). In addition, the applied force of the middle finger in patients with CTS (1 ± 0.1 N; 95% CI, 1.3-1.4 N) versus the control subjects (2 ± 0.2 N; 95% CI, 1.9-2.0 N) during the lowering phase was larger in CTS group (p ranges 0.039-0.050). The force correlations of the thumb-middle finger observed during the lowering phase in the patients with CTS (0.8 ± 0.2; 95% CI, 0.6-0.9) versus the control subjects (0.9 ± 0.1; 95% CI, 0.8-1.0; p = 0.04) were weaker in the CTS group. The thumb-little finger during holding in the patients with CTS (0.5 ± 0.2; 95% CI, 0.3-0.7) versus the control subjects (0.8 ± 0.2; 95% CI, 0.6-0.9; p = 0.02), and the lowering phase in the patients with CTS (0.6 ± 0.2; 95% CI, 0.3-0.8) versus the control subjects (0.9 ± 0.1; 95% CI, 0.8-1.0; p = 0.01) also were weaker. The force variabilities of patients with CTS were greater in the CTS group than in the control subjects: in the thumb ([0.26 ± 0.11 N, 95% CI, 0.20-0.32 N] versus [0.19 ± 0.06 N; 95% CI, 0.16-0.22 N], p = 0.03); index finger ([0.09 ± 0.07 N; 95% CI, 0.05-0.13 N] versus [0.05 ± 0.03 N; 95% CI, 0.04-0.07 N], p = 0.03); middle finger ([0.06 ± 0.04 N; 95% CI, 0.04-0.08 N] versus [0.03 ± 0.01 N; 95% CI, 0.02-0.04 N], p = 0.02), and ring finger ([0.04 ± 0.03 N; 95% CI, 0.20-0.06 N] versus [0.02 ± 0.01 N; 95% CI, 0.02-0.02 N], p = 0.01). Patients with CTS grasped with greater digit force associated with weaker correlation and higher variability on specific digits in different task demands. These altered patterns in daily grasping may lead to secondary problems, which will need to be assessed in future studies with this model to see if they are reversible in patients undergoing carpal tunnel release. The current results helped to identify altered patterns of grasping force during simulated daily function in patients with CTS and to provide the clinician with potential information that might help guide the rehabilitation of grasp in these patients.

SU-E-J-245: Is Off-Line Adaptive Radiotherapy Sufficient for Head and Neck Cancer with IGRT?

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

Li, Z; Cleveland Clinic, Cleveland, OH; Shang, Q

2014-06-01

Purpose: Radiation doses delivered to patients with head and neck cancer (HN) may deviate from the planned doses because of variations in patient setup and anatomy. This study was to evaluate whether off-line Adaptive Radiotherapy (ART) is sufficient. Methods: Ten HN patients, who received IMRT under daily imaging guidance using CT-on-rail/KV-CBCT, were randomly selected for this study. For each patient, the daily treatment setup was corrected with translational only directions. Sixty weekly verification CTs were retrospectively analyzed. On these weekly verification CTs, the tumor volumes and OAR contours were manually delineated by a physician. With the treatment iso-center placed onmore » the verification CTs, according to the recorded clinical shifts, the treatment beams from the original IMRT plans were then applied to these CTs to calculate the delivered doses. The electron density of the planning CTs and weekly CTs were overridden to 1 g/cm3. Results: Among 60 fractions, D99 of the CTVs in 4 fractions decreased more than 5% of the planned doses. The maximum dose of the spinal cord exceeded 10% of the planned values in 2 fractions. A close examination indicated that the dose discrepancy in these 6 fractions was due to patient rotations, especially shoulder rotations. After registering these 6 CTs with the planning CT allowing six degree of freedoms, the maximum rotations around 3 axes were > 1.5° for these fractions. With rotation setup errors removed, 4 out of 10 patients still required off-line ART to accommodate anatomical changes. Conclusion: A significant shoulder rotations were observed in 10% fractions, requiring patient re-setup. Off-line ART alone is not sufficient to correct for random variations of patient position, although ART is effective to adapt to patients' gradual anatomic changes. Re-setup or on-line ART may be considered for patients with large deviations detected early by daily IGRT images. The study is supported in part by Siemens Medical Solutions.« less

Declining trend in the use of repeat computed tomography for trauma patients admitted to a level I trauma center for traffic-related injuries.

PubMed

Psoter, Kevin J; Roudsari, Bahman S; Graves, Janessa M; Mack, Christopher; Jarvik, Jeffrey G

2013-06-01

To evaluate the trend in utilization of repeat (i.e. ≥2) computed tomography (CT) and to compare utilization patterns across body regions for trauma patients admitted to a level I trauma center for traffic-related injuries (TRI). We linked the Harborview Medical Center trauma registry (1996-2010) to the billing department data. We extracted the following variables: type and frequency of CTs performed, age, gender, race/ethnicity, insurance status, injury mechanism and severity, length of hospitalization, intensive care unit (ICU) admission and final disposition. TRIs were defined as motor vehicle collisions, motorcycle, bicycle and pedestrian-related injuries. Logistic regression was used to evaluate the association between utilization of different body region repeat (i.e. ≥2) CTs and year of admission, adjusting for patient and injury-related characteristics that could influence utilization patterns. A total of 28,431 patients were admitted for TRIs over the study period and 9499 (33%) received repeat CTs. From 1996 to 2010, the proportion of patients receiving repeat CTs decreased by 33%. Relative to 2000 and adjusting for other covariates, patients with TRIs admitted in 2010 had significantly lower odds of undergoing repeat head (OR=0.61; 95% CI: 0.49-0.76), pelvis (OR=0.37; 95% CI: 0.27-0.52), cervical spine (OR=0.23; 95% CI: 0.12-0.43), and maxillofacial CTs (OR=0.24; 95% CI: 0.10-0.57). However, they had higher odds of receiving repeat thoracic CTs (OR=1.86; 95% CI: 1.02-3.38). A significant decrease in the utilization of repeat CTs was observed in trauma patients presenting with traffic-related injuries over a 15-year period. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Diagnosis and treatment of hand-arm vibration syndrome and its relationship to carpal tunnel syndrome.

PubMed

Falkiner, Sonja

2003-07-01

Hand-arm vibration syndrome (HAVS) is a condition associated with the use of vibrating tools that occurs mainly in men. It consists primarily of 'occupational' Raynaud disease and digital polyneuropathy. Carpal tunnel syndrome (CTS) is also associated with hand transmitted vibration exposure and can coexist with HAVS. This article examines recent papers on causation, diagnosis, relationship to CTS and treatment. A Medline search was conducted, as was a search of UK, USA and Australian government occupational health and safety websites. Published papers that were single case studies or of poor design were not included. There are no 'gold standard' diagnostic tests for HAVS. It can mimic CTS in temperate climates and can occur with CTS. This is the diagnostic challenge when a male worker presents with apparent CTS symptoms. If he has worked with vibrating tools for many years, a diagnosis of HAVS or co-diagnosis of HAVS should be considered before a diagnosis of pure CTS is made. Nonwork risk factors for HAVS are predisposition, smoking, and exposure to vibration outside work. Cessation of exposure (and smoking) and redeployment is a critical part of treatment due to the dose response relationship of HAVS. This contrasts with adequately treated CTS, where the vast majority of workers can return to pre-injury duties. In severe cases, calcium antagonists are also used, but treatment is often ineffective. Few workplaces in Australia manage vibration risk or conduct screening to identify workers with early HAVS who should be redeployed. Local doctors have an important opportunity to diagnose HAVS and to make recommendations to the workplace on redeployment as part of treatment before symptoms become irreversible.

Therapeutic effect of Cryptotanshinone on experimental rheumatoid arthritis through downregulating p300 mediated-STAT3 acetylation.

PubMed

Wang, Ying; Zhou, Chun; Gao, Hui; Li, Cuixian; Li, Dong; Liu, Peiqing; Huang, Min; Shen, Xiaoyan; Liu, Liang

2017-08-15

The balance between T helper 17 (Th17) cells and regulatory T (Treg) cells, plays a critical role in rheumatoid arthritis (RA). The differentiation of Th17 cells requires the activation of STAT3, which determines the balance of Th17/Treg. Here, we investigated the therapeutic effect of Cryptotanshinone (CTS) on collagen induced mouse arthritis and explored the underlying mechanisms. Arthritis was induced in DBA/1 mice with bovine collagen type II and complete Freund's adjuvant. CTS was given at 20mgkg -1 d -1 or 60mgkg -1 d -1 by gavage for 6weeks. The immuno-inflammation and joint destruction were evaluated and the balance of Th17/Treg was determined. STAT3 acetylation and phosphorylation were detected by western blotting, and the involvement of p300 was investigated by siRNA and plasmid overexpression. CTS at a dose of 60mgkg -1 d -1 ameliorated the inflammation and joint destruction in CIA mice. It improved Th17/Treg imbalance, and inhibited both acetylation and phosphorylation of STAT3. CTS reduced p300 expression and its binding to STAT3, but increased phosphorylated AMPK. Knockdown of p300 mimicked the inhibitory effect of CTS on STAT3 acetylation and phosphorylation, which could be partially rescued by overexpression of p300-WT, but not p300-dominant negative (DN) construct. Our study suggested that the anti-arthritis effects of CTS were attained through suppression of p300-mediated STAT3 acetylation. Our data suggest that CTS might be a potential immune modulator for RA treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

Motor Unit Number Estimate and Isometric Hand Grip Strength in Military Veterans with or Without Muscular Complaints: Reference Values for Longitudinal Follow-up.

PubMed

Li, Mian; Yao, Wenguo; Sundahl, Cynthia

2018-03-26

It remains unclear if Gulf War (GW) veterans have a higher risk of developing motor neuron disorder. We intended to establish baseline neurophysiological values, including thenar motor unit number estimate (MUNE) and isometric hand grip (IHG) strength, to compare future follow-ups of deployed GW veterans with or without muscular complaints. We evaluated 19 GW veterans with self-reported weakness, cramps, or excessive muscle fatigue (Ill-19) and compared them with 18 controls without such muscular complaints (C-18). We performed MUNE on hand thenar muscles using adapted multipoint stimulation method for Ill-19 and 15 controls (C-15). We measured IHG strength (maximum force, endurance, and fatigue level) on Ill-19 and C-18 with a hand dynamometer. We performed nerve conduction studies on all study participants to determine which subjects had mild carpal tunnel syndrome (CTS). We compared the MUNE and IHG strength measures between Ill group and controls and between those with CTS and those without CTS. We obtained thenar MUNE of Ill-19 (95% CI of mean: 143-215; mean age: 46 yr) and compared it with that of C-15 (95% CI of mean: 161-230; mean age: 45 yr), and 95% of CI of mean among IHG strength variables (maximum force: 324-381 Newton; endurance: 32-42 s; fatigue level: 24%-33%) compared with C-18 (maximum force: 349-408 Newton; endurance: 35-46 s; fatigue level: 21%-27%). There was no significant difference in either MUNE or IHG strength between Ill-19 group and controls. The MUNE and IHG maximum forces were significantly lower in those with CTS compared with those without CTS. As a surrogate of mild CTS, the median versus ulnar distal sensory latency on nerve conduction study was only weakly associated with MUNE, maximum force, and fatigue level, respectively. To our knowledge, no published study on MUNE reference values of military veteran population has been available. The quantifiable values of both thenar MUNE and IHG strength of military veterans serve as baselines for our longitudinal follow-up of motor neuron function of deployed troops. These reference values are also useful for other laboratories to study veterans' motor system with or without mild CTS.

Impact by condensed tannins with different mean degrees of polymerization on protein precipitation

USDA-ARS?s Scientific Manuscript database

Condensed tannins (CTs) isolated from white clover (Trifolium repens) flowers and big trefoil (Lotus pedunculatus) leaves were evaluated in precipitation studies with bovine serum albumin (BSA), lysozyme (LYS), and alfalfa leaf protein (ALF). The CTs were of similar compositions, but differed in the...

Development and Determination of Reliability and Validity of Professional Learning Community Collaborative Team Survey (CTS)

ERIC Educational Resources Information Center

Colvin, Joshua A.

2013-01-01

The study of transformative learning within collaborative teams was conducted to gain new applicable knowledge used to influence overall school improvement and implementation of professional learning communities. To obtain this new knowledge, the Professional Learning Community Collaborative Team Survey (CTS) was developed and psychometrically…

Quantitative Measurement of Critical Thinking Skills in Novice and Experienced Physical Therapists

ERIC Educational Resources Information Center

Mulhall, Michele L.

2011-01-01

Critical thinking skills (CTS) have been emphasized in educational curricula and professional development of physical therapists. Studies assessing the measurement and development of CTS in healthcare professionals have primarily focused on students enrolled in professional phases of allied health educational programs. Despite the breadth of…

Infrared thermography based on artificial intelligence as a screening method for carpal tunnel syndrome diagnosis.

PubMed

Jesensek Papez, B; Palfy, M; Mertik, M; Turk, Z

2009-01-01

This study further evaluated a computer-based infrared thermography (IRT) system, which employs artificial neural networks for the diagnosis of carpal tunnel syndrome (CTS) using a large database of 502 thermal images of the dorsal and palmar side of 132 healthy and 119 pathological hands. It confirmed the hypothesis that the dorsal side of the hand is of greater importance than the palmar side when diagnosing CTS thermographically. Using this method it was possible correctly to classify 72.2% of all hands (healthy and pathological) based on dorsal images and > 80% of hands when only severely affected and healthy hands were considered. Compared with the gold standard electromyographic diagnosis of CTS, IRT cannot be recommended as an adequate diagnostic tool when exact severity level diagnosis is required, however we conclude that IRT could be used as a screening tool for severe cases in populations with high ergonomic risk factors of CTS.

An ergonomics study on the evaluation of carpal tunnel syndrome among Chikan embroidery workers of West Bengal, India

PubMed Central

Gangopadhyay, Somnath; Chakrabarty, Sabarni; Sarkar, Krishnendu; Dev, Samrat; Das, Tamal; Banerjee, Sunetra

2015-01-01

Background: Chikan embroidery is a popular handicraft in India that involves hand-intensive stitching while seated in a static posture with the upper back curved and the head bent over the fabric. Women perform most Chikan embroidery. Objectives: The aim of this study was to analyze the repetitive nature of this work among female Chikan embroiderers by measuring the prevalence of upper extremity discomfort and carpal tunnel syndrome (CTS). Methods: The Nordic musculoskeletal questionnaire was used to analyze the extent of upper extremity pain symptomology. The repetitive nature of Chikan embroidery work was evaluated using the Assessment of Repetitive Tasks of the upper limbs tool (ART). Motor nerve conduction studies of median and ulnar nerves were performed with embroidery workers and a control group to determine the risk of CTS. Results: Among embroidery workers, the prevalence of wrist pain was 68% and forearm pain was 60%. The embroiderers also commonly reported Tingling and numbness in the hands and fingertips. The ART analysis found that Chikan embroidery is a highly repetitive task and nerve conduction studies showed that the embroidery workers were more likely to experience CTS than women in the control group. Conclusions: Chikan embroidery is a hand-intensive occupation involving repetitive use of hands and wrists and this study population is at risk of experiencing CTS. Future research should explore the potential benefits of ergonomics measures including incorporating breaks, stretching exercises, and the use of wrist splints to reduce repetitive strain and the probability of developing CTS. PMID:25658674

An Exploratory Study of Elementary Classroom Teachers' Physical Activity Promotion from a Social Learning Perspective

ERIC Educational Resources Information Center

Webster, Collin A.; Buchan, Heather; Perreault, Melanie; Doan, Rob; Doutis, Panayiotis; Weaver, Robert Glenn

2015-01-01

Despite its recommended use, physical activity promotion in the academic classroom (PAPAC) has received little attention in terms of the factors that help to facilitate it. In this study, a social learning perspective was adopted to examine the role of physical activity biographies in generalist classroom teachers' (CTs) PAPAC. CTs (N = 213) were…

Assessment of the methodological and ethical quality of clinical trials published in family medicine journals

PubMed

Castaño-García, Alberto; Guillén-Grima, Francisco; León-Sanz, Pilar

2018-01-01

To evaluate some methodological and ethical quality variables of clinical trials (CTs) published in 10 family medicine journals. Quality descriptive study of 10 family medicine journals including CTs in humans published since 2010 to 2013. We obtained 141 CT and 2447 were excluded. CTs parallels controlled in 92.9% (95% confidence interval [95% CI]: 92.0-93.9). Masked randomization in 72.3% (95% CI: 71.7-73.1), decentralized in 51.8% (95% CI: 51.4-52.4) and using as control an active treatment in 82.2% (95% CI: 81.5-83.1). Wrote informed consent in 48.9% (95% CI: 48.5-49.5) and it was not withdrawn in 56.0% of cases (95% CI: 55.5-56.7). Approval by clinical research ethics committee (CREC) in 134, and there was no conflict of interest in 117 CTs. Average κ was 0.96 (95% CI: 0.93-0.99). We observe an increase in some quality variables like masked randomization (19.6%) and approval by CREC (75%) post CONSORT, in CTs published in 10 family medicine journals (2010-2013). Copyright: © 2018 SecretarÍa de Salud

Organically modified clay supported chitosan/hydroxyapatite-zinc oxide nanocomposites with enhanced mechanical and biological properties for the application in bone tissue engineering.

PubMed

Bhowmick, Arundhati; Banerjee, Sovan Lal; Pramanik, Nilkamal; Jana, Piyali; Mitra, Tapas; Gnanamani, Arumugam; Das, Manas; Kundu, Patit Paban

2018-01-01

The objective of this study is to design biomimetic organically modified montmorillonite clay (OMMT) supported chitosan/hydroxyapatite-zinc oxide (CTS/HAP-ZnO) nanocomposites (ZnCMH I-III) with improved mechanical and biological properties compared to previously reported CTS/OMMT/HAP composite. Fourier transform infrared spectroscopy, powder X-ray diffraction, scanning electron microscopy and transmission electron microscopy were used to analyze the composition and surface morphology of the prepared nanocomposites. Strong antibacterial properties against both Gram-positive and Gram-negative bacterial strains were established for ZnCMH I-III. pH and blood compatibility study revealed that ZnCMH I-III should be nontoxic to the human body. Cytocompatibility of these nanocomposites with human osteoblastic MG-63 cells was also established. Experimental findings suggest that addition of 5wt% of OMMT into CTS/HAP-ZnO (ZnCMH I) gives the best mechanical strength and water absorption capacity. Addition of 0.1wt% of ZnO nanoparticles into CTS-OMMT-HAP significantly enhanced the tensile strengths of ZnCMH I-III compared to previously reported CTS-OMMT-HAP composite. In absence of OMMT, control sample (ZnCH) also showed reduced tensile strength, antibacterial effect and cytocompatibility with osteoblastic cell compared to ZnCMH I. Considering all of the above-mentioned studies, it can be proposed that ZnCMH I nanocomposite has a great potential to be applied in bone tissue engineering. Copyright © 2017 Elsevier B.V. All rights reserved.

A comparative study of the target volume definition in radiotherapy with «Slow CT Scan» vs. 4D PET/CT Scan in early stages non-small cell lung cancer.

PubMed

Molla, M; Anducas, N; Simó, M; Seoane, A; Ramos, M; Cuberas-Borros, G; Beltran, M; Castell, J; Giralt, J

To evaluate the use of 4D PET/CT to quantify tumor respiratory motion compared to the «Slow»-CT (CTs) in the radiotherapy planning process. A total of 25 patients with inoperable early stage non small cell lung cancer (NSCLC) were included in the study. Each patient was imaged with a CTs (4s/slice) and 4D PET/CT. The adequacy of each technique for respiratory motion capture was evaluated using the volume definition for each of the following: Internal target volume (ITV) 4D and ITVslow in relation with the volume defined by the encompassing volume of 4D PET/CT and CTs (ITVtotal). The maximum distance between the edges of the volume defined by each technique to that of the total volume was measured in orthogonal beam's eye view. The ITV4D showed less differences in relation with the ITVtotal in both the cranio-caudal and the antero-posterior axis compared to the ITVslow. The maximum differences were 0.36mm in 4D PET/CTand 0.57mm in CTs in the antero-posterior axis. 4D PET/CT resulted in the definition of more accurate (ITV4D/ITVtotal 0.78 vs. ITVs/ITVtotal 0.63), and larger ITVs (19.9 cc vs. 16.3 cc) than those obtained with CTs. Planning with 4D PET/CT in comparison with CTs, allows incorporating tumor respiratory motion and improving planning radiotherapy of patients in early stages of lung cancer. Copyright © 2016 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

Synoptic and climatological analysis of atmospheric circulation impacts on particulate matter pollution in Shanghai, China

NASA Astrophysics Data System (ADS)

Liao, Z.; Fan, S.

2016-12-01

This study investigated the particulate matter characteristics within different circulation types (CTs) in the megacity of Shanghai during the period 2001-2015, and provided a quantitative evaluation of atmospheric circulation influences on PM10 pollution across a wide range of spatial and temporal scales, from local to region and daily to interannual. Ten CTs were identified over the Asian-Pacific region by objective Lamb Weather Type approach and each resulting CT was characterized with distinct local meteorology and air mass source. The PM10 loadings in the CTs associated with continental westerly flow were significant higher than that in the CTs linked to marine easterly air masses. Regional backgrounds that transported by the synoptic flows were more responsible for the distinct PM10 levels in different CTs. The locally-produced PM10 generally stabilized in range of 20-25 μg m-3, but enhanced to 41.2 μg m-3 in case of anticyclone type. There were distinct PM10 trends in different CTs (ranged from -3.74 to -0.28 μg m-3 yr-1), indicating the different background trends. Overall, the PM10 concentrations have decreased (-2.33 μg m-3 yr-1) in the studied period and the estimated locally-produced trend (-0.79 μg m-3 yr-1) accounted for 33.9% of overall downward trend. The occurrence frequency presented an increase (0.15 % yr-1) for anticyclone type, but a decrease (-0.10 % yr-1) for the type N associated with invasion of cold air. The 15-yr frequency change of atmospheric circulation induced an increase in PM­10 level (0.17 μg m-3) in Shanghai. On the contrary, controls on the pollutant emission had always positive effects and hence should be always encouraged.

In-vitro bioactivity, biocorrosion and antibacterial activity of silicon integrated hydroxyapatite/chitosan composite coating on 316 L stainless steel implants.

PubMed

Sutha, S; Kavitha, K; Karunakaran, G; Rajendran, V

2013-10-01

A simple and effective ultrasonication method was applied for the preparation of 0, 0.4, 0.8, 1.0 and 1.6 wt% silicon substituted hydroxyapatite (HAp) (SH). The Ca/P ratio of the synthesised SH nanoparticles were in the range of 1.58-1.70. Morphological changes were noticed in HAp with respect to the amount of Si from 0 to 1.6 wt%. The morphology of the particles changed from spherical shape to rod-like morphology with respect to the amount of Si which was confirmed using transmission electron microscopy. X-ray diffraction studies confirm the formation of phase pure SH nanoparticles without any secondary phase. Chitosan (CTS) blended SH nanocomposites coating on surgical grade 316 L stainless steel (316 L SS) implant was made by spin coating technique. The surface of the coated implant was characterised using scanning electron microscopy which confirms the uniform coating without cracks and pores. The increased corrosion resistance of the 1.6 wt% of SH/CTS-coated SS implant in the simulated body fluid (SBF) indicates the long-term biostability of SH composite-coated ceramics in vitro than the 0 wt% SH/CTS. The testing of SH/CTS nanocomposites with gram-positive and gram-negative bacterial strains confirms that the antibacterial ability improves with the higher substitution of Si. In addition, formation of bone-like apatite layer on the SH/CTS-coated implant in SBF was studied through SEM analysis and it confirms the ability to increase the HAp formation on the surface of 1.0 wt% SH/CTS-coated 316 L SS implant. Copyright © 2013 Elsevier B.V. All rights reserved.

Association of psychological distress, quality of life and costs with carpal tunnel syndrome severity: a cross-sectional analysis of the PALMS cohort.

PubMed

Jerosch-Herold, Christina; Houghton, Julie; Blake, Julian; Shaikh, Anum; Wilson, Edward Cf; Shepstone, Lee

2017-11-03

The Prediciting factors for response to treatment in carpal tunnel syndrome (PALMS) study is designed to identify prognostic factors for outcome from corticosteroid injection and surgical decompression for carpal tunnel syndrome (CTS) and predictors of cost over 2 years. The aim of this paper is to explore the cross-sectional association of baseline patient-reported and clinical severity with anxiety, depression, health-related quality of life and costs of CTS in patients referred to secondary care. Prospective, multicentre cohort study initiated in 2013. We collected baseline data on patient-reported symptom severity (CTS-6), psychological status (Hospital Anxiety and Depression Scale), hand function (Michigan Hand Questionnaire) comorbidities, EQ-5D-3L (3-level version of EuroQol-5 dimension) and sociodemographic variables. Nerve conduction tests classified patients into five severity grades (mild to very severe). Data were analysed using a general linear model. 753 patients with CTS provided complete baseline data. Multivariable linear regression adjusting for age, sex, ethnicity, duration of CTS, smoking status, alcohol consumption, employment status, body mass index and comorbidities showed a highly statistically significant relationship between CTS-6 and anxiety, depression and the EQ-5D (p<0.0001 in each case). Likewise, a significant relationship was observed between electrodiagnostic severity and anxiety (p=0.027) but not with depression (p=0.986) or the EQ-5D (p=0.257). National Health Service (NHS) and societal costs in the 3 months prior to enrolment were significantly associated with self-reported severity (p<0.0001) but not with electrodiagnostic severity. Patient-reported symptom severity in CTS is significantly and positively associated with anxiety, depression, health-related quality of life, and NHS and societal costs even when adjusting for age, gender, body mass index, comorbidities, smoking, drinking and occupational status. In contrast, there is little or no evidence of any relationship with objectively derived CTS severity. Future research is needed to understand the impact of approaches and treatments that address psychosocial stressors as well as biomedical factors on relief of symptoms from carpal tunnel syndrome. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Field Demonstration and Validation of TREECS and CTS for the Risk Assessment of Contaminants on Department of Defense Ranges

DTIC Science & Technology

2017-06-01

Chemical Transformation Simulator (CTS) was developed by the U.S. Environmental Protection Agency to provide physicochemical properties of complex...Site Model CTS Chemical Transformation Simulator developed by EPA D4EM Data for Environmental Modeling Demo Demolition area DNAN 2,4...U.S. Environmental Protection Agency (EPA), was the technical point-of-contact for the Contaminant Transformation Simulator (CTS) that was

"Comet tail sign": A pitfall of post-gadolinium magnetic resonance imaging findings for metastatic brain tumors.

PubMed

Mitsuya, Koichi; Nakasu, Yoko; Narita, Yoshitaka; Nakasu, Satoshi; Ohno, Makoto; Miyakita, Yasuji; Abe, Masato; Ito, Ichiro; Hayashi, Nakamasa; Endo, Masahiro

2016-05-01

A highly enhanced cap attached to the surface of metastatic tumors in the brain parenchyma is occasionally encountered on magnetic resonance (MR) images. This atypical enhanced cap tends to occur in severe peritumoral edema and may produce the characteristic bulge of a metastatic mass lesion termed the "comet tail sign" (CTS). The purpose of this study was to demonstrate the features of the CTS using MR imaging and pathological findings, and to clarify its clinical relevance. We selected 21 consecutive cases of newly diagnosed metastases from MR imaging studies that demonstrated the CTS; all had diffuse peritumoral edema. The MR T2-weighted images showed similarly homogenous and high intensity signals in both the tail and peritumoral edema. Fourteen of the 21 patients underwent surgical resection of their tumors, and 12 tails were separately removed for pathological examination, no tumor cells which revealed. We speculate that the CTS does not contain neoplastic tissues but is observed as a result of the leakage of contrast medium from the tumor body into the interstitial space of the white matter. Although CTS is a peculiar and uncommon enhancement pattern, it has clinical significance in determining the extent of the margin for invasive local treatments, such as surgical resection or stereotactic radiotherapy; this is particularly true in and near the eloquent areas.

Emergency medicine summary code for reporting CT scan results: implementation and survey results.

PubMed

Lam, Joanne; Coughlin, Ryan; Buhl, Luce; Herbst, Meghan; Herbst, Timothy; Martillotti, Jared; Coughlin, Bret

2018-06-01

The purpose of the study was to assess the emergency department (ED) providers' interest and satisfaction with ED CT result reporting before and after the implementation of a standardized summary code for all CT scan reporting. A summary code was provided at the end of all CTs ordered through the ED from August to October of 2016. A retrospective review was completed on all studies performed during this period. A pre- and post-survey was given to both ED and radiology providers. A total of 3980 CT scans excluding CTAs were ordered with 2240 CTs dedicated to the head and neck, 1685 CTs dedicated to the torso, and 55 CTs dedicated to the extremities. Approximately 74% CT scans were contrast enhanced. Of the 3980 ED CT examination ordered, 69% had a summary code assigned to it. Fifteen percent of the coded CTs had a critical or diagnostic positive result. The introduction of an ED CT summary code did not show a definitive improvement in communication. However, the ED providers are in consensus that radiology reports are crucial their patients' management. There is slightly increased satisfaction with the providers with less than 5 years of experience with the ED CT codes compared to more seasoned providers. The implementation of a user-friendly summary code may allow better analysis of results, practice improvement, and quality measurements in the future.

Analysis of exchanges between novice and cooperating teachers during internships using the NCATE/NASPE Standards for Teacher Preparation in Physical Education as guidelines.

PubMed

Banville, Dominique

2006-06-01

To be recognized as an accredited program, Physical Education Teacher Education (PETE) programs in the country must abide by guidelines put forward by the National Association for Sport and Physical Education (NASPE), in collaboration with the National Council for the Accreditation of Teacher Education (NCATE). The guidelines are divided into nine standards and identify a number of outcomes (NASPE, 1998). The purpose of this study was to determine the nature of the exchanges between novice teachers (NTs) and cooperating teachers (CTs), when using the NASPE Standards (1998) as a reference point, and determine if the focus of the exchanges differed over time and according to data source. Six pairs of CTs and their NT participated in the study. Data were collected through recorded conversations between NTs and their CT as well as NTs' logs. Data showed that the majority of conversations focused on planning and instruction (Standard 6) and management and motivation (Standard 4), while few related to diverse learners (Standard 3), growth and development (Standard 2), and communication (Standard 5). The small amount of information shared by CTs in some standards indicates a need for PETE programs to share the guidelines with CTs to make them aware of the importance of offering a variety of topics to interns, because CTs are the primary source of information during this crucial experience.

Diagnostic strategies using physical examination are minimally useful in defining carpal tunnel syndrome in population-based research studies.

PubMed

Descatha, A; Dale, A-M; Franzblau, A; Coomes, J; Evanoff, B

2010-02-01

We evaluated the utility of physical examination manoeuvres in the prediction of carpal tunnel syndrome (CTS) in a population-based research study. We studied a cohort of 1108 newly employed workers in several industries. Each worker completed a symptom questionnaire, a structured physical examination and nerve conduction study. For each hand, our CTS case definition required both median nerve conduction abnormality and symptoms classified as "classic" or "probable" on a hand diagram. We calculated the positive predictive values and likelihood ratios for physical examination manoeuvres in subjects with and without symptoms. The prevalence of CTS in our cohort was 1.2% for the right hand and 1.0% for the left hand. The likelihood ratios of a positive test for physical provocative tests ranged from 2.0 to 3.3, and those of a negative test from 0.3 to 0.9. The post-test probability of positive testing was <50% for all strategies tested. Our study found that physical examination, alone or in combination with symptoms, was not predictive of CTS in a working population. We suggest using specific symptoms as a first-level screening tool, and nerve conduction study as a confirmatory test, as a case definition strategy in research settings.

Synthesis of Glycyrrhetinic Acid-Modified Chitosan 5-Fluorouracil Nanoparticles and Its Inhibition of Liver Cancer Characteristics in Vitro and in Vivo

PubMed Central

Cheng, Mingrong; Gao, Xiaoyan; Wang, Yong; Chen, Houxiang; He, Bing; Xu, Hongzhi; Li, Yingchun; Han, Jiang; Zhang, Zhiping

2013-01-01

Nanoparticle drug delivery (NDDS) is a novel system in which the drugs are delivered to the site of action by small particles in the nanometer range. Natural or synthetic polymers are used as vectors in NDDS, as they provide targeted, sustained release and biodegradability. Here, we used the chitosan and hepatoma cell-specific binding molecule, glycyrrhetinic acid (GA), to synthesize glycyrrhetinic acid-modified chitosan (GA-CTS). The synthetic product was confirmed by Fourier transformed infrared spectroscopy (FT-IR) and 1H-nuclear magnetic resonance (1H-NMR). By combining GA-CTS and 5-FU (5-fluorouracil), we obtained a GA-CTS/5-FU nanoparticle, with a particle size of 217.2 nm, a drug loading of 1.56% and a polydispersity index of 0.003. The GA-CTS/5-FU nanoparticle provided a sustained release system comprising three distinct phases of quick, steady and slow release. We demonstrated that the nanoparticle accumulated in the liver. In vitro data indicated that it had a dose- and time-dependent anti-cancer effect. The effective drug exposure time against hepatic cancer cells was increased in comparison with that observed with 5-FU. Additionally, GA-CTS/5-FU significantly inhibited the growth of drug-resistant hepatoma, which may compensate for the drug-resistance of 5-FU. In vivo studies on an orthotropic liver cancer mouse model demonstrated that GA-CTS/5-FU significantly inhibited tumor growth, resulting in increased survival time. PMID:24048270

The effects of manganese oxide octahedral molecular sieve chitosan microspheres on sludge bacterial community structures during sewage biological treatment.

PubMed

Pan, Fei; Liu, Wen; Yu, Yang; Yin, Xianze; Wang, Qingrong; Zheng, Ziyan; Wu, Min; Zhao, Dongye; Zhang, Qiu; Lei, Xiaoman; Xia, Dongsheng

2016-11-21

This study examines the effects of manganese oxide octahedral molecular sieve chitosan microspheres (Fe 3 O 4 @OMS-2@CTS) on anaerobic and aerobic microbial communities during sewage biological treatment. The addition of Fe 3 O 4 @OMS-2@CTS (0.25 g/L) resulted in enhanced levels of operational performance for decolourization dye X-3B. However, degradation dye X-3B inhibition in the presence of Fe 3 O 4 @OMS-2@CTS was recorded as greater than or equal to 1.00 g/L. Illumina MiSeq high throughput sequencing of the 16 S rRNA gene showed that 108 genera were observed during the anaerobic process, while only 71 genera were observed during the aerobic process. The largest genera (Aequorivita) decreased from 21.14% to 12.65% and the Pseudomonas genera increased from 10.57% to 12.96% according to the abundance in the presence of 0.25 g/L Fe 3 O 4 @OMS-2@CTS during the anaerobic process. The largest Gemmatimonas genera decreased from 21.46% to 11.68% and the Isosphaerae genera increased from 5.8% to 11.98% according to the abundance in the presence of 0.25 g/L Fe 3 O 4 @OMS-2@CTS during the aerobic process. Moreover, the X-ray photoelectron spectroscopy results show that the valence states of Mn and Fe in Fe 3 O 4 @OMS-2@CTS changed during sewage biological treatment.

The role of ultrasound in the diagnosis and management of carpal tunnel syndrome: a new paradigm.

PubMed

McDonagh, Cara; Alexander, Michael; Kane, David

2015-01-01

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy, affecting 9% of women, and it is responsible for significant morbidity and occupational absence. Clinical assessment is used for initial diagnosis and nerve conduction (NC) studies are currently the principal test used to confirm the diagnosis. Sensitivity of NC studies is >85% and specificity is >95%. There is now good evidence that US can be used as an alternative to NC studies to diagnose CTS. US can assess the anatomy of the median nerve and also identify pathology of the surrounding structures that may compress the nerve. Median nerve enlargement (cross-sectional area ≥10 mm(2) at the level of the pisiform bone or tunnel inlet) is the most commonly used parameter to diagnose CTS on US, and sensitivity has been reported to be as high as 97.9% using this parameter. US may also be used to guide therapeutic corticosteroid injection into the carpal tunnel--thus avoiding median nerve injury--and to objectively monitor the response to treatment. There is now sufficient evidence to propose a new paradigm for the diagnosis of CTS that incorporates US. US is proposed as the initial diagnostic test in CTS based on similar sensitivity and specificity to NC studies but higher patient acceptability, lower cost and additional capability to assess carpal tunnel anatomy and guide injection. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

[Etiological factors of carpal tunnel syndrome in subjects occupationally exposed to monotype wrist movements].

PubMed

Lewańska, Magdalena; Walusiak-Skorupa, Jolanta

2014-01-01

Carpal tunnel syndrome (CTS) is the most common neuropathy of upper limbs and a leading cause of upper extremity musculoskeletal disorders, in terms of work exposure, repetitive and forceful exertions of the hand and use of vibrating hand tools. The aim of the study was to evaluate etiological factors of carpal tunnel syndrome in subjects occupationally exposed to monotype movements in wrist. We conducted the retrospective analysis of 300 patients (261 women, 39 men), mean age 52 years (standard deviation: +/-6.93) hospitalized with the suspicion of occupational CTS. The study revealed high percentage (68.7%) of diseases and systemic factors involved in the pathogenesis of CTS in the analyzed population, especially obesity (32%), thyroid diseases (28.7%), hormone replacement therapy and/or oophorectomy (16.3%) and diabetes mellitus (12%). In 111 patients the coexistence of at least a couple of potential etiological factors of the neuropathy was recognized. Clinical analysis and occupational exposure allowed to diagnose occupational carpal tunnel syndrome in 18 (6%) patients only. The undeniable long-term (20(.2+/-9.3 years) occupational exposure to repetitive, forceful movements in the wrist was observed in this group. The results of our study indicated that non-occupational etiological factors of CTS predominated and in 37% of patients at least several factors were found. The analysis showed the high prevalence of CTS in workers employed in various sectors of industry, including so called "blue collar" workers. Our study confirmed the multifactorial etiology of carpal tunnel syndrome, however, occupational agents contributed to only 6% of cases.

Incident CTS in a large pooled cohort study: associations obtained by a Job Exposure Matrix versus associations obtained from observed exposures.

PubMed

Dale, Ann Marie; Ekenga, Christine C; Buckner-Petty, Skye; Merlino, Linda; Thiese, Matthew S; Bao, Stephen; Meyers, Alysha Rose; Harris-Adamson, Carisa; Kapellusch, Jay; Eisen, Ellen A; Gerr, Fred; Hegmann, Kurt T; Silverstein, Barbara; Garg, Arun; Rempel, David; Zeringue, Angelique; Evanoff, Bradley A

2018-03-29

There is growing use of a job exposure matrix (JEM) to provide exposure estimates in studies of work-related musculoskeletal disorders; few studies have examined the validity of such estimates, nor did compare associations obtained with a JEM with those obtained using other exposures. This study estimated upper extremity exposures using a JEM derived from a publicly available data set (Occupational Network, O*NET), and compared exposure-disease associations for incident carpal tunnel syndrome (CTS) with those obtained using observed physical exposure measures in a large prospective study. 2393 workers from several industries were followed for up to 2.8 years (5.5 person-years). Standard Occupational Classification (SOC) codes were assigned to the job at enrolment. SOC codes linked to physical exposures for forceful hand exertion and repetitive activities were extracted from O*NET. We used multivariable Cox proportional hazards regression models to describe exposure-disease associations for incident CTS for individually observed physical exposures and JEM exposures from O*NET. Both exposure methods found associations between incident CTS and exposures of force and repetition, with evidence of dose-response. Observed associations were similar across the two methods, with somewhat wider CIs for HRs calculated using the JEM method. Exposures estimated using a JEM provided similar exposure-disease associations for CTS when compared with associations obtained using the 'gold standard' method of individual observation. While JEMs have a number of limitations, in some studies they can provide useful exposure estimates in the absence of individual-level observed exposures. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Composition and structural features of condensed tannins from Texas legumes exhibiting methane abatement activity during in vitro rumen digestion

USDA-ARS?s Scientific Manuscript database

Previous studies showed that a series of purified condensed tannins (CTs) from warm-season perennial legumes exhibited high variability in their modulation of methane production during in vitro rumen digestion. The molecular weight difference of these CTs did not provide correlation with either the ...

User Guidance for Application of TREECS (trademark) and CTS for Environmental Risk Assessment of Contaminants on Department of Defense (DoD) Ranges

DTIC Science & Technology

2017-06-01

physicochemical properties of complex organic chemicals. The CTS has capabilities for estimating chemical-specific properties in the absence of experimentally ...obtained properties; thus, CTS can help fill data gaps for properties, particularly for emerging MC that have limited experimental data. This report...specific properties in the absence of experimentally obtained properties; thus, CTS can help fill data gaps for properties, particularly for emerging

Attributable risk of carpal tunnel syndrome according to industry and occupation in a general population.

PubMed

Roquelaure, Yves; Ha, Catherine; Nicolas, Guillaume; Pélier-Cady, Marie-Christine; Mariot, Camille; Descatha, Alexis; Leclerc, Annette; Raimbeau, Guy; Goldberg, Marcel; Imbernon, Ellen

2008-09-15

An epidemiologic surveillance network for carpal tunnel syndrome (CTS) was set up in the general population of a French region to assess the proportion of CTS cases attributable to work in high-risk industries and occupations. Cases of CTS occurring among patients ages 20-59 years living in the Maine and Loire region were included prospectively from 2002 to 2004. Medical and occupation history was gathered by mailed questionnaire for 815 women and 320 men. Age-adjusted relative risks of CTS and the attributable risk fractions of CTS among exposed persons (AFEs) were computed in relation to industry sectors and occupation categories. Twenty-one industry sectors and 8 occupational categories for women and 10 sectors and 6 occupational categories for men were characterized by a significant excess risk of CTS. High AFE values were observed in the manufacturing (42-93% for both sexes), construction (66% for men), and personal service industries (66% for women) and in the trade and commerce sectors (49% for women). High AFE values were observed in lower-grade white-collar occupations for women (43-67%) and blue-collar occupations for men (60-74%) and women (48-88%). The attributable proportions of CTS cases among workers employed in industry sectors and occupation categories identified at high risk of CTS varied between 36% and 93%.

Using Medical Claims for Policy Effectiveness Surveillance: Reimbursement and Utilization of Abdomen/Pelvis Computed Tomography Scans.

PubMed

Horný, Michal; Morgan, Jake R; Merker, Vanessa L

2015-12-01

To quantify changes in private insurance payments for and utilization of abdominal/pelvic computed tomography scans (CTs) after 2011 changes in CPT coding and Medicare reimbursement rates, which were designed to reduce costs stemming from misvalued procedures. TruvenHealth Analytics MarketScan Commercial Claims and Encounters database. We used difference-in-differences models to compare combined CTs of the abdomen/pelvis to CTs of the abdomen or pelvis only. Our main outcomes were inflation-adjusted log payments per procedure, daily utilization rates, and total annual payments. Claims data were extracted for all abdominal/pelvic CTs performed in 2009-2011 within noncapitated, employer-sponsored private plans. Adjusted payments per combined CTs of the abdomen/pelvis dropped by 23.8 percent (p < .0001), and their adjusted daily utilization rate accelerated by 0.36 percent (p = .034) per month after January 2011. Utilization rate of abdominal-only or pelvic-only CTs dropped by 5.0 percent (p < .0001). Total annual payments for combined CTs of the abdomen/pelvis decreased in 2011 despite the increased utilization. Private insurance payments for combined CTs of the abdomen/pelvis declined and utilization accelerated significantly after 2011 policy changes. While growth in total annual payments was contained in 2011, it may not be sustained if 2011 utilization trends persist. © Health Research and Educational Trust.

Attributable risk of carpal tunnel syndrome according to industry and occupation in a general population

PubMed Central

Roquelaure, Yves; Ha, Catherine; Nicolas, Guillaume; Pélier-Cady, Marie-Christine; Mariot, Camille; Descatha, Alexis; Leclerc, Annette; Raimbeau, Guy; Goldberg, Marcel; Imbernon, Ellen

2008-01-01

Objectives An epidemiological surveillance network for carpal tunnel syndrome (CTS) was set up in the general population of a French region to assess the attributable fraction of CTS according to work in high risk industries and occupations. Methods Cases of CTS occurring among patients aged 20 to 59 living in the Maine and Loire region were included prospectively from 2002 to 2004. Medical and occupation history was gathered by mailed questionnaire for 815 women and 20 men. Age-adjusted relative risks of CTS and the attributable fractions of CTS to work among exposed persons (AFE) were computed in relation to industry sectors and occupation categories. Results Twenty-one industry sectors and eight occupational categories for women, and ten sectors and six occupational categories for men were characterized by a significant excess risk of CTS. High values of AFE were observed in the manufacturing (from 42 to 93% for both genders), construction (66 for men) and personal service industries (66 for women), and trade and commerce (49% for women) sectors. High values of AFE were observed in female lower grade white-collar occupations (from 43 to 67%), and male (from 60 to 74%) and female (from 48 to 88%) blue-collar occupations. Conclusion The attributable fractions of CTS among workers employed in industry sectors and occupation categories identified at high risk of CTS varied between 36 and 93% PMID:18759264

Action without Action Planning: The Potential of the Career Thinking Session in Enabling Transformational Career Learning and Development

ERIC Educational Resources Information Center

Bassot, Barbara

2017-01-01

This paper examines the potential of the Career Thinking Session (CTS) model to career guidance and counselling practice with young people. A qualitative research study is presented, focusing on the case study of a client involved in the transition to higher education. The setting for the research is described and the origins of the CTS are…

A fuzzy linguistic model for the prediction of carpal tunnel syndrome risks in an occupational environment.

PubMed

Bell, P M; Crumpton, L

1997-08-01

This research presents the development and evaluation of a fuzzy linguistic model designated to predict the risk of carpal tunnel syndrome (CTS) in an occupational setting. CTS has become one of the largest problems facing ergonomists and the medical community because it is developing in epidemic proportions within the occupational environment. In addition, practitioners are interested in identifying accurate methods for evaluating the risk of CTS in an occupational setting. It is hypothesized that many factors impact an individual's likelihood of developing CTS and the eventual development of CTS. This disparity in the occurrence of CTS for workers with similar backgrounds and work activities has confused researchers and has been a stumbling block in the development of a model for widespread use in evaluating the development of CTS. Thus this research is an attempt to develop a method that can be used to predict the likelihood of CTS risk in a variety of environments. The intent is that this model will be applied eventually in an occupational setting, thus model development was focused on a method that provided a usable interface and the desired system inputs can also be obtained without the benefit of a medical practitioner. The methodology involves knowledge acquisition to identify and categorize a holistic set of risk factors that include task-related, personal, and organizational categories. The determination of relative factor importance was accomplished using analytic hierarchy processing (AHP) analysis. Finally a mathematical representation of the CTS risk was accomplished by utilizing fuzzy set theory in order to quantify linguistic input parameters. An evaluation of the model including determination of sensitivity and specificity is conducted and the results of the model indicate that the results are fairly accurate and this method has the potential for widespread use. A significant aspect of this research is the comparison of this technique to other methods for assessing presence of CTS. The results of this evaluation technique are compared with more traditional methods for assessing the presence of CTS.

Trial sponsorship and self-reported conflicts of interest in breast cancer radiation therapy: An analysis of prospective clinical trials.

PubMed

Leite, Elton T T; Moraes, Fabio Y; Marta, Gustavo N; Taunk, Neil K; Vieira, Marina T L; Hanna, Samir A; Silva, João Luis F; Carvalho, Heloisa A

2017-06-01

We aim to assess any association between study and self-reported conflict of interest (COI) or trial sponsorship in breast cancer radiation clinical trials. We searched PubMed for all clinical trials (CTs) published between 09/2004 and 09/2014 related to breast cancer. We included only radiotherapy CTs with primary clinical endpoints. We classified eligible trials according to the funding source, presence or absence of conflict of interest, study conclusion and impact factor (IF). 1,603 CTs were retrieved. 72 randomized clinical trials were included for analysis. For-profit (PO), not for profit organization (nPO), none and not reported sponsorship rates were 9/72 (12.5%), 35/72 (48.6%), 1/72 (1.4%), 27/72 (37.5%), respectively. Present, absent or not reported COI were found in 6/72 (8.3%), 43/72 (59.7%) and 23/72 (32%) of the CTs, respectively. Conclusion was positive, neutral and negative in 57/72 (79.1%), 9/72 (12.5%) and 6/72 (8.4%) of the trials, respectively. Positive conclusion was reported in 33/44 (75%) funded trials (PO and nPO) and 5/6 (83.3%) CTs with reported COI. On univariate analysis no association with funding source (P=0.178), COI (P=0.678) or trial region (P=0.567) and trial positive conclusion was found. Sponsored trials (HR 4.50, 95CI-0.1.23-16.53;P=0.0023) and positive trials (HR 4.78, 95CI- 1.16-19.63;P=0.030) were more likely to be published in higher impact factor journals in the multivariate analysis. nPO funding was reported in almost 50% of the evaluated CTs. No significant association between study conclusion and funding source, COI or trial region was identified. Sponsored trials and positive trials were more likely to be published in higher impact factor journals. Copyright © 2017 Elsevier Ltd. All rights reserved.

Bilateral deficits in fine motor control and pinch grip force are not associated with electrodiagnostic findings in women with carpal tunnel syndrome.

PubMed

de la Llave-Rincón, Ana Isabel; Fernández-de-Las-Peñas, César; Pérez-de-Heredia-Torres, Marta; Martínez-Perez, Almudena; Valenza, Marie Carmen; Pareja, Juan A

2011-06-01

: The aim of this study was to analyze the differences in deficits in fine motor control and pinch grip force between patients with minimal, moderate/mild, or severe carpal tunnel syndrome (CTS) and healthy age- and hand dominance-matched controls. : A case-control study was conducted. The subtests of the Purdue Pegboard Test (one-hand and bilateral pin placements and assemblies) and pinch grip force between the thumb and the remaining four fingers of the hand were bilaterally evaluated in 66 women with minimal (n = 16), moderate (n = 16), or severe (n = 34) CTS and in 20 age- and hand-matched healthy women. The differences among the groups were analyzed using different mixed models of analysis of variance. : A two-way mixed analysis of variance revealed significant differences between groups, not depending on the presence of unilateral or bilateral symptoms (side), for the one-hand pin placement subtest: patients showed bilateral lower scores compared with controls (P < 0.001), without differences among those with minimal, moderate, or severe CTS (P = 0.946). The patients also exhibited lower scores in bilateral pin placement (P < 0.001) and assembly (P < 0.001) subtests, without differences among them. The three-way analysis of variance revealed significant differences among groups (P < 0.001) and fingers (P < 0.001), not depending on the presence of unilateral/bilateral symptoms (P = 0.684), for pinch grip force: patients showed bilateral lower pinch grip force in all fingers compared with healthy controls, without differences among those with minimal, moderate, or severe CTS. : The current study revealed similar bilateral deficits in fine motor control and pinch grip force in patients with minimal, moderate, or severe CTS, supporting that fine motor control deficits are a common feature of CTS not associated with electrodiagnostic findings.

Clinical course, costs and predictive factors for response to treatment in carpal tunnel syndrome: the PALMS study protocol.

PubMed

Jerosch-Herold, Christina; Shepstone, Lee; Wilson, Edward C F; Dyer, Tony; Blake, Julian

2014-02-07

Carpal tunnel syndrome (CTS) is the most common neuropathy of the upper limb and a significant contributor to hand functional impairment and disability. Effective treatment options include conservative and surgical interventions, however it is not possible at present to predict the outcome of treatment. The primary aim of this study is to identify which baseline clinical factors predict a good outcome from conservative treatment (by injection) or surgery in patients diagnosed with carpal tunnel syndrome. Secondary aims are to describe the clinical course and progression of CTS, and to describe and predict the UK cost of CTS to the individual, National Health Service (NHS) and society over a two year period. In this prospective observational cohort study patients presenting with clinical signs and symptoms typical of CTS and in whom the diagnosis is confirmed by nerve conduction studies are invited to participate. Data on putative predictive factors are collected at baseline and follow-up through patient questionnaires and include standardised measures of symptom severity, hand function, psychological and physical health, comorbidity and quality of life. Resource use and cost over the 2 year period such as prescribed medications, NHS and private healthcare contacts are also collected through patient self-report at 6, 12, 18 and 24 months. The primary outcome used to classify treatment success or failures will be a 5-point global assessment of change. Secondary outcomes include changes in clinical symptoms, functioning, psychological health, quality of life and resource use. A multivariable model of factors which predict outcome and cost will be developed. This prospective cohort study will provide important data on the clinical course and UK costs of CTS over a two-year period and begin to identify predictive factors for treatment success from conservative and surgical interventions.

Somatosensory cortical plasticity in carpal tunnel syndrome--a cross-sectional fMRI evaluation.

PubMed

Napadow, Vitaly; Kettner, Norman; Ryan, Angela; Kwong, Kenneth K; Audette, Joseph; Hui, Kathleen K S

2006-06-01

Carpal tunnel syndrome (CTS) is a common entrapment neuropathy of the median nerve characterized by paresthesias and pain in the first, second, and third digits. We hypothesize that aberrant afferent input in CTS will lead to cortical plasticity. Functional MRI (fMRI) and neurophysiological testing were performed on CTS patients and healthy adults. Median nerve innervated digit 2 (D2), and digit 3 (D3) and ulnar nerve innervated digit 5 (D5) were stimulated during fMRI. Surface-based and ROI-based analyses consistently demonstrated more extensive and stronger contralateral sensorimotor cortical representations of D2 and D3 for CTS patients as compared to healthy adults (P < 0.05). Differences were less profound for D5. Moreover, D3 fMRI activation in both the contralateral SI and motor cortex correlated positively with the D3 sensory conduction latency. Analysis of somatotopy suggested that contralateral SI representations for D2 and D3 were less separated for CTS patients (3.8 +/- 1.0 mm) than for healthy adults (7.5 +/- 1.2 mm). Furthermore, the D3/D2 separation distance correlated negatively with D2 sensory conduction latency-the greater the latency, the closer the D2/D3 cortical representations (r = -0.79, P < 0.05). Coupled with a greater extent of SI representation for these CTS affected digits, the closer cortical representations can be interpreted as a blurred somatotopic arrangement for CTS affected digits. These findings provide further evidence that CTS is not manifest in the periphery alone. Our results are consistent with Hebbian plasticity mechanisms, as our cohort of CTS patients had predominant paresthesias, which produce more temporally coherent afferent signaling from affected digits.

Effects of state managed care patient protection laws on physician satisfaction.

PubMed

Sloan, Frank A; Rattliff, John R; Hall, Mark A

2007-10-01

Physician dissatisfaction often drives public policy, and is associated with lower quality of care and disruption of treatment relationships. Physicians expressed strong dissatisfaction with managed care, leading to enactment of patient protection laws. By 2001, almost all states enacted laws to curb alleged abuses of managed care organizations. To date, no studies have examined whether such laws improved physician satisfaction. This article examines whether enactment of these laws improved physician satisfaction, using responses to the Physician Survey component of the Community Tracking Study (CTS), supplemented with data on state statutes/regulations. Career satisfaction increased for both primary care physicians (PCPs) and specialists following enactment of such laws; improvements were limited to early-adopting states. Enactment was associated with improvements in early-adopting states for specialists but not for PCPs on: ability to provide high quality care, clinical freedom, and ability to make clinical decisions in patients' interests without sacrificing physician income.

Construction of image database for newspapaer articles using CTS

NASA Astrophysics Data System (ADS)

Kamio, Tatsuo

Nihon Keizai Shimbun, Inc. developed a system of making articles' image database automatically by use of CTS (Computer Typesetting System). Besides the articles and the headlines inputted in CTS, it reproduces the image of elements of such as photography and graphs by article in accordance with information of position on the paper. So to speak, computer itself clips the articles out of the newspaper. Image database is accumulated in magnetic file and optical file and is output to the facsimile of users. With diffusion of CTS, newspaper companies which start to have structure of articles database are increased rapidly, the said system is the first attempt to make database automatically. This paper describes the device of CTS which supports this system and outline.

Variations in the service quality of medical practices.

PubMed

Ly, Dan P; Glied, Sherry A

2013-11-01

To examine regional variation in the service quality of physician practices and to assess the association of this variation with the supply and organization of physicians. Secondary analyses of the Community Tracking Study (CTS) household and physician surveys. A total of 40,339 individuals who had seen a primary care physician because of an illness or injury and 17,345 generalist physicians across 4 survey time periods in 60 CTS sites were included. Service quality measures used were lag between making an appointment and seeing a physician, and wait time at the physician's office. Our supply measure was the physician-to-population ratio. Our organizational measure was the percentage of physicians in group practices. Multivariate regressions were performed to examine the relationship between service quality and the supply and organization of physicians. There was substantial variation in the service quality of physician visits across the country. For example, in 2003, the average wait time to see a doctor was 16 minutes in Milwaukee but more than 41 minutes in Miami; the average appointment lag for a sick visit in 2003 was 1.2 days in west-central Alabama but almost 6 days in Northwestern Washington. Service quality was not associated with the primary care physician-to-population ratio and had varying associations with the organization of practices. Cross-site variation in service quality of care in primary care has been large, persistent, and associated with the organization of practices. Areas with higher primary care physician-to-population ratios had longer, not shorter, appointment lags.

Transfer of Critical Thinking: Literacy from Reading Art to Reading Text

ERIC Educational Resources Information Center

Vancil, Kelly

2009-01-01

This study examined (a) the effects of Visual Thinking Strategies (VTS) on student use of critical thinking skills (CTS) in written responses to district reading assessments, (b) if practiced oral responses affected the ability to respond critically using written language, (c) whether there was a relationship between the development of the CTS of…

Carpal tunnel syndrome and work organisation in repetitive work: a cross sectional study in France. Study Group on Repetitive Work

PubMed Central

Leclerc, A.; Franchi, P.; Cristofari, M. F.; Delemotte, B.; Mereau, P.; Teyssier-Cotte, C.; Touranchet, A.

1998-01-01

OBJECTIVES: To study the determinants of signs of carpal tunnel syndrome (CTS) in repetitive industrial work, with special attention to occupational constraints at group level and management practices of the companies. METHOD: A cross sectional study was conducted in three sectors: assembly line; clothing and shoe industry; food industry. A total of 1210 workers in repetitive work, from 53 different companies, was compared with a control group of 337 workers. Constraints at the workplace were partly self declared, and partly assessed by the occupational physicians in charge of the employees of the company. The definition of CTS was based on a standardised clinical examination. RESULTS: CTS was associated with repetitive work, especially packaging. It was more frequent among subjects who declared psychological and psychosomatic problems and those with a body mass index > or = 27. Dissatisfaction with work, lack of job control, short cycle time, and having to press repeatedly with the hand were associated with the syndrome. An odds ratio (OR) of 2.24 was found for "just in time" production. CONCLUSION: The results emphasise the complexity of the determinants of CTS, the role of psychosocial factors at work and the potentially negative effects of some practices of the companies aimed at enhancing their competitiveness.   PMID:9624269

Radiation grafting of acrylamide and maleic acid on chitosan and effective application for removal of Co(II) from aqueous solutions

NASA Astrophysics Data System (ADS)

Saleh, Alaaeldine Sh.; Ibrahim, Ahmed G.; Elsharma, Emad M.; Metwally, Essam; Siyam, Tharwat

2018-03-01

The graft copolymerization has been proven as a superior polymerization technique because it combines the functional advantages of the grafted and base polymers. In this work, the radiation-induced grafting of acrylamide (AAm) and maleic acid (MA) onto chitosan (CTS) was developed and optimized by determining the grafting percentage and efficiency as a function of grafting conditions such as AAm, MA, and CTS concentrations, and absorbed dose. Fourier transform infrared spectroscopic analysis (FTIR) confirmed the graft copolymerization. Thermogravimetric analysis (TGA) and differential thermal analysis (DTA) further characterized the grafted copolymers and showed their high thermal stability. Using batch sorption experiments and 60Co as a radiotracer, poly(CTS-AAm) and poly(CTS-MA) were evaluated for Co(II) removal from aqueous solutions. The Co(II) removal increases with increasing time, pH, polymer, and Co(II) concentrations. Experimentally, P(CTS-AAm) and P(CTS-MA) show high sorption capacities of Co(II), i.e. 150 mg g-1 and 421 mg g-1, respectively, which makes them potential sorbents of Co(II) for water and wastewater treatment. Finally, the Co(II) sorption was examined using sorption isotherm and kinetic models. The sorption was best fitted to Langmuir model which suggests the sorption is of chemisorption type. On the other hand, the sorption kinetics was best represented by Elovich model which also indicates the chemical nature of Co(II) sorption on P(CTS-AAm) and P(CTS-MA).

Development of cesium phosphotungstate salt and chitosan composite membrane for direct methanol fuel cells.

PubMed

Xiao, Yanxin; Xiang, Yan; Xiu, Ruijie; Lu, Shanfu

2013-10-15

A novel composite membrane has been developed by doping cesium phosphotungstate salt (CsxH3-xPW12O40 (0≤x≤3), Csx-PTA) into chitosan (CTS/Csx-PTA) for application in direct methanol fuel cells (DMFCs). Uniform distribution of Csx-PTA nanoparticles has been achieved in the chitosan matrix. The proton conductivity of the composite membrane is significantly affected by the Csx-PTA content in the composite membrane as well as the Cs substitution in PTA. The highest proton conductivity for the CTS/Csx-PTA membranes was obtained with x=2 and Cs2-PTA content of 5 wt%. The value is 6×10(-3) S cm(-1) and 1.75×10(-2) S cm(-1) at 298 K and 353 K, respectively. The methanol permeability of CTS/Cs2-PTA membrane is about 5.6×10(-7), 90% lower than that of Nafion-212 membrane. The highest selectivity factor (φ) was obtained on CTS/Cs2-PTA-5 wt% composite membrane, 1.1×10(4)/Scm(-3)s. The present study indicates the promising potential of CTS/Csx-PTA composite membrane as alternative proton exchange membranes in direct methanol fuel cells. Copyright © 2013 Elsevier Ltd. All rights reserved.

Frequency of Radiculopathy in Patients With Carpal Tunnel Syndrome and Paracervical Pain.

PubMed

Garcia-Santibanez, Rocio; Scelsa, Stephen N

2016-06-01

Patients with carpal tunnel syndrome (CTS) and paracervical pain (PCP) are often incorrectly diagnosed with cervical radiculopathy. The objective of the study is to determine how frequently such patients have electrophysiologic evidence of radiculopathy. We reviewed charts of patients with clinical features of CTS and at least 1 median nerve conduction parameter showing slowing across the wrist. Patients were divided into those with and without PCP. Radiculopathy was defined electrophysiologically. We assessed group differences in the frequency of radiculopathy and how radiculopathy frequency varied with median nerve entrapment severity. Of 108 patients meeting criteria, 56 had PCP and 52 did not. Eight of 56 patients with PCP and 4 of 52 without pain had cervical radiculopathy (P = 0.36). There was no difference in the frequency of radiculopathy related to the severity of median nerve entrapment (P = 0.64). In patients with CTS, PCP is not associated with cervical radiculopathy. Cervical radiculopathy is not more frequent in more severe CTS.

Physical Examination Has a Low Yield in Screening for Carpal Tunnel Syndrome

PubMed Central

Dale, Ann Marie; Descatha, Alexis; Coomes, Justin; Franzblau, Alfred; Evanoff, Bradley

2013-01-01

Background Physical examination is often used to screen workers for carpal tunnel syndrome (CTS). In a population of newly-hired workers, we evaluated the yield of such screening. Methods Our study population included 1108 newly-hired workers in diverse industries. Baseline data included a symptom questionnaire, physical exam, and bilateral nerve conduction testing of the median and ulnar nerves; individual results were not shared with the employer. We tested three outcomes: symptoms of CTS, abnormal median nerve conduction, and a case definition of CTS that required both symptoms and median neuropathy. Results Of the exam measures used, only Semmes-Weinstein sensory testing had a sensitivity value above 31%. Positive predictive values were low, and likelihood ratios were all under 5.0 for positive testing and over 0.2 for negative testing. Conclusion Physical examination maneuvers have a low yield for the diagnosis of CTS in workplace surveillance programs and in post-offer, pre-placement screening programs. PMID:21154516

Psychiatric reactions to continuous traumatic stress: A Latent Profile Analysis of two Israeli samples.

PubMed

Itzhaky, Liat; Gelkopf, Mark; Levin, Yafit; Stein, Jacob Y; Solomon, Zahava

2017-10-01

Many individuals worldwide are exposed to continuous traumatic stress (CTS). However, the psychiatric sequela of CTS and the relevance of posttraumatic stress disorder (PTSD) diagnostic criteria in this situation have yet to be determined. Filling this gap, the present study assessed psychiatric reactions to CTS and the relationship between such reactions and functional impairment among two representative samples of adults exposed to ongoing shelling over 6 (n=387) and 9 years (n=468). Assessment included PTSD symptomatology (i.e., intrusion, avoidance, hyperarousal), anxiety, somatization, and depression. Profile categorization aimed to underscore variations in symptom clustering and severity, and determine whether or not a profile is dominated by PTSD symptoms. Latent Profile analyses (LPA) of sample I revealed four distinct symptoms profiles: (1) 'symptomatically resilient'; (2) 'symptomatically low-moderate'; (3) 'symptomatically moderate-high'; and (4) 'symptomatically overall high'. LPA of sample II revealed three distinct symptoms profiles: (1) 'symptomatically resilient'; (2) 'symptomatically low-moderate'; (3) "symptomatically moderate-high". Moreover, profile variation was implicated in dysfunction. Consistent with studies focusing on single trauma exposure, the findings revealed that the most prevalent profile was the symptomatically resilient, indicating that most people exposed to CTS seem to evince a scarce number of psychiatric symptoms. Moreover, reactions to CTS proved broader than the existing PTSD symptomatology. Examining symptom dominance and severity in relation to impairment and dysfunction, and clinical considerations are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Antimicrobial Efficacy of Octenidine Hydrochloride and Calcium Hydroxide with and Without a Carrier: A Broth Dilution Analysis.

PubMed

Varghese, Vinaya Susan; Uppin, Veerendra; Bhat, Kishore; Pujar, Madhu; Hooli, Amruta B; Kurian, Nirmal

2018-01-01

An efficient antimicrobial agent action is required for a predetermined time period for absolute elimination of root canal microbes. Till date, there is limited or no data on the antimicrobial effect of octenidine as an intracanal medicament with chitosan (CTS) as a carrier against Candida albicans and Enterococcus faecalis . The aim of this microbiological study was to compare the antimicrobial efficacy of octenidine hydrochloride (OHC) and calcium hydroxide (Ca[OH] 2 ) as intracanal medicaments, both independently and along with CTS as a carrier molecule against the common resistant endodontic pathogens. A total of 160 single-rooted anterior teeth were selected, root canal preparation was done, and teeth were divided into two groups and contaminated with C. albicans and E. faecalis , which were further divided into four test groups each according to intracanal medicaments used. CTS was used as a vehicle for OHC and Ca(OH) 2 and antimicrobial assessment was performed on day 2 and day 7 following broth dilution method. Dentine samples were collected after each time interval, and the number of colony-forming units was determined. All four medicaments used in this study showed antifungal and antibacterial activity that diminished from day 2 to day 7. Group I (OHC alone) and Group IV (Ca[OH] 2 alone) showed significant antimicrobial activity against C. albicans and E. faecalis , respectively, than the other groups. A combination of OHC + CTS and Ca(OH) 2 + CTS produced inferior results than that of the medicaments used alone.

An operations management system for the Space Station

NASA Astrophysics Data System (ADS)

Savage, Terry R.

A description is provided of an Operations Management System (OMS) for the planned NASA Space Station. The OMS would be distributed both in space and on the ground, and provide a transparent interface to the communications and data processing facilities of the Space Station Program. The allocation of OMS responsibilities has, in the most current Space Station design, been fragmented among the Communications and Tracking Subsystem (CTS), the Data Management System (DMS), and a redefined OMS. In this current view, OMS is less of a participant in the real-time processing, and more an overseer of the health and management of the Space Station operations.

Cyclic Tensile Strain Upregulates Pro-Inflammatory Cytokine Expression Via FAK-MAPK Signaling in Chondrocytes.

PubMed

Yanoshita, Makoto; Hirose, Naoto; Okamoto, Yuki; Sumi, Chikako; Takano, Mami; Nishiyama, Sayuri; Asakawa-Tanne, Yuki; Horie, Kayo; Onishi, Azusa; Yamauchi, Yuka; Mitsuyoshi, Tomomi; Kunimatsu, Ryo; Tanimoto, Kotaro

2018-05-08

Excessive mechanical stimulation is considered an important factor in the destruction of chondrocytes. Focal adhesion kinase (FAK) is non-receptor tyrosine kinase related to a number of different signaling proteins. Little is known about the function of FAK in chondrocytes under mechanical stimulation. In the present study, we investigated the function of FAK in mechanical signal transduction and the mechanism through which cyclic tensile strain (CTS) induces expression of inflammation-related factors. Mouse ATDC5 chondrogenic cells were subjected to CTS of 0.5 Hz to 10% cell elongation with an FAK inhibitor. The expression of genes encoding COX-2, IL-1β, and TNF-α was examined using real-time RT-PCR after CTS application with FAK inhibitor. Phosphorylation of p-38, ERK, and JNK was analyzed by Western blotting. Differences in COX-2 expression following pretreatment with FAK, p-38, ERK, and JNK inhibitors were compared by Western blotting. We found that CTS increased the expression of genes encoding COX-2, IL-1β, and TNF-α and activated the phosphorylation of FAK, p-38, ERK, and JNK. Pretreatment with an FAK inhibitor for 2 h reduced the expression of genes encoding COX-2, IL-1β, and TNF-α induced by CTS-associated inflammation and decreased phosphorylation of FAK, p-38, ERK, and JNK. Pretreatment with FAK, p-38, ERK, and JNK inhibitors markedly suppressed COX-2 and IL-1β protein expression. In conclusion, FAK appears to regulate inflammation in chondrocytes under CTS via MAPK pathways.

Mg-Doped Hydroxyapatite/Chitosan Composite Coated 316L Stainless Steel Implants for Biomedical Applications.

PubMed

Sutha, S; Dhineshbabu, N R; Prabhu, M; Rajendran, V

2015-06-01

In this investigation, ultrasonication process was used for the synthesis of magnesium doped nano-hydroxyapatite (MH) (0, 1, 2, and 3 mol% of Mg concentration) particles with controlled size and surface morphology. The size of the prepared MH particles was in the range of 20-100 nm with narrow distribution. Increase in the concentration of Mg reduced the particle size distribution from 60 to 40 nm. On incorporation of Mg in HAp lattice, an increase of 20-66 nm in specific surface area was observed in microporous HAp particles. XRF and XRD patterns reveal that the particles possess stoichiometric composition with reduced crystallinity with respect to the Mg concentration. Surface morphology of MH/chitosan (CTS) coated implant was found to be uniform without any defects. The corrosion rate of the implant decreased with increase in Mg concentration. The in vitro formation of bonelike apatite layer on the surface of the MH/CTS coated implant was observed from simulated body fluid studies. The antimicrobial activity of the MH/CTS composites against gram-positive and gram-negative bacterial strains indicated that increasing Mg concentration enhanced antimicrobial properties. Nanoindentation analysis of apatite coated implant surface reveals that the mechanical property depends on the concentration of magnesium in HAp. From the cytotoxicity analysis against NIH 3T3 fibroblast, it was observed that the Mg incorporated HAp/CTS composite was less toxic than the MHO/CTS composite. From this result, it was concluded that the MH/CTS nanocomposites coated implant is the excellent material for implants.

The effects of manganese oxide octahedral molecular sieve chitosan microspheres on sludge bacterial community structures during sewage biological treatment

PubMed Central

Pan, Fei; Liu, Wen; Yu, Yang; Yin, Xianze; Wang, Qingrong; Zheng, Ziyan; Wu, Min; Zhao, Dongye; Zhang, Qiu; Lei, Xiaoman; Xia, Dongsheng

2016-01-01

This study examines the effects of manganese oxide octahedral molecular sieve chitosan microspheres (Fe3O4@OMS-2@CTS) on anaerobic and aerobic microbial communities during sewage biological treatment. The addition of Fe3O4@OMS-2@CTS (0.25 g/L) resulted in enhanced levels of operational performance for decolourization dye X-3B. However, degradation dye X-3B inhibition in the presence of Fe3O4@OMS-2@CTS was recorded as greater than or equal to 1.00 g/L. Illumina MiSeq high throughput sequencing of the 16 S rRNA gene showed that 108 genera were observed during the anaerobic process, while only 71 genera were observed during the aerobic process. The largest genera (Aequorivita) decreased from 21.14% to 12.65% and the Pseudomonas genera increased from 10.57% to 12.96% according to the abundance in the presence of 0.25 g/L Fe3O4@OMS-2@CTS during the anaerobic process. The largest Gemmatimonas genera decreased from 21.46% to 11.68% and the Isosphaerae genera increased from 5.8% to 11.98% according to the abundance in the presence of 0.25 g/L Fe3O4@OMS-2@CTS during the aerobic process. Moreover, the X-ray photoelectron spectroscopy results show that the valence states of Mn and Fe in Fe3O4@OMS-2@CTS changed during sewage biological treatment. PMID:27869226

The impact of cash transfers on social determinants of health and health inequalities in Sub-Saharan Africa: a systematic review protocol.

PubMed

Owusu-Addo, Ebenezer; Renzaho, Andre M N; Mahal, Ajay S; Smith, Ben J

2016-07-13

There is increasing pressure to address the social determinants of health (SDoH) and health inequities through the implementation of culturally acceptable interventions particularly in Sub-Saharan Africa (SSA) where health outcomes are generally poor. Available evaluation research on cash transfers (CTs) suggests that the programs may influence the wider determinants of health in SSA; yet, there has been no attempt to synthesize the evidence regarding their contribution to tackling the SDoH and health inequalities. To date, nearly all the reviews on CTs' impact on health have predominantly featured evidence from Latin America with limited transferability to the social, cultural, and political environments in SSA. Therefore, the aim of this study is to undertake a systematic review to assess the role of CTs in tackling the wider determinants of health and health inequalities in SSA. A systematic review of published and unpublished literature on CTs' impact on health and health determinants covering the period 2000-2016 will be undertaken. Studies will be considered for inclusion if they present quantitative or qualitative data, including all relevant study designs. The SDoH conceptual framework will be used to guide the data extraction process. EPPI Reviewer software will be used for data management and analysis. Studies included in the review will be analyzed by narrative synthesis and/or meta-analysis as appropriate for the nature of the data retrieved. This review will provide empirical evidence on the impact of CTs on SDoH to inform CT policy, implementation, and research in SSA. The protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). This protocol has been registered with the PROSPERO international prospective register of systematic reviews, reference CRD42015025015 .

Moderate to heavy cold-weather precipitation occurrences in Tehran and the associated circulation types

NASA Astrophysics Data System (ADS)

Khansalari, Sakineh; Raziei, Tayeb; Mohebalhojeh, Ali Reza; Ahmadi-Givi, Farhang

2018-02-01

Large-scale atmospheric circulations associated with 133 moderate to heavy cold-weather precipitation events recorded at Mehrabad station in Tehran, Iran, during the period 1951-2013 are analysed. To this end, the performance of un-rotated, orthogonally rotated and obliquely rotated solutions of T-mode principal component analysis (PCA) is examined in classifying the atmospheric circulations into a few representative circulation types (CTs). The T-mode PCAs were applied to the 500-hPa geopotential height for the events in a domain from 10∘E to 70∘E and from 20∘N to 50∘N. The first six leading principal components were retained and then orthogonally and obliquely rotated using varimax and promax solutions, respectively. Statistical inter-comparison of the CTs obtained using the three solutions suggests that the obliquely rotated solution is the better choice for circulation classification in the present study. The six CTs obtained using the oblique rotation were then linked to the daily total precipitation and daily mean temperature variability at Tehran station as well as to the standardized anomalies of the daily total precipitation and mean daily temperature of a dense network of stations distributed across Iran. It is found that the CTs identified, though generally comparable in producing significant precipitation in Tehran, vary in their potential to bring cold weather and generate snowfall in Tehran specifically and in the country in general. While the first three CTs give rise to regional patterns of standardized precipitation anomalies centred in Tehran, the next three CTs leave a pronounced precipitation signature almost across the whole country. As regards the standardized temperature anomalies, with the exception of one CT that causes deep and widespread negative standardized anomalies over most parts of the country, the other CTs are characterized with a dipolar structure of a deep intrusion of cold weather to the west and prevailing warm weather to the east of the country.

Development of internal/external short circuit protection for lithium D cells

NASA Technical Reports Server (NTRS)

Mcdonald, Robert C.; Bragg, Bobby J.

1992-01-01

A brief discussion of short circuit protection for lithium D cells is given in viewgraph format. The following topics are presented: (1) historical need; (2) program objectives; (3) composite thermal switch (CTS) development; (4) laboratory cells with CTS; and (5) the incorporation of CTS into lithium D cells.

Collective Thomson scattering of a high power electron cyclotron resonance heating beam in LHD (invited).

PubMed

Kubo, S; Nishiura, M; Tanaka, K; Shimozuma, T; Yoshimura, Y; Igami, H; Takahash, H; Mutoh, T; Tamura, N; Tatematsu, Y; Saito, T; Notake, T; Korsholm, S B; Meo, F; Nielsen, S K; Salewski, M; Stejner, M

2010-10-01

Collective Thomson scattering (CTS) system has been constructed at LHD making use of the high power electron cyclotron resonance heating (ECRH) system in Large Helical Device (LHD). The necessary features for CTS, high power probing beams and receiving beams, both with well defined Gaussian profile and with the fine controllability, are endowed in the ECRH system. The 32 channel radiometer with sharp notch filter at the front end is attached to the ECRH system transmission line as a CTS receiver. The validation of the CTS signal is performed by scanning the scattering volume. A new method to separate the CTS signal from background electron cyclotron emission is developed and applied to derive the bulk and high energy ion components for several combinations of neutral beam heated plasmas.

MRI-Apparent Localized Deformation of the Median Nerve Within the Carpal Tunnel During Functional Hand Loading

PubMed Central

Goetz, Jessica E.; Kunze, Nicole M.; Main, Erin K.; Thedens, Daniel R.; Baer, Thomas E.; Lawler, Ericka A.; Brown, Thomas D.

2013-01-01

In MR images, the median nerve of carpal tunnel syndrome (CTS) patients frequently appears flatter than in healthy subjects. The purpose of this work was to develop a metric to quantify localized median nerve deformation rather than global nerve flattening, the hypothesis being that localized median nerve deformation would be elevated in CTS patients. Twelve patients with CTS and 12 matched normals underwent MRI scanning in eight isometrically loaded hand conditions. 2D cross sections of the proximal and distal tunnel were analyzed for nerve cross sectional area, flattening ratio, and a position shift to the dorsal side of the tunnel. Additionally, new metrics based on the angulation of the nerve perimeter in 0.5-mm lengths around the boundary were calculated. The localized deformation metrics were able to detect differences between CTS patients and healthy subjects that could not be appreciated from the flattening ratio. During most hand activities, normal subjects had a higher average percentage of locally deformed nerve boundary than did CTS patients, despite having a rounder overall shape. Less local nerve deformation in the CTS patient group resulting from its interaction with flexor tendons suggests that the nerve may be less compliant in CTS patients. PMID:23612911

Metabolic Pathways Regulated by Chitosan Contributing to Drought Resistance in White Clover.

PubMed

Li, Zhou; Zhang, Yan; Zhang, Xinquan; Merewitz, Emily; Peng, Yan; Ma, Xiao; Huang, Linkai; Yan, Yanhong

2017-08-04

Increased endogenous chitosan (CTS) could be associated with improved drought resistance in white clover (Trifolium repens). Plants were pretreated with or without 1 mg/mL CTS and then were subjected to optimal or water-limited condition in controlled growth chambers for 6 days. Phenotypic and physiological results indicated that exogenous CTS significantly improved drought resistance of white clover. Metabolome results showed that exogenous CTS induced a significant increase in endogenous CTS content during dehydration accompanied by the maintenance of greater accumulation of sugars, sugar alcohols, amino acids, organic acids, and other metabolites (ascorbate, glutathione, flavonoids, putrescine, and spermidine). These compounds are associated with osmotic adjustment, antioxidant defense, stress signaling, and energy metabolism under stress condition. Similarly, transcriptome revealed that many genes in relation to amino acid and carbohydrate metabolism, energy production and conversion, and ascorbate-glutathione and flavonoid metabolism were significantly up-regulated by CTS in response to dehydration stress. CTS-induced drought resistance was associated with the accumulation of stress protective metabolites, the enhancement of ascorbate-glutathione and tricarboxylic acid cycle, and increases in the γ-aminobutyric acid shunt, polyamine synthesis, and flavonoids metabolism contributing to improved osmotic adjustment, antioxidant capacity, stress signaling, and energy production for stress defense, thereby maintaining metabolic homeostasis under dehydration stress.

SU-G-JeP2-01: A New Approach for MR-Only Treatment Planning: Tissue Segmentation-Based Pseudo-CT Generation Using T1-Weighted MRI

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

Yu, H; Leszczynski, K; Lee, Y

Purpose: To evaluate MR-only treatment planning for brain Stereotactic Ablative Radiotherapy (SABR) based on pseudo-CT (pCT) generation using one set of T1-weighted MRI. Methods: T1-weighted MR and CT images from 12 patients who were eligible for brain SABR were retrospectively acquired for this study. MR-based pCT was generated by using a newly in-house developed algorithm based on MR tissue segmentation and voxel-based electron density (ED) assignment (pCTv). pCTs using bulk density assignment (pCTb where bone and soft tissue were assigned 800HU and 0HU,respectively), and water density assignment (pCTw where all tissues were assigned 0HU) were generated for comparison of EDmore » assignment techniques. The pCTs were registered with CTs and contours of radiation targets and Organs-at-Risk (OARs) from clinical CT-based plans were copied to co-registered pCTs. Volumetric-Modulated-Arc-Therapy(VMAT) plans were independently created for pCTv and CT using the same optimization settings and a prescription (50Gy/10 fractions) to planning-target-volume (PTV) mean dose. pCTv-based plans and CT-based plans were compared with dosimetry parameters and monitor units (MUs). Beam fluence maps of CT-based plans were transferred to co-registered pCTs, and dose was recalculated on pCTs. Dose distribution agreement between pCTs and CT plans were quantified using Gamma analysis (2%/2mm, 1%/1mm with a 10% cut-off threshold) in axial, coronal and sagittal planes across PTV. Results: The average differences of PTV mean and maximum doses, and monitor units between independently created pCTv-based and CT-based plans were 0.5%, 1.5% and 1.1%, respectively. Gamma analysis of dose distributions of the pCTs and the CT calculated using the same fluence map resulted in average agreements of 92.6%/79.1%/52.6% with 1%/1mm criterion, and 98.7%/97.4%/71.5% with 2%/2mm criterion, for pCTv/CT, pCTb/CT and pCTw/CT, respectively. Conclusion: Plans produced on Voxel-based pCT is dosimetrically more similar to CT plans than bulk assignment-based pCTs. MR-only treatment planning using voxel-based pCT generated from T1-wieghted MRI may be feasible.« less

Risk factors for carpal tunnel syndrome related to the work organization: a prospective surveillance study in a large working population.

PubMed

Petit, Audrey; Ha, Catherine; Bodin, Julie; Rigouin, Pascal; Descatha, Alexis; Brunet, René; Goldberg, Marcel; Roquelaure, Yves

2015-03-01

The study aimed to determine the risk factors for incident carpal tunnel syndrome (CTS) in a large working population, with a special focus on factors related to work organization. In 2002-2005, 3710 workers were assessed and, in 2007-2010, 1611 were re-examined. At baseline all completed a self-administered questionnaire about personal/medical factors and work exposure. CTS symptoms and physical examination signs were assessed by a standardized medical examination at baseline and follow-up. The risk of "symptomatic CTS" was higher for women (OR = 2.9 [1.7-5.2]) and increased linearly with age (OR = 1.04 [1.00-1.07] for 1-year increment). Two work organizational factors remained in the multivariate risk model after adjustment for the personal/medical and biomechanical factors: payment on a piecework basis (OR = 2.0, 95% CI 1.1-3.5) and work pace dependent on automatic rate (OR = 1.9, 95% CI 0.9-4.1). Several factors related to work organization were associated with incident CTS after adjustment for potential confounders. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.

General Population Job Exposure Matrix Applied to a Pooled Study of Prevalent Carpal Tunnel Syndrome

PubMed Central

Dale, Ann Marie; Zeringue, Angelique; Harris-Adamson, Carisa; Rempel, David; Bao, Stephen; Thiese, Matthew S.; Merlino, Linda; Burt, Susan; Kapellusch, Jay; Garg, Arun; Gerr, Fred; Hegmann, Kurt T.; Eisen, Ellen A.; Evanoff, Bradley

2015-01-01

A job exposure matrix may be useful for the study of biomechanical workplace risk factors when individual-level exposure data are unavailable. We used job title–based exposure data from a public data source to construct a job exposure matrix and test exposure-response relationships with prevalent carpal tunnel syndrome (CTS). Exposures of repetitive motion and force from the Occupational Information Network were assigned to 3,452 active workers from several industries, enrolled between 2001 and 2008 from 6 studies. Repetitive motion and force exposures were combined into high/high, high/low, and low/low exposure groupings in each of 4 multivariable logistic regression models, adjusted for personal factors. Although force measures alone were not independent predictors of CTS in these data, strong associations between combined physical exposures of force and repetition and CTS were observed in all models. Consistent with previous literature, this report shows that workers with high force/high repetition jobs had the highest prevalence of CTS (odds ratio = 2.14–2.95) followed by intermediate values (odds ratio = 1.09–2.27) in mixed exposed jobs relative to the lowest exposed workers. This study supports the use of a general population job exposure matrix to estimate workplace physical exposures in epidemiologic studies of musculoskeletal disorders when measures of individual exposures are unavailable. PMID:25700886

Validity of the Upper Limb Neurodynamic Test 1 for the diagnosis of Carpal Tunnel Syndrome. The role of structural differentiation.

PubMed

Bueno-Gracia, Elena; Tricás-Moreno, José Miguel; Fanlo-Mazas, Pablo; Malo-Urriés, Miguel; Haddad-Garay, María; Estébanez-de-Miguel, Elena; Hidalgo-García, César; Krauss, John R

2016-04-01

Several studies have analysed the use of the Upper Limb Neurodynamic Test 1 (ULNT1) for diagnosing Carpal Tunnel Syndrome (CTS) obtaining weak diagnostic accuracy, which could be related to the lack of consensus in the selected diagnostic criteria of ULNT1. To determine the concurrent validity of ULNT1 in comparison to Nerve Conduction Studies (NCS) for the diagnosis of CTS, considering the structural differentiation (SD) as an essential part of the diagnosis. Prospective diagnostic test study. Individuals with suspected CTS referred for NCS were invited to voluntarily participate in the study. Each participant was tested with NCS and ULNT1. ULNT1 result was considered positive when the patient's clinical symptoms were reproduced during the test and symptoms changed during contralateral neck side bending (SD). 58 Participants (17 men, 44 women) with suspected CTS and a total of 95 limbs were examined using the NCS and ULNT1. Sensitivity of the ULNT1 was 57.9%, specificity was 84.2%, and the positive and negative likelihood ratios were 3.67 and 0.50 respectively. Results obtained in the study may indicate the ability of the ULNT1 to generate small shifts from pre-test to post-test probability. However, imprecision in the CIs limits interpretation from the data. 1b. Published by Elsevier Ltd.

Doctoral programs to train future leaders in clinical and translational science.

PubMed

Switzer, Galen E; Robinson, Georgeanna F W B; Rubio, Doris M; Fowler, Nicole R; Kapoor, Wishwa N

2013-09-01

Although the National Institutes of Health (NIH) has made extensive investments in educational programs related to clinical and translational science (CTS), there has been no systematic investigation of the number and characteristics of PhD programs providing training to future leaders in CTS. The authors undertook to determine the number of institutions that, having had received NIH-funded Clinical and Translational Science Awards (CTSAs), currently had or were developing PhD programs in CTS; to examine differences between programs developed before and after CTSA funding; and to provide detailed characteristics of new programs. In 2012, CTS program leaders at the 60 CTSA-funded institutions completed a cross-sectional survey focusing on four key domains related to PhD programs in CTS: program development and oversight; students; curriculum and research; and milestones. Twenty-two institutions had fully developed PhD programs in CTS, and 268 students were earning PhDs in this new field; 13 institutions were planning PhD programs. New programs were more likely to have fully developed PhD competencies and more likely to include students in medical school, students working only on their PhD, students working on a first doctoral degree, and students working in T1 translational research. They were less likely to include physicians and students working in clinical or T2 research. Although CTS PhD programs have similarities, they also vary in their characteristics and management of students. This may be due to diversity in translational science itself or to the relative infancy of CTS as a discipline.

Synthesis and characterization of silver/montmorillonite/chitosan bionanocomposites by chemical reduction method and their antibacterial activity.

PubMed

Shameli, Kamyar; Bin Ahmad, Mansor; Zargar, Mohsen; Yunus, Wan Md Zin Wan; Ibrahim, Nor Azowa; Shabanzadeh, Parvaneh; Moghaddam, Mansour Ghaffari

2011-01-01

Silver nanoparticles (AgNPs) of a small size were successfully synthesized using the wet chemical reduction method into the lamellar space layer of montmorillonite/chitosan (MMT/Cts) as an organomodified mineral solid support in the absence of any heat treatment. AgNO3, MMT, Cts, and NaBH4 were used as the silver precursor, the solid support, the natural polymeric stabilizer, and the chemical reduction agent, respectively. MMT was suspended in aqueous AgNO3/Cts solution. The interlamellar space limits were changed (d-spacing = 1.24-1.54 nm); therefore, AgNPs formed on the interlayer and external surface of MMT/Cts with d-average = 6.28-9.84 nm diameter. Characterizations were done using different methods, ie, ultraviolet-visible spectroscopy, powder X-ray diffraction, transmission electron microscopy, scanning electron microscopy, energy dispersive X-ray fluorescence spectrometry, and Fourier transform infrared spectroscopy. Silver/montmorillonite/chitosan bionanocomposite (Ag/MMT/Cts BNC) systems were examined. The antibacterial activity of AgNPs in MMT/Cts was investigated against Gram-positive bacteria, ie, Staphylococcus aureus and methicillin-resistant S. aureus and Gram-negative bacteria, ie, Escherichia coli, E. coli O157:H7, and Pseudomonas aeruginosa by the disc diffusion method using Mueller Hinton agar at different sizes of AgNPs. All of the synthesized Ag/MMT/Cts BNCs were found to have high antibacterial activity. These results show that Ag/MMT/Cts BNCs can be useful in different biological research and biomedical applications, including surgical devices and drug delivery vehicles.

Doctoral Programs to Train Future Leaders in Clinical and Translational Science

PubMed Central

Switzer, Galen E.; Robinson, Georgeanna F.W.B.; Rubio, Doris M.; Fowler, Nicole R.; Kapoor, Wishwa N.

2013-01-01

Purpose Although the National Institutes of Health (NIH) has made extensive investments in educational programs related to clinical and translational science (CTS), there has been no systematic investigation of the number and characteristics of PhD programs providing training to future leaders in CTS. The authors undertook to determine the number of institutions that, having had received NIH-funded Clinical and Translational Science Awards (CTSAs), currently had or were developing PhD programs in CTS; to examine differences between programs developed before and after CTSA funding; and to provide detailed characteristics of new programs. Method In 2012, CTS program leaders at the 60 CTSA-funded institutions completed a cross-sectional survey focusing on four key domains related to PhD programs in CTS: program development and oversight; students; curriculum and research; and milestones. Results Twenty-two institutions had fully developed PhD programs in CTS, and 268 students were earning a PhD in this new field; 13 institutions were planning a PhD program. New programs were more likely to have fully developed PhD competencies and more likely to include students in medical school, students working only on their PhD, students working on a first doctoral degree, and students working in T1 translational research. They were less likely to include physicians and students working in clinical or T2 research. Conclusions Although CTS PhD programs have similarities, they also vary in their characteristics and management of students. This may be due to diversity in translational science itself or to the relative infancy of CTS as a discipline. PMID:23899901

LOW-LEVEL LASER THERAPY AFTER CARPAL TUNNEL RELEASE

PubMed Central

Alves, Marcelo de Pinho Teixeira; de Araújo, Gabriel Costa Serrão

2015-01-01

Objective: Evaluate the post-operative treatment of CTS, using the LLLT. Method: We prospectively evaluated 58 patients with CTS, randomly divided into two groups: treatment with LLLT (Group 1) and placebo (Group 2). A 830 nm gallium-aluminum-arsenic laser was used, with a power of 30 mW. Results: There was female predominance in both groups. The mean age of the patients in Group 1 was 44.3 years and in Group 2, 51.9 years. The average duration of disease progression was around two years in both groups. The average time elapsed since discharge from treatment was 3.6 months in both groups, and fewer patients had postoperative complaints in Group 1 than in Group 2. At the end of the treatment, in Group 1, 29.41% of the patients presented electromyographic abnormalities, while in Group 2, 63.64% of the patients had abnormalities, after six months. Conclusion: This was an initial study on adjuvant therapy using postoperative LLLT on CTS. The method presented was sufficient for postoperative evaluation of the patients in this study. Patients undergoing LLLT after surgery for CTS were benefited and had better functional outcomes than shown by the control group. The technique was effective and did not have any adverse effects on the patients studied. PMID:27027075

Development of Independent-type Optical CT

NASA Astrophysics Data System (ADS)

Yamaguchi, Tatsushi; Shiozawa, Daigoro; Rokunohe, Toshiaki; Kida, Junzo; Zhang, Wei

Optical current transformers (optical CTs) have features that they can be made much smaller and lighter than conventional electromagnetic induction transformers by their simple structure, and contribute to improvement of equipment reliability because of their excellent surge resistance performance. Authors consider optical CTs to be next generation transformers, and are conducting research and development of optical CTs aiming to apply to measuring and protection in electric power systems. Specifically we developed an independent-type optical CT by utilizing basic data of optical CTs accumulated for large current characteristics, temperature characteristics, vibration resistance characteristics, and so on. In performance verification, type tests complying with IEC standards, such as short-time current tests, insulation tests, accuracy tests, and so on, showed good results. This report describes basic principle and configuration of optical CTs. After that, as basic characteristics of optical CTs, conditions and results of verification tests for dielectric breakdown characteristics of sensor fibers, large current characteristics, temperature characteristics, and vibration resistance characteristics are described. Finally, development outline of the independent-type optical CT aiming to apply to all digital substation and its type tests results are described.

Assessing the Value of High-Quality Care for Work-Associated Carpal Tunnel Syndrome in a Large Integrated Health Care System: Study Design.

PubMed

Conlon, Craig; Asch, Steven; Hanson, Mark; Avins, Andrew; Levitan, Barbara; Roth, Carol; Robbins, Michael; Dworsky, Michael; Seabury, Seth; Nuckols, Teryl

2016-01-01

Little is known about quality of care for occupational health disorders, although it may affect worker health and workers' compensation costs. Carpal tunnel syndrome (CTS) is a common work-associated condition that causes substantial disability. To describe the design of a study that is assessing quality of care for work-associated CTS and associations with clinical outcomes and costs. Prospective observational study of 477 individuals with new workers' compensation claims for CTS without acute trauma who were treated at 30 occupational health clinics from 2011 to 2013 and followed for 18 months. Timing of key clinical events, adherence to 45 quality measures, changes in scores on the Boston Carpal Tunnel Questionnaire and 12-item Short Form Health Survey Version 2 (SF-12v2), and costs associated with medical care and disability. Two hundred sixty-seven subjects (56%) received a diagnosis of CTS and had claims filed around the first visit to occupational health, 104 (22%) received a diagnosis before that visit and claim, and 98 (21%) received a diagnosis or had claims filed after that visit. One hundred seventy-eight (37%) subjects had time off work, which started around the time of surgery in 147 (83%) cases and lasted a median of 41 days (interquartile range = 42 days). The timing of diagnosis varied, but time off work was generally short and related to surgery. If associations of quality of care with key medical, economic, and quality-of-life outcomes are identified for work-associated CTS, systematic efforts to evaluate and improve quality of medical care for this condition are warranted.

Incidence rates of in-hospital carpal tunnel syndrome in the general population and possible associations with marital status.

PubMed

Mattioli, Stefano; Baldasseroni, Alberto; Curti, Stefania; Cooke, Robin M T; Bena, Antonella; de Giacomi, Giovanna; dell'Omo, Marco; Fateh-Moghadam, Pirous; Melani, Carla; Biocca, Marco; Buiatti, Eva; Campo, Giuseppe; Zanardi, Francesca; Violante, Francesco S

2008-10-28

Carpal tunnel syndrome (CTS) is a socially relevant condition associated with biomechanical risk factors. We evaluated age-sex-specific incidence rates of in-hospital cases of CTS in central/northern Italy and explored relations with marital status. Seven regions were considered (overall population, 14.9 million) over 3-6-year periods between 1997 and 2002 (when out-of-hospital CTS surgery was extremely rare). Incidence rates of in-hospital cases of CTS were estimated based on 1) codified demographic, diagnostic and intervention data in obligatory discharge records from all Italian public/private hospitals, archived (according to residence) on regional databases; 2) demographic general population data for each region. We compared (using the chiscore test) age-sex-specific rates between married, unmarried, divorced and widowed subsets of the general population. We calculated standardized incidence ratios (SIRs) for married/unmarried men and women. Age-standardized incidence rates (per 100,000 person-years) of in-hospital cases of CTS were 166 in women and 44 in men (106 overall). Married subjects of both sexes showed higher age-specific rates with respect to unmarried men/women. SIRs were calculated comparing married vs unmarried rates of both sexes: 1.59 (95% confidence interval [95% CI], 1.57-1.60) in women, and 1.42 (95% CI, 1.40-1.45) in men. As compared with married women/men, widows/widowers both showed 2-3-fold higher incidence peaks during the fourth decade of life (beyond 50 years of age, widowed subjects showed similar trends to unmarried counterparts). This large population-based study illustrates distinct age-related trends in men and women, and also raises the question whether marital status could be associated with CTS in the general population.

Follicle-stimulating hormone encapsulation in the cholesterol-modified chitosan nanoparticles via molecular dynamics simulations and binding free energy calculations.

PubMed

Yahyaei, Mohammad; Mehrnejad, Faramarz; Naderi-Manesh, Hossein; Rezayan, Ali Hossein

2017-09-30

Follicle-stimulating hormone (FSH) is widely applied in the modern ovarian stimulation techniques. However, it must be administered daily because of its short half-life. Recently, the cholesterol (CS) modified chitosan (CTS) nanogels have attracted significant interest as promising controlled release protein delivery because of their ability to minimize the aggregation and irreversible denaturation of proteins. Herein, we report a molecular dynamics (MD) simulation investigation on the molecular mechanisms of FSH encapsulation in the CS-CTS nanogels. The MD simulations have been performed using the GROMACS software for up to 200ns simulation time. Furthermore, the binding free energy has been calculated by the molecular mechanics [MM] with Poisson-Boltzmann [PB] and surface area solvation (MM/PBSA) method by using the g_mmpbsa tool. Our findings suggest that the main driving force of the formation of the CS-CTS nanogels is the hydrophobic interactions between the CS-CS moieties in water. The results have also indicated that the CS-CTS nanogel formation can occur through the hydrogen bonding in addition to the hydrophobic interactions. The obtained data demonstrate that the FSH encapsulation into the CS-CTS nanogels is a gradual process driven by the hydrophobic interactions between the hydrophobic patch of FSH and the hydrophobic nanodomains of the nanogel. Our results also reveal that except in the hydrophobic patch region, the flexibility of FSH was reduced in the presence of the nanogel. This study provides the elucidation of the nanogel-FSH interactions at the molecular level and presents new perspective for the ideal design and applications of the CS-CTS nanogel in protein delivery. Copyright © 2017 Elsevier B.V. All rights reserved.

Development, optimization and characterization of glycyrrhetinic acid-chitosan nanoparticles of atorvastatin for liver targeting.

PubMed

Rohilla, Raman; Garg, Tarun; Bariwal, Jitender; Goyal, Amit K; Rath, Goutam

2016-09-01

Glycyrrhetinic acid-modified chitosan (mGA-suc-CTS) is used as liver-targeted carrier for drug delivery. In this study, nanoparticles were prepared by ionic gelation process, and glycyrrhetinic acid act as the targeting ligand. The structure of the product was confirmed by IR and NMR techniques. The main aim of this study was to deliver atorvastatin directly to the liver by using same conjugate and reduce the associated side-effects, i.e. hepatotoxicity at high dose. Characterization of the developed formulation was performed by differential scanning calorimetry, particle size measurements and cellular uptake studies. Release profile, pharmacokinetics studies and organ distribution studies showed that developed formulation shows a relative higher liver uptake. The optimized formulation showed increased plasma concentration than the CTS nanoparticles as well as plain drug and the accumulation in the liver was nearly 2.59 times more than that of obtained with the CTS nanoparticles. Pharmaceutical and pharmacological indicators suggested that the proposed strategy can be successfully utilized for liver targeting of therapeutics.

Characterization of a Nucleus-Encoded Chitinase from the Yeast Kluyveromyces lactis

PubMed Central

Colussi, Paul A.; Specht, Charles A.; Taron, Christopher H.

2005-01-01

Endogenous proteins secreted from Kluyveromyces lactis were screened for their ability to bind to or to hydrolyze chitin. This analysis resulted in identification of a nucleus-encoded extracellular chitinase (KlCts1p) with a chitinolytic activity distinct from that of the plasmid-encoded killer toxin α-subunit. Sequence analysis of cloned KlCTS1 indicated that it encodes a 551-amino-acid chitinase having a secretion signal peptide, an amino-terminal family 18 chitinase catalytic domain, a serine-threonine-rich domain, and a carboxy-terminal type 2 chitin-binding domain. The association of purified KlCts1p with chitin is stable in the presence of high salt concentrations and pH 3 to 10 buffers; however, complete dissociation and release of fully active KlCts1p occur in 20 mM NaOH. Similarly, secreted human serum albumin harboring a carboxy-terminal fusion with the chitin-binding domain derived from KlCts1p also dissociates from chitin in 20 mM NaOH, demonstrating the domain's potential utility as an affinity tag for reversible chitin immobilization or purification of alkaliphilic or alkali-tolerant recombinant fusion proteins. Finally, haploid K. lactis cells harboring a cts1 null mutation are viable but exhibit a cell separation defect, suggesting that KlCts1p is required for normal cytokinesis, probably by facilitating the degradation of septum-localized chitin. PMID:15932978

Characterization of a nucleus-encoded chitinase from the yeast Kluyveromyces lactis.

PubMed

Colussi, Paul A; Specht, Charles A; Taron, Christopher H

2005-06-01

Endogenous proteins secreted from Kluyveromyces lactis were screened for their ability to bind to or to hydrolyze chitin. This analysis resulted in identification of a nucleus-encoded extracellular chitinase (KlCts1p) with a chitinolytic activity distinct from that of the plasmid-encoded killer toxin alpha-subunit. Sequence analysis of cloned KlCTS1 indicated that it encodes a 551-amino-acid chitinase having a secretion signal peptide, an amino-terminal family 18 chitinase catalytic domain, a serine-threonine-rich domain, and a carboxy-terminal type 2 chitin-binding domain. The association of purified KlCts1p with chitin is stable in the presence of high salt concentrations and pH 3 to 10 buffers; however, complete dissociation and release of fully active KlCts1p occur in 20 mM NaOH. Similarly, secreted human serum albumin harboring a carboxy-terminal fusion with the chitin-binding domain derived from KlCts1p also dissociates from chitin in 20 mM NaOH, demonstrating the domain's potential utility as an affinity tag for reversible chitin immobilization or purification of alkaliphilic or alkali-tolerant recombinant fusion proteins. Finally, haploid K. lactis cells harboring a cts1 null mutation are viable but exhibit a cell separation defect, suggesting that KlCts1p is required for normal cytokinesis, probably by facilitating the degradation of septum-localized chitin.

Effect of extracorporeal shock wave therapy on the treatment of patients with carpal tunnel syndrome.

PubMed

Vahdatpour, Babak; Kiyani, Abolghasem; Dehghan, Farnaz

2016-01-01

The carpal tunnel syndrome (CTS) is the most common neuropathy. The aim of this study was to evaluate the effect of a new and noninvasive treatment including extracorporeal shock wave therapy (ESWT) in the treatment of CTS. This study is a clinical trial conducted on 60 patients with moderate CTS in selected health centers of Isfahan Medical University from November 2014 to April 2015. Patients with CTS were randomly divided into two groups. Conservative treatment including wrist splint at night for 3 months, consumption of nonsteroidal anti-inflammatory drugs for 2 weeks, and oral consumption of Vitamin B1 for a month was recommended for both groups. The first group was treated with ESWT, one session per week for 4 weeks. Focus probe with 0.05, 0.07, 0.1, and 0.15 energy and shock numbers 800, 900, 1000, and 1100 were used from the first session to the fourth, respectively. The evaluated parameters were assessed before treatment and after 3 and 6 months. Data were analyzed using SPSS version 19, Student's t-test, and Chi-square test. All parameters were significantly decreased in the ESWT group after 3 months. These results remained almost constant after 6 months compared with 3 months after treatment. However, only two parameters considerably improved after 3 months of treatment in the control group. The entire indexes in the control group implicated the regression of results in long-term period. It is recommended to use ESWT as a conservative treatment in patients with CTS.

Antimicrobial Efficacy of Octenidine Hydrochloride and Calcium Hydroxide with and Without a Carrier: A Broth Dilution Analysis

PubMed Central

Varghese, Vinaya Susan; Uppin, Veerendra; Bhat, Kishore; Pujar, Madhu; Hooli, Amruta B.; Kurian, Nirmal

2018-01-01

Background: An efficient antimicrobial agent action is required for a predetermined time period for absolute elimination of root canal microbes. Till date, there is limited or no data on the antimicrobial effect of octenidine as an intracanal medicament with chitosan (CTS) as a carrier against Candida albicans and Enterococcus faecalis. Aim: The aim of this microbiological study was to compare the antimicrobial efficacy of octenidine hydrochloride (OHC) and calcium hydroxide (Ca[OH]2) as intracanal medicaments, both independently and along with CTS as a carrier molecule against the common resistant endodontic pathogens. Materials and Methods: A total of 160 single-rooted anterior teeth were selected, root canal preparation was done, and teeth were divided into two groups and contaminated with C. albicans and E. faecalis, which were further divided into four test groups each according to intracanal medicaments used. CTS was used as a vehicle for OHC and Ca(OH)2 and antimicrobial assessment was performed on day 2 and day 7 following broth dilution method. Dentine samples were collected after each time interval, and the number of colony-forming units was determined. Results: All four medicaments used in this study showed antifungal and antibacterial activity that diminished from day 2 to day 7. Group I (OHC alone) and Group IV (Ca[OH]2 alone) showed significant antimicrobial activity against C. albicans and E. faecalis, respectively, than the other groups. Conclusion: A combination of OHC + CTS and Ca(OH)2+ CTS produced inferior results than that of the medicaments used alone. PMID:29599588

Global shortage of neonatal and paediatric antibiotic trials: rapid review

PubMed Central

Thompson, Georgina; Barker, Charlotte I; Folgori, Laura; Bielicki, Julia A; Bradley, John S; Lutsar, Irja; Sharland, Mike

2017-01-01

Objectives There have been few clinical trials (CTs) on antibiotics that inform neonatal and paediatric drug labelling. The rate of unlicensed and off-label prescribing in paediatrics remains high. It is unclear whether the current neonatal and paediatric antibiotic research pipeline is adequate to inform optimal drug dosing. Using the ClinicalTrials.gov registry, this review aims to establish the current global status of antibiotic CTs in children up to 18 years of age. Methods Studies were identified using key word searches of the ClinicalTrials.gov registry and were manually filtered using prespecified inclusion/exclusion criteria. Results 76 registered open CTs of antibiotics in children were identified globally; 23 (30%) were recruiting newborns (only 8 (11%) included preterm neonates), 52 (68%) infants and toddlers, 58 (76%) children and 54 (71%) adolescents. The majority of registered trials were late phase (10 (15%) phase 3 and 23 (35%) phase 4/pharmacovigilance). Two-thirds were sponsored by non-profit organisations, compared with pharmaceutical companies (50 (66%) vs 26 (34%), respectively). A greater proportion of non-profit funded trials were efficacy-based strategic trials (n=34, 68%), in comparison with industry-led trials, which were most often focused on safety or pharmacokinetic data (n=17, 65%). Only 2 of the 37 antibiotics listed on the May 2016 Pew Charitable Trusts antibiotic development pipeline, currently being studied in adults, appear to be currently recruiting in open paediatric CTs. Conclusions This review highlights that very few paediatric antibiotic CTs are being conducted globally, especially in neonates. There is a striking disparity noted between antibiotic drug development programmes in adults and children. PMID:29030411

Subterahertz gyrotron developments for collective Thomson scattering in LHDa)

NASA Astrophysics Data System (ADS)

Notake, T.; Saito, T.; Tatematsu, Y.; Kubo, S.; Shimozuma, T.; Tanaka, K.; Nishiura, M.; Fujii, A.; Agusu, La; Ogawa, I.; Idehara, T.

2008-10-01

Collective Thomson scattering (CTS) is expected to provide the spatially resolved velocity distribution functions of not only thermal and tail ions but also alpha particles resulting from fusion reactions. CTS using gyrotrons with frequency higher than the conventional ones used for plasma heating would have advantages to alleviate refraction, cutoff effects, and background electron cyclotron emission noise. Therefore, a high-power pulse gyrotron operating at approximately 400 GHz is being developed for CTS in Large Helical Device (LHD). A single-mode oscillation with a frequency greater than 400 GHz, applying the second-harmonic resonance, was successfully demonstrated in the first stage. At the same time, concrete feasibility study based on ray tracing, scattering spectra, and electron cyclotron emission calculations has been conducted.

[Clinical and electrophysiological findings in carpal tunnel syndrome].

PubMed

Kohara, Nobuo

2007-11-01

Carpal tunnel syndrome (CTS) is the most common nerve entrapment disorder. The clinical features of CTS are variable, but usually include pain and paresthesia in the thumb, first two fingers, and the radial-half of the ring finger. Paresthesia and sensory deficits might involve the entire palm area in some cases. Pain frequently radiate proximally into the forearm, and occasionally to the shoulder. Many patients experience pain at night and are awakened by abnormal sensations. Shaking hand relief the symptom. The two classic tests for nerve compression at the wrist are the Tinel test and the Phalen maneuver, which diagnostic value is limited. Golden standard for the diagnosis is the combination of the clinical findings and the electrophysiological study. Routine median nerve conduction study is valuable. Prolonged terminal latency of motor or sensory nerve would be found in most CTS hands. If the routine study showed equivocal, more sensitive methods are needed. Those include segmental sensory conduction study across the carpal tunnel by median stimulation at midpalm, a comparison of median and ulnar sensory nerve latencies at ring finger and a comparison of median and radial sensory nerve latencies at thumb. A difference between the median motor latency to the second lumbrical and the ulnar motor latency to the interossei muscles has also diagnostic value in some cases. In addition, inching method can localized the compression site. Using these techniques, the diagnosis of CTS would become more reliable.

Automatic segmentation and centroid detection of skin sensors for lung interventions

NASA Astrophysics Data System (ADS)

Lu, Kongkuo; Xu, Sheng; Xue, Zhong; Wong, Stephen T.

2012-02-01

Electromagnetic (EM) tracking has been recognized as a valuable tool for locating the interventional devices in procedures such as lung and liver biopsy or ablation. The advantage of this technology is its real-time connection to the 3D volumetric roadmap, i.e. CT, of a patient's anatomy while the intervention is performed. EM-based guidance requires tracking of the tip of the interventional device, transforming the location of the device onto pre-operative CT images, and superimposing the device in the 3D images to assist physicians to complete the procedure more effectively. A key requirement of this data integration is to find automatically the mapping between EM and CT coordinate systems. Thus, skin fiducial sensors are attached to patients before acquiring the pre-operative CTs. Then, those sensors can be recognized in both CT and EM coordinate systems and used calculate the transformation matrix. In this paper, to enable the EM-based navigation workflow and reduce procedural preparation time, an automatic fiducial detection method is proposed to obtain the centroids of the sensors from the pre-operative CT. The approach has been applied to 13 rabbit datasets derived from an animal study and eight human images from an observation study. The numerical results show that it is a reliable and efficient method for use in EM-guided application.

Affinity and Interpretation in Oral Histories of Art Education

ERIC Educational Resources Information Center

Garnet, Dustin

2017-01-01

In the pursuit of my doctoral research on the institutional history of the art department at Central Technical School (CTS) in Toronto, Canada, I amassed a collection of oral histories from 20 current and former CTS art instructors and students, recorded across the country. As an instructor in the CTS art department in addition to being its…

Chotosan (Diaoteng San)-induced improvement of cognitive deficits in senescence-accelerated mouse (SAMP8) involves the amelioration of angiogenic/neurotrophic factors and neuroplasticity systems in the brain

PubMed Central

2011-01-01

Background Chotosan (CTS, Diaoteng San), a Kampo medicine (ie Chinese medicine) formula, is reportedly effective in the treatment of patients with cerebral ischemic insults. This study aims to evaluate the therapeutic potential of CTS in cognitive deficits and investigates the effects and molecular mechanism(s) of CTS on learning and memory deficits and emotional abnormality in an animal aging model, namely 20-week-old senescence-accelerated prone mice (SAMP8), with and without a transient ischemic insult (T2VO). Methods Age-matched senescence-resistant inbred strain mice (SAMR1) were used as control. SAMP8 received T2VO (T2VO-SAMP8) or sham operation (sham-SAMP8) at day 0. These SAMP8 groups were administered CTS (750 mg/kg, p.o.) or water daily for three weeks from day 3. Results Compared with the control group, both sham-SAMP8 and T2VO-SAMP8 groups exhibited cognitive deficits in the object discrimination and water maze tests and emotional abnormality in the elevated plus maze test. T2VO significantly exacerbated spatial cognitive deficits of SAMP8 elucidated by the water maze test. CTS administration ameliorated the cognitive deficits and emotional abnormality of sham- and T2VO-SAMP8 groups. Western blotting and immunohistochemical studies revealed a marked decrease in the levels of phosphorylated forms of neuroplasticity-related proteins, N-methyl-D-aspartate receptor 1 (NMDAR1), Ca2+/calmodulin-dependent protein kinase II (CaMKII), cyclic AMP responsive element binding protein (CREB) and brain-derived neurotrophic factor (BDNF) in the frontal cortices of sham-SAMP8 and T2VO-SAMP8. Moreover, these animal groups showed significantly reduced levels of vasculogenesis/angiogenesis factors, vascular endothelial growth factor (VEGF), VEGF receptor type 2 (VEGFR2), platelet-derived growth factor-A (PDGF-A) and PDGF receptor α (PDGFRα). CTS treatment reversed the expression levels of these factors down-regulated in the brains of sham- and T2VO-SAMP8. Conclusion Recovery of impaired neuroplasticity system and VEGF/PDGF systems may play a role in the ameliorative effects of CTS on cognitive dysfunction caused by aging and ischemic insult. PMID:21943225

MO-AB-BRA-09: Development and Evaluation of a Biomechanical Modeling-Assisted CBCT Reconstruction Technique (Bio-Recon)

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

Zhang, Y; Nasehi Tehrani, J; Wang, J

Purpose: To develop a Bio-recon technique by incorporating the biomechanical properties of anatomical structures into the deformation-based CBCT reconstruction process. Methods: Bio-recon reconstructs the CBCT by deforming a prior high-quality CT/CBCT using a deformation-vector-field (DVF). The DVF is solved through two alternating steps: 2D–3D deformation and finite-element-analysis based biomechanical modeling. 2D–3D deformation optimizes the DVF through an ‘intensity-driven’ approach, which updates the DVF to minimize intensity mismatches between the acquired projections and the simulated projections from the deformed CBCT. In contrast, biomechanical modeling optimizes the DVF through a ‘biomechanical-feature-driven’ approach, which updates the DVF based on the biophysical properties ofmore » anatomical structures. In general, Biorecon extracts the 2D–3D deformation-optimized DVF at high-contrast structure boundaries, and uses it as the boundary condition to drive biomechanical modeling to optimize the overall DVF, especially at low-contrast regions. The optimized DVF is fed back into the 2D–3D deformation for further optimization, which forms an iterative loop. The efficacy of Bio-recon was evaluated on 11 lung patient cases, each with a prior CT and a new CT. Cone-beam projections were generated from the new CTs to reconstruct CBCTs, which were compared with the original new CTs for evaluation. 872 anatomical landmarks were also manually identified by a clinician on both the prior and new CTs to track the lung motion, which was used to evaluate the DVF accuracy. Results: Using 10 projections for reconstruction, the average (± s.d.) relative errors of reconstructed CBCTs by the clinical FDK technique, the 2D–3D deformation-only technique and Bio-recon were 46.5±5.9%, 12.0±2.3% and 10.4±1.3%, respectively. The average residual errors of DVF-tracked landmark motion by the 2D–3D deformation-only technique and Bio-recon were 5.6±4.3mm and 3.1±2.4mm, respectively. Conclusion: Bio-recon improved accuracy for both the reconstructed CBCT and the DVF. The accurate DVF can benefit multiple clinical practices, such as image-guided adaptive radiotherapy. We acknowledge funding support from the American Cancer Society (RSG-13-326-01-CCE), from the US National Institutes of Health (R01 EB020366), and from the Cancer Prevention and Research Institute of Texas (RP130109).« less

A consensus-guided approach yields a heat-stable alkane-producing enzyme and identifies residues promoting thermostability.

PubMed

Shakeel, Tabinda; Gupta, Mayank; Fatma, Zia; Kumar, Rakesh; Kumar, Raubins; Singh, Rahul; Sharma, Medha; Jade, Dhananjay; Gupta, Dinesh; Fatma, Tasneem; Yazdani, Syed Shams

2018-06-15

Aldehyde-deformylating oxygenase (ADO) is an essential enzyme for production of long-chain alkanes as drop-in biofuels, which are compatible with existing fuel systems. The most active ADOs are present in mesophilic cyanobacteria, especially Nostoc punctiforme Given the potential applications of thermostable enzymes in biorefineries, here we generated a thermostable (Cts)-ADO based on a consensus of ADO sequences from several thermophilic cyanobacterial strains. Using an in silico design pipeline and a metagenome library containing 41 hot-spring microbial communities, we created Cts-ADO. Cts-ADO displayed a 3.8-fold increase in pentadecane production on raising the temperature from 30 to 42 °C, whereas ADO from N. punctiforme (Np-ADO) exhibited a 1.7-fold decline. 3D structure modeling and molecular dynamics simulations of Cts- and Np-ADO at different temperatures revealed differences between the two enzymes in residues clustered on exposed loops of these variants, which affected the conformation of helices involved in forming the ADO catalytic core. In Cts-ADO, this conformational change promoted ligand binding to its preferred iron, Fe2, in the di-iron cluster at higher temperature, but the reverse was observed in Np-ADO. Detailed mapping of residues conferring Cts-ADO thermostability identified four amino acids, which we substituted individually and together in Np-ADO. Among these substitution variants, A161E was remarkably similar to Cts-ADO in terms of activity optima, kinetic parameters, and structure at higher temperature. A161E was located in loop L6, which connects helices H5 and H6, and supported ligand binding to Fe2 at higher temperatures, thereby promoting optimal activity at these temperatures and explaining the increased thermostability of Cts-ADO. © 2018 by The American Society for Biochemistry and Molecular Biology, Inc.

Are adolescent treatment studies of eating disorders utilizing clinically relevant samples? A comparison of RCT and clinic treatment-seeking youth with eating disorders.

PubMed

Stiles-Shields, Colleen; Goldschmidt, Andrea B; Lock, James; Le Grange, Daniel

2013-09-01

To assess potential selection bias in participant recruitment for randomized controlled trials (RCTs) of adolescent eating disorders (EDs), we compared participants recruited for RCTs evaluating psychosocial treatments with individuals seeking fee-for-service outpatient ED treatment [clinic treatment-seeking (CTS)]. Participants were 214 adolescents presenting to an outpatient ED research-clinical program (92.1% female; M age = 15.4 ± 1.8 years). ANOVA and chi-square tests assessed differences between CTS participants and those presenting for no-cost treatment through RCTs. A secondary analysis compared RCT participants to participants eligible for the RCTs that opted for fee-for-service treatment. RCT participants had greater baseline ED and general psychopathology (p < .001); however, CTS participants were more likely to present with a comorbid psychiatric disorder (p < .05) and higher family income (p < .05). Results suggest that RCT participants did not have less pathology than CTS participants. While preliminary, results do not indicate a systematic population bias in selecting healthier patients for RCTs involving adolescent ED. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.

Is carpal tunnel syndrome related to computer exposure at work? A review and meta-analysis.

PubMed

Mediouni, Zakia; de Roquemaurel, Alexis; Dumontier, Christian; Becour, Bertrand; Garrabe, Hélène; Roquelaure, Yves; Descatha, Alexis

2014-02-01

A meta-analysis on epidemiological studies was undertaken to assess association between carpal tunnel syndrome (CTS) and computer work. Four databases (PubMed, Embase, Web of Science, and Base de Donnees de Sante Publique) were searched with cross-references from published reviews. We included recent studies, original epidemiological studies for which the association was assessed with blind reviewing with control group. Relevant associations were extracted, and a metarisk was calculated using the generic variance approach (meta-odds ratio [meta-OR]). Six studies met the criteria for inclusion. Results are contradictory because of heterogeneous work exposure. The meta-OR for computer use was 1.67 (95% confidence interval [CI], 0.79 to 3.55). The meta-OR for keyboarding was 1.11 (95% CI, 0.62 to 1.98) and for mouse 1.94 (95% CI, 0.90 to 4.21). It was not possible to show an association between computer use and CTS, although some particular work circumstances may be associated with CTS.

Clinical course, costs and predictive factors for response to treatment in carpal tunnel syndrome: the PALMS study protocol

PubMed Central

2014-01-01

Background Carpal tunnel syndrome (CTS) is the most common neuropathy of the upper limb and a significant contributor to hand functional impairment and disability. Effective treatment options include conservative and surgical interventions, however it is not possible at present to predict the outcome of treatment. The primary aim of this study is to identify which baseline clinical factors predict a good outcome from conservative treatment (by injection) or surgery in patients diagnosed with carpal tunnel syndrome. Secondary aims are to describe the clinical course and progression of CTS, and to describe and predict the UK cost of CTS to the individual, National Health Service (NHS) and society over a two year period. Methods/Design In this prospective observational cohort study patients presenting with clinical signs and symptoms typical of CTS and in whom the diagnosis is confirmed by nerve conduction studies are invited to participate. Data on putative predictive factors are collected at baseline and follow-up through patient questionnaires and include standardised measures of symptom severity, hand function, psychological and physical health, comorbidity and quality of life. Resource use and cost over the 2 year period such as prescribed medications, NHS and private healthcare contacts are also collected through patient self-report at 6, 12, 18 and 24 months. The primary outcome used to classify treatment success or failures will be a 5-point global assessment of change. Secondary outcomes include changes in clinical symptoms, functioning, psychological health, quality of life and resource use. A multivariable model of factors which predict outcome and cost will be developed. Discussion This prospective cohort study will provide important data on the clinical course and UK costs of CTS over a two-year period and begin to identify predictive factors for treatment success from conservative and surgical interventions. PMID:24507749

Two-point discrimination and kinesthetic sense disorders in productive age individuals with carpal tunnel syndrome.

PubMed

Wolny, Tomasz; Saulicz, Edward; Linek, Paweł; Myśliwiec, Andrzej

2016-06-16

The aim of this study was to evaluate two-point discrimination (2PD) sense and kinesthetic sense dysfunctions in carpal tunnel syndrome (CTS) patients compared with a healthy group. The 2PD sense, muscle force, and kinesthetic differentiation (KD) of strength; the range of motion in radiocarpal articulation; and KD of motion were assessed. The 2PD sense assessment showed significantly higher values in all the examined fingers in the CTS group than in those in the healthy group (p<0.01). There was a significant difference in the percentage value of error in KD of pincer and cylindrical grip (p<0.01) as well as in KD of flexion and extension movement in the radiocarpal articulation (p<0.01) between the studied groups. There are significant differences in the 2PD sense and KD of strength and movement between CTS patients compared with healthy individuals.

Two-point discrimination and kinesthetic sense disorders in productive age individuals with carpal tunnel syndrome

PubMed Central

Wolny, Tomasz; Saulicz, Edward; Linek, Paweł; Myśliwiec, Andrzej

2016-01-01

Objectives: The aim of this study was to evaluate two-point discrimination (2PD) sense and kinesthetic sense dysfunctions in carpal tunnel syndrome (CTS) patients compared with a healthy group. Methods: The 2PD sense, muscle force, and kinesthetic differentiation (KD) of strength; the range of motion in radiocarpal articulation; and KD of motion were assessed. Results: The 2PD sense assessment showed significantly higher values in all the examined fingers in the CTS group than in those in the healthy group (p<0.01). There was a significant difference in the percentage value of error in KD of pincer and cylindrical grip (p<0.01) as well as in KD of flexion and extension movement in the radiocarpal articulation (p<0.01) between the studied groups. Conclusions: There are significant differences in the 2PD sense and KD of strength and movement between CTS patients compared with healthy individuals. PMID:27108640

Carpal tunnel syndrome: just a peripheral neuropathy?

PubMed

Fernández-de-Las-Peñas, César; Plaza-Manzano, Gustavo

2018-06-05

Carpal tunnel syndrome (CTS) is considered just a peripheral neuropathy of the upper extremity associated to the compression of the median nerve. There is evidence suggesting the presence of complex sensitization mechanisms in CTS. These processes are manifested by symptoms in extra-median regions and the presence of bilateral sensory and motor impairments. These sensory and motor changes are not associated to electrodiagnostic findings. The presence of sensitization mechanisms suggests that CTS should not be considered just as a peripheral neuropathy. The presence of altered nociceptive gain processing should be considered for therapeutic management of CTS by considering the application of therapeutic interventions that modulate nociceptive barrage into the CNS.

Hypothalamus and amygdala response to acupuncture stimuli in Carpal Tunnel Syndrome.

PubMed

Napadow, V; Kettner, N; Liu, J; Li, M; Kwong, K K; Vangel, M; Makris, N; Audette, J; Hui, K K S

2007-08-01

Brain processing of acupuncture stimuli in chronic neuropathic pain patients may underlie its beneficial effects. We used fMRI to evaluate verum and sham acupuncture stimulation at acupoint LI-4 in Carpal Tunnel Syndrome (CTS) patients and healthy controls (HC). CTS patients were retested after 5 weeks of acupuncture therapy. Thus, we investigated both the short-term brain response to acupuncture stimulation, as well as the influence of longer-term acupuncture therapy effects on this short-term response. CTS patients responded to verum acupuncture with greater activation in the hypothalamus and deactivation in the amygdala as compared to HC, controlling for the non-specific effects of sham acupuncture. A similar difference was found between CTS patients at baseline and after acupuncture therapy. For baseline CTS patients responding to verum acupuncture, functional connectivity was found between the hypothalamus and amygdala--the less deactivation in the amygdala, the greater the activation in the hypothalamus, and vice versa. Furthermore, hypothalamic response correlated positively with the degree of maladaptive cortical plasticity in CTS patients (inter-digit separation distance). This is the first evidence suggesting that chronic pain patients respond to acupuncture differently than HC, through a coordinated limbic network including the hypothalamus and amygdala.

154 GHz collective Thomson scattering in LHD

NASA Astrophysics Data System (ADS)

Tanaka, K.; Nishiura, M.; Kubo, S.; Shimozuma, T.; Saito, T.; Moseev, D.; Abramovic, I.

2018-01-01

Collective Thomson scattering (CTS) was developed by using a 154 GHz gyrotron, and the first data has been obtained. Already, 77 GHz CTS has worked successfully. However, in order to access higher density region, 154 GHz option enhances the usability that reduces the refraction effect, which deteriorates in the local measurements. The system in the down converted frequency was almost identical to the system for 77 GHz. Probing beam, a notch filter, a mixer, and a local oscillator in the receiver system for 77 GHz option were replaced to those for the 154 GHz option. 154 GHz gyrotron was originally prepared for the second harmonic electron cyclotron heating (ECRH) at 2.75 T. However, scattering signal was masked by the second harmonic electron cyclotron emission (ECE) at 2.75 T. Therefore, 154 GHz CTS was operated at 1.375 T with fourth harmonic ECE, and an acceptable signal to noise ratio was obtained. There is a signature of fast ion components with neutral beam (NB) injection. In addition, the CTS spectrum became broader in hydrogen discharge than in deuterium discharge, as the theoretical CTS spectrum expects. This observation indicates a possibility to identify ion species ratio by the 154 GHz CTS diagnostic.

Factors Associated with the Income Distribution of Full-Time Physicians: A Quantile Regression Approach

PubMed Central

Shih, Ya-Chen Tina; Konrad, Thomas R

2007-01-01

Objective Physician income is generally high, but quite variable; hence, physicians have divergent perspectives regarding health policy initiatives and market reforms that could affect their incomes. We investigated factors underlying the distribution of income within the physician population. Data Sources Full-time physicians (N=10,777) from the restricted version of the 1996–1997 Community Tracking Study Physician Survey (CTS-PS), 1996 Area Resource File, and 1996 health maintenance organization penetration data. Study Design We conducted separate analyses for primary care physicians (PCPs) and specialists. We employed least square and quantile regression models to examine factors associated with physician incomes at the mean and at various points of the income distribution, respectively. We accounted for the complex survey design for the CTS-PS data using appropriate weighted procedures and explored endogeneity using an instrumental variables method. Principal Findings We detected widespread and subtle effects of many variables on physician incomes at different points (10th, 25th, 75th, and 90th percentiles) in the distribution that were undetected when employing regression estimations focusing on only the means or medians. Our findings show that the effects of managed care penetration are demonstrable at the mean of specialist incomes, but are more pronounced at higher levels. Conversely, a gender gap in earnings occurs at all levels of income of both PCPs and specialists, but is more pronounced at lower income levels. Conclusions The quantile regression technique offers an analytical tool to evaluate policy effects beyond the means. A longitudinal application of this approach may enable health policy makers to identify winners and losers among segments of the physician workforce and assess how market dynamics and health policy initiatives affect the overall physician income distribution over various time intervals. PMID:17850525

Early Identification of Transformation in the Proficiency Level of Critical Thinking Skills (CTS) for the First Semester Associate Degree Nursing (ADN) Student

ERIC Educational Resources Information Center

Swing, Velmarie K.

2014-01-01

Critical thinking (CT) in the new nursing graduate continues to be a topic of concern in the academic and acute care settings. While research studies have analyzed critical thinking skills (CTS) at the beginning and end of nursing programs, few have focused on early program evaluation of CT. In this non-experimental, explanatory, quantitative…

A quality control study on cytotechnologist-cytopathologist concordance and its relationship to the number of dots on the slide.

PubMed

Bongiovanni, Massimo; De Saussure, Barbara; Kumar, Neeta; Pache, Jean-Claude; Cibas, Edmund S

2009-01-01

To study cytotechnologist (CT)-cytopathologist (CP) concordance for evaluating individual CTs' performance and for quality assurance and educational feedback. The interpretations of individual CTs were compared with the final interpretations (according to the 2001 Bethesda System) of the CP. Concordance percentages and kappa values were calculated for each CT and correlated with the numbers of dots on each slide, years of experience and percentage of work hours devoted to cytology. A total of 10,453 Pap tests were screened by 9 CTs during one year, out of which 993 (9.5%) were referred to one CP for a final interpretation. Mean concordance between the aggregate CT interpretations and those of the CP was 65.5%. Five CTs had good concordance, 3 had moderately good concordance, and one had surprisingly poor concordance that contrasted with good subjective impressions. No correlation was found between concordance and the average number of dots per slide, screening experience in cervicovaginal cytology or percentage of work hours devoted to cytology. Monitoring CT-CP concordance rates can unveil performance issues not detected by subjective impressions. An excessive number of dots per slide may not reflect poor diagnostic precision so much as a lack of confidence in interpretation.

Emergency management for congenital tracheal stenosis with endoluminal stenting in pediatric intensive care units

PubMed Central

Xu, Xuan; Ding, Hui; Liu, Xicheng; Zhu, Bin; Feng, Zhichun

2016-01-01

Objective: The objective of this study was to share our experience in the management of congenital tracheal stenosis (CTS) using self-expanding intraluminal stents in infants. Methods: From January 2010 to August 2012, 31 infants with CTS treated using stents by bronchoscope in pediatric intensive care units (PICUs) were recruited for this study. Results: Among the 31 patients, 17 were male and 14 were female with their ages ranging from 55 days to 22 months. CTS was associated with congenital heart disease (CHD) in 22 patients. There were no immediate stent-related airway complications. A significant and immediate improvement of respiratory obstruction following stent placement in all 31 patients led to successful weaning from the breathing machine and extubation. Granulation tissue formation as a complication was observed in three (9.7%) patients, but all were successfully managed using cryotherapy. During follow up (up to 24 months), stents in 29 infants remained functional. In seven cases, stents were retrieved under bronchoscope (the same day to 10 months), and three cases required stent replacement (each of the three cases had the stent replaced three times). Nine infants died after stenting due to other causes and two infants abandoned treatment. Conclusion: Airway stenting may provide an important therapeutic option in infants with CTS. PMID:27126522

Development and validation of a brief trauma screening measure for children: The Child Trauma Screen.

PubMed

Lang, Jason M; Connell, Christian M

2017-05-01

Childhood exposure to trauma, including violence and abuse, is a major public health concern that has resulted in increased efforts to promote trauma-informed child-serving systems. Trauma screening is an important component of such trauma-informed systems, yet widespread use of trauma screening is rare in part due to the lack of brief, validated trauma screening measures for children. We describe development and validation of the Child Trauma Screen (CTS), a 10-item screening measure of trauma exposure and posttraumatic stress disorder (PTSD) symptoms for children consistent with the DSM-5 definition of PTSD. Study 1 describes measure development incorporating analysis to derive items based on existing measures from 1,065 children and caregivers together with stakeholder input to finalize item selection. Study 2 describes validation of the CTS with a clinical sample of 74 children and their caregivers. Results support the CTS as an empirically derived, reliable measure to screen children for trauma exposure and PTSD symptoms with strong convergent, divergent, and criterion validity. The CTS is a promising measure for rapidly and reliably screening children for trauma exposure and PTSD symptoms. Future research is needed to confirm validation and to examine feasibility and utility of its use across various child-serving systems. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Increased pain sensitivity is not associated with electrodiagnostic findings in women with carpal tunnel syndrome.

PubMed

de la Llave-Rincón, Ana Isabel; Fernández-de-las-Peñas, César; Laguarta-Val, Sofia; Alonso-Blanco, Cristina; Martínez-Perez, Almudena; Arendt-Nielsen, Lars; Pareja, Juan A

2011-01-01

To determine the differences in widespread pressure pain and thermal hypersensitivity in women with minimal, moderate, and severe carpal tunnel syndrome (CTS) and healthy controls. A total of 72 women with CTS (19 with minimal, 18 with moderate, and 35 with severe) and 19 healthy age-matched women participated. Pressure pain thresholds were bilaterally assessed over the median, ulnar, and radial nerves, the C5 to C6 zygapophyseal joint, the carpal tunnel, and the tibialis anterior muscle. In addition, warm and cold detection thresholds and heat and cold pain thresholds were bilaterally assessed over the carpal tunnel and the thenar eminence. All outcome parameters were assessed by an assessor blinded to the participant's condition. No significant differences in pain parameters among patients with minimal, moderate, and severe CTS were found. The results showed that PPT were significantly decreased bilaterally over the median, ulnar, and radial nerve trunks, the carpal tunnel, C5 to C6 zygapophyseal joint, and the tibialis anterior muscle in patients with minimal, moderate, or severe CTS as compared with healthy controls (all, P<0.001). In addition, patients with CTS also showed lower heat pain threshold and reduced cold pain threshold compared with controls (P<0.001). No significant sensory differences between minimal, moderate, or severe CTS were found. The similar widespread pressure and thermal hypersensitivity in patients with minimal, moderate, or severe CTS and pain intensity suggests that increased pain sensitivity is not related to electrodiagnostic findings.

Peripheral nervous system assessment in acromegaly patients under somatostatin analogue therapy.

PubMed

Alibas, H; Gogas Yavuz, D; Kahraman Koytak, P; Uygur, M; Tanridag, T; Uluc, K

2017-01-01

Acromegaly is known to affect peripheral nervous system (PNS) causing carpal tunnel syndrome (CTS) and polyneuropathy. The frequency of these disorders and the evaluation methods vary among studies. In the present study, we aimed to examine PNS of acromegaly patients under somatostatin analogue (SSA) therapy. Forty-eight acromegaly patients (26 F/22 M, 45.58 ± 11.6 years) under SSA treatment and 44 healthy controls (25 F/19 M, 47.46 ± 8.7 years) were assessed by symptom questionnaires, neurologic examination and electrophysiological studies. 87.5 % of the acromegaly patients had at least one abnormal finding regarding PNS. With the incorporation of palm-wrist median nerve conduction velocity method, we detected CTS in 50 % of patients. Polyneuropathy was less frequent (29.2 %). Both conditions were independent from the coexisting diabetes mellitus (p = 0.22 for CTS, p = 0.71 for polyneuropathy). Polyneuropathy but not CTS was more common among biochemically uncontrolled acromegaly patients rather than those under control (p = 0.03; p = 0.68, respectively). Our findings emphasize the high prevalence of peripheral nervous system involvement in acromegaly patients under SSA therapy and importance of neurological evaluation of these patients. Early diagnosis and treatment of the disease may reduce the PNS involvement.

Effects of taping therapy for carpal space expansion on electrophysiological change in patients with carpal tunnel syndrome.

PubMed

Park, Yeong-Dong; Park, Yun-Jin; Park, Sang-Seo; Lee, Hae-Lim; Moon, Hyeong-Hun; Kim, Myung-Ki

2017-06-01

Taping therapy is one of the most conservative treatments for carpal tunnel syndrome (CTS). Preceding research studied on pain control, grip strength, and wrist function but no studies have been reported on electrophysiolgical changes after taping therapy. The aim of this study is to evaluate the effects of taping therapy for carpal space expansion on electrophysiological in 20 female patients aged from 40s to 60s with CTS. Experimental group applied taping therapy for carpal space expansion twice a week for 4 weeks and control group did not. There were significant differences between distal motor latency (DML) and sensory nerve conduction velocity (SNCV), but no difference between compound muscle action potential and sensory nerve action potential (SNAP) after 4 weeks taping treatment. Also, there was a significant difference in DML, SNCV, and SNAP in between groups. In conclusion, taping therapy for carpal space expansion can help to reduce the pressure of the carpal tunnel in CTS patients with mild symptoms.

Hospital contacts for injuries and musculoskeletal diseases among seamen and fishermen: a population-based cohort study.

PubMed

Kaerlev, Linda; Jensen, Anker; Nielsen, Per Sabro; Olsen, Jørn; Hannerz, Harald; Tüchsen, Finn

2008-01-23

We studied musculoskeletal diseases (MSD) and injuries among fishermen and seamen with focus on low back disorders, carpal tunnel syndrome (CTS), rotator cuff syndrome and arthrosis. Cohorts of all male Danish seamen (officers and non-officers) and fishermen employed 1994 and 1999 with at least six months employment history were linked to the Occupational Hospitalisation Register. We calculated standardised incidence ratios (SIR) for the two time periods, using rates for the entire Danish workforce as a reference. Among fishermen, we found high SIRs for knee arthrosis, thoraco-lumbar disc disorders, injuries and statistically significant SIRs above 200 were seen for both rotator cuff syndrome and CTS. The SIR was augmented for injuries and reduced for hip arthrosis between the two time periods. The SIRs for injuries and CTS were high for non-officers. A sub-analysis revealed that the highest risk for CTS was found among male non-officers working as deck crew, SIR 233 (95% CI: 166-317) based on 40 cases. Among officers, the SIRs for injuries and MSDs were low. The number of employed Danish fishermen declined with 25% 1994-1999 to 3470. Short-term employments were common. None of the SIRs increased with increasing length of employment. Both fishermen and non-officers have high SIRs for injuries and fishermen also for MSD. Only the SIR for injuries among fishermen was augmented between 1994 and 1999. Our findings suggest an association between the incidence of rotator cuff syndrome and CTS and work within fishery. Long-term cumulative effects of employment were not shown for any of the disease outcomes. Other conditions may play a role.

Risk Factors for Post-treatment Complex Regional Pain Syndrome (CRPS): An Analysis of 647 Cases of CRPS from the Danish Patient Compensation Association.

PubMed

Petersen, Pelle B; Mikkelsen, Kim L; Lauritzen, Jes B; Krogsgaard, Michael R

2018-03-01

Complex regional pain syndrome is a challenging condition that includes a broad spectrum of sensory, autonomic, and motor features predominantly in extremities recovering from a trauma. Few large-scale studies have addressed occurrence of and factors associated with complex regional pain syndrome (CRPS) following orthopedic treatment. The present study aimed to identify factors associated with post-treatment development of CRPS. Using the Danish Patient Compensation Association's database, we identified 647 patients claiming post-treatment CRPS between 1992 and 2015. Age, gender, initial diagnosis, treatment, and amount of compensation were extracted. Multivariate logistic regressions were performed to identify variables associated with approval of the claim. For carpal tunnel syndrome (CTS) patients, we registered whether symptoms were bilateral or unilateral and if neurophysiology prior to treatment was pathologic. The following ratios were found: women:men was 4:1, primary diagnosis to the upper limb:lower limb was 2.5:1, and surgical:nonsurgical treatment was 3:1. Mean age was 47.5 ± 13.7 years, and no intergender difference was detected. Antebrachial fracture (23%) and CTS (9%) were the most common primary conditions. Surgical treatment was associated with approval of the claim (odds ratio 3.5, 95% confidence interval 2.3 to 5.3; P < 0.001). Half of CTS patients had normal neurophysiology prior to surgery; among patients with unilateral symptoms, 71.4% had normal neurophysiology. Female gender, surgical treatment, and treatment to the upper limb were risk factors. Elective surgery accounted for a large number of post-treatment CRPS patients. In CTS patients developing CRPS, normal neurophysiological examination findings were common, and it could be suspected that these patients were suffering from an pre-clinical stage of CRPS, not CTS. © 2017 World Institute of Pain.

Global shortage of neonatal and paediatric antibiotic trials: rapid review.

PubMed

Thompson, Georgina; Barker, Charlotte I; Folgori, Laura; Bielicki, Julia A; Bradley, John S; Lutsar, Irja; Sharland, Mike

2017-10-13

There have been few clinical trials (CTs) on antibiotics that inform neonatal and paediatric drug labelling. The rate of unlicensed and off-label prescribing in paediatrics remains high. It is unclear whether the current neonatal and paediatric antibiotic research pipeline is adequate to inform optimal drug dosing. Using the ClinicalTrials.gov registry, this review aims to establish the current global status of antibiotic CTs in children up to 18 years of age. Studies were identified using key word searches of the ClinicalTrials.gov registry and were manually filtered using prespecified inclusion/exclusion criteria. 76 registered open CTs of antibiotics in children were identified globally; 23 (30%) were recruiting newborns (only 8 (11%) included preterm neonates), 52 (68%) infants and toddlers, 58 (76%) children and 54 (71%) adolescents. The majority of registered trials were late phase (10 (15%) phase 3 and 23 (35%) phase 4/pharmacovigilance). Two-thirds were sponsored by non-profit organisations, compared with pharmaceutical companies (50 (66%) vs 26 (34%), respectively). A greater proportion of non-profit funded trials were efficacy-based strategic trials (n=34, 68%), in comparison with industry-led trials, which were most often focused on safety or pharmacokinetic data (n=17, 65%). Only 2 of the 37 antibiotics listed on the May 2016 Pew Charitable Trusts antibiotic development pipeline, currently being studied in adults, appear to be currently recruiting in open paediatric CTs. This review highlights that very few paediatric antibiotic CTs are being conducted globally, especially in neonates. There is a striking disparity noted between antibiotic drug development programmes in adults and children. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Dental Student Hand Hygiene Decreased With Increased Clinical Experience.

PubMed

Yaembut, Nanmanas; Ampornaramveth, Ruchanee S; Pisarnturakit, Pagaporn P; Subbalekha, Keskanya

2016-01-01

To investigate the effectiveness, related knowledge, attitudes, and practices of hand hygiene (HH) among dental students with different levels of clinical experience. This was a cross-sectional analytical study. Bacterial samples on the participants' hands were obtained using a swab technique before and after handwashing, for oral surgical procedures. After culturing, the colony-forming units were counted. Self-reported questionnaires reflecting the knowledge, attitudes, and practices related to HH were completed by the participants. This study was performed in a primary oral health care institution, Faculty of Dentistry, Chulalongkorn University (Bangkok, Thailand). Bacterial samples and self-reported questionnaires were collected in the Department of Oral and Maxillofacial Surgery. Bacterial culture was performed in the Department of Microbiology. The 120 participants comprised first, second, third-year clinical training students (CTs), and postgraduate dental students (PGs) (32, 34, 30, and 24 participants, respectively). More than 99% of the bacteria were eliminated from the participants' hands after handwashing. Significantly higher numbers of bacteria were recovered from the hands of the PGs compared with those of the CTs, and the hands of the third-year CTs compared with those of the first-year CTs (p < 0.001), after HH. The first-year CTs had the highest attitude scores, whereas the PGs had the lowest practice scores. The knowledge scores were similar in all groups. HH effectiveness, attitudes, and practices of dental students decreased as students gained more clinical experience, whereas knowledge did not. Our results suggest that HH instruction should be given throughout the duration of dental students' education. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

[Clinical auxiliary diagnosis value of high frequency ultrasonographic measurements of the thickness of transverse carpal ligaments in carpal tunnel syndrome patients].

PubMed

Xu, L; Chen, F M; Wang, L; Zhang, P X; Jiang, X R

2016-04-18

To evaluate the meaning and value of high-frequency ultrasound in the diagnosis of carpal tunnel syndrome (CTS). In this study, 48 patients (unilateral hand) with CTS were analyzed. The thickness of transverse carpal ligaments at the pisiform bone was measured using high-frequency ultrasound. Open carpal tunnel release procedure was performed in the 48 CTS patients, and the thickness of transverse carpal ligaments at the hamate hook bone measured using vernier caliper under direct vision. The accuracy of thickness of transverse carpal ligaments was evaluated using high-frequency ultrasound. high-frequency ultrasound measurement of thickness of transverse carpal ligaments at the hamate hook bone and pisiform bone, and determination of the diagnostic threshold measurement index using receiver operating characteristic (ROC) curve, sensitivity and specificity were performed and the correlation between the thickness of transverse carpal ligaments and nerve conduction study (NCS) analyzed. The thickness of transverse carpal ligaments in the CTS patients were (0.42±0.08) cm (high-frequency ultrasound) and (0.41±0.06) cm (operation) at hamate hook bone, and there was no significant difference between the two ways (t=0.672, P>0.05). The optimal cut-off value of the transverse carpal ligaments at hamate hook bone was 0.385 cm, the sensitivity 0.775, and the specificity 0.788. The optimal cut-off value of the transverse carpal ligaments at the pisiform bone was 0.315 cm, the sensitivity 0.950, and the specificity 1.000. The transverse carpal ligaments thickness and wrist-index finger sensory nerve conduction velocity (SCV), wrist-middle finger SCV showed a negative correlation. High frequency ultrasound measurements of thickness of transverse carpal ligaments is a valuable method for the diagnosis of CTS.

Carpal tunnel syndrome: assessment of surgeon and patient preferences and priorities for decision-making.

PubMed

Hageman, Michiel G J S; Kinaci, Ahmet; Ju, Kevin; Guitton, Thierry G; Mudgal, Chaitanya S; Ring, David

2014-09-01

This study tested the null hypothesis that there are no differences between the preferences of hand surgeons and those patients with carpal tunnel syndrome (CTS) facing decisions about management of CTS (ie, the preferred content of a decision aid). One hundred three hand surgeons of the Science of Variation Group and 79 patients with CTS completed a survey about their priorities and preferences in decision making regarding the management of CTS. The questionnaire was structured according the Ottawa Decision Support Framework for the development of a decision aid. Important areas on which patient and hand surgeon interests differed included a preference for nonpainful, nonoperative treatment and confirmation of the diagnosis with electrodiagnostic testing. For patients, the main disadvantage of nonoperative treatment was that it was likely to be only palliative and temporary. Patients preferred, on average, to take the lead in decision making, whereas physicians preferred shared decision making. Patients and physicians agreed on the value of support from family and other physicians in the decision-making process. There were some differences between patient and surgeon priorities and preferences regarding decision making for CTS, particularly the risks and benefits of diagnostic and therapeutic procedures. Information that helps inform patients of their options based on current best evidence might help patients understand their own preferences and values, reduce decisional conflict, limit surgeon-to-surgeon variations, and improve health. Copyright © 2014 American Society for Surgery of the Hand. All rights reserved.

Development of the Inventory Management and Tracking System (IMATS) to Track the Availability of Public Health Department Medical Countermeasures During Public Health Emergencies

PubMed Central

Sahar, Liora; Faler, Guy; Hristov, Emil; Hughes, Susan; Lee, Leslie; Westnedge, Caroline; Erickson, Benjamin; Nichols, Barbara

2015-01-01

Objective To bridge gaps identified during the 2009 H1N1 influenza pandemic by developing a system that provides public health departments improved capability to manage and track medical countermeasures at the state and local levels and to report their inventory levels to the Centers for Disease Control and Prevention (CDC). Materials and Methods The CDC Countermeasure Tracking Systems (CTS) program designed and implemented the Inventory Management and Tracking System (IMATS) to manage, track, and report medical countermeasure inventories at the state and local levels. IMATS was designed by CDC in collaboration with state and local public health departments to ensure a “user-centered design approach.” A survey was completed to assess functionality and user satisfaction. Results IMATS was deployed in September 2011 and is provided at no cost to public health departments. Many state and local public health departments nationwide have adopted IMATS and use it to track countermeasure inventories during public health emergencies and daily operations. Discussion A successful response to public health emergencies requires efficient, accurate reporting of countermeasure inventory levels. IMATS is designed to support both emergency operations and everyday activities. Future improvements to the system include integrating barcoding technology and streamlining user access. To maintain system readiness, we continue to collect user feedback, improve technology, and enhance its functionality. Conclusion IMATS satisfies the need for a system for monitoring and reporting health departments’ countermeasure quantities so that decision makers are better informed. The “user-centered design approach” was successful, as evident by the many public health departments that adopted IMATS. PMID:26392843

Standard Anatomic Terminologies: Comparison for Use in a Health Information Exchange–Based Prior Computed Tomography (CT) Alerting System

PubMed Central

Lowry, Tina; Vreeman, Daniel J; Loo, George T; Delman, Bradley N; Thum, Frederick L; Slovis, Benjamin H; Shapiro, Jason S

2017-01-01

Background A health information exchange (HIE)–based prior computed tomography (CT) alerting system may reduce avoidable CT imaging by notifying ordering clinicians of prior relevant studies when a study is ordered. For maximal effectiveness, a system would alert not only for prior same CTs (exams mapped to the same code from an exam name terminology) but also for similar CTs (exams mapped to different exam name terminology codes but in the same anatomic region) and anatomically proximate CTs (exams in adjacent anatomic regions). Notification of previous same studies across an HIE requires mapping of local site CT codes to a standard terminology for exam names (such as Logical Observation Identifiers Names and Codes [LOINC]) to show that two studies with different local codes and descriptions are equivalent. Notifying of prior similar or proximate CTs requires an additional mapping of exam codes to anatomic regions, ideally coded by an anatomic terminology. Several anatomic terminologies exist, but no prior studies have evaluated how well they would support an alerting use case. Objective The aim of this study was to evaluate the fitness of five existing standard anatomic terminologies to support similar or proximate alerts of an HIE-based prior CT alerting system. Methods We compared five standard anatomic terminologies (Foundational Model of Anatomy, Systematized Nomenclature of Medicine Clinical Terms, RadLex, LOINC, and LOINC/Radiological Society of North America [RSNA] Radiology Playbook) to an anatomic framework created specifically for our use case (Simple ANatomic Ontology for Proximity or Similarity [SANOPS]), to determine whether the existing terminologies could support our use case without modification. On the basis of an assessment of optimal terminology features for our purpose, we developed an ordinal anatomic terminology utility classification. We mapped samples of 100 random and the 100 most frequent LOINC CT codes to anatomic regions in each terminology, assigned utility classes for each mapping, and statistically compared each terminology’s utility class rankings. We also constructed seven hypothetical alerting scenarios to illustrate the terminologies’ differences. Results Both RadLex and the LOINC/RSNA Radiology Playbook anatomic terminologies ranked significantly better (P<.001) than the other standard terminologies for the 100 most frequent CTs, but no terminology ranked significantly better than any other for 100 random CTs. Hypothetical scenarios illustrated instances where no standard terminology would support appropriate proximate or similar alerts, without modification. Conclusions LOINC/RSNA Radiology Playbook and RadLex’s anatomic terminologies appear well suited to support proximate or similar alerts for commonly ordered CTs, but for less commonly ordered tests, modification of the existing terminologies with concepts and relations from SANOPS would likely be required. Our findings suggest SANOPS may serve as a framework for enhancing anatomic terminologies in support of other similar use cases. PMID:29242174

CTS United States experiments - A progress report. [Communications Technology Satellite for high power broadcasting

NASA Technical Reports Server (NTRS)

Robbins, W. H.; Donoughe, P. L.

1976-01-01

The Communications Technology Satellite (CTS) is a high-power broadcast satellite launched by NASA on January 17, 1976. CTS is the first satellite to operate at a frequency of 12 gigahertz and incorporates technology making possible new satellite telecommunications services. CTS is a cooperative program of the United States and Canada. This paper presents the results of the United States experimental activity to date. Wide segments of the population are involved in the Experiments Program, including the scientific community, other government agencies, industry, and the education and health entities. The experiments are associated with both technological objectives and the demonstration of new community and social services via satellite.

Collective Thomson scattering data analysis for Wendelstein 7-X

NASA Astrophysics Data System (ADS)

Abramovic, I.; Pavone, A.; Svensson, J.; Moseev, D.; Salewski, M.; Laqua, H. P.; Lopes Cardozo, N. J.; Wolf, R. C.

2017-08-01

Collective Thomson scattering (CTS) diagnostic is being installed on the Wendelstein 7-X stellarator to measure the bulk ion temperature in the upcoming experimental campaign. In order to prepare for the data analysis, a forward model of the diagnostic (eCTS) has been developed and integrated into the Bayesian data analysis framework Minerva. Synthetic spectra have been calculated with the forward model and inverted using Minerva in order to demonstrate the feasibility to measure the ion temperature in the presence of nuisance parameters that also influence CTS spectra. In this paper we report on the results of this anlysis and discuss the main sources of uncertainty in the CTS data analysis.

The Incidence of Complex Regional Pain Syndrome in Simultaneous Surgical Treatment of Carpal Tunnel Syndrome and Dupuytren Contracture.

PubMed

Buller, Mitchell; Schulz, Steven; Kasdan, Morton; Wilhelmi, Bradon J

2017-07-01

To determine the incidence of complex regional pain syndrome (CRPS) in the concurrent surgical treatment of Dupuytren contracture (DC) and carpal tunnel syndrome (CTS) through a thorough review of evidence available in the literature. The indices of 260 hand surgery books and PubMed were searched for concomitant references to DC and CTS. Studies were eligible for inclusion if they evaluated the outcome of patients treated with simultaneous fasciectomy or fasciotomy for DC and carpal tunnel release using CRPS as a complication of treatment. Of the literature reviewed, only 4 studies met the defined criteria for use in the study. Data from the 4 studies were pooled, and the incidence of recurrence and complications, specifically CRPS, was noted. The rate of CRPS was found to be 10.4% in the simultaneous treatment group versus 4.1% in the fasciectomy-only group. This rate is nearly half the 8.3% rate of CRPS found in a randomized trial of patients undergoing carpal tunnel release. Our analysis demonstrates a marginal increase in the occurrence of CRPS by adding the carpal tunnel release to patients in need of fasciectomy, contradicting the original reports demonstrating a much higher rate of CRPS. This indicates that no clear clinical risk is associated with simultaneous surgical treatment of DC and CTS. In some patients, simultaneous surgical management of DC and CTS can be accomplished safely with minimal increased risk of CRPS type 1.

Crosshift Vibrometry: Biomarker for Ergonomic Stress

DTIC Science & Technology

1994-09-01

identification of high risk tasi that may lead to the development of carpal tunnel syndrome. This dissertation consisted of three field studies conducted at... risk for development of CTS. Repeated exertions with a flexed or hyperextended wrist, pressure at the base of the palm or wrist, and low frequency hand...The 12 females came from a variety of clerical and industrial jobs. Four groups were established for comparison (control (no CTS symptoms), at- risk (no

Cracked tooth syndrome: A report of three cases.

PubMed

Sadasiva, Kadandale; Ramalingam, Sathishmuthukumar; Rajaram, Krishnaraj; Meiyappan, Alagappan

2015-08-01

Cracked tooth syndrome (CTS), the term was coined by Cameron in 1964, which refers to an incomplete fracture of a vital posterior tooth extending to the dentin and occasionally into the pulp. CTS has always been a nightmare to the patient because of its unpredictable symptoms and a diagnostic dilemma for the dental practitioner due to its variable, bizarre clinical presentation. The treatment planning and management of CTS has also given problems and challenges the dentist as there is no specific treatment option. The management of CTS varies from one case to another or from one tooth to another in the same individual based on the severity of the symptoms and depth of tooth structure involved. After all, the prognosis of such tooth is still questionable and requires continuous evaluation. This article aims at presenting a series three cases of CTS with an overview on the clinical presentation, diagnosis and the different treatment options that varies from one case to another.

Cracked tooth syndrome: A report of three cases

PubMed Central

Sadasiva, Kadandale; Ramalingam, Sathishmuthukumar; Rajaram, Krishnaraj; Meiyappan, Alagappan

2015-01-01

Cracked tooth syndrome (CTS), the term was coined by Cameron in 1964, which refers to an incomplete fracture of a vital posterior tooth extending to the dentin and occasionally into the pulp. CTS has always been a nightmare to the patient because of its unpredictable symptoms and a diagnostic dilemma for the dental practitioner due to its variable, bizarre clinical presentation. The treatment planning and management of CTS has also given problems and challenges the dentist as there is no specific treatment option. The management of CTS varies from one case to another or from one tooth to another in the same individual based on the severity of the symptoms and depth of tooth structure involved. After all, the prognosis of such tooth is still questionable and requires continuous evaluation. This article aims at presenting a series three cases of CTS with an overview on the clinical presentation, diagnosis and the different treatment options that varies from one case to another. PMID:26538947

Chotosan ameliorates cognitive and emotional deficits in an animal model of type 2 diabetes: possible involvement of cholinergic and VEGF/PDGF mechanisms in the brain

PubMed Central

2012-01-01

Background Diabetes is one of the risk factors for cognitive deficits such as Alzheimer’s disease. To obtain a better understanding of the anti-dementia effect of chotosan (CTS), a Kampo formula, we investigated its effects on cognitive and emotional deficits of type 2 diabetic db/db mice and putative mechanism(s) underlying the effects. Methods Seven-week-old db/db mice received daily administration of CTS (375 – 750 mg/kg, p.o.) and the reference drug tacrine (THA: 2.5 mg/kg, i.p.) during an experimental period of 7 weeks. From the age of 9-week-old, the animals underwent the novel object recognition test, the modified Y-maze test, and the water maze test to elucidate cognitive performance and the elevated plus maze test to elucidate anxiety-related behavior. After completing behavioral studies, Western blotting and immunohistochemical studies were conducted. Results Compared with age-matched non-diabetic control strain (m/m) mice, db/db mice exhibited impaired cognitive performance and an increased level of anxiety. CTS ameliorated cognitive and emotional deficits of db/db mice, whereas THA improved only cognitive performance. The phosphorylated levels of Akt and PKCα in the hippocampus were significantly lower and higher, respectively, in db/db mice than in m/m mice. Expression levels of the hippocampal cholinergic marker proteins and the number of the septal cholinergic neurons were also reduced in db/db mice compared with those in m/m mice. Moreover, the db/db mice had significantly reduced levels of vasculogenesis/angiogenesis factors, vascular endothelial growth factor (VEGF), VEGF receptor type 2, platelet-derived growth factor-B, and PDGF receptor β, in the hippocampus. CTS and THA treatment reversed these neurochemical and histological alterations caused by diabetes. Conclusion These results suggest that CTS ameliorates diabetes-induced cognitive deficits by protecting central cholinergic and VEGF/PDGF systems via Akt signaling pathway and that CTS exhibits the anxiolytic effect via neuronal mechanism(s) independent of cholinergic or VEGF/PDGF systems in db/db mice. PMID:23082896

Chotosan ameliorates cognitive and emotional deficits in an animal model of type 2 diabetes: possible involvement of cholinergic and VEGF/PDGF mechanisms in the brain.

PubMed

Zhao, Qi; Niu, Yimin; Matsumoto, Kinzo; Tsuneyama, Koichi; Tanaka, Ken; Miyata, Takeshi; Yokozawa, Takako

2012-10-20

Diabetes is one of the risk factors for cognitive deficits such as Alzheimer's disease. To obtain a better understanding of the anti-dementia effect of chotosan (CTS), a Kampo formula, we investigated its effects on cognitive and emotional deficits of type 2 diabetic db/db mice and putative mechanism(s) underlying the effects. Seven-week-old db/db mice received daily administration of CTS (375 - 750 mg/kg, p.o.) and the reference drug tacrine (THA: 2.5 mg/kg, i.p.) during an experimental period of 7 weeks. From the age of 9-week-old, the animals underwent the novel object recognition test, the modified Y-maze test, and the water maze test to elucidate cognitive performance and the elevated plus maze test to elucidate anxiety-related behavior. After completing behavioral studies, Western blotting and immunohistochemical studies were conducted. Compared with age-matched non-diabetic control strain (m/m) mice, db/db mice exhibited impaired cognitive performance and an increased level of anxiety. CTS ameliorated cognitive and emotional deficits of db/db mice, whereas THA improved only cognitive performance. The phosphorylated levels of Akt and PKCα in the hippocampus were significantly lower and higher, respectively, in db/db mice than in m/m mice. Expression levels of the hippocampal cholinergic marker proteins and the number of the septal cholinergic neurons were also reduced in db/db mice compared with those in m/m mice. Moreover, the db/db mice had significantly reduced levels of vasculogenesis/angiogenesis factors, vascular endothelial growth factor (VEGF), VEGF receptor type 2, platelet-derived growth factor-B, and PDGF receptor β, in the hippocampus. CTS and THA treatment reversed these neurochemical and histological alterations caused by diabetes. These results suggest that CTS ameliorates diabetes-induced cognitive deficits by protecting central cholinergic and VEGF/PDGF systems via Akt signaling pathway and that CTS exhibits the anxiolytic effect via neuronal mechanism(s) independent of cholinergic or VEGF/PDGF systems in db/db mice.

Test Review: Reynolds, C. R., Voress, J. V., Kamphaus, R. W. (2015), "Mathematics Fluency and Calculation Tests (MFaCTs) review." PRO-ED

ERIC Educational Resources Information Center

Marbach, Joshua

2017-01-01

The Mathematics Fluency and Calculation Tests (MFaCTs) are a series of measures designed to assess for arithmetic calculation skills and calculation fluency in children ages 6 through 18. There are five main purposes of the MFaCTs: (1) identifying students who are behind in basic math fact automaticity; (2) evaluating possible delays in arithmetic…

Reevaluation of the major histocompatibility complex genes of the NOD-progenitor CTS/Shi strain.

PubMed

Mathews, C E; Graser, R T; Serreze, D V; Leiter, E H

2000-01-01

The common Kd and/or Db alleles of NOD mice contribute to the development of autoimmune diabetes, but their respective contributions are unresolved. The major histocompatibility complex (MHC) of the CTS/Shi mouse, originally designated as H2ct, shares MHC class II region identity with the H2g7 haplotype of NOD mice. However, CTS mice were reported to express distinct but undefined MHC class I gene products. Because diabetes frequency was reduced 56% in females of a NOD stock congenic for H2ct, this partial resistance may have derived from the MHC class I allelic differences. In the present report, we use a combination of serologic analysis and sequencing of MHC class I cDNAs to establish that NOD/Lt and CTS/Shi share a common H2-Kd allele but differ at the H2-D end of the MHC complex. The H2-D allele of CTS/Shi was identified as the rare H2-Ddx recently described in ALR/Lt, another NOD-related strain. These results in mouse model systems show that multiple MHC genes confer diabetes resistance and suggest that at least one of the protective MHC or MHC-linked genes in CTS mice may be at the H2-D end of the complex.

Prevalence and Work-Relatedness of Carpal Tunnel Syndrome in the Working Population, United States, 2010 National Health Interview Survey

PubMed Central

Luckhaupt, Sara E.; Dahlhamer, James M.; Ward, Brian W.; Sweeney, Marie H.; Sestito, John P.; Calvert, Geoffrey M.

2015-01-01

Background Patterns of prevalence and work-relatedness of carpal tunnel syndrome (CTS) among workers offer clues about risk factors and targets for prevention. Methods Data from an occupational health supplement to the 2010 National Health Interview Survey were used to estimate the prevalence of self-reported clinician-diagnosed CTS overall and by demographic characteristics. The proportion of these cases self-reported to have been attributed to work by clinicians was also examined overall and by demographic characteristics. In addition, the distribution of industry and occupation (I&O) categories to which work-related cases of CTS were attributed was compared to the distribution of I&O categories of employment among current/recent workers. Results Data were available for 27,157 adults, including 17,524 current/recent workers. The overall lifetime prevalence of clinician-diagnosed CTS among current/recent workers was 6.7%. The 12-month prevalence was 3.1%, representing approximately 4.8 million workers with current CTS; 67.1% of these cases were attributed to work by clinicians, with overrepresentation of certain I&O categories. Conclusions CTS affected almost 5 million U.S. workers in 2010, with prevalence varying by demographic characteristics and I&O. PMID:22495886

An electrochemical sensor based on polyaniline for monitoring hydroquinone and its damage on DNA.

PubMed

Tang, Wenwei; Zhang, Min; Li, Weihao; Zeng, Xinping

2014-09-01

A dsDNA/PANI/CTS/GCE biosensor was constructed by using the biocompatible chitosan (CTS) and the polyaniline (PANI) with excellent electric catalytic properties and large specific surface areas. The electrochemical behavior of hydroquinone on biosensor and its DNA-damaging mechanisms were investigated. Results showed that the redox peak current was remarkably increased after glassy carbon electrode (GCE) was modified by PANI/CTS. The dsDNA damage by hydroquinone was concentration dependent, and increased along with the increase of hydroquinone oxidation peak current and the reduction of dsDNA guanine oxidation peak current. The linear detection range of hydroquinone with dsDNA/PANI/CTS/GCE was 1.25×10(-6)-3.2×10(-4) M, and the detection limit was 9.65×10(-7) M. It was confirmed by the UV method that applying dsDNA/PANI/CTS/GCE to monitor hydroquinone was accurate and reliable. In addition, it could be deduced that the mode of interaction between the hydroquinone and dsDNA was intercalation. The electrochemical oxidation of hydroquinone on the dsDNA/PANI/CTS/GCE electrode was an adsorption-controlled irreversible and a two-electron two-proton transfer process. Copyright © 2014 Elsevier B.V. All rights reserved.

Survey of training and education of cytotechnologists in Europe.

PubMed

Anic, V; Eide, M L

2014-10-01

This report presents the results of a survey of the training and education of cytotechnologists (CTs) in 15 European countries and suggests guidelines on which future education should be developed. A questionnaire was sent to 25 countries in 2011: 14 with and 11 without a European Advisory Committee of Cytotechnology (EACC) member or representative. We received responses from 18 countries, among which three were excluded from the survey because they did not have CTs in training. The number of fully trained and employed CTs in these 15 European countries varied from 35 to 2600. The level of responsibility for most CTs in 14 of these countries was intermediate (signing out negative and inadequate gynaecological samples), whereas seven also had a minority of CTs at an advanced level (signing out abnormal gynaecological samples). Basic education was equally divided (7/8) between countries requiring a bachelor degree or training in medical technology before entry into cytology training. The training in cytology was given as a separate course/education or a combination of separate courses and in-house training, but was often confined to gynaecological cytology. It was recognized that CTs should extend their activities with the advent of human papillomavirus (HPV) testing and vaccination. The training requirement for CTs was usually decided by the national professional society. Most cytology training programmes were accredited by academic institutions at university level and were recognized nationally in almost all of the countries. For most of the countries, the optimal education in the future should be at university level with a diploma in cytotechnology certified or accredited by the European Federation of Cytology Societies. The survey showed variation in basic education and cytology training, especially with respect to non-gynaecological cytology, although graduate entry was favoured. The role of CTs is changing and the education and training programmes need to adapt to these changes. © 2014 John Wiley & Sons Ltd.

Transcriptome signatures of class I and III stress response deregulation in Lactobacillus plantarum reveal pleiotropic adaptation

PubMed Central

2013-01-01

Background To cope with environmental challenges bacteria possess sophisticated defense mechanisms that involve stress-induced adaptive responses. The canonical stress regulators CtsR and HrcA play a central role in the adaptations to a plethora of stresses in a variety of organisms. Here, we determined the CtsR and HrcA regulons of the lactic acid bacterium Lactobacillus plantarum WCFS1 grown under reference (28°C) and elevated (40°C) temperatures, using ctsR, hrcA, and ctsR-hrcA deletion mutants. Results While the maximum specific growth rates of the mutants and the parental strain were similar at both temperatures (0.33 ± 0.02 h-1 and 0.34 ± 0.03 h-1, respectively), DNA microarray analyses revealed that the CtsR or HrcA deficient strains displayed altered transcription patterns of genes encoding functions involved in transport and binding of sugars and other compounds, primary metabolism, transcription regulation, capsular polysaccharide biosynthesis, as well as fatty acid metabolism. These transcriptional signatures enabled the refinement of the gene repertoire that is directly or indirectly controlled by CtsR and HrcA of L. plantarum. Deletion of both regulators, elicited transcriptional changes of a large variety of additional genes in a temperature-dependent manner, including genes encoding functions involved in cell-envelope remodeling. Moreover, phenotypic assays revealed that both transcription regulators contribute to regulation of resistance to hydrogen peroxide stress. The integration of these results allowed the reconstruction of CtsR and HrcA regulatory networks in L. plantarum, highlighting the significant intertwinement of class I and III stress regulons. Conclusions Taken together, our results enabled the refinement of the CtsR and HrcA regulatory networks in L. plantarum, illustrating the complex nature of adaptive stress responses in this bacterium. PMID:24238744

DSM-5 Pathological Personality Traits and Intimate Partner Violence Among Male and Female College Students.

PubMed

Dowgwillo, Emily A; Ménard, Kim S; Krueger, Robert F; Pincus, Aaron L

2016-01-01

The purpose of this study was to examine associations between pathological personality traits identified in the Diagnostic and Statistical Manual of Mental Disorders (5th ed., DSM-5) Section III alternative model of personality disorder (using the Personality Inventory for DSM-5; PID-5) and intimate partner violence (IPV; using the Conflict Tactics Scale [CTS]) in a sample of male (N = 1,106) and female (N = 1,338) college students. In this sample, self and partner perpetration of CTS Relationship Violence and CTS Negotiation tactics loaded onto 2 separate factors. The PID-5 facets and domains were differentially associated with these factors for both men and women. Facets and domains explained 10.1%-16.1% and 5.8%-10.6% of the variance in CTS Relationship Violence tactics, respectively. For both genders, detachment was positively associated with relationship violence. Antagonism was uniquely associated with relationship violence for women, whereas disinhibition was uniquely associated with relationship violence for men. Associations with lower level pathological personality facets were also examined. Overall, results indicate that DSM-5 pathological personality traits are associated with IPV reported by both men and women.

Accumulation of Content Validation Evidence for the Critical Thinking Self-Assessment Scale.

PubMed

Nair, Girija Gopinathan; Hellsten, Laurie-Ann M; Stamler, Lynnette Leeseberg

2017-04-01

Critical thinking skills (CTS) are essential for nurses; assessing students' acquisition of these skills is a mandate of nursing curricula. This study aimed to develop a self-assessment instrument of critical thinking skills (Critical Thinking Self-Assessment Scale [CTSAS]) for students' self-monitoring. An initial pool of 196 items across 6 core cognitive skills and 16 subskills were generated using the American Philosophical Association definition of CTS. Experts' content review of the items and their ratings provided evidence of content relevance using the item-level content validity index (I-CVI) and Aiken's content validity coefficient (VIk). 115 items were retained (range of I-CVI values = .70 to .94 and range of VIk values = .69-.95; significant at p< .05). The CTSAS is the first CTS instrument designed specifically for self-assessment purposes.

Fate of tannins in Corsican pine litter.

PubMed

Nierop, Klaas G J; Verstraten, Jacobus M

2006-12-01

Tannins are ubiquitous in higher plants and also in litter and soils where they affect many biogeochemical processes. Despite this well-recognized role, their fate in litter and mineral soils is hardly known, as often only trace amounts, if any, are measured. In this study, we conducted an incubation experiment with Corsican pine litter to which known amounts of tannic acid (TA) or condensed tannins (CTs) from Corsican pine were added. Using Folin-Ciocalteu as a measure for total phenolics and HCl-butanol as an assay specific for CTs, acetone/water extractable phenolics and tannins decreased with time towards very low levels. Application of thermally assisted hydrolysis and methylation to litter before and after acetone/water extraction revealed that TA concentration decreased. By contrast, CTs remained to a great extent in the litter and could not be extracted suggesting that they were tightly bound.

Effectiveness of PELOID therapy in carpal tunnel syndrome: A randomized controlled single blind study

NASA Astrophysics Data System (ADS)

Metin Ökmen, Burcu; Kasapoğlu Aksoy, Meliha; Güneş, Aygül; Eröksüz, Riza; Altan, Lale

2017-08-01

Carpal tunnel syndrome(CTS) is the most common neuromuscular cause of upper extremity disability. We aimed to investigate the effectiveness of peloid therapy in patients with CTS. This randomized, controlled, single-blind study enrolled 70 patients between the ages of 30 to 65 who had a diagnosis of either mild, mild-to-moderate, or moderate CTS. The patients were randomized into two groups using random number table. In the first group, (Group 1)( n = 35), patients were given splint (every night for 6 weeks) + peloid treatment(five consecutive days a week for 2 weeks) and in the second group, (Group 2)( n = 28), patients received splint treatment(every night for 6 weeks) alone. The patients were assessed by using visual analog scale(VAS) for pain, electroneuromyography(ENMG), the Boston Carpal Tunnel Syndrome Questionnaire(BCTSQ), hand grip strength(HGS), finger grip strength(FGS), and Short Form-12(SF-12). The data were obtained before treatment(W0), immediately after treatment(W2), and one month after treatment(W6). Both in Group 1 and 2, there was a statistically significant improvement in all the evaluation parameters at W2 and W6 when compared to W0( p < 0.05). Comparison of the groups with each other revealed significantly better results for VAS, BCTSQ, mSNCV, SF-12 in Group 1 than in Group 2 at W2( p < 0.05). There was also a statistically significant difference in favor of Group 1 for VAS, BCTSQ, FGS and MCS at W6 when compared to W0 ( p < 0.05). The results of our study demonstrated that in patients with CTS; peloid + splint treatment was more effective than splint treatment alone in pain, functionality and life quality both at after treatment(W2) and one month after treatment (W6). We may suggest peloid as a supplementary therapeutic agent in CTS.

Producers add 3 cts/gal

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

Vames, S.

Methanol list prices will continue to rise in March with a nominated price increase of 3 cts/gal (CW, Feb. 26, p. 39). The increases will bring Methanex`s posting price to 70 cts/gal, while most other producers will be at 67 cts/gal. Several producers, including Methanex and Hoechst, expanded capacity last month, but the methanol market remains strong and there are no indications that prices will soften soon. There are hints, however, that the rate of increase of methanol prices may slow. Tightness in the market seems to be easing as producers in eastern Europe increase capacity. The psychology of tightnessmore » was stoked by reports of spot and regional shortages and resulted in buying panics and price increases in fourth-quarter 1996.« less

Studies on Plasmoid Merging using Compact Toroid Injectors

NASA Astrophysics Data System (ADS)

Allfrey, Ian; Matsumoto, Tadafumi; Roche, Thomas; Gota, Hiroshi; Edo, Takahiro; Asai, Tomohiko; Sheftman, Daniel; Osin Team; Dima Team

2017-10-01

C-2 and C-2U experiments have used magnetized coaxial plasma guns (MCPG) to inject compact toroids (CTs) for refueling the long-lived advanced beam-driven field-reversed configuration (FRC) plasma. This refueling method will also be used for the C-2W experiment. To minimize momentum transfer from the CT to the FRC two CTs are injected radially, diametrically opposed and coincident in time. To improve understanding of the CT characteristics TAE has a dedicated test bed for the development of CT injectors (CTI), where plasmoid merging experiments are performed. The test bed has two CTIs on axis with both axial and transverse magnetic fields. The 1 kG magnetic fields, intended to approximate the magnetic field strength and injection angle on C-2W, allow studies of cross-field transport and merging. Both CTIs are capable of injecting multiple CTs at up to 1 kHz. The resulting merged CT lives >100 μs with a radius of 25 cm. More detailed results of CT parameters will be presented.

Score Reliability and Construct Validity of the Flinn Performance Screening Tool for Adults With Symptoms of Carpal Tunnel Syndrome

PubMed Central

Flinn, Sharon R.; Pease, William S.; Freimer, Miriam L.

2013-01-01

OBJECTIVE We investigated the psychometric properties of the Flinn Performance Screening Tool (FPST) for people referred with symptoms of carpal tunnel syndrome (CTS). METHOD An occupational therapist collected data from 46 participants who completed the Functional Status Scale (FSS) and FPST after the participants’ nerve conduction velocity study to test convergent and contrasted-group validity. RESULTS Seventy-four percent of the participants had abnormal nerve conduction studies. Cronbach’s α coefficients for subscale and total scores of the FPST ranged from .96 to .98. Intrarater reliability for six shared items of the FSS and the FPST was supported by high agreement (71%) and a fair κ statistic (.36). Strong to moderate positive relationships were found between the FSS and FPST scores. Functional status differed significantly among severe, mild, and negative CTS severity groups. CONCLUSION The FPST shows adequate psychometric properties as a client-centered screening tool for occupational performance of people referred for symptoms of CTS. PMID:22549598

Bilateral hand/wrist heat and cold hyperalgesia, but not hypoesthesia, in unilateral carpal tunnel syndrome.

PubMed

de la Llave-Rincón, Ana Isabel; Fernández-de-las-Peñas, César; Fernández-Carnero, Josué; Padua, Luca; Arendt-Nielsen, Lars; Pareja, Juan A

2009-10-01

The aim of the current study was to evaluate bilaterally warm/cold detection and heat/cold pain thresholds over the hand/wrist in patients with carpal tunnel syndrome (CTS). A total of 25 women with strictly unilateral CTS (mean 42 +/- 10 years), and 20 healthy matched women (mean 41 +/- 8 years) were recruited. Warm/cold detection and heat/cold pain thresholds were assessed bilaterally over the carpal tunnel and the thenar eminence in a blinded design. Self-reported measures included both clinical pain history (intensity, location and area) and Boston Carpal Tunnel Questionnaire. No significant differences between groups for both warm and cold detection thresholds in either carpal tunnel or thenar eminence (P > 0.5) were found. Further, significant differences between groups, but not between sides, for both heat and cold pain thresholds in both the carpal tunnel and thenar eminence were found (all P < 0.001). Heat pain thresholds (P < 0.01) were negatively correlated, whereas cold pain thresholds (P < 0.001) were positively correlated with hand pain intensity and duration of symptoms. Our findings revealed bilateral thermal hyperalgesia (lower heat pain and reduced cold pain thresholds) but not hypoesthesia (normal warm/cold detection thresholds) in patients with strictly unilateral CTS when compared to controls. We suggest that bilateral heat and cold hyperalgesia may reflect impairments in central nociceptive processing in patients with unilateral CTS. The bilateral thermal hyperalgesia associated with pain intensity and duration of pain history supports a role of generalized sensitization mechanisms in the initiation, maintenance and spread of pain in CTS.

Symptoms, signs and nerve conduction velocities in patients with suspected carpal tunnel syndrome.

PubMed

Ntani, Georgia; Palmer, Keith T; Linaker, Cathy; Harris, E Clare; Van der Star, Richard; Cooper, Cyrus; Coggon, David

2013-08-15

To inform the clinical management of patients with suspected carpal tunnel syndrome (CTS) and case definition for CTS in epidemiological research, we explored the relation of symptoms and signs to sensory nerve conduction (SNC) measurements. Patients aged 20-64 years who were referred to a neurophysiology service for investigation of suspected CTS, completed a symptom questionnaire (including hand diagrams) and physical examination (including Tinel's and Phalen's tests). Differences in SNC velocity between the little and index finger were compared according to the anatomical distribution of symptoms in the hand and findings on physical examination. Analysis was based on 1806 hands in 908 patients (response rate 73%). In hands with numbness or tingling but negative on both Tinel's and Phalen's tests, the mean difference in SNC velocities was no higher than in hands with no numbness or tingling. The largest differences in SNC velocities occurred in hands with extensive numbness or tingling in the median nerve sensory distribution and both Tinel's and Phalen's tests positive (mean 13.8, 95% confidence interval (CI) 12.6-15.0 m/s). Hand pain and thumb weakness were unrelated to SNC velocity. Our findings suggest that in the absence of other objective evidence of median nerve dysfunction, there is little value in referring patients of working age with suspected CTS for nerve conduction studies if they are negative on both Tinel's and Phalen's tests. Alternative case definitions for CTS in epidemiological research are proposed according to the extent of diagnostic information available and the relative importance of sensitivity and specificity.

Pathogenesis of aortic dilatation in mucopolysaccharidosis VII mice may involve complement activation

PubMed Central

Baldo, Guilherme; Wu, Susan; Howe, Ruth A.; Ramamoothy, Meera; Knutsen, Russell H.; Fang, Jiali; Mecham, Robert P.; Liu, Yuli; Wu, Xiaobo; Atkinson, John P.; Ponder, Katherine P.

2012-01-01

Mucopolysaccharidosis VII (MPS VII) is due to mutations within the gene encoding the lysosomal enzyme β-glucuronidase, and results in the accumulation of glycosaminoglycans. MPS VII causes aortic dilatation and elastin fragmentation, which is associated with upregulation of the elastases cathepsin S (CtsS) and matrix metalloproteinase 12 (MMP12). To test the role of these enzymes, MPS VII mice were crossed with mice deficient in CtsS or MMP12, and the effect upon aortic dilatation was determined. CtsS deficiency did not protect against aortic dilatation in MPS VII mice, but also failed to prevent an upregulation of cathepsin enzyme activity. Further analysis with substrates and inhibitors specific for particular cathepsins suggests that this enzyme activity was due to CtsB, which could contribute to elastin fragmentation. Similarly, MMP12 deficiency and deficiency of both MMP12 and CtsS could not prevent aortic dilatation in MPS VII mice. Microarray and reverse-transcriptase real-time PCR were performed to look for upregulation of other elastases. This demonstrated that mRNA for complement component D was elevated in MPS VII mice, while immunostaining demonstrated high levels of complement component C3 on surfaces within the aortic media. Finally, we demonstrate that neonatal intravenous injection of a retroviral vector encoding β-glucuronidase reduced aortic dilatation. We conclude that neither CtsS nor MMP12 are necessary for elastin fragmentation in MPS VII mouse aorta, and propose that CtsB and/or complement component D may be involved. Complement may be activated by the GAGs that accumulate, and may play a role in signal transduction pathways that upregulate elastases. PMID:21944884

Spin-labeled derivatives of cardiotonic steroids as tools for characterization of the extracellular entrance to the binding site on Na+ ,K+ -ATPase.

PubMed

Guo, Jin-Hua; Jiang, Ren-Wang; Andersen, Jacob Lauwring; Esmann, Mikael; Fedosova, Natalya U

2018-04-24

The information obtained from crystallized complexes of the Na + ,K + -ATPase with cardiotonic steroids (CTS) is not sufficient to explain differences in the inhibitory properties of CTS such as stereoselectivity of CTS binding or effect of glycosylation on the preference to enzyme isoforms. The uncertainty is related to the spatial organization of the hydrophilic cavity at the entrance of the CTS-binding site. Therefore, there is a need to supplement the crystallographic description with data obtained in aqueous solution, where molecules have significant degree of flexibility. This work addresses the applicability of the electron paramagnetic resonance (EPR) method for the purpose. We have designed and synthesized spin-labeled compounds based on the cinobufagin steroid core. The length of the spacer arms between the steroid core and the nitroxide group determines the position of the reporting group (N-O) confined to the binding site. High affinity to Na + ,K + -ATPase is inferred from their ability to inhibit enzymatic activity. The differences between the EPR spectra in the absence and presence of high ouabain concentrations identify the signature peaks originating from the fraction of the spin labels bound within the ouabain site. The degree of perturbations of the EPR spectra depends on the length of the spacer arm. Docking of the compounds into the CTS site suggests which elements of the protein structure might be responsible for interference with the spin label (e.g., steric clashes or immobilization). Thus, the method is suitable for gathering information on the cavity leading to the CTS-binding site in Na + ,K + -ATPase in all conformations with high affinity to CTS. © 2018 Federation of European Biochemical Societies.

Somatosensory cortical plasticity in carpal tunnel syndrome treated by acupuncture.

PubMed

Napadow, Vitaly; Liu, Jing; Li, Ming; Kettner, Norman; Ryan, Angela; Kwong, Kenneth K; Hui, Kathleen K S; Audette, Joseph F

2007-03-01

Carpal tunnel syndrome (CTS) is a common entrapment neuropathy of the median nerve characterized by paresthesias and pain in the first through fourth digits. We hypothesize that aberrant afferent input from CTS will lead to maladaptive cortical plasticity, which may be corrected by appropriate therapy. Functional MRI (fMRI) scanning and clinical testing was performed on CTS patients at baseline and after 5 weeks of acupuncture treatment. As a control, healthy adults were also tested 5 weeks apart. During fMRI, sensory stimulation was performed for median nerve innervated digit 2 (D2) and digit 3 (D3), and ulnar nerve innervated digit 5 (D5). Surface-based and region of interest (ROI)-based analyses demonstrated that while the extent of fMRI activity in contralateral Brodmann Area 1 (BA 1) and BA 4 was increased in CTS compared to healthy adults, after acupuncture there was a significant decrease in contralateral BA 1 (P < 0.005) and BA 4 (P < 0.05) activity during D3 sensory stimulation. Healthy adults demonstrated no significant test-retest differences for any digit tested. While D3/D2 separation was contracted or blurred in CTS patients compared to healthy adults, the D2 SI representation shifted laterally after acupuncture treatment, leading to increased D3/D2 separation. Increasing D3/D2 separation correlated with decreasing paresthesias in CTS patients (P < 0.05). As CTS-induced paresthesias constitute diffuse, synchronized, multidigit symptomatology, our results for maladaptive change and correction are consistent with Hebbian plasticity mechanisms. Acupuncture, a somatosensory conditioning stimulus, shows promise in inducing beneficial cortical plasticity manifested by more focused digital representations. (c) 2006 Wiley-Liss, Inc.

DC-Compensated Current Transformer.

PubMed

Ripka, Pavel; Draxler, Karel; Styblíková, Renata

2016-01-20

Instrument current transformers (CTs) measure AC currents. The DC component in the measured current can saturate the transformer and cause gross error. We use fluxgate detection and digital feedback compensation of the DC flux to suppress the overall error to 0.15%. This concept can be used not only for high-end CTs with a nanocrystalline core, but it also works for low-cost CTs with FeSi cores. The method described here allows simultaneous measurements of the DC current component.

Acuros CTS: A fast, linear Boltzmann transport equation solver for computed tomography scatter - Part I: Core algorithms and validation.

PubMed

Maslowski, Alexander; Wang, Adam; Sun, Mingshan; Wareing, Todd; Davis, Ian; Star-Lack, Josh

2018-05-01

To describe Acuros ® CTS, a new software tool for rapidly and accurately estimating scatter in x-ray projection images by deterministically solving the linear Boltzmann transport equation (LBTE). The LBTE describes the behavior of particles as they interact with an object across spatial, energy, and directional (propagation) domains. Acuros CTS deterministically solves the LBTE by modeling photon transport associated with an x-ray projection in three main steps: (a) Ray tracing photons from the x-ray source into the object where they experience their first scattering event and form scattering sources. (b) Propagating photons from their first scattering sources across the object in all directions to form second scattering sources, then repeating this process until all high-order scattering sources are computed using the source iteration method. (c) Ray-tracing photons from scattering sources within the object to the detector, accounting for the detector's energy and anti-scatter grid responses. To make this process computationally tractable, a combination of analytical and discrete methods is applied. The three domains are discretized using the Linear Discontinuous Finite Elements, Multigroup, and Discrete Ordinates methods, respectively, which confer the ability to maintain the accuracy of a continuous solution. Furthermore, through the implementation in CUDA, we sought to exploit the parallel computing capabilities of graphics processing units (GPUs) to achieve the speeds required for clinical utilization. Acuros CTS was validated against Geant4 Monte Carlo simulations using two digital phantoms: (a) a water phantom containing lung, air, and bone inserts (WLAB phantom) and (b) a pelvis phantom derived from a clinical CT dataset. For these studies, we modeled the TrueBeam ® (Varian Medical Systems, Palo Alto, CA) kV imaging system with a source energy of 125 kVp. The imager comprised a 600 μm-thick Cesium Iodide (CsI) scintillator and a 10:1 one-dimensional anti-scatter grid. For the WLAB studies, the full-fan geometry without a bowtie filter was used (with and without the anti-scatter grid). For the pelvis phantom studies, a half-fan geometry with bowtie was used (with the anti-scatter grid). Scattered and primary photon fluences and energies deposited in the detector were recorded. The Acuros CTS and Monte Carlo results demonstrated excellent agreement. For the WLAB studies, the average percent difference between the Monte Carlo- and Acuros-generated scattered photon fluences at the face of the detector was -0.7%. After including the detector response, the average percent differences between the Monte Carlo- and Acuros-generated scatter fractions (SF) were -0.1% without the grid and 0.6% with the grid. For the digital pelvis simulation, the Monte Carlo- and Acuros-generated SFs agreed to within 0.1% on average, despite the scatter-to-primary ratios (SPRs) being as high as 5.5. The Acuros CTS computation time for each scatter image was ~1 s using a single GPU. Acuros CTS enables a fast and accurate calculation of scatter images by deterministically solving the LBTE thus offering a computationally attractive alternative to Monte Carlo methods. Part II describes the application of Acuros CTS to scatter correction of CBCT scans on the TrueBeam system. © 2018 American Association of Physicists in Medicine.

Training and career development in clinical and translational science: an opportunity for rehabilitation scientists.

PubMed

Kelly, Thomas H; Mattacola, Carl G

2010-11-01

The National Institutes of Health's Clinical and Translational Science Award initiative is designed to establish and promote academic centers of clinical and translational science (CTS) that are empowered to train and advance multi- and interdisciplinary investigators and research teams to apply new scientific knowledge and techniques to enhance patient care. Among the key components of a full-service center for CTS is an educational platform to support research training in CTS. Educational objectives and resources available to support the career development of the clinical and translational scientists, including clinical research education, mentored research training, and career development support, are described. The purpose of the article is to provide an overview of the CTS educational model so that rehabilitation specialists can become more aware of potential resources that are available and become more involved in the delivery and initiation of the CTS model in their own workplace. Rehabilitation clinicians and scientists are well positioned to play important leadership roles in advancing the academic mission of CTS. Rigorous academic training in rehabilitation science serves as an effective foundation for supporting the translation of basic scientific discovery into improved health care. Rehabilitation professionals are immersed in patient care, familiar with interdisciplinary health care delivery, and skilled at working with multiple health care professionals. The NIH Clinical and Translational Science Award initiative is an excellent opportunity to advance the academic development of rehabilitation scientists.

Pre-surgery Disability Compensation Predicts Long-Term Disability among Workers with Carpal Tunnel Syndrome

PubMed Central

Spector, June T.; Turner, Judith A.; Fulton-Kehoe, Deborah; Franklin, Gary

2012-01-01

Background We sought to identify early risk factors for work disability compensation prior to and after carpal tunnel syndrome (CTS) surgery, and to determine whether pre-surgery disability compensation is associated with long-term disability. Methods Washington State workers’ compensation administrative data and data from interviews with workers 18 days (median) after submitting new workers’ compensation claims for CTS were examined. Baseline risk factors for pre-surgery disability compensation and for long-term disability (≥365 days of work disability compensation prior to two years after claim filing) were evaluated for workers who underwent CTS surgery and had at least one day of disability compensation (N=670). Results After adjustment for baseline long-term disability risk factors, workers with pre-surgery disability compensation had over five times the odds of long-term disability. Baseline factors in multiple domains, including job, psychosocial, clinical, and worker pain and function, were associated with both pre-surgery disability compensation and long-term disability. Conclusions Risk factors for work disability prior to and after CTS surgery are similar, and early work disability is a risk factor for long-term CTS-related disability. An integrated approach to CTS-related disability prevention could include identifying and addressing combined risk factors soon after claim filing, more efficient use of conservative treatments and appropriate work modifications to minimize early work loss, and, when indicated, timely surgical intervention. PMID:22392804

Multi-phase structures of boron-doped copper tin sulfide nanoparticles synthesized by chemical bath deposition for optoelectronic devices

NASA Astrophysics Data System (ADS)

Rakspun, Jariya; Kantip, Nathakan; Vailikhit, Veeramol; Choopun, Supab; Tubtimtae, Auttasit

2018-04-01

We investigated the influence of boron doping on the structural, optical, and electrical properties of copper tin sulfide (CTS) nanoparticles coated on a WO3 surface and synthesized using chemical bath deposition. Boron doping at concentrations of 0.5, 1.0, 1.5, and 2.0 wt% was investigated. The X-ray diffraction pattern of CTS showed the presence of monoclinic Cu2Sn3S7, cubic Cu2SnS3, and orthorhombic Cu4SnS4. Boron doping influenced the preferred orientation of the nanoparticles for all phase structures and produced a lattice strain effect and changes in the dislocation density. Increasing the concentration of boron in CTS from 0.5 wt% to 2.0 wt% reduced the band gap for all phases of CTS from 1.46 to 1.29 eV and reduced the optical transmittance. Optical constants, such as the refractive index, extinction coefficient, and dissipation factor, were also obtained for B-doped CTS. The dispersion behavior of the refractive index was investigated in terms of a single oscillator model and the physical parameters were determined. Fourier transform infrared spectroscopy confirmed the successful synthesis of CTS nanoparticles. Cyclic voltammetry indicated that optimum boron doping (<1.5 wt% for all phases) resulted in desirable p-n junction behavior for optoelectronic applications.

Report on the development and application of PET/CT in mainland China.

PubMed

Chen, Yumei; Chen, Ruohua; Zhou, Xiang; Liu, Jianjun; Huang, Gang

2017-09-08

To examine the development and application of systems combining positron emission and x-ray-computed tomography systems (PET/CTs) in mainland China. Using a questionnaire, we surveyed Chinese medical institutions on a variety topics relating to their PET/CT systems and its use. The respondents had PET/CTs installed and in clinical use before 31 December 2015. We examined the clinical scenarios to which Chinese PET/CTs were applied by reviewing the related Chinese and international literature from the start of 1995 to the end of 2013; these papers were found by searching the Wanfang and PubMed databases, respectively. The data were then classified and analyzed statistically. At the end of 2015, there were 240 PET/CTs and 101 medical cyclotrons in mainland China. The total number of PET studies performed in 2015 was 469,364. The main clinical applications of PET were found to be diagnostic fludeoxyglucose ( 18 F-FDG) imaging and oncological imaging. A minority of PET/CT studies were performed using 11 C-choline and other imaging agents. The number of papers relating to clinical use of PET/CT in mainland China increased each year over the period of study, in both the Chinese and international literature. Despite this progress, important problems were also apparent, including unbalanced regional development and the limited quality of the research. This study provides detailed information for understanding the development PET/CT technology in mainland China, along with its geographical distribution and clinical application. It may thus prove a useful reference for all those involved in planning the future of PET/CT in China.

Musculoskeletal disorders among construction apprentices in Hungary.

PubMed

Rosecrance, J; Pórszász, J; Cook, T; Fekecs, E; Karácsony, T; Merlino, L; Anton, D

2001-11-01

The purpose of this study was to determine the prevalence of occupationally related musculoskeletal disorder (MSD) symptoms and carpal tunnel syndrome (CTS) among construction apprentices in Hungary. Symptoms of occupational MSDs and the job factors contributing to the symptoms were determined through an administered symptom and job factors survey. The prevalence of CTS was based on a case definition that included hand symptoms and nerve conduction studies of the median nerve across the carpal tunnel. The participation rate was 96% among the 201 eligible construction apprentices. More than 50% of the apprentices reported occupationally related musculoskeletal symptoms in the previous 12 months. Job tasks that required awkward postures and working in a static position were the two factors that contributed most to MSD symptoms. No cases of CTS were found in this sample of apprentices. Although disorders of the musculoskeletal system are more prevalent among experienced construction workers, this study indicated that symptoms of MSDs are present among young construction workers. Assessing the magnitude and nature of occupational related MSDs is the first step in promoting a healthier, safer, and more efficient workforce.

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

Cheung, Michael L M; Chan, Anthony T C; The Chinese University of Hong Kong

Purpose: To develop a formulation for 4D treatment planning for a tumour tracking volumetric modulated arc therapy treatment (VMAT) plan for lung cancer. Methods: A VMAT plan was optimized based on a reference phase of the 4DCT of a lung cancer patient. The PTV was generated from the GTV of the reference phase. The collimator angle was set to 90 degrees such that the MLC travels along superior-inferior direction which is the main component of movement of a lung tumour. Then, each control point of the VMAT plan was assigned to a particular phase of the 4DCT in chronological order.more » The MLC positions of each control point were shifted according to the position of the tumour centroid of its assigned phase to form a tumour tracking VMAT plan. The control points of the same phase were grouped to form a pseudo VMAT plan for that particular phase. Dose calculation was performed for each pseudo VMAT plan on the corresponding phase of the 4DCT. The CTs of all phases were registered to the reference phase CT according to the displacement of the tumour centroid. The individual dose distributions of the pseudo VMAT plans were summed up and displayed on the reference phase of the 4DCT. A control VMAT plan was optimized based on a PTV generated from the ITV of all phases and compared with the tumour tracking VMAT plan. Results: Both plans achieved >95% volume coverage at the prescription dose level (96% for the tumour tracking plan and 97% for the control plan). But the normal lung volume irradiated at the prescription dose level was 39% less for the tumour tracking plan than the control plan. Conclusion: A formulation of 4D treatment planning for tumour tracking VMAT plans for lung cancer was developed.« less

CTS TEP thermal anomalies: Heat pipe system performance

NASA Technical Reports Server (NTRS)

Marcus, B. D.

1977-01-01

A part of the investigation is summarized of the thermal anomalies of the transmitter experiment package (TEP) on the Communications Technology Satellite (CTS) which were observed on four occasions in 1977. Specifically, the possible failure modes of the variable conductance heat pipe system (VCHPS) used for principal thermal control of the high-power traveling wave tube in the TEP are considered. Further, the investigation examines how those malfunctions may have given rise to the TEP thermal anomalies. Using CTS flight data information, ground test results, analysis conclusions, and other relevant information, the investigation concentrated on artery depriming as the most likely VCHPS failure mode. Included in the study as possible depriming mechanisms were freezing of the working fluid, Marangoni flow, and gas evolution within the arteries. The report concludes that while depriming of the heat pipe arteries is consistent with the bulk of the observed data, the factors which cause the arteries to deprime have yet to be identified.

Heterogeneous biomimetic catalysis using iron porphyrin for cyclohexane oxidation promoted by chitosan

NASA Astrophysics Data System (ADS)

Huang, Guan; Liu, Yao; Cai, Jing Li; Chen, Xiang Feng; Zhao, Shu Kai; Guo, Yong An; Wei, Su Juan; Li, Xu

2017-04-01

This study investigates how ligands modulate metalloporphyrin activity with the goal of producing a practical biomimetic catalyst for use in the chemical industry. We immobilized iron porphyrinate [iron-tetrakis-(4-sulfonatophenyl)-porphyrin; Fe(III) (TPPS)] on powdered chitosan (pd-CTS) to form an immobilized catalyst Fe(III) (TPPS)/pd-CTS, which was characterized using modern spectroscopic techniques and used for catalytic oxidation of cyclohexane with O2. Amino coordination to iron porphyrin in Fe(III) (TPPS)/pd-CTS altered the electron cloud density around the iron cation, probably by reducing the activation energy of Fe(III) (TPPS) and raising the reactivity of the iron ion catalytic center, thereby improving the catalytic efficiency. One milligram of Fe(III) (TPPS) catalyst can be reused three times for the oxidation reaction to yield an average of 22.9 mol% of cyclohexanone and cyclohexanol.

CTS digital video college curriculum-sharing experiment. [Communications Technology Satellite

NASA Technical Reports Server (NTRS)

Lumb, D. R.; Sites, M. J.

1974-01-01

NASA-Ames Research Center, Stanford University, and Carleton University, Ottawa, Canada, are participating in a joint experiment to evaluate the feasibility and effectiveness of college curriculum sharing using compressed digital television and the Communications Technology Satellite (CTS). Each university will offer televised courses to the other during the 1976-1977 academic year via CTS, a joint program by NASA and the Canadian Department of Communications. The video compression techniques to be demonstrated will enable economical interconnection of educational institutions using existing and planned domestic satellites.

DC-Compensated Current Transformer †

PubMed Central

Ripka, Pavel; Draxler, Karel; Styblíková, Renata

2016-01-01

Instrument current transformers (CTs) measure AC currents. The DC component in the measured current can saturate the transformer and cause gross error. We use fluxgate detection and digital feedback compensation of the DC flux to suppress the overall error to 0.15%. This concept can be used not only for high-end CTs with a nanocrystalline core, but it also works for low-cost CTs with FeSi cores. The method described here allows simultaneous measurements of the DC current component. PMID:26805830

Factors associated with the income distribution of full-time physicians: a quantile regression approach.

PubMed

Shih, Ya-Chen Tina; Konrad, Thomas R

2007-10-01

Physician income is generally high, but quite variable; hence, physicians have divergent perspectives regarding health policy initiatives and market reforms that could affect their incomes. We investigated factors underlying the distribution of income within the physician population. Full-time physicians (N=10,777) from the restricted version of the 1996-1997 Community Tracking Study Physician Survey (CTS-PS), 1996 Area Resource File, and 1996 health maintenance organization penetration data. We conducted separate analyses for primary care physicians (PCPs) and specialists. We employed least square and quantile regression models to examine factors associated with physician incomes at the mean and at various points of the income distribution, respectively. We accounted for the complex survey design for the CTS-PS data using appropriate weighted procedures and explored endogeneity using an instrumental variables method. We detected widespread and subtle effects of many variables on physician incomes at different points (10th, 25th, 75th, and 90th percentiles) in the distribution that were undetected when employing regression estimations focusing on only the means or medians. Our findings show that the effects of managed care penetration are demonstrable at the mean of specialist incomes, but are more pronounced at higher levels. Conversely, a gender gap in earnings occurs at all levels of income of both PCPs and specialists, but is more pronounced at lower income levels. The quantile regression technique offers an analytical tool to evaluate policy effects beyond the means. A longitudinal application of this approach may enable health policy makers to identify winners and losers among segments of the physician workforce and assess how market dynamics and health policy initiatives affect the overall physician income distribution over various time intervals.

Spatial Distribution of Dengue in a Brazilian Urban Slum Setting: Role of Socioeconomic Gradient in Disease Risk.

PubMed

Kikuti, Mariana; Cunha, Geraldo M; Paploski, Igor A D; Kasper, Amelia M; Silva, Monaise M O; Tavares, Aline S; Cruz, Jaqueline S; Queiroz, Tássia L; Rodrigues, Moreno S; Santana, Perla M; Lima, Helena C A V; Calcagno, Juan; Takahashi, Daniele; Gonçalves, André H O; Araújo, Josélio M G; Gauthier, Kristine; Diuk-Wasser, Maria A; Kitron, Uriel; Ko, Albert I; Reis, Mitermayer G; Ribeiro, Guilherme S

2015-01-01

Few studies of dengue have shown group-level associations between demographic, socioeconomic, or geographic characteristics and the spatial distribution of dengue within small urban areas. This study aimed to examine whether specific characteristics of an urban slum community were associated with the risk of dengue disease. From 01/2009 to 12/2010, we conducted enhanced, community-based surveillance in the only public emergency unit in a slum in Salvador, Brazil to identify acute febrile illness (AFI) patients with laboratory evidence of dengue infection. Patient households were geocoded within census tracts (CTs). Demographic, socioeconomic, and geographical data were obtained from the 2010 national census. Associations between CTs characteristics and the spatial risk of both dengue and non-dengue AFI were assessed by Poisson log-normal and conditional auto-regressive models (CAR). We identified 651 (22.0%) dengue cases among 2,962 AFI patients. Estimated risk of symptomatic dengue was 21.3 and 70.2 cases per 10,000 inhabitants in 2009 and 2010, respectively. All the four dengue serotypes were identified, but DENV2 predominated (DENV1: 8.1%; DENV2: 90.7%; DENV3: 0.4%; DENV4: 0.8%). Multivariable CAR regression analysis showed increased dengue risk in CTs with poorer inhabitants (RR: 1.02 for each percent increase in the frequency of families earning ≤1 times the minimum wage; 95% CI: 1.01-1.04), and decreased risk in CTs located farther from the health unit (RR: 0.87 for each 100 meter increase; 95% CI: 0.80-0.94). The same CTs characteristics were also associated with non-dengue AFI risk. This study highlights the large burden of symptomatic dengue on individuals living in urban slums in Brazil. Lower neighborhood socioeconomic status was independently associated with increased risk of dengue, indicating that within slum communities with high levels of absolute poverty, factors associated with the social gradient influence dengue transmission. In addition, poor geographic access to health services may be a barrier to identifying both dengue and non-dengue AFI cases. Therefore, further spatial studies should account for this potential source of bias.

Combination of inquiry learning model and computer simulation to improve mastery concept and the correlation with critical thinking skills (CTS)

NASA Astrophysics Data System (ADS)

Nugraha, Muhamad Gina; Kaniawati, Ida; Rusdiana, Dadi; Kirana, Kartika Hajar

2016-02-01

Among the purposes of physics learning at high school is to master the physics concepts and cultivate scientific attitude (including critical attitude), develop inductive and deductive reasoning skills. According to Ennis et al., inductive and deductive reasoning skills are part of critical thinking. Based on preliminary studies, both of the competence are lack achieved, it is seen from student learning outcomes is low and learning processes that are not conducive to cultivate critical thinking (teacher-centered learning). One of learning model that predicted can increase mastery concepts and train CTS is inquiry learning model aided computer simulations. In this model, students were given the opportunity to be actively involved in the experiment and also get a good explanation with the computer simulations. From research with randomized control group pretest-posttest design, we found that the inquiry learning model aided computer simulations can significantly improve students' mastery concepts than the conventional (teacher-centered) method. With inquiry learning model aided computer simulations, 20% of students have high CTS, 63.3% were medium and 16.7% were low. CTS greatly contribute to the students' mastery concept with a correlation coefficient of 0.697 and quite contribute to the enhancement mastery concept with a correlation coefficient of 0.603.

High incidence of defective high-shear platelet function among platelet donors.

PubMed

Harrison, Paul; Segal, Helen; Furtado, Charlene; Verjee, Salim; Sukhu, Kampta; Murphy, Michael F

2004-05-01

Because single-donor plateletpheresis concentrates now account for a large percentage of PLT concentrates, the PLT quality of individual donations is increasingly important. There has been little previous work on PLT function in blood donors. The aim of this study was to investigate the prevalence of defective PLT function among 100 healthy UK PLT donors on 3 consecutive donation days. Citrated blood samples were taken before plateletpheresis. High-shear PLT function testing was performed by a PLT function analyzer (PFA-100, Dade Behring), within both collagen-ADP (CADP) and collagen-epinephrine (CEPI) cartridges. Sixteen percent of PLT donors (mainly over the 3 donating days) had prolonged CEPI closure times (CTs) only, indicative of an aspirin-like pattern; 9 percent had a severe defect with prolonged CEPI CTs between 200 and 300 seconds, and 4 percent had maximal CEPI CTs of greater than 300 seconds. The majority of prolonged CEPI CTs appeared transient in nature. PLT dysfunction as detected by the PFA-100 is surprisingly common within a voluntary PLT donor population. The majority of CEPI defects appeared transient in nature and are indicative of surreptitious intake of cyclooxygenase inhibitors (e.g., aspirin). Identification of defective PLT function within donors would provide a simple means to eradicate defective PLTs from being clinically utilized.

Strategic supplementation of cassava top silage to enhance rumen fermentation and milk production in lactating dairy cows in the tropics.

PubMed

Wanapat, Metha; Phesatcha, Kampanat; Viennasay, Bounnaxay; Phesatcha, Burarat; Ampapon, Thiwakorn; Kang, Sungchhang

2018-04-19

High-quality protein roughage is an important feed for productive ruminants. This study examined the effects of strategic feeding of lactating cows with cassava (Manihot esculenta) top silage (CTS) on rumen fermentation, feed intake, milk yield, and quality. Four early lactating crossbred dairy cows (75% Holstein-Friesian and 25% Thai) with body weight (BW) 410 ± 30 kg and milk yield 12 ± 2 kg/day were randomly allotted in a 4 × 4 Latin square design to four different supplementation levels of CTS namely, 0, 0.75, 1.50, and 2.25 kg/day of dry matter (DM). Strategic supplementation of CTS significantly affected ruminal fermentation end-products, especially increased propionate production, decreased protozoal population and suppressed methane production (P < 0.05). Increasing the CTS supplementation level substantially enhanced milk yield and the 3.5% FCM from 12.7 to 14.0 kg/day and from 14.6 to 17.2 kg/day (P < 0.05) for non-supplemented group and for the 2.25 kg/day supplemented group, respectively. We conclude that high-quality protein roughage significantly enhances rumen fermentation end-products, milk yield, and quality in dairy cows.

Carpal tunnel syndrome: Analysis of online patient information with the EQIP tool.

PubMed

Frueh, F S; Palma, A F; Raptis, D A; Graf, C P; Giovanoli, P; Calcagni, M

2015-06-01

Patients suffering from carpal tunnel syndrome (CTS) actively search for medical information on the Internet. The World Wide Web represents the main source of patient information. The aim of this study was to systematically assess the quality of patient information about CTS in the Internet. A qualitative and quantitative assessment of websites was performed with the modified Ensuring Quality Information for Patients (EQIP) tool that contains 36 standardized items. Five hundred websites with information on CTS treatment options were identified through Google, Bing, Yahoo, Ask.com and AOL. Duplicates and irrelevant websites were excluded. One hundred and ten websites were included. Only five websites addressed more than 20 items; quality scores were not significantly different between the various providing groups. A median of 15 EQIP items was found, with the top website addressing 26 out of 36 items. Major complications such as median nerve injury were reported in 27% of the websites and their treatment in only 3%. This analysis revealed several critical shortcomings in the quality of the information provided to patients suffering from CTS. There is a collective need to provide interactive, informative and educational websites for standard procedures in hand surgery. These websites should be compatible with international quality standards for hand surgery procedures. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Chromosome Territories

PubMed Central

Cremer, Thomas; Cremer, Marion

2010-01-01

Chromosome territories (CTs) constitute a major feature of nuclear architecture. In a brief statement, the possible contribution of nuclear architecture studies to the field of epigenomics is considered, followed by a historical account of the CT concept and the final compelling experimental evidence of a territorial organization of chromosomes in all eukaryotes studied to date. Present knowledge of nonrandom CT arrangements, of the internal CT architecture, and of structural interactions with other CTs is provided as well as the dynamics of CT arrangements during cell cycle and postmitotic terminal differentiation. The article concludes with a discussion of open questions and new experimental strategies to answer them. PMID:20300217

Conservative treatment in patients with mild to moderate carpal tunnel syndrome: A systematic review.

PubMed

Jiménez Del Barrio, S; Bueno Gracia, E; Hidalgo García, C; Estébanez de Miguel, E; Tricás Moreno, J M; Rodríguez Marco, S; Ceballos Laita, L

2016-07-22

Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy. It is characterised by the compression of the median nerve in the carpal tunnel. CTS presents a high prevalence and it is a disabling condition from the earliest stages. Severe cases are usually treated surgically, while conservative treatment is recommended in mild to moderate cases. The aim of this systematic review is to present the conservative treatments and determine their effectiveness in mild-to-moderate cases of CTS over the last 15 years. A systematic review was performed according to PRISMA criteria. We used the Medline, PEDro, and Cochrane databases to find and select randomised controlled clinical trials evaluating the effects of conservative treatment on the symptoms and functional ability of patients with mild to moderate CTS; 32 clinical trials were included. There is evidence supporting the effectiveness of oral drugs, although injections appear to be more effective. Splinting has been shown to be effective, and it is also associated with use of other non-pharmacological techniques. Assessments of the use of electrotherapy techniques alone have shown no conclusive results about their effectiveness. Other soft tissue techniques have also shown good results but evidence on this topic is limited. Various treatment combinations (drug and non-pharmacological treatments) have been proposed without conclusive results. Several conservative treatments are able to relieve symptoms and improve functional ability of patients with mild-to-moderate CTS. These include splinting, oral drugs, injections, electrotherapy, specific manual techniques, and neural gliding exercises as well as different combinations of the above. We have been unable to describe the best technique or combination of techniques due to the limitations of the studies; therefore, further studies of better methodological quality are needed. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Feasibility of a Novel Functional Sensibility Test as an Assisted Examination for Determining Precision Pinch Performance in Patients with Carpal Tunnel Syndrome

PubMed Central

Hsu, Hsiu-Yun; Kuo, Li-Chieh; Kuo, Yao-Lung; Chiu, Haw-Yen; Jou, I-Ming; Wu, Po-Ting; Su, Fong-Chin

2013-01-01

To understand the feasibility of a novel functional sensibility test for determining precision pinch performance in patients with carpal tunnel syndrome, this study investigates the validity, sensitivity and specificity of functional sensibility derived from a pinch-holding-up activity (PHUA) test. Participants include 70 clinically defined carpal tunnel syndrome (CTS) patients with 119 involved hands and 70 age- and gender-matched controls. To examine the discriminating ability of the functional sensibility test, the differences in the ability of pinch force adjustments to the inertial load of handling object between CTS and control subjects are analyzed. The results of functional sensibility are correlated with the severity of CTS to establish concurrent validity. The receiver operating characteristic (ROC) curve is constructed to demonstrate the accuracy of the proposed test. The functional sensibility score significantly discriminates the patients and control groups (respectively, 12.94±1.72 vs. 11.51±1.15N in peak pinch force (FPPeak), p<0.001; 2.92±0.41 vs. 2.52±0.24 in force ratio, p<0.001) and is moderately correlated (r = 0.42–0.54, p<0.001) with the results of traditional sensibility tests (touch-pressure threshold and two-point discrimination test). In addition, there is a statistical difference in the results of functional sensibility (p<0.001) among the subgroups of CTS severity based on electrophysiological study. The sensitivity and specificity are 0.79 and 0.76, respectively, for the functional sensibility test. The areas under the ROC curve are 0.85 and 0.80 for the force ratio and FPPeak, respectively. In conclusion, the functional sensibility test could be feasibly used as a clinical tool for determining both the sensibility and precision pinch performance of hands for the patients with CTS. PMID:23977209

Identification of Subgroups of Women with Carpal Tunnel Syndrome with Central Sensitization.

PubMed

Fernández-de-Las-Peñas, César; Fernández-Muñoz, Juan J; Navarro-Pardo, Esperanza; da-Silva-Pocinho, Ricardo F; Ambite-Quesada, Silvia; Pareja, Juan A

2016-09-01

Identification of subjects with different sensitization mechanisms can help to identify better therapeutic strategies for carpal tunnel syndrome (CTS). The aim of the current study was to identify subgroups of women with CTS with different levels of sensitization. A total of 223 women with CTS were recruited. Self-reported variables included pain intensity, function, disability, and depression. Pressure pain thresholds (PPT) were assessed bilaterally over median, ulnar, and radial nerves, C5-C6 joint, carpal tunnel, and tibialis anterior to assess widespread pressure pain hyperalgesia. Heat (HPT) and cold (CPT) pain thresholds were also bilaterally assessed over the carpal tunnel and the thenar eminence to determine thermal pain hyperalgesia. Pinch grip force between the thumb and the remaining fingers was calculated to determine motor assessment. Subgroups were determined according to the status on a previous clinical prediction rule: PPT over the affected C5-C6 joint < 137 kPa, HPT on affected carpal tunnel <39.6ºC, and general health >66 points. The ANOVA showed that women within group 1 (positive rule, n = 60) exhibited bilateral widespread pressure hyperalgesia (P < 0.001) and bilateral thermal thresholds (P < 0.001) than those within group 2 (negative rule, n = 162). Women in group 1 also exhibited higher depression than those in group 2 (P = 0.023). No differences in self-reported variables were observed. This study showed that a clinical prediction rule originally developed for identifying women with CTS who are likely to respond favorably to manual physical therapy was able to identify women exhibiting higher widespread pressure hyper-sensitivity and thermal hyperalgesia. This subgroup of women with CTS exhibiting higher sensitization may need specific therapeutic programs. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Which nerve conduction parameters can predict spontaneous electromyographic activity in carpal tunnel syndrome?

PubMed

Chang, Chia-Wei; Lee, Wei-Ju; Liao, Yi-Chu; Chang, Ming-Hong

2013-11-01

We investigate electrodiagnostic markers to determine which parameters are the best predictors of spontaneous electromyographic (EMG) activity in carpal tunnel syndrome (CTS). We enrolled 229 patients with clinically proven and nerve conduction study (NCS)-proven CTS, as well as 100 normal control subjects. All subjects were evaluated using electrodiagnostic techniques, including median distal sensory latencies (DSLs), sensory nerve action potentials (SNAPs), distal motor latencies (DMLs), compound muscle action potentials (CMAPs), forearm median nerve conduction velocities (FMCVs) and wrist-palm motor conduction velocities (W-P MCVs). All CTS patients underwent EMG examination of the abductor pollicis brevis (APB) muscle, and the presence or absence of spontaneous EMG activities was recorded. Normal limits were determined by calculating the means ± 2 standard deviations from the control data. Associations between parameters from the NCS and EMG findings were investigated. In patients with clinically diagnosed CTS, abnormal median CMAP amplitudes were the best predictors of spontaneous activity during EMG examination (p<0.001; OR 36.58; 95% CI 15.85-84.43). If the median CMAP amplitude was ≤ 2.1 mV, the rate of occurrence of spontaneous EMG activity was >95% (positive predictive rate >95%). If the median CMAP amplitude was higher than the normal limit (>4.9 mV), the rate of no spontaneous EMG activity was >94% (negative predictive rate >94%). An abnormal SNAP amplitude was the second best predictor of spontaneous EMG activity (p<0.001; OR 4.13; 95% CI 2.16-7.90), and an abnormal FMCV was the third best predictor (p=0.01; OR 2.10; 95% CI 1.20-3.67). No other nerve conduction parameters had significant power to predict spontaneous activity upon EMG examination. The CMAP amplitudes of the APB are the most powerful predictors of the occurrence of spontaneous EMG activity. Low CMAP amplitudes are strongly associated with spontaneous activity, whereas high CMAP amplitude are less associated with spontaneous activity, implying that needle EMG examination should be recommended for the detection of spontaneous activity in those CTS patients whose NCS reveals CMAP amplitudes between 2.1 mV and the lower normal limit (4.9mV in the present study). Using NCS, electromyographers can predict the presence of spontaneous EMG activity in CTS patients. Copyright © 2013 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Finite element simulation of the mechanical impact of computer work on the carpal tunnel syndrome.

PubMed

Mouzakis, Dionysios E; Rachiotis, George; Zaoutsos, Stefanos; Eleftheriou, Andreas; Malizos, Konstantinos N

2014-09-22

Carpal tunnel syndrome (CTS) is a clinical disorder resulting from the compression of the median nerve. The available evidence regarding the association between computer use and CTS is controversial. There is some evidence that computer mouse or keyboard work, or both are associated with the development of CTS. Despite the availability of pressure measurements in the carpal tunnel during computer work (exposure to keyboard or mouse) there are no available data to support a direct effect of the increased intracarpal canal pressure on the median nerve. This study presents an attempt to simulate the direct effects of computer work on the whole carpal area section using finite element analysis. A finite element mesh was produced from computerized tomography scans of the carpal area, involving all tissues present in the carpal tunnel. Two loading scenarios were applied on these models based on biomechanical data measured during computer work. It was found that mouse work can produce large deformation fields on the median nerve region. Also, the high stressing effect of the carpal ligament was verified. Keyboard work produced considerable and heterogeneous elongations along the longitudinal axis of the median nerve. Our study provides evidence that increased intracarpal canal pressures caused by awkward wrist postures imposed during computer work were associated directly with deformation of the median nerve. Despite the limitations of the present study the findings could be considered as a contribution to the understanding of the development of CTS due to exposure to computer work. Copyright © 2014 Elsevier Ltd. All rights reserved.

Multifunctional zirconium oxide doped chitosan based hybrid nanocomposites as bone tissue engineering materials.

PubMed

Bhowmick, Arundhati; Jana, Piyali; Pramanik, Nilkamal; Mitra, Tapas; Banerjee, Sovan Lal; Gnanamani, Arumugam; Das, Manas; Kundu, Patit Paban

2016-10-20

This paper reports the development of multifunctional zirconium oxide (ZrO2) doped nancomposites having chitosan (CTS), organically modified montmorillonite (OMMT) and nano-hydroxyapatite (HAP). Formation of these nanocomposites was confirmed by various characterization techniques such as Fourier transform infrared spectroscopy and powder X-ray diffraction. Scanning electron microscopy images revealed uniform distribution of OMMT and nano-HAP-ZrO2 into CTS matrix. Powder XRD study and TEM study revealed that OMMT has partially exfoliated into the polymer matrix. Enhanced mechanical properties in comparison to the reported literature were obtained after the addition of ZrO2 nanoparticle into the nanocomposites. In rheological measurements, CMZH I-III exhibited greater storage modulus (G') than loss modulus (G″). TGA results showed that these nanocomposites are thermally more stable compare to pure CTS film. Strong antibacterial zone of inhibition and the lowest minimum inhibition concentration (MIC) value of these nanocomposites against bacterial strains proved that these materials have the ability to prevent bacterial infection in orthopedic implants. Compatibility of these nanocomposites with pH and blood of human body was established. It was observed from the swelling study that the swelling percentage was increased with decreasing the hydrophobic OMMT content. Human osteoblastic MG-63 cell proliferations were observed on the nanocomposites and cytocompatibility of these nanocomposites was also established. Moreover, addition of 5wt% OMMT and 5wt% nano-HAP-ZrO2 into 90wt% CTS matrix provides maximum tensile strength, storage modulus, aqueous swelling and cytocompatibility along with strong antibacterial effect, pH and erythrocyte compatibility. Copyright © 2016 Elsevier Ltd. All rights reserved.

Handwriting Impairments in People With Parkinson's Disease and Freezing of Gait.

PubMed

Heremans, Elke; Nackaerts, Evelien; Broeder, Sanne; Vervoort, Griet; Swinnen, Stephan P; Nieuwboer, Alice

2016-11-01

Recent studies show that patients with Parkinson's disease (PD) and freezing of gait (FOG) experience motor problems outside their gait freezing episodes. Because handwriting is also a sequential movement, it may be affected in PD patients with FOG relative to those without. The current study aimed to assess the quality of writing in PD patients with and without FOG in comparison to healthy controls (CTs) during various writing tasks. Handwriting was assessed by the writing of cursive loops on a touch-sensitive writing tablet and by means of the Systematic Screening of Handwriting Difficulties (SOS) test in 30 PD patients with and without freezing and 15 healthy age-matched CTs. The tablet tests were performed at 2 different sizes, either continuously or alternatingly, as indicated by visual target lines. Patients with freezing showed decreased writing amplitudes and increased variability compared with CTs and patients without freezing on the writing tablet tests. Writing problems were present during both tests but were more pronounced during writing at alternating compared with writing at continuous size. Patients with freezing also had a higher total score on the SOS test than patients without freezing and CTs, reflecting more extensive handwriting problems, particularly with writing fluency. Writing is more severely affected in PD patients with FOG than in those without FOG. These results indicate that deficient movement sequencing and adaptation is a generic problem in patients with FOG. © The Author(s) 2016.

Accuracy and Acceptability of a Screening Tool for Identifying Intimate Partner Violence Perpetration among Women Veterans: A Pre-Implementation Evaluation.

PubMed

Portnoy, Galina A; Haskell, Sally G; King, Matthew W; Maskin, Rachel; Gerber, Megan R; Iverson, Katherine M

2018-06-06

Veterans are at heightened risk for perpetrating intimate partner violence (IPV), yet there is limited evidence to inform practice and policy for the detection of IPV perpetration. The present study evaluated the accuracy and acceptability of a potential IPV perpetration screening tool for use with women veterans. A national sample of women veterans completed a 2016 web-based survey that included a modified 5-item Extended-Hurt/Insult/Threaten/Scream (Modified E-HITS) and the Revised Conflict Tactics Scales (CTS-2). Items also assessed women's perceptions of the acceptability and appropriateness of the modified E-HITS questions for use in healthcare settings. Accuracy statistics, including sensitivity and specificity, were calculated using the CTS-2 as the reference standard. Primary measures included the Modified E-HITS (index test), CTS-2 (reference standard), and items assessing acceptability. This study included 187 women, of whom 31 women veterans (16.6%) reported past-6-month IPV perpetration on the CTS-2. The Modified E-HITS demonstrated good overall accuracy (area under the curve, 0.86; 95% confidence interval, 0.78-0.94). In addition, the majority of women perceived the questions to be acceptable and appropriate. Findings demonstrate that the Modified E-HITS is promising as a low-burden tool for detecting of IPV perpetration among women veterans. This tool may help the Veterans Health Administration and other health care providers detect IPV perpetration and offer appropriate referrals for comprehensive assessment and services. Published by Elsevier Inc.

Anaerobic digestion of corn ethanol thin stillage in batch and by high-rate down-flow fixed film reactors.

PubMed

Wilkinson, A; Kennedy, K J

2012-01-01

Thin stillage (CTS) from a dry-grind corn ethanol plant was evaluated as a carbon source for anaerobic digestion (AD) by batch and high rate semi-continuous down-flow stationary fixed film (DSFF) reactors. Biochemical methane potential (BMP) assays were carried out with CTS concentrations ranging from approximately 2,460-27,172 mg total chemical oxygen demand (TCOD) per litre, achieved by diluting CTS with clean water or a combination of clean water and treated effluent. High TCOD, SCOD and volatile solids (VS) removal efficiencies of 85 ± 2, 94 ± 0 and 82 ± 1% were achieved for CTS diluted with only clean water at an organic concentration of 21,177 mg TCOD per litre, with a methane yield of 0.30 L methane per gram TCOD(removed) at standard temperature and pressure (STP, 0 °C and 1 atmosphere). Batch studies investigating the use of treated effluent for dilution showed promising results. Continuous studies employed two mesophilic DSFF anaerobic digesters treating thin stillage, operated at hydraulic retention times (HRT) of 20, 14.3, 8.7, 6.3, 5 and 4.2 d. Successful digestion was achieved up to an organic loading rate (OLR) of approximately 7.4 g TCOD L(-1)d(-1) at a 5 d HRT with a yield of 2.05 LCH(4) L(-1)d(-1) (at STP) and TCOD and VS removal efficiencies of 89 ± 3 and 85 ± 3%, respectively.

Carpal tunnel syndrome assessment with ultrasonography: value of inlet-to-outlet median nerve area ratio in patients versus healthy volunteers.

PubMed

Fu, Tengfei; Cao, Manlin; Liu, Fang; Zhu, Jiaan; Ye, Dongmei; Feng, Xianxuan; Xu, Yiming; Wang, Gang; Bai, Yuehong

2015-01-01

To evaluate the diagnostic value of the Inlet-to-outlet median nerve area ratio (IOR) in patients with clinically and electrophysiologically confirmed carpal tunnel syndrome (CTS). Forty-six wrists in 46 consecutive patients with clinical and electrodiagnostic evidence of CTS and forty-four wrists in 44 healthy volunteers were examined with ultrasonography. The cross-sectional area (CSA) of the median nerve was measured at the carpal tunnel inlet (the level of scaphoid-pisiform) and outlet (the level of the hook of the hamate), and the IOR was calculated for each wrist. Ultrasonography and electrodiagnostic tests were performed under blinded conditions. Electrodiagnostic testing combined with clinical symptoms were considered to be the gold standard test. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic value between the inlet CSA and IOR. The study population included 16 men and 30 women (mean age, 45.3 years; range, 18-83 years). The control population included 18 men and 26 women (mean age, 50.4 years; range, 18-79 years). The mean inlet CSA was 8.7 mm2 in healthy controls and 14.6mm2 in CTS group (P<0.001). The mean IOR in healthy volunteers (1.0) was smaller than that in patients (1.6, P<0.001). Receiver operating characteristic analysis revealed a diagnostic advantage to using the IOR rather than the inlet CSA (P<0.01). An IOR cutoff value of ≥ 1.3 would yield 93% specificity and 91% sensitivity in the diagnosis of CTS. The IOR of median nerve area promises to be an effective means in the diagnosis of CTS. A large-scale, randomized controlled trial is required to determine how and when this parameter will be used.

Use of a decision aid did not decrease decisional conflict in patients with carpal tunnel syndrome.

PubMed

Gong, Hyun Sik; Park, Jin Woo; Shin, Young Ho; Kim, Kahyun; Cho, Kwan Jae; Baek, Goo Hyun

2017-03-21

Although a model for shared decision-making is important for patient-centered care, decisional conflict can emerge when patients participate in the decision-making. A decision aid is proposed to provide information and to involve patients more comfortably in the decision-making process. We aimed to determine whether a decision aid helps patients with carpal tunnel syndrome (CTS) experience less decisional conflict regarding their decision-making for surgery. Eighty patients with CTS were randomized into two groups. The test group was given a decision aid in addition to regular information and the control group regular information only. The decision aid consisted of a 6-min videoclip that explains diagnosis and information regarding surgery for CTS with other treatment options. We evaluated patients' decisional conflict regarding surgery, knowledge about CTS, and symptom severity as measured by the Disabilities of Arm, Shoulder, and Hand (DASH) Questionnaire. There was no difference in the decisional conflict scale (DCS) between both groups (p = 0.76). The test group had significantly better knowledge than the control group (p = 0.04). There was no correlation between the knowledge score and the DCS (p = 0.76). However, less severe symptoms were correlated with greater decisional conflict (r = -0.29, p = 0.02). We found that a decision aid does not reduce decisional conflict in patients with CTS, although it can help them be better informed. This study suggests that although a decision-aid is effective for patient education, doctor-patient communication should be more emphasized for patients with less severe symptoms, as they can have greater decisional conflict. SNUBH Registry 1510/317-003 Registered November 13, 2015.

Symptoms, signs and nerve conduction velocities in patients with suspected carpal tunnel syndrome

PubMed Central

2013-01-01

Background To inform the clinical management of patients with suspected carpal tunnel syndrome (CTS) and case definition for CTS in epidemiological research, we explored the relation of symptoms and signs to sensory nerve conduction (SNC) measurements. Methods Patients aged 20–64 years who were referred to a neurophysiology service for investigation of suspected CTS, completed a symptom questionnaire (including hand diagrams) and physical examination (including Tinel’s and Phalen’s tests). Differences in SNC velocity between the little and index finger were compared according to the anatomical distribution of symptoms in the hand and findings on physical examination. Results Analysis was based on 1806 hands in 908 patients (response rate 73%). In hands with numbness or tingling but negative on both Tinel’s and Phalen’s tests, the mean difference in SNC velocities was no higher than in hands with no numbness or tingling. The largest differences in SNC velocities occurred in hands with extensive numbness or tingling in the median nerve sensory distribution and both Tinel’s and Phalen’s tests positive (mean 13.8, 95% confidence interval (CI) 12.6-15.0 m/s). Hand pain and thumb weakness were unrelated to SNC velocity. Conclusions Our findings suggest that in the absence of other objective evidence of median nerve dysfunction, there is little value in referring patients of working age with suspected CTS for nerve conduction studies if they are negative on both Tinel’s and Phalen’s tests. Alternative case definitions for CTS in epidemiological research are proposed according to the extent of diagnostic information available and the relative importance of sensitivity and specificity. PMID:23947775

Perspectives on the relevance of the circadian time structure to workplace threshold limit values and employee biological monitoring.

PubMed

Smolensky, Michael H; Reinberg, Alain E; Sackett-Lundeen, Linda

2017-01-01

The circadian time structure (CTS) and its disruption by rotating and nightshift schedules relative to work performance, accident risk, and health/wellbeing have long been areas of occupational medicine research. Yet, there has been little exploration of the relevance of the CTS to setting short-term, time-weighted, and ceiling threshold limit values (TLVs); conducting employee biological monitoring (BM); and establishing normative reference biological exposure indices (BEIs). Numerous publications during the past six decades document the CTS substantially affects the disposition - absorption, distribution, metabolism, and elimination - and effects of medications. Additionally, laboratory animal and human studies verify the tolerance to chemical, biological (contagious), and physical agents can differ extensively according to the circadian time of exposure. Because of slow and usually incomplete CTS adjustment by rotating and permanent nightshift workers, occupational chemical and other contaminant encounters occur during a different circadian stage than for dayshift workers. Thus, the intended protection of some TLVs when working the nightshift compared to dayshift might be insufficient, especially in high-risk settings. The CTS is germane to employee BM in that large-amplitude predictable-in-time 24h variation can occur in the concentration of urine, blood, and saliva of monitored chemical contaminants and their metabolites plus biomarkers indicative of adverse xenobiotic exposure. The concept of biological time-qualified (for rhythms) reference values, currently of interest to clinical laboratory pathology practice, is seemingly applicable to industrial medicine as circadian time and workshift-specific BEIs to improve surveillance of night workers, in particular. Furthermore, BM as serial assessments performed frequently both during and off work, exemplified by employee self-measurement of lung function using a small portable peak expiratory flow meter, can easily identify intolerance before induction of pathology.

ctsGE-clustering subgroups of expression data.

PubMed

Sharabi-Schwager, Michal; Or, Etti; Ophir, Ron

2017-07-01

A pre-requisite to clustering noisy data, such as gene-expression data, is the filtering step. As an alternative to this step, the ctsGE R-package applies a sorting step in which all of the data are divided into small groups. The groups are divided according to how the time points are related to the time-series median. Then clustering is performed separately on each group. Thus, the clustering is done in two steps. First, an expression index (i.e. a sequence of 1, -1 and 0) is defined and genes with the same index are grouped together, and then each group of genes is clustered by k-means to create subgroups. The ctsGE package also provides an interactive tool to visualize and explore the gene-expression patterns and their subclusters. ctsGE proposes a way of organizing and exploring expression data without eliminating valuable information. Freely available as part of the Bioconductor project at https://bioconductor.org/packages/ctsGE/ . ron@agri.gov.il. Supplementary data are available at Bioinformatics online. © The Author (2017). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Chemical Transformation System: Cloud Based ...

EPA Pesticide Factsheets

Integrated Environmental Modeling (IEM) systems that account for the fate/transport of organics frequently require physicochemical properties as well as transformation products. A myriad of chemical property databases exist but these can be difficult to access and often do not contain the proprietary chemicals that environmental regulators must consider. We are building the Chemical Transformation System (CTS) to facilitate model parameterization and analysis. CTS integrates a number of physicochemical property calculators into the system including EPI Suite, SPARC, TEST and ChemAxon. The calculators are heterogeneous in their scientific methodologies, technology implementations and deployment stacks. CTS also includes a chemical transformation processing engine that has been loaded with reaction libraries for human biotransformation, abiotic reduction and abiotic hydrolysis. CTS implements a common interface for the disparate calculators accepting molecular identifiers (SMILES, IUPAC, CAS#, user-drawn molecule) before submission for processing. To make the system as accessible as possible and provide a consistent programmatic interface, we wrapped the calculators in a standardized RESTful Application Programming Interface (API) which makes it capable of servicing a much broader spectrum of clients without constraints to interoperability such as operating system or programming language. CTS is hosted in a shared cloud environment, the Quantitative Environmental

The effect of symptoms of carpal tunnel syndrome on ultrasonographic median nerve measures before and after wheelchair propulsion.

PubMed

Impink, Bradley G; Collinger, Jennifer L; Boninger, Michael L

2011-09-01

To quantify median nerve characteristics before and after strenuous wheelchair propulsion and relate them to symptoms of carpal tunnel syndrome (CTS). We hypothesized that persons with and without symptoms of CTS would have significantly different nerve characteristics at baseline and after propulsion. A repeated-measures design was used to obtain ultrasound images of the median nerve at 3 levels of the wrist (radius, pisiform, and hamate) before and after wheelchair propulsion. Investigators were blinded to subject history related to CTS. The 2007 and 2008 National Veterans Wheelchair Games and the Human Engineering Research Laboratories. Fifty-four participants between the ages of 18 and 65 years with a nonprogressive disability who used a manual wheelchair as their primary means of mobility completed this study. Participants completed questionnaires regarding demographics and the presence and severity of symptoms of CTS. Ultrasound images of the median nerve were obtained before and after a 15-minute strenuous wheelchair-propulsion task. Baseline values and post-propulsion changes were determined for median nerve cross-sectional area, flattening ratio, and swelling ratio. Differences in median nerve variables between symptomatic and asymptomatic groups were assessed. No significant differences between symptom groups were identified at baseline; however, persons with symptoms of CTS showed a significantly different percent change from baseline compared with the asymptomatic participants for cross-sectional area at pisiform (P = .014) and flattening ratio at hamate (P = .022), and they showed a strong trend toward a difference in swelling ratio (P = .0502). For each of these variables, the change in the symptomatic group was in the opposite direction of the change in the asymptomatic group. We found several median nerve responses to wheelchair propulsion associated with symptoms of CTS. These responses occurred even though no baseline ultrasound difference was found based on symptoms. Future research is necessary to determine how propulsion characteristics (ie, force, repetition, and posture) affect the median nerve response. Copyright © 2011 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Report on the development and application of PET/CT in mainland China

PubMed Central

Zhou, Xiang; Liu, Jianjun; Huang, Gang

2017-01-01

Purpose To examine the development and application of systems combining positron emission and x-ray-computed tomography systems (PET/CTs) in mainland China. Methods Using a questionnaire, we surveyed Chinese medical institutions on a variety topics relating to their PET/CT systems and its use. The respondents had PET/CTs installed and in clinical use before 31 December 2015. We examined the clinical scenarios to which Chinese PET/CTs were applied by reviewing the related Chinese and international literature from the start of 1995 to the end of 2013; these papers were found by searching the Wanfang and PubMed databases, respectively. The data were then classified and analyzed statistically. Results At the end of 2015, there were 240 PET/CTs and 101 medical cyclotrons in mainland China. The total number of PET studies performed in 2015 was 469,364. The main clinical applications of PET were found to be diagnostic fludeoxyglucose (18F-FDG) imaging and oncological imaging. A minority of PET/CT studies were performed using 11C-choline and other imaging agents. The number of papers relating to clinical use of PET/CT in mainland China increased each year over the period of study, in both the Chinese and international literature. Despite this progress, important problems were also apparent, including unbalanced regional development and the limited quality of the research. Conclusions This study provides detailed information for understanding the development PET/CT technology in mainland China, along with its geographical distribution and clinical application. It may thus prove a useful reference for all those involved in planning the future of PET/CT in China. PMID:28969081

How are we communicating about clinical trials?: an assessment of the content and readability of recruitment resources.

PubMed

Friedman, Daniela B; Kim, Sei-Hill; Tanner, Andrea; Bergeron, Caroline D; Foster, Caroline; General, Kevin

2014-07-01

Clinical trials (CTs) are important for advancing public health and medical research, however, CT recruitment is challenging. The high reading level of CT information and the technical language of providers or researchers can serve as barriers to recruitment. Prior studies on the informed consent process found that consent documents often contain complicated terms. Limited research has examined resources specifically used to recruit individuals into CTs. The purpose of this study was to examine the content and readability of CT recruitment education resources in one U.S. state. Convenience sampling was employed for the collection of CT recruitment materials. A codebook was developed based on previous content analyses and emergent themes from statewide focus groups about CTs. A total of 127 materials were collected and analyzed (37.8% print; 62.2% Web). Most content was focused on treatment-related CTs (60.6%). Inclusion criteria related to specific disease conditions (88.9%) and age (73.6%) were described most often. Only 30% of resources had an explicit call to action. Overall mean readability level was Grade 11.7. Web-based materials were significantly more likely to be written at a higher grade level than print materials (p ≤ .0001). Readability also differed significantly according to resource distributor/creator, CT type, person quoted, and presence or absence of inclusion criteria and an explicit call to action. Our study provides insight into the content and difficulty level of recruitment materials intended to provide initial information about a CT. Future studies should examine individuals' comprehension of recruitment materials and how participation intentions are associated with recruitment messages. Copyright © 2014 Elsevier Inc. All rights reserved.

Comparing the effectiveness of ultrasound-guided versus blind steroid injection in the treatment of severe carpal tunnel syndrome

PubMed

Karaahmet, Özgür Zeliha; Gürçay, Eda; Kara, Murat; Serçe, Azize; Kıraç Ünal, Zeynep; Çakcı, Aytül

2017-12-19

Background/aim: This study aimed to compare the effectiveness of ultrasound (US)-guided injection versus blind injection of corticosteroids in the treatment of carpal tunnel syndrome (CTS). Materials and methods: This prospective, randomized clinical trial included patients with severe CTS based on clinical and electrophysiological criteria. The patients were evaluated for clinical and electrophysiological parameters at baseline and 4 weeks after treatment. Symptom severity and hand function were assessed by the Boston questionnaire. The patients underwent blind injection or US-guided injection. Results: When compared with baseline, both groups showed significant improvement in Boston questionnaire scores and all electrophysiological parameters. Significant differences were observed between the groups for clinical parameters (Boston Symptom Severity Scale: P = 0.007; Functional Status Scale: P < 0.001) in favor of the US-guided group. Conclusion: This study demonstrated that both US-guided and blind injections were effective in reducing symptoms and improving hand function. US-guided injections may yield more effective clinical results in the short-term than blind injections in the treatment of patients with severe CTS.

Short-term clinical outcome of orthosis alone vs combination of orthosis, nerve, and tendon gliding exercises and ultrasound therapy for treatment of carpal tunnel syndrome.

PubMed

Sim, Sze En; Gunasagaran, Jayaletchumi; Goh, Khean-Jin; Ahmad, Tunku Sara

2018-02-07

Prospective randomized study. Carpal tunnel syndrome (CTS) has been described as the most common compression neuropathy. Many modalities exist for conservative treatment. Efficacy of each modality has been described in the literature. However, the effectiveness of combination of these modalities is not well established. The purpose of this study is to assess the short-term clinical outcome of conservative treatment for CTS comparing orthosis alone with combination of orthosis, nerve/tendon gliding exercises, and ultrasound therapy. Forty-one patients who presented to Upper Limb Reconstructive and Microsurgery Clinic, University Malaya Medical Centre with CTS and positive electrodiagnostic study were recruited. Fifteen patients had bilateral CTS. Fifty-six wrists were equally randomized to orthosis alone and a combined therapy of orthosis, nerve/tendon gliding exercise, and ultrasound therapy. All patients were required to complete the Boston Carpal Tunnel Questionnaire during the first visit and 2 months after treatment. Both the orthosis and combined therapy groups showed a significant improvement in symptoms and function after treatment. The mean difference of symptoms in the orthosis group was 0.53; 95% confidence interval [CI]: 0.23-0.83 (P = .001) and in the combined therapy group was 0.48; 95% CI: 0.24-0.72 (P < .001). Mean difference of function in the orthosis group was 0.59; 95% CI: 0.28-0.91 (P = .001) and combined group was 0.69; 95% CI: 0.49-0.89 (P < .001). However, there was no significant difference in symptom severity and functional status scores between the groups. Our findings support other findings where orthosis and exercises improved symptom severity and functional status scores, however, there was no significant difference between orthosis alone and combined treatment. Patients who underwent conservative management for CTS showed improvement in symptoms and function. However, the combination of orthosis, nerve/tendon gliding exercises, and ultrasound therapy did not offer additional benefit compared to orthosis alone. Copyright © 2018 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Classification of ASASSN-17em/AT2017cts

NASA Astrophysics Data System (ADS)

Bersier, David

2017-04-01

We obtained a spectrum of the candidate supernova ASASSN-17em/AT2017cts (ATEL #10241), using the SPRAT spectrograph mounted on the robotic 2m Liverpool Telescope at the Roque de los Muchachos observatory (La Palma).

Reducing the bioavailability of cadmium in contaminated soil by dithiocarbamate chitosan as a new remediation.

PubMed

Yin, Zheng; Cao, Jingjing; Li, Zhen; Qiu, Dong

2015-07-01

Dithiocarbamate chitosan (DTC-CTS) was used as a new amendment for remediation of cadmium (Cd)-contaminated soils to reduce the Cd bioavailability. Arabidopsis thaliana was chosen as a model plant to evaluate its efficiency. It was found that DTC-CTS could effectively improve the growth of A. thaliana. The amount of Cd up-taken by A. thaliana could be decreased by as much as 50% compared with that grown in untreated Cd-contaminated soil samples. The chlorophyll content and the aerial biomass of Arabidopsis also increased substantially and eventually returned to a level comparable to plants grown in non-contaminated soils, with the addition of DTC-CTS. These findings suggested that DTC-CTS amendment could be effective in immobilizing Cd and mitigating its accumulation in plants grown in Cd-contaminated soils, with potential application as an in situ remediation of Cd-polluted soils.

Euparyphium albuferensis and Echinostoma friedi (Trematoda: Echinostomatidae): experimental cercarial transmission success in sympatric snail communities.

PubMed

Muñoz-Antoli, Carla; Marin, Antoni; Vidal, Amparo; Toledo, Rafael; Esteban, José Guillermo

2008-06-01

Euparyphium albuferensis and Echinostoma friedi cercarial infectivity to four species of sympatric snails was examined under single- or multiple-choice laboratory conditions to show the level of parasite-snail host compatibility. Radix peregra, Lymnaeafuscus, Physella acuta and Gyraulus chinensis act as second intermediate hosts of both parasite species although different cercarial transmission success (CTS) was observed. In single-host experiments, R. peregra and P. acuta showed a high degree of compatibility with E. albuferensis, while only P. acuta in the case of E. friedi. In two-choice snail communities, a snail with high CTS increased the values of another with low compatibility, in both parasite species. In multiple-choice snail communities, high CTS of some hosts decreased, while low CTS of other hosts increased. The degree of parasite-host compatibility of each snail species could be determined by the presence of other snails in the community.

Spray pyrolyzed Cu2SnS3 thin films for photovoltaic application

NASA Astrophysics Data System (ADS)

Patel, Biren; Waldiya, Manmohansingh; Pati, Ranjan K.; Mukhopadhyay, Indrajit; Ray, Abhijit

2018-05-01

We report the fabrication of Cu2SnS3 (CTS) thin films by a non-vacuum and low cost spray pyrolysis technique. Annealing of the as-deposited film in the sulphur atmosphere produces highly stoichiometric, granular and crystalline CTS phase. The CTS thin films shows direct optical band gap of 1.58 eV with high absorption coefficient of 105 cm-1. Hall measurement shows the carrier concentration of the order of 1021 cm-3 and a favourable resistivity of 10-3 Ω cm. A solar cell architecture of Glass/FTO/CTS/CdS/Al:ZnO/Al was fabricated and its current-voltage characteristic shows an open circuit voltage, short circuit current density and fill-factor of 12.6 mV, 20.2 µA/cm2 and 26% respectively. A further improvement in the solar cell parameters is underway.

The development of a 4D treatment planning methodology to simulate the tracking of central lung tumors in an MRI-linac.

PubMed

Al-Ward, Shahad M; Kim, Anthony; McCann, Claire; Ruschin, Mark; Cheung, Patrick; Sahgal, Arjun; Keller, Brian M

2018-01-01

Targeting and tracking of central lung tumors may be feasible on the Elekta MRI-linac (MRL) due to the soft-tissue visualization capabilities of MRI. The purpose of this work is to develop a novel treatment planning methodology to simulate tracking of central lung tumors with the MRL and to quantify the benefits in OAR sparing compared with the ITV approach. Full 4D-CT datasets for five central lung cancer patients were selected to simulate the condition of having 4D-pseudo-CTs derived from 4D-MRI data available on the MRL with real-time tracking capabilities. We used the MRL treatment planning system to generate two plans: (a) with a set of MLC-defined apertures around the target at each phase of the breathing ("4D-MRL" method); (b) with a fixed set of fields encompassing the maximum inhale and exhale of the breathing cycle ("ITV" method). For both plans, dose accumulation was performed onto a reference phase. To further study the potential benefits of a 4D-MRL method, the results were stratified by tumor motion amplitude, OAR-to-tumor proximity, and the relative OAR motion (ROM). With the 4D-MRL method, the reduction in mean doses was up to 3.0 Gy and 1.9 Gy for the heart and the lung. Moreover, the lung's V12.5 Gy was spared by a maximum of 300 cc. Maximum doses to serial organs were reduced by up to 6.1 Gy, 1.5 Gy, and 9.0 Gy for the esophagus, spinal cord, and the trachea, respectively. OAR dose reduction with our method depended on the tumor motion amplitude and the ROM. Some OARs with large ROMs and in close proximity to the tumor benefited from tracking despite small tumor amplitudes. We developed a novel 4D tracking methodology for the MRL for central lung tumors and quantified the potential dosimetric benefits compared with our current ITV approach. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Methylation-dependent DNA discrimination in natural transformation of Campylobacter jejuni

PubMed Central

Leveque, Rhiannon M.; Dawid, Suzanne; DiRita, Victor J.

2017-01-01

Campylobacter jejuni, a leading cause of bacterial gastroenteritis, is naturally competent. Like many competent organisms, C. jejuni restricts the DNA that can be used for transformation to minimize undesirable changes in the chromosome. Although C. jejuni can be transformed by C. jejuni-derived DNA, it is poorly transformed by the same DNA propagated in Escherichia coli or produced with PCR. Our work indicates that methylation plays an important role in marking DNA for transformation. We have identified a highly conserved DNA methyltransferase, which we term Campylobacter transformation system methyltransferase (ctsM), which methylates an overrepresented 6-bp sequence in the chromosome. DNA derived from a ctsM mutant transforms C. jejuni significantly less well than DNA derived from ctsM+ (parental) cells. The ctsM mutation itself does not affect transformation efficiency when parental DNA is used, suggesting that CtsM is important for marking transforming DNA, but not for transformation itself. The mutant has no growth defect, arguing against ongoing restriction of its own DNA. We further show that E. coli plasmid and PCR-derived DNA can efficiently transform C. jejuni when only a subset of the CtsM sites are methylated in vitro. A single methylation event 1 kb upstream of the DNA involved in homologous recombination is sufficient to transform C. jejuni, whereas otherwise identical unmethylated DNA is not. Methylation influences DNA uptake, with a slight effect also seen on DNA binding. This mechanism of DNA discrimination in C. jejuni is distinct from the DNA discrimination described in other competent bacteria. PMID:28855338

Ecological equivalency as a tool for endangered species management.

PubMed

Searcy, Christopher A; Rollins, Hilary B; Shaffer, H Bradley

2016-01-01

The use of taxon substitutes for extinct or endangered species is a controversial conservation measure. We use the example of the endangered California tiger salamander (Ambystoma californiense; CTS), which is being replaced by hybrids with the invasive barred tiger salamander (Ambystoma mavortium), to illustrate a strategy for evaluating taxon substitutes based on their position in a multivariate community space. Approximately one-quarter of CTS's range is currently occupied by "full hybrids" with 70% nonnative genes, while another one-quarter is occupied by "superinvasives" where a specific set of 3/68 genes comprising 4% of the surveyed genome is nonnative. Based on previous surveys of natural CTS breeding ponds, we stocked experimental mesocosms with field-verified, realistic densities of tiger salamander larvae and their prey, and used these mesocosms to evaluate ecological equivalency between pure CTS, full hybrids, and superinvasives in experimental pond communities. We also included a fourth treatment with no salamanders present to evaluate the community effects of eliminating Ambystoma larvae altogether. We found that pure CTS and superinvasive larvae were ecologically equivalent, because their positions in the multivariate community space were statistically indistinguishable and they did not differ significantly along any univariate community axes. Full hybrids were ecologically similar, but not equivalent, to the other two genotypes, and the no-Ambystoma treatment was by far the most divergent. We conclude that, at least for the larval stage, superinvasives are adequate taxon substitutes for pure CTS and should probably be afforded protection under the Endangered Species Act. The proper conservation status for full hybrids remains debatable.

Systematic Reviews and Clinical Trials in Rehabilitation: Comprehensive Analyses of Publication Trends.

PubMed

Jesus, Tiago S

2016-11-01

To analyze publication trends of clinical trials (CTs) and systematic reviews (SRs) in rehabilitation. PubMed searches were performed with appropriate combinations of Medical Subject Headings. All entries until December 2013, and their yearly distributions since 1981 (when the first rehabilitation SR was identified), were retrieved. After the initial data visualization, data analyses were narrowed to specific periods. Linear regression techniques analyzed the growth of publications and their relative percentages over time. Not applicable. Not applicable. Not applicable. Not applicable. Although not observed for SRs, CTs have grown at a much higher rate in rehabilitation than in the broader health/medical field-more than twice the difference for both periods analyzed (1989-2001, 2001-2013). Rehabilitation journals published about 20% or less of the rehabilitation SRs and CTs, and no significant increases were observed over time (P>.05; 2001-2013). Neurologic conditions, particularly cerebrovascular, were the most addressed by rehabilitation SRs and CTs, while differences between neurologic and other groups of conditions typically widened over time (eg, more than doubled between neurologic and musculoskeletal conditions in 15y). While publications of CTs are increasing at a much higher rate within rehabilitation than within broader health care, further research is warranted to explain why this trend is not being followed by SRs, particularly those with meta-analysis. Similarly, research might determine whether the (growing) differences in the publications of rehabilitation SRs and CTs across groups of conditions are justified by clinical or population need. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

The Effectiveness of a Short Cognitive Behavioral Training Course on Awareness, Knowledge, and Transferability of Competencies in Clinical Practice.

PubMed

Mitchell, Andrew Edward Paul

2017-04-01

In this study, we investigated the effects of training on knowledge acquisition and core competencies in cognitive and behavioral therapy (CBT). Forty-three students attended 15 half-day, weekly sessions and were tested with the Cognitive Therapy Awareness Scale (CTAS) at weeks 1 and 15 in a before and after study. The students' case studies were assessed with competency items 7-12 on the Cognitive Rating Scale-Revised (CTS-R). Improvements in the CTAS were modest. Key competencies on the CTS-R subscales at week 15 were also observed. CBT knowledge acquisition might improve patients' outcomes through impact on competencies. © 2015 Wiley Periodicals, Inc.

Managing costs, managing benefits: employer decisions in local health care markets.

PubMed

Christianson, Jon B; Trude, Sally

2003-02-01

To better understand employer health benefit decision making, how employer health benefits strategies evolve over time, and the impact of employer decisions on local health care systems. Data were collected as part of the Community Tracking Study (CTS), a longitudinal analysis of health system change in 12 randomly selected communities. This is an observational study with data collection over a six-year period. The study used semistructured interviews with local respondents, combined with monitoring of local media, to track changes in health care systems over time and their impact on community residents. Interviewing began in 1996 and was carried out at two-year intervals, with a total of approximately 2,200 interviews. The interviews provided a variety of perspectives on employer decision making concerning health benefits; these perspectives were triangulated to reach conclusions. The tight labor market during the study period was the dominant consideration in employer decision making regarding health benefits. Employers, in managing employee compensation, made independent decisions in pursuit of individual goals, but these decisions were shaped by similar labor market conditions. As a result, within and across our study sites, employer decisions in aggregate had an important impact on local health care systems, although employers' more highly visible public efforts to bring about health system change often met with disappointing results. General economic conditions in the 1990s had an important impact on the configuration of local health systems through their effect on employer decision making regarding health benefits offered to employees, and the responses of health plans and providers to those decisions.

Transcription-dependent radial distribution of TCF7L2 regulated genes in chromosome territories.

PubMed

Torabi, Keyvan; Wangsa, Darawalee; Ponsa, Immaculada; Brown, Markus; Bosch, Anna; Vila-Casadesús, Maria; Karpova, Tatiana S; Calvo, Maria; Castells, Antoni; Miró, Rosa; Ried, Thomas; Camps, Jordi

2017-10-01

Human chromosomes occupy distinct territories in the interphase nucleus. Such chromosome territories (CTs) are positioned according to gene density. Gene-rich CTs are generally located in the center of the nucleus, while gene-poor CTs are positioned more towards the nuclear periphery. However, the association between gene expression levels and the radial positioning of genes within the CT is still under debate. In the present study, we performed three-dimensional fluorescence in situ hybridization experiments in the colorectal cancer cell lines DLD-1 and LoVo using whole chromosome painting probes for chromosomes 8 and 11 and BAC clones targeting four genes with different expression levels assessed by gene expression arrays and RT-PCR. Our results confirmed that the two over-expressed genes, MYC on chromosome 8 and CCND1 on chromosome 11, are located significantly further away from the center of the CT compared to under-expressed genes on the same chromosomes, i.e., DLC1 and SCN3B. When CCND1 expression was reduced after silencing the major transcription factor of the WNT/β-catenin signaling pathway, TCF7L2, the gene was repositioned and mostly detected in the interior of the CT. Thus, we suggest a non-random distribution in which over-expressed genes are located more towards the periphery of the respective CTs.

The influence of atmospheric circulation types on regional patterns of precipitation in Marmara (NW Turkey)

NASA Astrophysics Data System (ADS)

Baltacı, H.; Kındap, T.; Ünal, A.; Karaca, M.

2017-02-01

In this study, regional patterns of precipitation in Marmara are described for the first time by means of Ward's hierarchical cluster analysis. Daily values of winter precipitation data based on 19 meteorological stations were used for the period from 1960 to 2012. Five clusters of coherent zones were determined, namely Black Sea-Marmara, Black Sea, Marmara, Thrace, and Aegean sub-regions. To investigate the prevailing atmospheric circulation types (CTs) that cause precipitation occurrence and intensity in these five different rainfall sub-basins, objective Lamb weather type (LWT) methodology was applied to National Centers of Environmental Prediction (NCEP)/National Center for Atmospheric Research (NCAR) reanalysis of daily mean sea level pressure (MSLP) data. Precipitation occurrence suggested that wet CTs (i.e. N, NE, NW, and C) offer a high chance of precipitation in all sub-regions. For the eastern (western) part of the region, the high probability of rainfall occurrence is shown under the influence of E (SE, S, SW) atmospheric CTs. In terms of precipitation intensity, N and C CTs had the highest positive gradients in all the sub-basins of the Marmara. In addition, although Marmara and Black Sea sub-regions have the highest daily rainfall potential during NE types, high daily rainfall totals are recorded in all sub-regions except the Black Sea during NW types.

The effect of the involvement of the dominant or non-dominant hand on grip/pinch strengths and the Levine score in patients with carpal tunnel syndrome.

PubMed

Zyluk, A; Walaszek, I

2012-06-01

The Levine questionnaire is a disease-oriented instrument developed for outcome measurement of carpal tunnel syndrome (CTS) management. The objective of this study was to compare Levine scores in patients with unilateral CTS, involving the dominant or non-dominant hand, before and after carpal tunnel release. Records of 144 patients, 126 women (87%) and 18 men (13%) aged a mean of 58 years with unilateral CTS, treated operatively, were analysed. The dominant hand was involved in 100 patients (69%), the non-dominant in 44 (31%). The parameters were analysed pre-operatively, and at 1 and 6 months post-operatively. A comparison of Levine scores in patients with the involvement of the dominant or non-dominant hand showed no statistically significant differences at baseline and any of the follow-up measurements. Statistically significant differences were noted in total grip strength at baseline and at 6 month assessments and in key-pinch strength at 1 and 6 months.

Building and evaluation of a structured representation of pharmacokinetics information presented in SPCs: from existing conceptual views of pharmacokinetics associated with natural language processing to object-oriented design.

PubMed

Duclos-Cartolano, Catherine; Venot, Alain

2003-01-01

Develop a detailed representation of pharmacokinetics (PK), derived from the information in Summaries of Product Characteristics (SPCs), for use in computerized systems to help practitioners in pharmaco-therapeutic reasoning. Available knowledge about PK was studied to identify main PK concepts and organize them in a preliminary generic model. The information from 1950 PK SPC-texts in the French language was studied using a morpho-syntactic analyzer. It produced a list of candidate terms (CTs) from which those describing main PK concepts were selected. The contexts in which they occurred were explored to discover co-occurring CTs. The regrouping according to CT semantic types led to a detailed object-oriented model of PK. The model was evaluated. A random sample of 100 PK texts structured according to the model was judged for completeness and semantic accuracy by 8 experts who were blinded to other experts' responses. The PK text file contained about 300000 words, and the morpho-syntactic analysis extracted 17520 different CTs. The context of 592 CTs was studied and used to deduce the PK model. It consists of four entities: the information about the real PK process, the experimental protocol, the mathematical modeling, and the influence of factors causing variation. Experts judged that the PK model represented the information in 100 sample PK texts completely in 89% of cases and nearly completely in the other 11%. There was no distortion of meaning in 98% of cases and little distortion in the remainder. The PK model seems to be applicable to all SPCs and can be used to retranscribe legal information from PK sections of SPCs into structured databases.

Comparison of Risk of Carpal Tunnel Syndrome in Patients with Distal Radius Fractures After 7 Treatments

PubMed Central

Zhao, Huan-Li; Wang, Gui-Bin; Jia, Yue-Qing; Zhu, Shi-Cai; Zhang, Feng-Fang; Liu, Hong-Mei

2015-01-01

Background To compare risk of carpal tunnel syndrome (CTS) in distal radius fracture (DRF) patients after 7 treatments using bridging external fixation (BrEF), non-bridging external fixation (non-BrEF), plaster fixation, K-wire fixation, dorsal plating fixation, volar plating fixation, and dorsal and volar plating by performing a network meta-analysis. Material/Methods An exhaustive search of electronic databases identified randomized controlled trails (RCTs) closely related to our study topic. The published articles were screened, based on predefined inclusion and exclusion criteria, to select high-quality studies for the present network meta-analysis. Data extracted from the selected studies were analyzed using STATA version 12.0 software. Results The literature search and selection process identified 12 eligible RCTs that contained a total of 1370 DRF patients (394 patients with BrEF, 377 patients with non-BrEF, 89 patients with K-wire fixation, 192 patients with plaster fixation, 42 patients with dorsal plating fixation, 152 patients with volar plating fixation, and 124 patients with dorsal and volar plating fixation). Our network meta-analysis results demonstrated no significant differences in CTS risk among the 7 treatments (P>0.05). The value of surface under the cumulative ranking curve (SUCRA), however, suggested that dorsal plating fixation is the optimal treatment, with the lowest risk of CTS in DRF patients (dorsal plating fixation: 89.2%; dorsal and volar plating: 57.8%; plaster fixation: 50.9%; non-BrEF: 50.6%; volar plating fixation: 39.6%; BrEF: 38.4%; K-wire fixation: 23.6%). Conclusions Our network meta-analysis provides evidence that dorsal plating fixation significantly decreases the risk of CTS and could be the method of choice in DRF patients. PMID:26391617

Building and Evaluation of a Structured Representation of Pharmacokinetics Information Presented in SPCs: From Existing Conceptual Views of Pharmacokinetics Associated with Natural Language Processing to Object-oriented Design

PubMed Central

Duclos-Cartolano, Catherine; Venot, Alain

2003-01-01

Objective: Develop a detailed representation of pharmacokinetics (PK), derived from the information in Summaries of Product Characteristics (SPCs), for use in computerized systems to help practitioners in pharmaco-therapeutic reasoning. Methods: Available knowledge about PK was studied to identify main PK concepts and organize them in a preliminary generic model. The information from 1,950 PK SPC-texts in the French language was studied using a morpho-syntactic analyzer. It produced a list of candidate terms (CTs) from which those describing main PK concepts were selected. The contexts in which they occurred were explored to discover co-occurring CTs. The regrouping according to CT semantic types led to a detailed object-oriented model of PK. The model was evaluated. A random sample of 100 PK texts structured according to the model was judged for completeness and semantic accuracy by 8 experts who were blinded to other experts’ responses. Results: The PK text file contained about 300,000 words, and the morpho-syntactic analysis extracted 17,520 different CTs. The context of 592 CTs was studied and used to deduce the PK model. It consists of four entities: the information about the real PK process, the experimental protocol, the mathematical modeling, and the influence of factors causing variation. Experts judged that the PK model represented the information in 100 sample PK texts completely in 89% of cases and nearly completely in the other 11%. There was no distortion of meaning in 98% of cases and little distortion in the remainder. Conclusion: The PK model seems to be applicable to all SPCs and can be used to retranscribe legal information from PK sections of SPCs into structured databases. PMID:12626375

Treatment of Carpal Tunnel Syndrome in pregnancy with Polarized Polychromatic Non-coherent Light (Bioptron Light): A Preliminary, Prospective, Open Clinical Trial.

PubMed

Dimitrios, Stasinopoulos; Stasinopoulos, Loannis

2017-12-31

The aim of this trial was to assess the efficacy of polarized polychromatic noncoherent light (Bioptron light) in the treatment of Carpal Tunnel Syndrome (CTS) in pregnancy. An uncontrolled experimental study was conducted in pregnant patients with CTS who visited our clinic from January 2006 to January 2010. Bioptron light (480-3400 nm; 95% polarization; 40 mW/cm 2 ; and 2.4 J/cm 2 ) was administered perpendicular to the carpal tunnel area. The irradiation time for each session was 6 min at an operating distance of 5-10 cm from the carpal tunnel area, twice each day, five days per week for 2 weeks. Pain and paraesthesia using a visual analogue scale (VAS) and finger pinch strength were evaluated at the end of treatment (week 2) and 1-month (week 6) after the end of treatment. The Student'sttest was used and p values < 0.05 were accepted as statistically significant. 46 patients participated in the study. The mean age of subjects was 27.6 years (range 22-37). The patient population had a mean duration of CTS of 2.3 months (range 1-4). All patients were in the third trimester. Pain and paraesthesia decreased at the end of treatment and at the 1-month follow-up, whereas the finger pinch strength increased at the end of treatment and at the 1-month follow-up. In conclusion, the results of the present study suggest that Bioptron light is a reliable, safe, and effective treatment option in pregnant patients with CTS. Controlled clinical trials are needed to establish the absolute and relative effectiveness of this intervention.

Notification: CTS Asheville Superfund Site Update: Sampling, Monitoring, Communication and Opportunities for Cleanup Efficiencies

EPA Pesticide Factsheets

Project #OPE-FY14-0044, July 22, 2014. The EPA OIG plans to begin preliminary research of the EPA's sampling, monitoring, communication and opportunities for cleanup efficiencies for the CTS Asheville Superfund Site, North Carolina.

Development of a cancer clinical trials multi-media intervention: clinical trials: are they right for you?

PubMed

Wells, Kristen J; Quinn, Gwendolyn P; Meade, Cathy D; Fletcher, Michelle; Tyson, Dinorah Martinez; Jim, Heather; Jacobsen, Paul B

2012-08-01

To describe processes used to develop a multi-media psycho-educational intervention to prepare patients for a discussion about cancer clinical trials (CTs). Guided by a Steering Committee, formative research was conducted to develop an informative and engaging tool about cancer CTs. Twenty-three patients and caregivers participated in formative in-depth interviews to elicit information about perceptions of cancer CTs to inform production of a new media product. Formative research revealed participants had concerns about experimentation, held beliefs that cancer CTs were for patients who had no other treatment options, and wanted a balance of information about pros and cons of CT participation. The value of physicians as credible spokespersons and the use of patients as role-models were supported. Using iterative processes, the production team infused the results into creation of a multimedia psycho-educational intervention titled Clinical Trials: Are they Right for You? An intervention, developed through an iterative consumer-focused process involving multiple stakeholders and formative research, may result in an engaging informative product. If found to be efficacious, Clinical Trials: Are they Right for You? is a low-cost and easily disseminated multimedia psycho-educational intervention to assist cancer patients with making an informed decision about cancer CTs. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Gender adjustment or stratification in discerning upper extremity musculoskeletal disorder risk?

PubMed

Silverstein, Barbara; Fan, Z Joyce; Smith, Caroline K; Bao, Stephen; Howard, Ninica; Spielholz, Peregrin; Bonauto, David; Viikari-Juntura, Eira

2009-03-01

The aim was to explore whether "adjustment" for gender masks important exposure differences between men and women in a study of rotator cuff syndrome (RCS) and carpal tunnel syndrome (CTS) and work exposures. This cross-sectional study of 733 subjects in 12 health care and manufacturing workplaces used detailed individual health and work exposure assessment methods. Multiple logistic regression analysis was used to compare gender stratified and adjusted models. Prevalence of RCS and CTS among women was 7.1% and 11.3% respectively, and among men 7.8% and 6.4%. In adjusted (gender, age, body mass index) multivariate analyses of RCS and CTS, gender was not statistically significantly different. For RCS, upper arm flexion >/=45 degrees and forceful pinch increased the odds in the gender-adjusted model (OR 2.66, 95% CI 1.26-5.59) but primarily among women in the stratified analysis (OR 6.68, 95% CI 1.81-24.66 versus OR 1.45, 95% CI 0.53-4.00). For CTS, wrist radial/ulnar deviation >/=4% time and lifting >/=4.5kg >3% time, the adjusted OR was higher for women (OR 4.85, 95% CI 2.12-11.11) and in the gender stratified analyses, the odds were increased for both genders (women OR 5.18, 95% CI 1.70-15.81 and men OR 3.63, 95% CI 1.08-12.18). Gender differences in response to physical work exposures may reflect gender segregation in work and potential differences in pinch and lifting capacity. Reduction in these exposures may reduce prevalence of upper extremity disorders for all workers.

A novel 3D micron-scale DPTV (Defocused Particle Tracking Velocimetry) and its applications in microfluidic devices

NASA Astrophysics Data System (ADS)

Roberts, John

2005-11-01

The rapid advancements in micro/nano biotechnology demand quantitative tools for characterizing microfluidic flows in lab-on-a-chip applications, validation of computational results for fully 3D flows in complex micro-devices, and efficient observation of cellular dynamics in 3D. We present a novel 3D micron-scale DPTV (defocused particle tracking velocimetry) that is capable of mapping out 3D Lagrangian, as well as 3D Eulerian velocity flow fields at sub-micron resolution and with one camera. The main part of the imaging system is an epi-fluorescent microscope (Olympus IX 51), and the seeding particles are fluorescent particles with diameter range 300nm - 10um. A software package has been developed for identifying (x,y,z,t) coordinates of the particles using the defocused images. Using the imaging system, we successfully mapped the pressure driven flow fields in microfluidic channels. In particular, we measured the Laglangian flow fields in a microfluidic channel with a herring bone pattern at the bottom, the later is used to enhance fluid mixing in lateral directions. The 3D particle tracks revealed the flow structure that has only been seen in numerical computation. This work is supported by the National Science Foundation (CTS - 0514443), the Nanobiotechnology Center at Cornell, and The New York State Center for Life Science Enterprise.

Effects of traditional cupping therapy in patients with carpal tunnel syndrome: a randomized controlled trial.

PubMed

Michalsen, Andreas; Bock, Silke; Lüdtke, Rainer; Rampp, Thomas; Baecker, Marcus; Bachmann, Jürgen; Langhorst, Jost; Musial, Frauke; Dobos, Gustav J

2009-06-01

We investigated the effectiveness of cupping, a traditional method of treating musculoskeletal pain, in patients with carpal tunnel syndrome (CTS) in an open randomized trial. n = 52 outpatients (58.5 +/- 8.0 years) with neurologically confirmed CTS were randomly assigned to either a verum (n = 26) or a control group (n = 26). Verum patients were treated with a single application of wet cupping, and control patients with a single local application of heat within the region overlying the trapezius muscle. Patients were followed up on day 7 after treatment. The primary outcome, severity of CTS symptoms (VAS), was reduced from 61.5 +/- 20.5 to 24.6 +/- 22.7 mm at day 7 in the cupping group and from 67.1 +/- 20.2 to 51.7 +/- 23.9 mm in the control group [group difference -24.5mm (95%CI -36.1; -2.9, P < .001)]. Significant treatment effects were also found for the Levine CTS-score (-.6 pts: 95%CI -.9; -.2, P = .002), neck pain (-12.6mm; 95%CI -18.8; -6.4, P < .001), functional disability (DASH-Score) (-11.1 pts; 95%CI -17.1; -5.1, P < .001), and physical quality of life (.3; 95%CI .0; .3, P = .048). The treatment was safe and well tolerated. We conclude that cupping therapy may be effective in relieving the pain and other symptoms related to CTS. The efficacy of cupping in the long-term management of CTS and related mechanisms remains to be clarified. The results of a randomized trial on the clinical effects of traditional cupping therapy in patients with carpal tunnel syndrome are presented. Cupping of segmentally related shoulder zones appears to alleviate the symptoms of carpal tunnel syndrome.

Changes in rumen protozoal community by condensed tannin fractions of different molecular weights from a Leucaena leucocephala hybrid in vitro.

PubMed

Saminathan, M; Gan, H M; Abdullah, N; Wong, C M V L; Ramiah, S K; Tan, H Y; Sieo, C C; Ho, Y W

2017-04-23

To evaluate the effects of condensed tannins (CTs) fractions of differing molecular weights (MWs) from a Leucaena leucocephala hybrid-Rendang on the rumen protozoal community in vitro. The effects of unfractionated CTs (F0) and CT fractions of different MWs (F1 > F2 > F3 > F4 > F5) on protozoal population and community were evaluated in vitro using rumen microbes and ground guinea grass as the substrate. Higher-MW CT fractions F1 and F2 significantly (P < 0·05) decrease the number of ciliate protozoa. The real-time PCR analysis showed that the total protozoa was significantly (P < 0·05) lower in F0 and all CTs with fractions F1 and F2 having the lowest value. High-throughput sequencing of the partial 18S rRNA gene showed that the genus Entodinium significantly (P < 0·05) decreased with increasing MWs of CT, whereas Anoplodinium-Diplodinium were significantly (P < 0·05) increased. Inclusion of the highest MW CT fraction F1 decreased the relative abundance of the minor genera such as Eudiplodinium and Polyplastron compared to the control and CT fractions F2-F5. CTs of differing MWs could reduce and alter the rumen protozoa population in vitro. This effect was more pronounced for higher-MW CTs. The high MW CTs should be considered as a feed supplement in the ruminant diet to reduce the protozoal population which are known to be associated with methanogens as a means to mitigate methane production in the rumen. Journal of Applied Microbiology © 2017 The Society for Applied Microbiology.

Do exposure limits for hand-transmitted vibration prevent carpal tunnel syndrome?

PubMed

Gillibrand, S; Ntani, G; Coggon, D

2016-07-01

An apparently high frequency of carpal tunnel syndrome (CTS) among shipyard workers undergoing health surveillance because of exposure to hand-transmitted vibration (HTV) prompted concerns that current regulatory limits on exposure might not protect adequately against the disorder. To explore whether within regulatory limits, higher exposures to HTV predispose to CTS. As part of a retrospective audit, we compared duration and current intensity of exposure to HTV in cases with new-onset CTS and controls matched for age. Conditional logistic regression was used to quantify associations, which were summarized by odds ratios (ORs) and 95% confidence intervals (CIs). There were 23 cases and 55 controls. After adjustment for body mass index and previous diagnosis of diabetes, no clear associations were observed either with duration of exposure to HTV or with current intensity of exposure. Risk was non-significantly elevated in men with ≥30 years' exposure to HTV (OR 1.6), but in the highest category of current exposure [8-h energy-equivalent frequency-weighted acceleration (A8) ≥ 4.0 m/s(2)], risk was lower than that in the reference category (A8 < 2.5 m/s(2)). Moreover, there was a significantly reduced risk of CTS in men with a previous diagnosis of hand-arm vibration syndrome (HAVS) (OR 0.2, 95% CI 0.1-0.9). We found no evidence that below the current limit for A(8) of 5 m/s(2), higher exposures to HTV predispose to CTS. However, care should be taken not to overlook the possibility of treatable CTS when workers with diagnosed HAVS present with new or worsening sensory symptoms in the hand. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Chitosan-immobilized pectinolytics with novel catalytic features and fruit juice clarification potentialities.

PubMed

Irshad, Muhammad; Murtza, Aimen; Zafar, Muddassar; Bhatti, Khizar Hayat; Rehman, Abdul; Anwar, Zahid

2017-11-01

Biological macromolecules are primarily composed of complex polysaccharides that strengthen microbial growth for the production of industrially relevant enzymes. The presence of polysaccharides in the form of the disrupted cell wall and cell materials are among major challenges in the fruit juice industry. The breakdown of such biological macromolecules including cellulose and pectin is vital for the juices processing. In this background, pectinolytic enzymes including polygalacturonase (PG), pectin lyase (PL), and pectin methylesterase (PME) were isolated from Aspergillus ornatus, statistically optimized and purified via ammonium sulfate fractionation (ASF), dialysis, and Sephadex G-100 gel permeation chromatography. After passing through Sephadex G-100 column, PG, PL, and PME were 2.60-fold, 3.30-fold, and 4.52-fold purified with specific activities of 475.2U/mg, 557.1U/mg, and 205.7U/mg. The active PG, PL, and PME, each separately, were surface immobilized using various concentrations of chitosan and dextran polyaldehyde as a macromolecular crosslinking agent. Prior to exploit for juice clarification purposes, various parameters including pH, thermal and Michaelis-Menten kinetic constants of purified and chitosan-immobilized fractions were investigated. A considerable improvement in the pH and thermal profiles was recorded after immobilization. However, the negligible difference between the K m and V max values of purified free and chitosan-immobilized fractions revealed that the conformational flexibility of pectinolytics was retained as such. A significant color and turbidity reductions were recorded after 60min treatment with CTS-PG, followed by CTS-PME, and CTS-PL. It can be concluded that the clarification of apples, mango, peach, and apricot juices was greatly affected by CTS-PG, CTS-PME, and CTS-PL treatments rendering them as potential candidatures for food industry applications. Copyright © 2017 Elsevier B.V. All rights reserved.

Integrating data from multiple sources for data completeness in a web-based registry for pediatric renal transplantation--the CERTAIN Registry.

PubMed

Köster, Lennart; Krupka, Kai; Höcker, Britta; Rahmel, Axel; Samuel, Undine; Zanen, Wouter; Opelz, Gerhard; Süsal, Caner; Döhler, Bernd; Plotnicki, Lukasz; Kohl, Christian D; Knaup, Petra; Tönshoff, Burkhard

2015-01-01

Patient registries are a useful tool to measure outcomes and compare the effectiveness of therapies in a specific patient population. High data quality and completeness are therefore advantageous for registry analysis. Data integration from multiple sources may increase completeness of the data. The pediatric renal transplantation registry CERTAIN identified Eurotransplant (ET) and the Collaborative Transplant Study (CTS) as possible partners for data exchange. Import and export interfaces with CTS and ET were implemented. All parties reached their projected goals and benefit from the exchange.

Activity, purification, and analysis of condensed tannins

USDA-ARS?s Scientific Manuscript database

As a class of plant polyphenolic compounds contained in some forages (i.e., sanfoin, big trefoil, birdfoot trefoil), condensed tannins (CTs), also referred to as proanthocyanidins (PAs), exhibit a variety of biological effects on ruminants and on the dairy farm nitrogen cycle. Interest in CTs stems ...

Effectiveness of Surgical and Postsurgical Interventions for Carpal Tunnel Syndrome-A Systematic Review.

PubMed

Huisstede, Bionka M; van den Brink, Janneke; Randsdorp, Manon S; Geelen, Sven J; Koes, Bart W

2017-05-31

To present an evidence-based overview of the effectiveness of surgical and postsurgical interventions for carpal tunnel syndrome (CTS). The Cochrane Library, PubMed, EMBASE, CINAHL, and PEDro were searched for relevant systematic reviews and randomized controlled trials (RCTs) up to April 8, 2016. Two reviewers independently applied the inclusion criteria to select potential studies. Two reviewers independently extracted the data and assessed the methodologic quality. A best-evidence synthesis was performed to summarize the results. Four systematic reviews and 33 RCTs were included. Surgery versus nonsurgical interventions, timing of surgery, and various surgical techniques and postoperative interventions were studied. Corticosteroid injection was more effective than surgery (strong evidence, short-term). Surgery was more effective than splinting or anti-inflammatory drugs plus hand therapy (moderate evidence, midterm and long-term). Manual therapy was more effective than surgical treatment (moderate evidence, short-term and midterm). Within surgery, corticosteroid irrigation of the median nerve before skin closure as additive to CTS release or the direct vision plus tunneling technique was more effective than standard open CTS release (moderate evidence, short-term). Furthermore, short was more effective than long bulky dressings, and a sensory retraining program was more effective than no program after surgery (moderate evidence, short-term). For all other interventions only conflicting, limited, or no evidence was found. Surgical treatment seems to be more effective than splinting or anti-inflammatory drugs plus hand therapy in the short-term, midterm, and/or long-term to treat CTS. However there is strong evidence that a local corticosteroid injection is more effective than surgery in the short-term, and moderate evidence that manual therapy is more effective than surgery in the short-term and midterm. There is no unequivocal evidence that suggests one surgical treatment is more effective than the other. Postsurgical, a short- (2-3 days) favored a long-duration (9-14 days) bulky dressing and a sensory retraining program seems to be more effective than no program in short-term. More research regarding the optimal timing of surgery for CTS is needed. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Cor triatriatum sinister identified after new onset atrial fibrillation in an elderly man.

PubMed

Zepeda, Ignacio A; Morcos, Peter; Castellanos, Luis R

2014-01-01

A 73-year-old man with new onset atrial fibrillation with rapid ventricular response underwent transthoracic echocardiography that revealed an echogenic linear structure along the left atrium, suggestive of cor triatriatum sinister (CTS). CTS was confirmed with transesophageal echocardiography which demonstrated a proximal accessory atrium receiving pulmonary venous flow separated from a distal true atrium by a fibromuscular membrane with a large fenestration allowing flow between the chambers. In CTS, the left atrium is divided into proximal and distal chambers by a fenestrated fibromuscular septum. This cardiac anomaly accounts for 0.1% of cases of congenital heart disease and rarely presents in adults. CTS is primarily diagnosed with echocardiography and is associated with left atrial enlargement and development of atrial fibrillation. Treatment options depend on size of the communication between proximal and distal chambers, the gradient across the membrane, and the position of pulmonary veins. In some instances, surgical resection of the membrane that divides the left atrium is warranted.

Cor Triatriatum Sinister Identified after New Onset Atrial Fibrillation in an Elderly Man

PubMed Central

Zepeda, Ignacio A.; Morcos, Peter; Castellanos, Luis R.

2014-01-01

A 73-year-old man with new onset atrial fibrillation with rapid ventricular response underwent transthoracic echocardiography that revealed an echogenic linear structure along the left atrium, suggestive of cor triatriatum sinister (CTS). CTS was confirmed with transesophageal echocardiography which demonstrated a proximal accessory atrium receiving pulmonary venous flow separated from a distal true atrium by a fibromuscular membrane with a large fenestration allowing flow between the chambers. In CTS, the left atrium is divided into proximal and distal chambers by a fenestrated fibromuscular septum. This cardiac anomaly accounts for 0.1% of cases of congenital heart disease and rarely presents in adults. CTS is primarily diagnosed with echocardiography and is associated with left atrial enlargement and development of atrial fibrillation. Treatment options depend on size of the communication between proximal and distal chambers, the gradient across the membrane, and the position of pulmonary veins. In some instances, surgical resection of the membrane that divides the left atrium is warranted. PMID:25614746

Effects of adopting new precession, nutation and equinox corrections on the terrestrial reference frame

NASA Technical Reports Server (NTRS)

Zhu, S. Y.; Mueller, I. I.

1982-01-01

The effect of adopting definitive precession and equinox corrections on the terrestrial reference frame was investigated. It is noted that the effect on polar motion is a diurnal periodic term with an amplitude increasing linearly in time whole on UT1 it is a linear term: general principles are given to determine the effects of small rotations of the frame of a conventional inertial reference system (CIS) on the frame of the conventional terrestrial reference system (CTS); seven CTS options are presented, one of which is necessary to accommodate such rotation. Accommodating possible future changes in the astronomical nutation is discussed. The effects of differences which may exist between the various CTS's and CIS's on Earth rotation parameters (ERP) and how these differences can be determined are examined. It is shown that the CTS differences can be determined from observations made at the same site. The CIS differences by comparing the ERP's are determined by the different techniques during the same time period.

Effects of adopting new precession, nutation and equinox corrections on the terrestrial reference frame

NASA Technical Reports Server (NTRS)

Zhu, S. Y.; Mueller, I. I.

1982-01-01

The effects of adopting new definitive precession and equinox corrections on the terrestrial reference frame was investigated. It is noted that: (1) the effect on polar motion is a diurnal periodic term with an amplitude increasing linearly in time whole on UT1 it is a linear term; (2) general principles are given to determine the effects of small rotations of the frame of a conventional inertial reference system (CIS) on the frame of the conventional terrestrial reference system (CTS); (3) seven CTS options are presented, one of which is necessary to accommodate such rotation. Accommodating possible future changes in the astronomical nutation is discussed. The effects of differences which may exist between the various CTS's and CIS's on Earth rotation parameters (ERP) and how these differences can be determined are examined. It is shown that the CTS differences can be determined from observations made at the same site, while the CIS differences by comparing the ERP's determined by the different techniques during the same time period.

Chitosan-based nanocarriers for antimalarials

NASA Astrophysics Data System (ADS)

Dreve, Simina; Kacso, Iren; Popa, Adriana; Raita, Oana; Bende, A.; Borodi, Gh.; Bratu, I.

2012-02-01

The objective of this research was to synthesize and characterize chitosan-based liquid and solid materials with unique absorptive and mechanical properties as carriers for quinine - one of the most used antimalarial drug. The use of chitosan (CTS) as base in polyelectrolyte complex systems, to prepare solid release systems as sponges is presented. The preparation by double emulsification of CTS hydrogels carrying quinine as anti-malarial drug is reported. The concentration of quinine in the CTS hydrogel was 0.08 mmol. Chitosan - drug loaded hydrogel was used to generate solid sponges by freeze-drying at -610°C and 0.09 atm. Structural investigations of the solid formulations were done by Fourier-transformed infrared spectroscopy (FTIR), ultraviolet-visible spectroscopy (UV-VIS), spectrofluorimetry, differential scanning calorimetry (DSC) and X-ray diffractometry. The results indicated that the drug molecule is forming temporary chelates in CTS hydrogels and sponges. Electron paramagnetic resonance (EPR) demonstrates the presence of free radicals in a wide range and the antioxidant activity for chitosan - drug supramolecular cross-linked assemblies.

[Bilateral "crocodile tears syndrome" associated with Melkersson-Rosenthal syndrome--case report].

PubMed

Owecki, Michał K; Kapelusiak-Pielok, Magdalena; Kowal, Piotr; Kozubski, Wojciech

2006-01-01

We present a rare case of bilateral crocodile tears syndrome (CTS) in the course of Melkersson-Rosenthal syndrome. Melkersson-Rosenthal syndrome is characterised by a triad of recurrent orofacial swelling, relapsing facial paralysis, and fissured tongue. The classic triad is infrequent and oligosymptomatic variants are seen more frequently. CTS is a rare complication of facial nerve paralysis characterised by inappropriate lacrimation on the side of the palsy in response to salivary stimuli. It results from aberrant reinnervation of the lacrimal gland by salivary parasympathetic fibres. The therapeutic approach for an acute bout of Melkersson-Rosenthal syndrome consists mainly of steroid administration. CTS management is composed of anticholinergic drugs and surgical procedures. Botulin toxin injection into the lacrimal gland is the most modern therapeutic option. In the case presented CTS developed in a 50-year-old man after 5 incidents of facial palsy due to Melkersson-Rosenthal syndrome. The case deserves attention due to the rarity of the observed symptoms and signs.

Extreme X-ray Behaviour of Mrk 421

NASA Astrophysics Data System (ADS)

Kapanadze, Bidzina

2013-03-01

In ATel #4864 (B. Kapanadze, M4k 421 Still Active through X-rays), we reported the flaring activity in the high-energy peaked BL Lacertae source Mrk 421 (z=0.031) detected via the observations performed during March 1-5, 2013, by the X-ray Telescope (XRT) onboard the Swift satellite. The recent observations, performed by this telescope, show increasing X-ray activity of this source. The data, allocated at the webpage http://www.swift.psu.edu/monitoring/ , show that the source was extremely active on hours timescale during the March 17 pointing: the 0.3-10 keV flux dropped from 16.83+0.17 cts/s (Orbit 1) to 12.46+0.24 cts/s (Orbit 5) in about 4.2 hr; it increased then to 24.60+0.14 cts/s for next orbit (in 1.45 hr) and afterwards drooped again to 16.01+0.15 cts/s in the case of next orbit (in 1.7 hr).

Carpal Tunnel Syndrome in Aberrant Muscle Syndrome: A Case Report and Review of the Literature.

PubMed

Steele, Jessica; Coombs, Christopher

2018-06-01

Aberrant Muscle Syndrome (AMS) is a rare congenital hand difference that is characterised by unilateral non-progressive muscular hyperplasia. The aetiology of aberrant muscle syndrome is not known, but a recently published case has shown a somatic PIK3CA activating mutation in a patient with AMS. Carpal tunnel syndrome (CTS) in children is rare. The most common causes are the mucopolysaccaridoses but space-occupying lesions have also been reported to cause CTS in children. We report the first case of CTS in a child with AMS successfully treated with open carpal tunnel release and excision of aberrant muscles.

Neuropathic symptoms and findings in women with Fabry disease.

PubMed

Laaksonen, Satu M; Röyttä, Matias; Jääskeläinen, Satu K; Kantola, Ilkka; Penttinen, Maila; Falck, Björn

2008-06-01

To examine the neurologic and neurophysiologic findings and neurologic symptoms in 12 women with Fabry disease and to study the relationship between the subjective symptoms and the findings on the various tests done. Neurography, vibratory and thermal quantitative sensory testing (QST), skin biopsy for measuring intraepidermal nerve fiber density (IENFD). Heart rate variability (HRV) and sympathetic skin response (SSR) tests for detecting autonomic dysfunction, pain-, depression- and somatic symptom questionnaires and clinical examination. Only two women had no persistent symptoms or signs of polyneuropathy, 10 had symptoms of small fiber neuropathy. Neurological examination was normal in most patients. Five patients had decreased IENFD or thermal hypoesthesia in QST. In QST, Adelta-fiber function for innocuous cold was more often impaired than C-fiber function. Conventional nerve conduction studies were mostly normal. Carpal tunnel syndrome (CTS) incidence was increased, 25% had symptomatic CTS. Heterozygous women carrying the gene for Fabry disease have symptoms and findings of small-fiber polyneuropathy more often than has previously been considered. The prevalence of CTS is also increased. While the clinical diagnosis of small-fiber neuropathy is difficult, the diagnostic yield can be increased using a combination of thermal QST and IENFD measurements.

Time course and predictors of median nerve conduction after carpal tunnel release.

PubMed

Rotman, Mitchell B; Enkvetchakul, Bobby V; Megerian, J Thomas; Gozani, Shai N

2004-05-01

To identify predictors of outcome and of electrophysiologic recovery in patients with carpal tunnel syndrome (CTS) treated by endoscopic carpal tunnel release using a nerve conduction testing system (NC-Stat; NEUROMetrix, Inc, Waltham, MA). Validity of the automated nerve conduction testing system was shown by comparing presurgical distal motor latencies (DMLs) against a reference obtained by referral to an electromyography laboratory. The DML was evaluated in 48 patients with CTS. Measurements were obtained within 1 hour of surgery and at 2 weeks, 6 weeks, 3 months, and 6 months after carpal tunnel release. Presurgical and postsurgical DMLs were then compared and correlated with variables and possible predictors of outcome including age, body mass index, gender, and presurgical DMLs. The automated nerve conduction testing system DMLs matched those of reference electromyography/nerve conduction study values with high correlation. Sensitivity of the automated nerve conduction testing system when compared with a standardized CTS case definition was 89%, with a specificity of 95%. A significant correlation was found between the DML before release and the DML 1 hour after release. Moreover, maximal postsurgical DML improvement was highly dependent on the presurgical DML, with no improvement shown for the <4-ms group, mild improvement for the 4-to-6-ms group, and maximal improvement in the >6-ms group. Among the clinical variables of age, gender, and body mass index only age was mildly predictive of postrelease DML changes at 6 months. No other correlations between clinical variables and postsurgical DMLs were significant. In addition the predictive value of age was lost when combined with the presurgical DML in a multivariate analysis. Postsurgical changes in the median nerve DML were highly dependent on the prerelease latency. The sensitivity and specificity of a nerve conduction monitoring system in detecting and aiding in the diagnosis of CTS is useful in the long-term management of patients with CTS and can aid in determining the level of improvement in median nerve function after endoscopic carpal tunnel release.

Carpal tunnel syndrome and keyboard use at work: a population-based study.

PubMed

Atroshi, Isam; Gummesson, Christina; Ornstein, Ewald; Johnsson, Ragnar; Ranstam, Jonas

2007-11-01

To investigate the relationship between carpal tunnel syndrome (CTS) and keyboard use at work in a general population. A health status questionnaire was mailed to 2,465 persons of working age (25-65 years) who were randomly selected from the general population of a representative region of Sweden. The questionnaire required the subjects to provide information about the presence and severity of pain, numbness and tingling in each body region, employment history, and work activities, including average time spent using a keyboard during a usual working day. Those reporting recurrent hand numbness or tingling in the median nerve distribution were asked to undergo a physical examination and nerve conduction testing. The prevalence of CTS, defined as symptoms plus abnormal results on nerve conduction tests, was compared between groups of subjects that differed in their intensity of keyboard use, adjusting for age, sex, body mass index, and smoking status. Eighty-two percent responded to the questionnaire, and 80% of all symptomatic persons attended the examinations. Persons who had reported intensive keyboard use on the questionnaire were significantly less likely to be diagnosed as having CTS than were those who had reported little keyboard use, with a prevalence that increased from 2.6% in the highest keyboard use group (> or = 4 hours/day), to 2.9% in the moderate use group (1 to <4 hours/day), 4.9% in the low use group (<1 hour/day), and 5.2% in the no keyboard use at work group (P for trend = 0.032). Using > or = 1 hour/day to designate high keyboard use and <1 hour/day to designate low keyboard use, the prevalence ratio of CTS in the groups with high to low keyboard use was 0.55 (95% confidence interval 0.32, 0.96). Intensive keyboard use appears to be associated with a lower risk of CTS.

A Decade of Change: Training and Career Paths of Cardiothoracic Surgery Residents 2003 to 2014.

PubMed

Stephens, Elizabeth H; Odell, David; Stein, William; LaPar, Damien J; DeNino, Walter F; Aftab, Muhammad; Berfield, Kathleen; Eilers, Amanda L; Groth, Shawn; Lazar, John F; Robich, Michael P; Shah, Asad A; Smith, Danielle A; Stock, Cameron; Tchantchaleishvili, Vakhtang; Mery, Carlos M; Turek, Joseph W; Salazar, Jorge; Nguyen, Tom C

2015-10-01

During the past decade, cardiothoracic surgery (CTS) education has undergone tremendous change with the advent of new technologies and the implementation of integrated programs, to name a few. The goal of this study was to assess how residents' career paths, training, and perceptions changed during this period. The 2006 to 2014 surveys accompanying the Thoracic Surgery Residents Association/Thoracic Surgery Directors' Association in-training examination taken by CTS residents were analyzed, along with a 2003 survey of graduating CTS residents. Of 2,563 residents surveyed, 2,434 (95%) responded. During the decade, fewer residents were interested in mixed adult cardiac/thoracic practice (20% in 2014 vs 52% in 2003, p = 0.004), more planned on additional training (10% in 2003 vs 41% to 47% from 2011 to 2014), and the frequent use of simulation increased from 1% in 2009 to 24% in 2012 (p < 0.001). More residents recommended CTS to potential trainees (79% in 2014 vs 65% in 2010, p = 0.007). Job offers increased from a low of 12% in 2008 with three or more offers to 34% in 2014. Debt increased from 0% with more than $200,000 in 2003 to 40% in 2013 (p < 0.001). Compared with residents in traditional programs, more integrated residents in 2014 were interested in adult cardiac surgery (53% vs 31%) and congenital surgery (22% vs 7%), fewer were interested in general thoracic surgery (5% vs 31%, p < 0.001), and more planned on additional training (66% vs 36%, p < 0.001). With the evolution in CTS over the last decade, residents' training and career paths have changed substantially, with increased specialization and simulation accompanied by increased resident satisfaction and an improved job market. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Managing Costs, Managing Benefits: Employer Decisions in Local Health Care Markets

PubMed Central

Christianson, Jon B; Trude, Sally

2003-01-01

Objectives To better understand employer health benefit decision making, how employer health benefits strategies evolve over time, and the impact of employer decisions on local health care systems. Data Sources/Study Setting. Data were collected as part of the Community Tracking Study (CTS), a longitudinal analysis of health system change in 12 randomly selected communities. Study Design This is an observational study with data collection over a six-year period. Data Collection/Extraction Methods The study used semistructured interviews with local respondents, combined with monitoring of local media, to track changes in health care systems over time and their impact on community residents. Interviewing began in 1996 and was carried out at two-year intervals, with a total of approximately 2,200 interviews. The interviews provided a variety of perspectives on employer decision making concerning health benefits; these perspectives were triangulated to reach conclusions. Principal Findings The tight labor market during the study period was the dominant consideration in employer decision making regarding health benefits. Employers, in managing employee compensation, made independent decisions in pursuit of individual goals, but these decisions were shaped by similar labor market conditions. As a result, within and across our study sites, employer decisions in aggregate had an important impact on local health care systems, although employers' more highly visible public efforts to bring about health system change often met with disappointing results. Conclusions General economic conditions in the 1990s had an important impact on the configuration of local health systems through their effect on employer decision making regarding health benefits offered to employees, and the responses of health plans and providers to those decisions. PMID:12650371

Mutations in the Arabidopsis Peroxisomal ABC Transporter COMATOSE Allow Differentiation between Multiple Functions In Planta: Insights from an Allelic Series

PubMed Central

Dietrich, Daniela; Schmuths, Heike; Lousa, Carine De Marcos; Baldwin, Jocelyn M.; Baldwin, Stephen A.; Baker, Alison; Holdsworth, Michael J.

2009-01-01

COMATOSE (CTS), the Arabidopsis homologue of human Adrenoleukodystrophy protein (ALDP), is required for import of substrates for peroxisomal β-oxidation. A new allelic series and a homology model based on the bacterial ABC transporter, Sav1866, provide novel insights into structure-function relations of ABC subfamily D proteins. In contrast to ALDP, where the majority of mutations result in protein absence from the peroxisomal membrane, all CTS mutants produced stable protein. Mutation of conserved residues in the Walker A and B motifs in CTS nucleotide-binding domain (NBD) 1 resulted in a null phenotype but had little effect in NBD2, indicating that the NBDs are functionally distinct in vivo. Two alleles containing mutations in NBD1 outside the Walker motifs (E617K and C631Y) exhibited resistance to auxin precursors 2,4-dichlorophenoxybutyric acid (2,4-DB) and indole butyric acid (IBA) but were wild type in all other tests. The homology model predicted that the transmission interfaces are domain-swapped in CTS, and the differential effects of mutations in the conserved “EAA motif” of coupling helix 2 supported this prediction, consistent with distinct roles for each NBD. Our findings demonstrate that CTS functions can be separated by mutagenesis and the structural model provides a framework for interpretation of phenotypic data. PMID:19019987

Hounsfield unit values of retropharyngeal abscess-like lesions seen in Kawasaki disease.

PubMed

Sasaki, Toru; Miyata, Rie; Hatai, Yoshiho; Makita, Kohzoh; Tsunoda, Koichi

2014-04-01

Retropharyngeal abscess-like lesions are occasionally seen in computed tomography (CT) imaging of patients with Kawasaki disease (KD) and these patients often undergo unnecessary surgery. We could distinguish the lesions from true abscesses by measuring their Hounsfield unit values (HUs). To distinguish the retropharyngeal abscess-like lesions from true abscesses without any surgical procedure. We investigated six cases of KD showing such lesions on CTs, both with and without contrast enhancement (CE). We measured the HUs of those lesions and compared them with those of 10 true abscesses as controls. Abscess-like lesions of KD were well enhanced by CE, whereas abscesses showed virtually no enhancement. The mean HU in the six KD cases was 20.0 ± 4.65 (mean ± SD) on plain CTs and 35.6 ± 4.49 on contrast CTs. In abscesses, it was 30.3 ± 4.42 on plain CTs and 30.3 ± 3.57 on contrast CTs. The difference in HU values [(HU on contrast CT) - (HU on plain CT)] was defined as ΔHU. The mean ΔHU was 15.6 ± 5.36 in the six KD lesions and 0.0 ± 2.93 in abscesses, with statistical significance of p < 0.0001 by Student's t test. Thus, ΔHU value may potentially be a useful parameter for their distinction.

Construction and Characterization of a Chitosan-Immobilized-Enzyme and β-Cyclodextrin-Included-Ferrocene-Based Electrochemical Biosensor for H₂O₂ Detection.

PubMed

Dong, Wenbo; Wang, Kaiyin; Chen, Yu; Li, Weiping; Ye, Yanchun; Jin, Shaohua

2017-07-28

An electrochemical detection biosensor was prepared with the chitosan-immobilized-enzyme (CTS-CAT) and β-cyclodextrin-included-ferrocene (β-CD-FE) complex for the determination of H₂O₂. Ferrocene (FE) was included in β-cyclodextrin (β-CD) to increase its stability. The structure of the β-CD-FE was characterized. The inclusion amount, inclusion rate, and electrochemical properties of inclusion complexes were determined to optimize the reaction conditions for the inclusion. CTS-CAT was prepared by a step-by-step immobilization method, which overcame the disadvantages of the conventional preparation methods. The immobilization conditions were optimized to obtain the desired enzyme activity. CTS-CAT/β-CD-FE composite electrodes were prepared by compositing the CTS-CAT with the β-CD-FE complex on a glassy carbon electrode and used for the electrochemical detection of H₂O₂. It was found that the CTS-CAT could produce a strong reduction peak current in response to H₂O₂ and the β-CD-FE could amplify the current signal. The peak current exhibited a linear relationship with the H₂O₂ concentration in the range of 1.0 × 10 -7 -6.0 × 10 -3 mol/L. Our work provided a novel method for the construction of electrochemical biosensors with a fast response, good stability, high sensitivity, and a wide linear response range based on the composite of chitosan and cyclodextrin.

Cannabis, Cigarettes, and Their Co-Occurring Use: Disentangling Differences in Gray Matter Volume

PubMed Central

Jagannathan, Kanchana; Hager, Nathan; Childress, Anna Rose; Rao, Hengyi; Franklin, Teresa R.

2015-01-01

Background: Structural magnetic resonance imaging techniques are powerful tools for examining the effects of drug use on the brain. The nicotine and cannabis literature has demonstrated differences between nicotine cigarette smokers and cannabis users compared to controls in brain structure; however, less is known about the effects of co-occurring cannabis and tobacco use. Methods: We used voxel-based morphometry to examine gray matter volume differences between four groups: (1) cannabis-dependent individuals who do not smoke tobacco (Cs); (2) cannabis-dependent individuals who smoke tobacco (CTs); (3) cannabis-naïve, nicotine-dependent individuals who smoke tobacco (Ts); and (4) healthy controls (HCs). We also explored associations between gray matter volume and measures of cannabis and tobacco use. Results: A significant group effect was observed in the left putamen, thalamus, right precentral gyrus, and left cerebellum. Compared to HCs, the Cs, CTs, and Ts exhibited larger gray matter volumes in the left putamen. Cs also had larger gray matter volume than HCs in the right precentral gyrus. Cs and CTs exhibited smaller gray matter volume than HCs in the thalamus, and CTs and Ts had smaller left cerebellar gray matter volume than HCs. Conclusions: This study extends previous research that independently examined the effects of cannabis or tobacco use on brain structure by including an examination of co-occurring cannabis and tobacco use, and provides evidence that cannabis and tobacco exposure are associated with alterations in brain regions associated with addiction. PMID:26045474

Results of an OSHA ergonomic intervention program in New Hampshire.

PubMed

May, David C

2002-11-01

A number of articles have been written about the value of OSHA inspections, and to a lesser extent, OSHA targeting. However, there have been few, if any, that quantify the effectiveness of an injury specific targeting program. This study examines the change in the incidence of carpal tunnel syndrome (CTS) in a group of employers following the implementation of an OSHA Local Emphasis Program (LEP) for ergonomics by an area office of the Occupational Safety and Health Administration (OSHA). The OSHA program consisted of inspections initiated between 1992 and 1995 in New Hampshire at work sites with a history of CTS and tendinitis workers' compensation claims. Workers' compensation data for 14 employers were examined and the annual incidence for that group were compared with the experience of all other New Hampshire employers. New Hampshire employers who had one or more of their work sites experienced a decline in carpal tunnel syndrome greater than in other New Hampshire employers. The annual incidence of CTS of inspected employers fell from 38/10,000 in 1992 to 3.8/10,000 in 1997. New Hampshire employers not receiving an inspection focused on upper extremity cumulative trauma hazards fell from 6.6/10,000 to 3.4/10,000 during that same period. The LEP group of employers was responsible for 17 percent of all workers' compensation CTS cases in New Hampshire in 1992. By 1997 their contribution had dropped to less than 5 percent.

Reliability of the nerve conduction monitor in repeated measures of median and ulnar nerve latencies

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

Washington, I A

According to the Bureau of Labor Statistics, carpal tunnel syndrome (CTS), one of the most rapidly growing work-related injuries, cost American businesses up to $10 billion dollars in medical costs each year (1992). Because conservative therapy can be implemented and CTS is more reversible in it early stages, early detection will not only save industry unnecessary health care costs, but also prevent employees from experiencing debilitating pain and unnecessary surgery. In response to the growing number of cases of CTS, many companies have introduced screening tools to detect early stages of carpal tunnel syndrome. Neurotron Medical (New Jersey) has designedmore » a portable nerve conduction monitor (Nervepace S-200) which measures motor and sensory nerve latencies. The slowing of these latencies is one diagnostic indicator of carpal tunnel syndrome. In this study, we determined the reliability of the Nervepace Monitor in measure ulnar and median nerve latencies during repeated testing. The testing was performed on 28 normal subjects between the ages of 20 and 35 who had no prior symptoms of CTS. They were tested at the same time each day for three consecutive days. Nerve latencies between different ethnic groups and genders were compared. Results show that there was no significant daily variation of the median motor and lunar sensory latencies or the median sensory latencies. No significant differences of latencies was observed among ethnic groups; however, a significant difference of latencies between male and female subjects was observed (p<0.05).« less

[The contribution made by neurophysiological and ultrasound imaging studies to the diagnosis of carpal tunnel syndrome. Surgical correlation].

PubMed

de Pablos, C; Velasco-Zarzosa, M; Landeras-Alvaro, R; Rubio-Lorenzo, M; Martínez-Zubieta, P

Electrophysiological study has been for long time the elected approach for the diagnosis and clinical evaluation of carpal tunnel syndrome (CTS). More recently, echography and other imaging techniques have been introduced in current medicine for their potential in the anatomical evaluation of the neural compression. To asses the usefulness of both diagnostic procedures we have compared the findings obtained by electrophysiological and echographic approaches in a group of 60 CTS patients with different degrees of the disease. In all patients the conduction velocity was evaluated in the median and cubital nerves using surface electrodes. For echography lineal transductors of 5-10 Hz and 5-12.5 MHz were employed. The patients were distributed for each test on a scale depending of the severity of the alterations detected by the corresponding technique and both files were subsequently compared by regression analysis, Pearson test and paired-test. No correlation was detected in any of the statistical test. The lack of correlation between the results of both proofs emphasizes the usefulness of the two diagnostic approaches in CTS. While electrophysiological study provides information about nerve function, ecography unravels the morphological alterations accounting for the syndrome, therefore being non-excluding complementary approaches.

Sensory function assessment. A pilot comparison study of touch pressure threshold with texture and tactile discrimination.

PubMed

King, P M

1997-01-01

The purpose of this study was to determine if a correlation exists between touch-pressure threshold testing and sensory discrimination function, specifically tactile gnosis for texture and object recognition. Twenty-nine patients diagnosed with carpal tunnel syndrome (CTS), as confirmed by electromyography or nerve conduction velocity tests, were administered three sensibility tests: the Semmes-Weinstein monofilament test, a texture discrimination test, and an object identification test. Norms were established for texture and object recognition tests using 100 subjects (50 females and 50 males) with normal touch-pressure thresholds as assessed by the Semmes-Weinstein monofilament test. The CTS patients were grouped into three categories of sensibility as determined by their performance on the Semmes-Weinstein monofilament test: normal, diminished light touch, and diminished protective sensation. Through an independent t test statistical procedure, each of the three categories mean response times for identification of textures of objects were compared with the normed response times. Accurate responses were given for identification of all textures and objects. No significant difference (p < .05) was noted in mean response times of the CTS patients with normal touch-pressure thresholds. A significant difference (p < .05) in response times by those CTS patients with diminished light touch was detected in identification in four out of six objects. Subjects with diminished protective sensation had significantly longer response times (p < .05) for identification of the textures of cork, coarse and fine sandpaper, and rubber. Significantly longer response times were recorded by the same subjects for identification of such objects as a screw and a button, and for the shapes of a square, triangle, and oval.

Report: Progress Made, but Improvements Needed at CTS of Asheville Superfund Site in North Carolina to Advance Cleanup Pace and Reduce Potential Exposure

EPA Pesticide Factsheets

Report #16-P-0296, August 31, 2016. EPA Region 4 can accelerate the cleanup and completeness of work, and improve public communications, to better control human exposure to unsafe industrial contamination at the CTS site.

78 FR 54201 - Misuse of Internet Protocol (IP) Captioned Telephone Service; Telecommunications Relay Services...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-03

...] Misuse of Internet Protocol (IP) Captioned Telephone Service; Telecommunications Relay Services and... further possible actions necessary to improve internet protocol captioned telephone relay service (IP CTS... for calculating the compensation rate paid to IP CTS providers. This action is necessary to ensure...

78 FR 76097 - Request for Comment on Petition Filed by Sprint Corporation for Reconsideration of Certain Rules...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-16

... for Internet Protocol Captioned Telephone Service AGENCY: Federal Communications Commission. ACTION... Internet Protocol Captioned Telephone Service (IP CTS) in the IP CTS Reform Order. The Commission seeks... from the Interstate Telecommunications Relay Service Fund (TRS Fund) for minutes of use generated by...

Efficacy of topical chamomile oil for mild and moderate carpal tunnel syndrome: A randomized double-blind placebo-controlled clinical trial.

PubMed

Hashempur, Mohammad Hashem; Ghasemi, Mohammad Sadegh; Daneshfard, Babak; Ghoreishi, Parissa Sadat; Lari, Zeinab Nasiri; Homayouni, Kaynoosh; Zargaran, Arman

2017-02-01

To evaluate the efficacy of topical chamomile oil in patients with mild and moderate carpal tunnel syndrome (CTS). Eighty six patients with electrodiagnostic criteria of mild and moderate CTS were enrolled in this randomized double-blind placebo-controlled clinical trial and received wrist splint plus topical chamomile oil or placebo for 4 weeks. They were evaluated at the baseline and end of the study regarding functional and symptomatic scores, dynamometry, and electrodiagnostic indexes. Dynamometry, functionality, and symptom severity scores of the patients were significantly improved in the chamomile oil group compared with the placebo group (P = 0.040, P = 0.0001, P = 0.017, respectively). Additionally, compound latency of the median nerve in the chamomile oil group significantly decreased (P = 0.035) compared to the placebo group. Other electerodiagnostic measurements did not change significantly. Complementary treatment with topical chamomile oil may have some benefits for patients with mild and moderate CTS, both subjectively and objectively. Copyright © 2016 Elsevier Ltd. All rights reserved.

Transparent, biocompatible nanostructured surfaces for cancer cell capture and culture

PubMed Central

Cheng, Boran; He, Zhaobo; Zhao, Libo; Fang, Yuan; Chen, Yuanyuan; He, Rongxiang; Chen, Fangfang; Song, Haibin; Deng, Yuliang; Zhao, Xingzhong; Xiong, Bin

2014-01-01

Circulating tumor cells (CTCs) in the blood which have detached from both the primary tumor and any metastases may be considered as a “liquid biopsy” and are expected to replace tumor biopsies in the monitoring of treatment response and determining patient prognosis. Here, we introduce a facile and efficient CTC detection material made of hydroxyapatite/chitosan (HA/CTS), which is beneficial because of its transparency and excellent biological compatibility. Atomic force microscopy images show that the roughness of the HA/CTS nanofilm (HA/CTSNF) substrates can be controlled by changing the HA:CTS ratio. Enhanced local topographic interactions between nano-components on cancer cell membranes, and the antibody coated nanostructured substrate lead to improved CTC capture and separation. This remarkable nanostructured substrate has the potential for CTC culture in situ and merits further analysis. CTCs captured from artificial blood samples were observed in culture on HA/CTSNF substrates over a period of 14 days by using conventional staining methods (hematoxylin eosin and Wright’s stain). We conclude that these substrates are multifunctional materials capable of isolating and culturing CTCs for subsequent studies. PMID:24904216

Copper nanoparticles mediated by chitosan: synthesis and characterization via chemical methods.

PubMed

Usman, Muhammad Sani; Ibrahim, Nor Azowa; Shameli, Kamyar; Zainuddin, Norhazlin; Yunus, Wan Md Zin Wan

2012-12-14

Herein we report a synthesis of copper nanoparticles (Cu-NPs) in chitosan (Cts) media via a chemical reaction method. The nanoparticles were synthesized in an aqueous solution in the presence of Cts as stabilizer and CuSO(4)·5H(2)O precursor. The synthesis proceeded with addition of NaOH as pH moderator, ascorbic acid as antioxidant and hydrazine( )as the reducing agent. The characterization of the prepared NPs was done using ultraviolet-visible spectroscopy, which showed a 593 nm copper band. The Field Emission Scanning Electron Microscope (FESEM) images were also observed, and found to be in agreement with the UV-Vis result, confirming the formation of metallic Cu-NPs. The mean size of the Cu-NPs was estimated to be in the range of 35-75 nm using X-ray diffraction. XRD was also used in analysis of the crystal structure of the NPs. The interaction between the chitosan and the synthesized NPs was studied using Fourier transform infrared (FT-IR) spectroscopy, which showed the capping of the NPs by Cts.

Coexisting cervical spondylotic myelopathy and bilateral carpal tunnel syndromes.

PubMed

Epstein, N E; Epstein, J A; Carras, R

1989-03-01

In six patients, operations for bilateral carpal tunnel syndromes (CTS) were performed or were about to be performed without the awareness of the presence of underlying cervical spondylo-stenosis. Only later, when symptoms of myeloradiculopathy were recognized, was the diagnosis confirmed and decompressive laminectomy performed. Because the symptoms of CTS may resemble or be masked and accentuated by the cervical disorder, patients with the presumed diagnosis of bilateral CTS should undergo appropriate critical neurologic, electrodiagnostic, and neuroradiologic (magnetic resonance imaging, computed tomography, myelo-computed tomography) assessment. If these guidelines are followed, the radiculopathy caused by cervical pathology will be appropriately recognized and treated, possibly averting the need for carpal tunnel decompression or modifying treatment.

Tracing a Path to the Past: Exploring the Use of Commercial Credit Reporting Data to Construct Residential Histories for Epidemiologic Studies of Environmental Exposures.

PubMed

Hurley, Susan; Hertz, Andrew; Nelson, David O; Layefsky, Michael; Von Behren, Julie; Bernstein, Leslie; Deapen, Dennis; Reynolds, Peggy

2017-02-01

Large-scale environmental epidemiologic studies often rely on exposure estimates based on linkage to residential addresses. This approach, however, is limited by the lack of residential histories typically available for study participants. Our objective was to evaluate the feasibility of using address data from LexisNexis (a division of RELX, Inc., Dayton, Ohio), a commercially available credit reporting company, to construct residential histories for participants in the California Teachers Study (CTS), a prospective cohort study initiated in 1995-1996 to study breast cancer (n = 133,479). We evaluated the degree to which LexisNexis could provide retrospective addresses prior to study enrollment, as well as the concordance with existing prospective CTS addresses ascertained at the time of the completion of 4 self-administered questionnaires. For approximately 80% of CTS participants, LexisNexis provided at least 1 retrospective address, including nearly 25,000 addresses completely encompassed by time periods prior to enrollment. This approach more than doubled the proportion of the study population for whom we had an address of residence during the childbearing years-an important window of susceptibility for breast cancer risk. While overall concordance between the prospective addresses contained in these 2 data sources was good (85%), it was diminished among black women and women under the age of 40 years. © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

Gene expression profiling of a pressure-tolerant Listeria monocytogenes Scott A CtsR deletion mutant

USDA-ARS?s Scientific Manuscript database

Listeria monocytogenes is a food-borne pathogen of significant threat to public health. High hydrostatic pressure (HPP) treatment can be used to control Listeria monocytogenes in food. The CtsR (class three stress gene repressor) protein negatively regulates the expression of class III heat shock ...

Measuring Psychological and Physical Abuse of Children with the Conflict Tactics Scales.

ERIC Educational Resources Information Center

Straus, Murray A.

Application of the Conflict Tactics Scales (CTS) to the assessment of child abuse is described. The CTS is a brief instrument designed to measure three aspects of parent-to-child behavior: (1) reasoning; (2) psychological aggression; and (3) physical aggression. The psychological and physical aggression indexes are intended to measure the…

Confined Assembly of Hollow Carbon Spheres in Carbonaceous Nanotube: A Spheres-in-Tube Carbon Nanostructure with Hierarchical Porosity for High-Performance Supercapacitor.

PubMed

Chen, Ze; Ye, Sunjie; Evans, Stephen D; Ge, Yuanhang; Zhu, Zhifeng; Tu, Yingfeng; Yang, Xiaoming

2018-05-01

Carbonaceous nanotubes (CTs) represent one of the most popular and effective carbon electrode materials for supercapacitors, but the electrochemistry performance of CTs is largely limited by their relatively low specific surface area, insufficient usage of intratube cavity, low content of heteroatom, and poor porosity. An emerging strategy for circumventing these issues is to design novel porous CT-based nanostructures. Herein, a spheres-in-tube nanostructure with hierarchical porosity is successfully engineered, by encapsulating heteroatom-doping hollow carbon spheres into one carbonaceous nanotube (HCSs@CT). This intriguing nanoarchitecture integrates the merits of large specific surface area, good porosity, and high content of heteroatoms, which synergistically facilitates the transportation and exchange of ions and electrons. Accordingly, the as-prepared HCSs@CTs possess outstanding performances as electrode materials of supercapacitors, including superior capacitance to that of CTs, HCSs, and their mixtures, coupled with excellent cycling life, demonstrating great potential for applications in energy storage. © 2018 The Authors. Published by WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Human machine interface to manually drive rhombic like vehicles in remote handling operations

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

Lopes, Pedro; Vale, Alberto; Ventura, Rodrigo

2015-07-01

In the thermonuclear experimental reactor ITER, a vehicle named CTS is designed to transport a container with activated components inside the buildings. In nominal operations, the CTS is autonomously guided under supervision. However, in some unexpected situations, such as in rescue and recovery operations, the autonomous mode must be overridden and the CTS must be remotely guided by an operator. The CTS is a rhombic-like vehicle, with two drivable and steerable wheels along its longitudinal axis, providing omni-directional capabilities. The rhombic kinematics correspond to four control variables, which are difficult to manage in manual mode operation. This paper proposes amore » Human Machine Interface (HMI) to remotely guide the vehicle in manual mode. The proposed solution is implemented using a HMI with an encoder connected to a micro-controller and an analog 2-axis joystick. Experimental results were obtained comparing the proposed solution with other controller devices in different scenarios and using a software platform that simulates the kinematics and dynamics of the vehicle. (authors)« less

Surface functionalization of Cu-Ni alloys via grafting of a bactericidal polymer for inhibiting biocorrosion by Desulfovibrio desulfuricans in anaerobic seawater.

PubMed

Yuan, S J; Liu, C K; Pehkonen, S O; Bai, R B; Neoh, K G; Ting, Y P; Kang, E T

2009-01-01

A novel surface modification technique was developed to provide a copper nickel alloy (M) surface with bactericidal and anticorrosion properties for inhibiting biocorrosion. 4-(chloromethyl)-phenyl tricholorosilane (CTS) was first coupled to the hydroxylated alloy surface to form a compact silane layer, as well as to confer the surface with chloromethyl functional groups. The latter allowed the coupling of 4-vinylpyridine (4VP) to generate the M-CTS-4VP surface with biocidal functionality. Subsequent surface graft polymerization of 4VP, in the presence of benzoyl peroxide (BPO) initiator, from the M-CTS-4VP surface produced the poly(4-vinylpyridine) (P(4VP)) grafted surface, or the M-CTS-P(4VP) surface. The pyridine nitrogen moieties on the M-CTS-P(4VP) surface were quaternized with hexylbromide to produce a high concentration of quaternary ammonium groups. Each surface functionalization step was ascertained by X-ray photoelectron spectroscopy (XPS) and static water contact angle measurements. The alloy with surface-quaternized pyridinium cation groups (N+) exhibited good bactericidal efficiency in a Desulfovibrio desulfuricans-inoculated seawater-based modified Barr's medium, as indicated by viable cell counts and fluorescence microscopy (FM) images of the surface. The anticorrosion capability of the organic layers was verified by the polarization curve and electrochemical impedance spectroscopy (EIS) measurements. In comparison, the pristine (surface hydroxylated) Cu-Ni alloy was found to be readily susceptible to biocorrosion under the same environment.

Neuroanatomical term generation and comparison between two terminologies.

PubMed

Srinivas, Prashanti R; Gusfield, Daniel; Mason, Oliver; Gertz, Michael; Hogarth, Michael; Stone, James; Jones, Edward G; Gorin, Fredric A

2003-01-01

An approach and software tools are described for identifying and extracting compound terms (CTs), acronyms and their associated contexts from textual material that is associated with neuroanatomical atlases. A set of simple syntactic rules were appended to the output of a commercially available part of speech (POS) tagger (Qtag v 3.01) that extracts CTs and their associated context from the texts of neuroanatomical atlases. This "hybrid" parser. appears to be highly sensitive and recognized 96% of the potentially germane neuroanatomical CTs and acronyms present in the cat and primate thalamic atlases. A comparison of neuroanatomical CTs and acronymsbetween the cat and primate atlas texts was initially performed using exact-term matching. The implementation of string-matching algorithms significantly improved the identification of relevant terms and acronyms between the two domains. The End Gap Free string matcher identified 98% of CTs and the Needleman Wunsch (NW) string matcher matched 36% of acronyms between the two atlases. Combining several simple grammatical and lexical rules with the POS tagger ("hybrid parser") (1) extracted complex neuroanatomical terms and acronyms from selected cat and primate thalamic atlases and (2) and facilitated the semi-automated generation of a highly granular thalamic terminology. The implementation of string-matching algorithms (1) reconciled terminological errors generated by optical character recognition (OCR) software used to generate the neuroanatomical text information and (2) increased the sensitivity of matching neuroanatomical terms and acronyms between the two neuroanatomical domains that were generated by the "hybrid" parser.

Uniaxial cyclic strain enhances adipose-derived stem cell fusion with skeletal myocytes

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

Andersen, Jens Isak; Juhl, Morten; Nielsen, Thøger

2014-07-25

Highlights: • Uniaxial cyclic tensile strain (CTS) applied to ASCs alone or in coculture with myogenic precursors. • CTS promoted the formation of a highly ordered array of parallel ASCs. • Without biochemical supplements, CTS did not support advanced myogenic differentiation of ASCs. • Mechanical stimulation of cocultures boosted fusion of ASCs with skeletal myoblasts. - Abstract: Although adult muscle tissue possesses an exceptional capacity for regeneration, in the case of large defects, the restoration to original state is not possible. A well-known source for the de novo regeneration is the adipose-derived stem cells (ASCs), which can be readily isolatedmore » and have been shown to have a broad differentiation and regenerative potential. In this work, we employed uniaxial cyclic tensile strain (CTS), to mechanically stimulate human ASCs to participate in the formation skeletal myotubes in an in vitro model of myogenesis. The application of CTS for 48 h resulted in the formation of a highly ordered array of parallel ASCs, but failed to support skeletal muscle terminal differentiation. When the same stimulation paradigm was applied to cocultures with mouse skeletal muscle myoblasts, the percentage of ASCs contributing to the formation of myotubes significantly exceeded the levels reported in the literature hitherto. In perspective, the mechanical strain may be used to increase the efficiency of incorporation of ASCs in the skeletal muscles, which could be found useful in diverse traumatic or pathologic scenarios.« less

Construction and Characterization of a Chitosan-Immobilized-Enzyme and β-Cyclodextrin-Included-Ferrocene-Based Electrochemical Biosensor for H2O2 Detection

PubMed Central

Dong, Wenbo; Wang, Kaiyin; Chen, Yu; Li, Weiping; Ye, Yanchun; Jin, Shaohua

2017-01-01

An electrochemical detection biosensor was prepared with the chitosan-immobilized-enzyme (CTS-CAT) and β-cyclodextrin-included-ferrocene (β-CD-FE) complex for the determination of H2O2. Ferrocene (FE) was included in β-cyclodextrin (β-CD) to increase its stability. The structure of the β-CD-FE was characterized. The inclusion amount, inclusion rate, and electrochemical properties of inclusion complexes were determined to optimize the reaction conditions for the inclusion. CTS-CAT was prepared by a step-by-step immobilization method, which overcame the disadvantages of the conventional preparation methods. The immobilization conditions were optimized to obtain the desired enzyme activity. CTS-CAT/β-CD-FE composite electrodes were prepared by compositing the CTS-CAT with the β-CD-FE complex on a glassy carbon electrode and used for the electrochemical detection of H2O2. It was found that the CTS-CAT could produce a strong reduction peak current in response to H2O2 and the β-CD-FE could amplify the current signal. The peak current exhibited a linear relationship with the H2O2 concentration in the range of 1.0 × 10−7–6.0 × 10−3 mol/L. Our work provided a novel method for the construction of electrochemical biosensors with a fast response, good stability, high sensitivity, and a wide linear response range based on the composite of chitosan and cyclodextrin. PMID:28773229

Barley has two peroxisomal ABC transporters with multiple functions in β-oxidation

PubMed Central

Mendiondo, Guillermina M.; Medhurst, Anne; van Roermund, Carlo W.; Zhang, Xuebin; Devonshire, Jean; Scholefield, Duncan; Fernández, José; Axcell, Barry; Ramsay, Luke; Waterham, Hans R.; Waugh, Robbie; Theodoulou, Frederica L.; Holdsworth, Michael J.

2014-01-01

In oilseed plants, peroxisomal β-oxidation functions not only in lipid catabolism but also in jasmonate biosynthesis and metabolism of pro-auxins. Subfamily D ATP-binding cassette (ABC) transporters mediate import of β-oxidation substrates into the peroxisome, and the Arabidopsis ABCD protein, COMATOSE (CTS), is essential for this function. Here, the roles of peroxisomal ABCD transporters were investigated in barley, where the main storage compound is starch. Barley has two CTS homologues, designated HvABCD1 and HvABCD2, which are widely expressed and present in embryo and aleurone tissues during germination. Suppression of both genes in barley RNA interference (RNAi) lines indicated roles in metabolism of 2,4-dichlorophenoxybutyrate (2,4-DB) and indole butyric acid (IBA), jasmonate biosynthesis, and determination of grain size. Transformation of the Arabidopsis cts-1 null mutant with HvABCD1 and HvABCD2 confirmed these findings. HvABCD2 partially or completely complemented all tested phenotypes of cts-1. In contrast, HvABCD1 failed to complement the germination and establishment phenotypes of cts-1 but increased the sensitivity of hypocotyls to 100 μM IBA and partially complemented the seed size phenotype. HvABCD1 also partially complemented the yeast pxa1/pxa2Δ mutant for fatty acid β-oxidation. It is concluded that the core biochemical functions of peroxisomal ABC transporters are largely conserved between oilseeds and cereals but that their physiological roles and importance may differ. PMID:24913629

NCV Flow Diagnostic Test Results

NASA Technical Reports Server (NTRS)

Cappuccio, Mina

1999-01-01

There were two objectives for this test. First, was to assess the reasons why there is approximately 1.5 drag counts (cts) discrepancy between measured and computed drag improvement of the Non-linear Cruise Validation (NCV) over the Technology Concept Airplane (TCA) wing body (WB) configurations. The Navier-Stokes (N-S) pre-test predictions from Boeing Commercial Airplane Group (BCAG) show 4.5 drag cts of improvement for NCV over TCA at a lift coefficient (CL) of 0. I at Mach 2.4. The pre-test predictions from Boeing Phantom Works - Long Beach, BPW-LB, show 3.75 drag cts of improvement. BCAG used OVERFLOW and BPW-LB used CFL3D. The first test entry to validate the improvement was held at the NASA Langley Research Center (LARC) UPV;T, test number 1687. The experimental results showed that the drag improvement was only 2.6 cts, not accounting for laminar run and trip drag. This is approximately 1.5 cts less than predicted computationally. In addition to the low Reynolds Number (RN) test, there was a high RN test in the Boeing Supersonic Wind Tunnel (BSWT) of NCV and TCA. BSV@T test 647 showed that the drag improvement of NCV over TCA was also 2.6 cts, but this did account for laminar run and trip drag. Every effort needed to be done to assess if the improvement measured in LaRC UPWT and BSWT was correct. The second objective, once the first objective was met, was to assess the performance increment of NCV over TCA accounting for the associated laminar run and trip drag corrections in LaRC UPWT. We know that the configurations tested have laminar flow on portions of the wing and have trip drag due to the mechanisms used to force the flow to go from laminar to turbulent aft of the transition location.

Integrin – Dependent Mechanotransduction in Mechanically Stimulated Human Annulus Fibrosus Cells: Evidence for an Alternative Mechanotransduction Pathway Operating with Degeneration

PubMed Central

Gilbert, Hamish T. J.; Nagra, Navraj S.; Freemont, Anthony J.; Millward-Sadler, Sarah J.; Hoyland, Judith A.

2013-01-01

Intervertebral disc (IVD) cells derived from degenerate tissue respond aberrantly to mechanical stimuli, potentially due to altered mechanotransduction pathways. Elucidation of the altered, or alternative, mechanotransduction pathways operating with degeneration could yield novel targets for the treatment of IVD disease. Our aim here was to investigate the involvement of RGD-recognising integrins and associated signalling molecules in the response to cyclic tensile strain (CTS) of human annulus fibrosus (AF) cells derived from non-degenerate and degenerate IVDs. AF cells from non-degenerate and degenerate human IVDs were cyclically strained with and without function blocking RGD – peptides with 10% strain, 1.0 Hz for 20 minutes using a Flexercell® strain device. QRT-PCR and Western blotting were performed to analyse gene expression of type I collagen and ADAMTS -4, and phosphorylation of focal adhesion kinase (FAK), respectively. The response to 1.0 Hz CTS differed between the two groups of AF cells, with decreased ADAMTS -4 gene expression and decreased type I collagen gene expression post load in AF cells derived from non-degenerate and degenerate IVDs, respectively. Pre-treatment of non-degenerate AF cells with RGD peptides prevented the CTS-induced decrease in ADAMTS -4 gene expression, but caused an increase in expression at 24 hours, a response not observed in degenerate AF cells where RGD pre-treatment failed to inhibit the mechano-response. In addition, FAK phosphorylation increased in CTS stimulated AF cells derived from non-degenerate, but not degenerate IVDs, with RGD pre-treatment inhibiting the CTS – dependent increase in phosphorylated FAK. Our findings suggest that RGD -integrins are involved in the 1.0 Hz CTS – induced mechano-response observed in AF cells derived from non-degenerate, but not degenerate IVDs. This data supports our previous work, suggesting an alternative mechanotransduction pathway may be operating in degenerate AF cells. PMID:24039840

The Alexander Technique and musicians: a systematic review of controlled trials.

PubMed

Klein, Sabine D; Bayard, Claudine; Wolf, Ursula

2014-10-24

Musculoskeletal disorders, stress and performance anxiety are common in musicians. Therefore, some use the Alexander Technique (AT), a psycho-physical method that helps to release unnecessary muscle tension and re-educates non-beneficial movement patterns through intentional inhibition of unwanted habitual behaviours. According to a recent review AT sessions may be effective for chronic back pain. This review aimed to evaluate the evidence for the effectiveness of AT sessions on musicians' performance, anxiety, respiratory function and posture. The following electronic databases were searched up to February 2014 for relevant publications: PUBMED, Google Scholar, CINAHL, EMBASE, AMED, PsycINFO and RILM. The search criteria were "Alexander Technique" AND "music*". References were searched, and experts and societies of AT or musicians' medicine contacted for further publications. 237 citations were assessed. 12 studies were included for further analysis, 5 of which were randomised controlled trials (RCTs), 5 controlled but not randomised (CTs), and 2 mixed methods studies. Main outcome measures in RCTs and CTs were music performance, respiratory function, performance anxiety, body use and posture. Music performance was judged by external experts and found to be improved by AT in 1 of 3 RCTs; in 1 RCT comparing neurofeedback (NF) to AT, only NF caused improvements. Respiratory function was investigated in 2 RCTs, but not improved by AT training. Performance anxiety was mostly assessed by questionnaires and decreased by AT in 2 of 2 RCTs and in 2 of 2 CTs. A variety of outcome measures has been used to investigate the effectiveness of AT sessions in musicians. Evidence from RCTs and CTs suggests that AT sessions may improve performance anxiety in musicians. Effects on music performance, respiratory function and posture yet remain inconclusive. Future trials with well-established study designs are warranted to further and more reliably explore the potential of AT in the interest of musicians.

Functional measures developed for clinical populations identified impairment among active workers with upper extremity disorders

PubMed Central

Gardner, Bethany T.; Dale, Ann Marie; Buckner-Petty, Skye; Rachford, Robert; Strickland, Jaime; Kaskutas, Vicki; Evanoff, Bradley

2017-01-01

Purpose Few studies have explored measures of function across a range of health outcomes in a general working population. Using four upper extremity (UE) case definitions from the scientific literature, we described the performance of functional measures of work, activities of daily living, and overall health. Methods A sample of 573 workers completed several functional measures: modified recall versions of the QuickDASH, Levine Functional Status Scale (FSS), DASH Work module (DASH-W), and standard SF-8 physical component score. We determined case status based on four UE case definitions: 1) UE symptoms, 2) UE musculoskeletal disorders (MSD), 3) carpal tunnel syndrome (CTS), and 4) work limitations due to UE symptoms. We calculated effect sizes for each case definition to show the magnitude of the differences that were detected between cases and non-cases for each case definition on each functional measure. Sensitivity and specificity analyses showed how well each measure identified functional impairments across the UE case definitions. Results All measures discriminated between cases and non-cases for each case definition with the largest effect sizes for CTS and work limitations, particularly for the modified FSS and DASH-W measures. Specificity was high and sensitivity was low for outcomes of UE symptoms and UE MSD in all measures. Sensitivity was high for CTS and work limitations. Conclusions Functional measures developed specifically for use in clinical, treatment-seeking populations may identify mild levels of impairment in relatively healthy, active working populations, but measures performed better among workers with CTS or those reporting limitations at work. PMID:26091980

Cannabis, Cigarettes, and Their Co-Occurring Use: Disentangling Differences in Gray Matter Volume.

PubMed

Wetherill, Reagan R; Jagannathan, Kanchana; Hager, Nathan; Childress, Anna Rose; Rao, Hengyi; Franklin, Teresa R

2015-06-04

Structural magnetic resonance imaging techniques are powerful tools for examining the effects of drug use on the brain. The nicotine and cannabis literature has demonstrated differences between nicotine cigarette smokers and cannabis users compared to controls in brain structure; however, less is known about the effects of co-occurring cannabis and tobacco use. We used voxel-based morphometry to examine gray matter volume differences between four groups: (1) cannabis-dependent individuals who do not smoke tobacco (Cs); (2) cannabis-dependent individuals who smoke tobacco (CTs); (3) cannabis-naïve, nicotine-dependent individuals who smoke tobacco (Ts); and (4) healthy controls (HCs). We also explored associations between gray matter volume and measures of cannabis and tobacco use. A significant group effect was observed in the left putamen, thalamus, right precentral gyrus, and left cerebellum. Compared to HCs, the Cs, CTs, and Ts exhibited larger gray matter volumes in the left putamen. Cs also had larger gray matter volume than HCs in the right precentral gyrus. Cs and CTs exhibited smaller gray matter volume than HCs in the thalamus, and CTs and Ts had smaller left cerebellar gray matter volume than HCs. This study extends previous research that independently examined the effects of cannabis or tobacco use on brain structure by including an examination of co-occurring cannabis and tobacco use, and provides evidence that cannabis and tobacco exposure are associated with alterations in brain regions associated with addiction. © The Author 2015. Published by Oxford University Press on behalf of CINP.

'What vision?': experiences of Team members in a community service for adults with intellectual disabilities.

PubMed

Clare, I C H; Madden, E M; Holland, A J; Farrington, C J T; Whitson, S; Broughton, S; Lillywhite, A; Jones, E; Wade, K A; Redley, M; Wagner, A P

2017-03-01

In the UK, the closure of 'long-stay' hospitals was accompanied by the development of community teams (CTs) to support people with intellectual disabilities (IDs) to live in community settings. The self-reported experiences of staff working in such teams have been neglected. Focusing on a single county-wide service, comprising five multi-disciplinary and inter-agency CTs, we measured perceptions among the health care and care management Team members of (1) their personal well-being; (2) the functioning of their team; and (3) the organisation's commitment to quality, and culture. Almost three-quarters of the questionnaires were returned (73/101; 72%). The scores of health care practitioners and care managers were very similar: (1) the MBI scores of more than half the respondents were 'of concern'; (2) similarly, almost four in ten respondents' scores on the Vision scale of the TCI were 'of concern'; (3) the perceived commitment to quality (QIIS-II Part 2) was uncertain; and (4) the organisational culture (QIIS-II, Part 1) was viewed as primarily hierarchical. The perceived absence of a vision for the service, combined with a dominant culture viewed by its members as strongly focussed on bureaucracy and process, potentially compromises the ability of these CTs to respond proactively to the needs of people with IDs. Given the changes in legislation, policy and practice that have taken place since CTs were established, it would be timely to revisit their role and purpose. © 2016 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

SCI peer health coach influence on self-management with peers: a qualitative analysis.

PubMed

Skeels, S E; Pernigotti, D; Houlihan, B V; Belliveau, T; Brody, M; Zazula, J; Hasiotis, S; Seetharama, S; Rosenblum, D; Jette, A

2017-11-01

A process evaluation of a clinical trial. To describe the roles fulfilled by peer health coaches (PHCs) with spinal cord injury (SCI) during a randomized controlled trial research study called 'My Care My Call', a novel telephone-based, peer-led self-management intervention for adults with chronic SCI 1+ years after injury. Connecticut and Greater Boston Area, MA, USA. Directed content analysis was used to qualitatively examine information from 504 tele-coaching calls, conducted with 42 participants with SCI, by two trained SCI PHCs. Self-management was the focus of each 6-month PHC-peer relationship. PHCs documented how and when they used the communication tools (CTs) and information delivery strategies (IDSs) they developed for the intervention. Interaction data were coded and analyzed to determine PHC roles in relation to CT and IDS utilization and application. PHCs performed three principal roles: Role Model, Supporter, and Advisor. Role Model interactions included CTs and IDSs that allowed PHCs to share personal experiences of managing and living with an SCI, including sharing their opinions and advice when appropriate. As Supporters, PHCs used CTs and IDSs to build credible relationships based on dependability and reassuring encouragement. PHCs fulfilled the unique role of Advisor using CTs and IDSs to teach and strategize with peers about SCI self-management. The SCI PHC performs a powerful, flexible role in promoting SCI self-management among peers. Analysis of PHC roles can inform the design of peer-led interventions and highlights the importance for the provision of peer mentor training.

Quality measures for the diagnosis and non-operative management of carpal tunnel syndrome in occupational settings.

PubMed

Nuckols, Teryl; Harber, Philip; Sandin, Karl; Benner, Douglas; Weng, Haoling; Shaw, Rebecca; Griffin, Anne; Asch, Steven

2011-03-01

Providing higher quality medical care to workers with occupationally associated carpal tunnel syndrome (CTS) may reduce disability, facilitate return to work, and lower the associated costs. Although many workers' compensation systems have adopted treatment guidelines to reduce the overuse of unnecessary care, limited attention has been paid to ensuring that the care workers do receive is high quality. Further, guidelines are not designed to enable objective assessments of quality of care. This study sought to develop quality measures for the diagnostic evaluation and non-operative management of CTS, including managing occupational activities and functional limitations. Using a variation of the well-established RAND/UCLA Appropriateness Method, we developed draft quality measures using guidelines and literature reviews. Next, in a two-round modified-Delphi process, a multidisciplinary panel of 11 U.S. experts in CTS rated the measures on validity and feasibility. Of 40 draft measures, experts rated 31 (78%) valid and feasible. Nine measures pertained to diagnostic evaluation, such as assessing symptoms, signs, and risk factors. Eleven pertain to non-operative treatments, such as the use of splints, steroid injections, and medications. Eleven others address assessing the association between symptoms and work, managing occupational activities, and accommodating functional limitations. These measures will complement existing treatment guidelines by enabling providers, payers, policymakers, and researchers to assess quality of care for CTS in an objective, structured manner. Given the characteristics of previous measures developed with these methods, greater adherence to these measures will probably lead to improved patient outcomes at a population level.

New receiving line for the remote-steering antenna of the 140 GHz CTS diagnostics in the FTU Tokamak

NASA Astrophysics Data System (ADS)

D'Arcangelo, O.; Bin, W.; Bruschi, A.; Cappelli, M.; Fanale, F.; Gittini, G.; Pallotta, F.; Rocchi, G.; Tudisco, O.; Garavaglia, S.; Granucci, G.; Moro, A.; Tuccillo, A. A.

2018-01-01

A new receiving antenna for collecting signals of the Collective Thomson Scattering (CTS) diagnostics in FTU Tokamak has been recently installed. The squared corrugated section and the precisely defined length make it possible to receive from different directions by remotely steering the receiving mirrors. This type of Remote-Steering (RS) antennas, being studied on FTU for the DEMO Electron Cyclotron Heating (ECH) system launch, is already installed on the W7- X stellarator and will be tested in the next campaign. The transmission of the signal from the antenna in the tokamak hall to the CTS diagnostics hall will be mainly realized by means of oversized circular corrugated waveguides carrying the hybrid HE11 (quasi-gaussian) waveguide mode, with inclusion of a special smooth-waveguide section and a short run of reduced-size square-corrugated waveguide through the tokamak bio-shield. The coupling between different waveguide types is made with ellipsoidal focusing mirrors, using quasi-optical matching formulas between the gaussian-shaped beams in input and output to the waveguides. In this work, after a complete study of feasibility of the overall line, a design for the receiving line will be proposed, in order to realize an executive layout to be used as a guideline for the commissioning phase.

Seven Experiment Designs Addressing Problems of Safety and Capacity on Two-Lane Rural Highways : Volume 6. Experimental Design for Comparative Evaluation of Warning-Advisory and Regulatory Traffic Control Devices

DOT National Transportation Integrated Search

2006-04-14

This report presents the results of the national evaluation of the South Lake Tahoe coordinated Transit System (CTS) Project. The CTS Project involved combining transit services offered by private and public sector stakeholders in South Lake Tahoe in...

Genes that are involved in high hydrostatic pressure treatments in a Listeria monocytogenes Scott A ctsR deletion mutant

USDA-ARS?s Scientific Manuscript database

Listeria monocytogenes is a food-borne pathogen of significant threat to public health. High Hydrostatic Pressure (HHP) treatment can be used to control L. monocytogenes in food. The CtsR (class three stress gene repressor) protein negatively regulates the expression of class III heat shock genes....

A depolarization and attenuation experiment using the COMSTAR and CTS satellites

NASA Technical Reports Server (NTRS)

Bostian, C. W.; Kauffman, S. R.; Manus, E. A.; Marshall, R. E.; Overstreet, W. P.; Persinger, R. R.; Stutzman, W. L.; Wiley, P. H.

1978-01-01

An experiment for measuring precipitation attenuation and depolarization on the CTS 11.7 and the COMSTAR 19.04 and 28.56 GHz downlinks is described. Attenuation scaling, effective path length, and the relationship between isolation and attenuation are discussed. Attenuation and effective path data are presented for the months of July, August, and September, 1977.

78 FR 53684 - Misuse of Internet Protocol (IP) Captioned Telephone Service; Telecommunications Relay Services...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-30

... eligibility in order to get a free IP CTS device should be made under penalty of perjury; whether to prohibit the free or significantly subsidized distribution of end user equipment by IP CTS providers; whether... and restrictions on rewards and free equipment. 4. Legal Authority. Section 225(b) of the Act directs...

Facile purification of milligram to gram quantities of condensed tannins according to mean degree of polymerization and flavan-3-ol subunit composition

USDA-ARS?s Scientific Manuscript database

Unambiguous investigation of condensed tannin (CT) structure-activity relationships in biological systems requires well-characterized, high-purity CTs. Sephadex LH-20 and Toyopearl HW-50F resins were compared for separating CTs from acetone/water extracts, and column fractions analyzed for flavan-3-...

MD-CTS: An integrated terminology reference of clinical and translational medicine.

PubMed

Ray, Will; Finamore, Joe; Rastegar-Mojarad, Majid; Kadolph, Chris; Ye, Zhan; Bohne, Jacquie; Xu, Yin; Burish, Dan; Sondelski, Joshua; Easker, Melissa; Finnegan, Brian; Bartkowiak, Barbara; Smith, Catherine Arnott; Tachinardi, Umberto; Mendonca, Eneida A; Weichelt, Bryan; Lin, Simon M

2016-01-01

New vocabularies are rapidly evolving in the literature relative to the practice of clinical medicine and translational research. To provide integrated access to new terms, we developed a mobile and desktop online reference-Marshfield Dictionary of Clinical and Translational Science (MD-CTS). It is the first public resource that comprehensively integrates Wiktionary (word definition), BioPortal (ontology), Wiki (image reference), and Medline abstract (word usage) information. MD-CTS is accessible at http://spellchecker.mfldclin.edu/. The website provides a broadened capacity for the wider clinical and translational science community to keep pace with newly emerging scientific vocabulary. An initial evaluation using 63 randomly selected biomedical words suggests that online references generally provided better coverage (73%-95%) than paper-based dictionaries (57-71%).

CTRI – Clicking to greater transparency and accountability

PubMed Central

George, Bobby

2012-01-01

A clinical trial registry (CTR) is an official platform for registering a clinical trial (CT) with an objective of providing increased transparency and access to CTs to the public at large. Clinical Trials Registry - India (CTRI) is a free online public record system for registration of CTs being conducted in India. The vision of the CTRI is to ensure that every CT conducted in the region is prospectively registered with full disclosure of the trial data set items. With more number of CTs being conducted in the country, with a large number being global multicentre trials, it is binding on the industry/investigators/sponsor to comply with the requirements laid down. While there are pros and cons, there is enough scope for improvement of CTRI. PMID:23293758

United States societal experiments via the Communications Technology Satellite. [antenna coverage

NASA Technical Reports Server (NTRS)

Donoughe, P. L.

1976-01-01

The Communications Technology Satellite (CTS) is a cooperative experimental program of the United States and Canadian governments. The CTS uses a high-power transponder at the frequencies of 14/12 GHz for two-way television and voice communication. The United States and Canada have agreed to share equally in the use of CTS. The U.S. program includes a variety of societal experiments. The ground stations for these experiments are located from the Atlantic to the Pacific. The satellite communications capabilities and the antenna coverage for the U.S. are summarized. Emphasis is placed on the U.S. societal experiments in the areas of education, health care, and community and special services; nine separate experiments are discussed.

Feasibility of MRI-only treatment planning for proton therapy in brain and prostate cancers: Dose calculation accuracy in substitute CT images

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

Koivula, Lauri

Purpose: Magnetic resonance imaging (MRI) is increasingly used for radiotherapy target delineation, image guidance, and treatment response monitoring. Recent studies have shown that an entire external x-ray radiotherapy treatment planning (RTP) workflow for brain tumor or prostate cancer patients based only on MRI reference images is feasible. This study aims to show that a MRI-only based RTP workflow is also feasible for proton beam therapy plans generated in MRI-based substitute computed tomography (sCT) images of the head and the pelvis. Methods: The sCTs were constructed for ten prostate cancer and ten brain tumor patients primarily by transforming the intensity valuesmore » of in-phase MR images to Hounsfield units (HUs) with a dual model HU conversion technique to enable heterogeneous tissue representation. HU conversion models for the pelvis were adopted from previous studies, further extended in this study also for head MRI by generating anatomical site-specific conversion models (a new training data set of ten other brain patients). This study also evaluated two other types of simplified sCT: dual bulk density (for bone and water) and homogeneous (water only). For every clinical case, intensity modulated proton therapy (IMPT) plans robustly optimized in standard planning CTs were calculated in sCT for evaluation, and vice versa. Overall dose agreement was evaluated using dose–volume histogram parameters and 3D gamma criteria. Results: In heterogeneous sCTs, the mean absolute errors in HUs were 34 (soft tissues: 13, bones: 92) and 42 (soft tissues: 9, bones: 97) in the head and in the pelvis, respectively. The maximum absolute dose differences relative to CT in the brain tumor clinical target volume (CTV) were 1.4% for heterogeneous sCT, 1.8% for dual bulk sCT, and 8.9% for homogenous sCT. The corresponding maximum differences in the prostate CTV were 0.6%, 1.2%, and 3.6%, respectively. The percentages of dose points in the head and pelvis passing 1% and 1 mm gamma index criteria were over 91%, 85%, and 38% with heterogeneous, dual bulk, and homogeneous sCTs, respectively. There were no significant changes to gamma index pass rates for IMPT plans first optimized in CT and then calculated in heterogeneous sCT versus IMPT plans first optimized in heterogeneous sCT and then calculated on standard CT. Conclusions: This study demonstrates that proton therapy dose calculations on heterogeneous sCTs are in good agreement with plans generated with standard planning CT. An MRI-only based RTP workflow is feasible in IMPT for brain tumors and prostate cancers.« less

Experiences with preventing carpal tunnel syndrome in an automotive plant.

PubMed

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

2017-02-21

Carpal tunnel syndrome (CTS) is a common occupational disease. The aim was to assess the effect of preventive measures in automotive assembly workers. The analysis summarizes data from annual crosssectional studies. The 7-year analysis of data was based on medical records obtained from an occupational physician and inspections carried out at the workplace where targeted preventive measures were introduced, including better ergonomic arrangement of the workplace, technical adjustments facilitating the work, preventive nerve conduction studies (NCS) testing of the median nerve once a year, switching of workers and their targeted rotation within the workplace. The NCS testing of median nerve conduction at the wrist was the basic objective method for assessment of the prevalence and severity of CTS. Over the study period, the sample comprised 1804 workers at risk for repetitive overuse of the upper extremities, of whom 281 were females with a mean age of 38.5 years and 1523 were males with a mean age of 31.4 years. Over the study period, a total of 13 cases of CTS were recognized as an occupational disease in the plant, 8 of which occurred within the first 2 years from the initiation of production. Introduction of preventive measures decreased the prevalence of median neuropathy from 18.3% of examined extremities in 2011 to 10.5% in 2013 (p = 0.003). In early 2014, the production pace increased and this was accompanied by a rise in abnormal NCS findings to 16.9%. Over the study period, the rate of sensorimotor neuropathy decreased in favor of merely sensory neuropathies, which have been most frequent since 2013. The percentage of employees whose contracts were terminated due to median neuropathy decreased steadily from 5.5% to 0.4%. Targeted prevention of work-related CTS is effective as evidenced by the decrease in the prevalence of median neuropathy detected by NCS. Int J Occup Med Environ Health 2017;30(1):45-54. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

SU-F-J-109: Generate Synthetic CT From Cone Beam CT for CBCT-Based Dose Calculation

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

Wang, H; Barbee, D; Wang, W

Purpose: The use of CBCT for dose calculation is limited by its HU inaccuracy from increased scatter. This study presents a method to generate synthetic CT images from CBCT data by a probabilistic classification that may be robust to CBCT noise. The feasibility of using the synthetic CT for dose calculation is evaluated in IMRT for unilateral H&N cancer. Methods: In the training phase, a fuzzy c-means classification was performed on HU vectors (CBCT, CT) of planning CT and registered day-1 CBCT image pair. Using the resulting centroid CBCT and CT values for five classified “tissue” types, a synthetic CTmore » for a daily CBCT was created by classifying each CBCT voxel to obtain its probability belonging to each tissue class, then assigning a CT HU with a probability-weighted summation of the classes’ CT centroids. Two synthetic CTs from a CBCT were generated: s-CT using the centroids from classification of individual patient CBCT/CT data; s2-CT using the same centroids for all patients to investigate the applicability of group-based centroids. IMRT dose calculations for five patients were performed on the synthetic CTs and compared with CT-planning doses by dose-volume statistics. Results: DVH curves of PTVs and critical organs calculated on s-CT and s2-CT agree with those from planning-CT within 3%, while doses calculated with heterogeneity off or on raw CBCT show DVH differences up to 15%. The differences in PTV D95% and spinal cord max are 0.6±0.6% and 0.6±0.3% for s-CT, and 1.6±1.7% and 1.9±1.7% for s2-CT. Gamma analysis (2%/2mm) shows 97.5±1.6% and 97.6±1.6% pass rates for using s-CTs and s2-CTs compared with CT-based doses, respectively. Conclusion: CBCT-synthesized CTs using individual or group-based centroids resulted in dose calculations that are comparable to CT-planning dose for unilateral H&N cancer. The method may provide a tool for accurate dose calculation based on daily CBCT.« less

Anatomical robust optimization to account for nasal cavity filling variation during intensity-modulated proton therapy: a comparison with conventional and adaptive planning strategies

NASA Astrophysics Data System (ADS)

van de Water, Steven; Albertini, Francesca; Weber, Damien C.; Heijmen, Ben J. M.; Hoogeman, Mischa S.; Lomax, Antony J.

2018-01-01

The aim of this study is to develop an anatomical robust optimization method for intensity-modulated proton therapy (IMPT) that accounts for interfraction variations in nasal cavity filling, and to compare it with conventional single-field uniform dose (SFUD) optimization and online plan adaptation. We included CT data of five patients with tumors in the sinonasal region. Using the planning CT, we generated for each patient 25 ‘synthetic’ CTs with varying nasal cavity filling. The robust optimization method available in our treatment planning system ‘Erasmus-iCycle’ was extended to also account for anatomical uncertainties by including (synthetic) CTs with varying patient anatomy as error scenarios in the inverse optimization. For each patient, we generated treatment plans using anatomical robust optimization and, for benchmarking, using SFUD optimization and online plan adaptation. Clinical target volume (CTV) and organ-at-risk (OAR) doses were assessed by recalculating the treatment plans on the synthetic CTs, evaluating dose distributions individually and accumulated over an entire fractionated 50 GyRBE treatment, assuming each synthetic CT to correspond to a 2 GyRBE fraction. Treatment plans were also evaluated using actual repeat CTs. Anatomical robust optimization resulted in adequate CTV doses (V95%  ⩾  98% and V107%  ⩽  2%) if at least three synthetic CTs were included in addition to the planning CT. These CTV requirements were also fulfilled for online plan adaptation, but not for the SFUD approach, even when applying a margin of 5 mm. Compared with anatomical robust optimization, OAR dose parameters for the accumulated dose distributions were on average 5.9 GyRBE (20%) higher when using SFUD optimization and on average 3.6 GyRBE (18%) lower for online plan adaptation. In conclusion, anatomical robust optimization effectively accounted for changes in nasal cavity filling during IMPT, providing substantially improved CTV and OAR doses compared with conventional SFUD optimization. OAR doses can be further reduced by using online plan adaptation.

Prevalence and characteristics of unoperated patients with severe aortic stenosis.

PubMed

Bach, David S

2011-05-01

Although aortic valve replacement (AVR) is the preferred therapy for severe symptomatic aortic stenosis (AS), a substantial number of patients with indications for surgery do not undergo AVR. The study aim was to address, at multiple geographic locations and practice settings, the prevalence of unoperated patients with severe AS, and to explore potential barriers to intervention. The medical records at 10 centers of various size and geographic distribution were reviewed retrospectively to identify patients with clinically severe AS (echocardiography/Doppler mean gradient > or = 40 mm Hg, effective orifice area < 1.0 cm2, or an overall interpretation of severe AS; and no clinical contradiction of severe AS). Demographic, clinical and outcomes data were recorded, including referral to a cardiothoracic surgeon (CTS), performance of AVR, and rationale when no AVR was performed. Of 952 patients who met the criteria for clinically severe AS, 497 (52%) were referred to a CTS for evaluation for AVR; subsequently, 395 patients (41%) underwent AVR and 557 (59%) were unoperated. Trends were similar across the institutions. Symptoms were present in 666 (79%) of 842 patients with available data, including 296 of 340 (87%) operated patients and 370 of 502 (74%) unoperated patients. Those patients referred to a CTS were younger, more often male, had higher aortic valve gradients, and more often were symptomatic. The dominant reasons cited for not undergoing AVR were comorbidities or high operative risk, advanced age or limited life expectancy, asymptomatic status, and patient or family refusal. The one-year survival was 94 +/- 2% for operated patients, and 69 +/- 3% for unoperated patients (66 +/- 3% for unoperated symptomatic and 78 +/- 5% for unoperated asymptomatic patients). In this multicenter survey, only about one-half of the patients with severe AS were referred to a CTS, and only about 40% underwent AVR. Three-quarters of unoperated patients were symptomatic. Referral to a CTS appeared more likely in the setting of symptoms of angina rather than heart failure or syncope, and elevated echocardiographic gradient rather than low valve area. Many patients who likely could benefit from AVR do not undergo evaluation for the condition, and similar observations were made at multiple medical institutions.

In vitro and in vivo assessment of lactic acid-modified chitosan scaffolds for potential treatment of full-thickness burns.

PubMed

Velasquillo, Cristina; Silva-Bermudez, Phaedra; Vázquez, Nadia; Martínez, Alan; Espadín, Andres; García-López, Julieta; Medina-Vega, Antonio; Lecona, Hugo; Pichardo-Baena, Raúl; Ibarra, Clemente; Shirai, Keiko

2017-10-01

Autologous skin transplantation is today's "gold standard" treatment for full-thickness burns. However, when > 30% of total body surface area is damaged, there is an important shortage of autologous donor sites for skin grafting; then, treatment alternatives become crucial. Such alternatives can be based on polymeric scaffolds capable of functioning as protective covers and cells/factors carriers. Chitosan (CTS) is a natural-derived polymer with relevant biological-related properties but poor mechanical performance. Improved mechanical properties can be achieved through lactic acid grafting (LA-g); nevertheless, LA-g affects the biological response towards the CTS-based materials. In this work, CTS-LA scaffolds with different LA-g percentages were synthesized and evaluated to determine appropriate LA-g degrees for full-thickness burns treatment. In vitro results indicated that the higher the LA-g percentage, the lower the capability of the scaffolds to sustain fibroblasts culture. Scaffolds with LA-g around 28% (CTS-LA28) sustained cell culture and allowed normal cell functionality. Further evaluation of CTS-LA28 as acellular and cellular grafts in a full-thickness burn mouse model showed that at 28 days post-burn, macroscopic characteristic of the reparation tissue were closer to healthy skin when cellular grafts were used for treatment; histological evaluation also showed that dermis cellularity and collagenous fibers structure were similar to those in healthy skin when cellular grafts were used for burns treatment. © 2017 Wiley Periodicals Inc. J Biomed Mater Res Part A: 105A: 2875-2891, 2017. © 2017 Wiley Periodicals, Inc.

A 20-Amino Acid Module of Protein Kinase Cϵ Involved in Translocation and Selective Targeting at Cell-Cell Contacts*

PubMed Central

Diouf, Barthélémy; Collazos, Alejandra; Labesse, Gilles; Macari, Françoise; Choquet, Armelle; Clair, Philippe; Gauthier-Rouvière, Cécile; Guérineau, Nathalie C.; Jay, Philippe; Hollande, Frédéric; Joubert, Dominique

2009-01-01

In the pituitary gland, activated protein kinase C (PKC) isoforms accumulate either selectively at the cell-cell contact (α and ϵ) or at the entire plasma membrane (β1 and δ). The molecular mechanisms underlying these various subcellular locations are not known. Here, we demonstrate the existence within PKCϵ of a cell-cell contact targeting sequence (3CTS) that, upon stimulation, is capable of targeting PKCδ, chimerin-α1, and the PKCϵ C1 domain to the cell-cell contact. We show that this selective targeting of PKCϵ is lost upon overexpression of 3CTS fused to a (R-Ahx-R)4 (where Ahx is 6-aminohexanoic acid) vectorization peptide, reflecting a dominant-negative effect of the overexpressed 3CTS on targeting selectivity. 3CTS contains a putative amphipathic α-helix, a 14-3-3-binding site, and the Glu-374 amino acid, involved in targeting selectivity. We show that the integrity of the α-helix is important for translocation but that 14-3-3 is not involved in targeting selectivity. However, PKCϵ translocation is increased when PKCϵ/14-3-3 interaction is abolished, suggesting that phorbol 12-myristate 13-acetate activation may initiate two sets of PKCϵ functions, those depending on 14-3-3 and those depending on translocation to cell-cell contacts. Thus, 3CTS is involved in the modulation of translocation via its 14-3-3-binding site, in cytoplasmic desequestration via the α-helix, and in selective PKCϵ targeting at the cell-cell contact via Glu-374. PMID:19429675

Candida albicans CHT3 encodes the functional homolog of the Cts1 chitinase of Saccharomyces cerevisiae.

PubMed

Dünkler, Alexander; Walther, Andrea; Specht, Charles A; Wendland, Jürgen

2005-11-01

Chitin synthesis and chitin degradation play an important role in cellular morphogenesis and influence the cell shape of fungal organisms. The Candida albicans genome contains four chitinase genes, CHT1, CHT2, and CHT3, which are homologous to the Saccharomyces cerevisiae CTS1 gene and C. albicans CHT4, which is homologous to S. cerevisiae CTS2. To determine which of the C. albicans CHT genes represents the functional homolog of the S. cerevisiae CTS1 gene we constructed mutants of these genes and characterized the resulting phenotypes using morphological assays such as in vivo time lapse microscopy and enzymatic assays to determine the chitinase activity. Deletion of CaCHT1 and CaCHT2 provided no phenotypic alterations in liquid culture but resulted in increased hyphal growth on solid media. Deletion of CaCHT3 generated chains of unseparated cells in the yeast growth phase strongly resembling the cts1 deletion phenotype of S. cerevisiae cells. Expression of CHT3 under control of the regulatable MAL2-promoter in C. albicans resulted in the reversion of the cell separation defect when cells were grown in maltose. Cht3, but not Cht2 when expressed in S. cerevisiae was also able to reverse the cell separation defect of the S. cerevisiae c ts1 deletion strain. Measurements of chitinase activity from yeast cells of C. albicans showed that Cht2 is bound to cells, consistent with it being GPI-anchored while Cht3 is secreted into growth medium; Cht3 is also the principal, observed activity.

Frequency Correction for MIRO Chirp Transformation Spectroscopy Spectrum

NASA Technical Reports Server (NTRS)

Lee, Seungwon

2012-01-01

This software processes the flyby spectra of the Chirp Transform Spectrometer (CTS) of the Microwave Instrument for Rosetta Orbiter (MIRO). The tool corrects the effect of Doppler shift and local-oscillator (LO) frequency shift during the flyby mode of MIRO operations. The frequency correction for CTS flyby spectra is performed and is integrated with multiple spectra into a high signal-to-noise averaged spectrum at the rest-frame RF frequency. This innovation also generates the 8 molecular line spectra by dividing continuous 4,096-channel CTS spectra. The 8 line spectra can then be readily used for scientific investigations. A spectral line that is at its rest frequency in the frame of the Earth or an asteroid will be observed with a time-varying Doppler shift as seen by MIRO. The frequency shift is toward the higher RF frequencies on approach, and toward lower RF frequencies on departure. The magnitude of the shift depends on the flyby velocity. The result of time-varying Doppler shift is that of an observed spectral line will be seen to move from channel to channel in the CTS spectrometer. The direction (higher or lower frequency) in the spectrometer depends on the spectral line frequency under consideration. In order to analyze the flyby spectra, two steps are required. First, individual spectra must be corrected for the Doppler shift so that individual spectra can be superimposed at the same rest frequency for integration purposes. Second, a correction needs to be applied to the CTS spectra to account for the LO frequency shifts that are applied to asteroid mode.

Disparities in the Population Distribution of African American and Non-Hispanic White Smokers along the Quitting Continuum

ERIC Educational Resources Information Center

Trinidad, Dennis R.; Xie, Bin; Fagan, Pebbles; Pulvers, Kim; Romero, Devan R.; Blanco, Lyzette; Sakuma, Kari-Lyn K.

2015-01-01

Purpose: To examine disparities and changes over time in the population-level distribution of smokers along a cigarette quitting continuum among African American smokers compared with non-Hispanic Whites. Methods: Secondary data analyses of the 1999, 2002, 2005, and 2008 California Tobacco Surveys (CTS). The CTS are large, random-digit-dialed,…

Yoga Asanas for the Relief and Prevention of Carpal Tunnel Syndrome.

ERIC Educational Resources Information Center

Beleu, Steve

This collection of yoga asanas (exercises) can help relieve the pain of carpal tunnel syndrome (CTS) and help prevent CTS among people who work on computer terminals. For maximum benefit, the exercises should be practiced daily or on as regular a schedule as possible. They are not intended to replace surgery or a physician's prescribed care. They…

Differences in force normalising procedures during submaximal anisometric contractions.

PubMed

Škarabot, Jakob; Ansdell, Paul; Brownstein, Callum; Howatson, Glyn; Goodall, Stuart; Durbaba, Rade

2018-05-26

Eccentric contractions are thought to require a unique neural activation strategy. However, due to greater intrinsic force generating capacity of muscle fibres during eccentric contraction, the understanding of neural modulation of different contraction types during submaximal contractions may be impeded by the force normalisation procedure employed. In the present experiment, subjects performed maximal isometric dorsiflexion at shorter (80°), intermediate (90°) and longer (100°) muscle lengths, and maximal concentric and eccentric contractions. Thereafter, submaximal concentric and eccentric contractions were performed normalised to either isometric maximum at 90° (ISO), contraction type specific maximum (CTS) or muscle length specific maximum (MLS). When using ISO or MLS for normalisation, mean submaximal eccentric torque levels were significantly lower when compared to CTS normalisation (11 and 7% lower compared to CTS; p = 0.003 and p = 0.018 for ISO and MLS, respectively). These experimentally observed differences closely matched those expected from the predictive model. During submaximal concentric contraction, mean torque levels were similar between ISO and CTS normalisation with similar discrepancies noted in EMG activity. These findings suggest that normalising to ISO and MLS might not be accurate for assessment and prescription of submaximal eccentric contractions. Copyright © 2018 Elsevier Ltd. All rights reserved.

A Location-Based Duplex Scheme for Cost Effective Rural Broadband Connectivity Using IEEE 802.22 Cognitive Radio Based Wireless Regional Area Networks

NASA Astrophysics Data System (ADS)

Kalidoss, R.; Bhagyaveni, M. A.; Vishvaksenan, K. S.

2014-08-01

The search for a method of utilizing the scarce spectrum in an efficient manner is an active area of research in both academic and industrial communities. IEEE 802.22 is a standard for wireless regional area network (WRAN) based on cognitive radio (CR) that operates over underutilized portions of TV bands (54-862 MHz). Time division duplex (TDD)-based WRAN cells have such advantages as dynamic traffic allocation, traffic asymmetry to users and ease of spectrum allocation. However, these cells suffer from severe cross time slot (CTS) interference when the frames of the cells are not synchronized with adjacent WRAN cells. In this paper, we evaluate the location-based duplex (LBD) scheme for eliminating the CTS interference. The proposed LBD system is much more flexible and efficient in providing asymmetric data service and eliminating CTS interference by exploiting the advantages of both TDD and frequency division duplex (FDD) schemes. We also compare the performance of LBD systems with virtual cell concepts. Furthermore, our simulation results reveal that LBD-based systems outperform the virtual cell approach in terms of the low signal-to-interference (SIR) ratio requirement by mitigating the effects of CTS.

Faster and exact implementation of the continuous cellular automaton for anisotropic etching simulations

NASA Astrophysics Data System (ADS)

Ferrando, N.; Gosálvez, M. A.; Cerdá, J.; Gadea, R.; Sato, K.

2011-02-01

The current success of the continuous cellular automata for the simulation of anisotropic wet chemical etching of silicon in microengineering applications is based on a relatively fast, approximate, constant time stepping implementation (CTS), whose accuracy against the exact algorithm—a computationally slow, variable time stepping implementation (VTS)—has not been previously analyzed in detail. In this study we show that the CTS implementation can generate moderately wrong etch rates and overall etching fronts, thus justifying the presentation of a novel, exact reformulation of the VTS implementation based on a new state variable, referred to as the predicted removal time (PRT), and the use of a self-balanced binary search tree that enables storage and efficient access to the PRT values in each time step in order to quickly remove the corresponding surface atom/s. The proposed PRT method reduces the simulation cost of the exact implementation from {O}(N^{5/3}) to {O}(N^{3/2} log N) without introducing any model simplifications. This enables more precise simulations (only limited by numerical precision errors) with affordable computational times that are similar to the less precise CTS implementation and even faster for low reactivity systems.

Early breast cancer screening using iron/iron oxide-based nanoplatforms with sub-femtomolar limits of detection.

PubMed

Udukala, Dinusha N; Wang, Hongwang; Wendel, Sebastian O; Malalasekera, Aruni P; Samarakoon, Thilani N; Yapa, Asanka S; Abayaweera, Gayani; Basel, Matthew T; Maynez, Pamela; Ortega, Raquel; Toledo, Yubisela; Bossmann, Leonie; Robinson, Colette; Janik, Katharine E; Koper, Olga B; Li, Ping; Motamedi, Massoud; Higgins, Daniel A; Gadbury, Gary; Zhu, Gaohong; Troyer, Deryl L; Bossmann, Stefan H

2016-01-01

Proteases, including matrix metalloproteinases (MMPs), tissue serine proteases, and cathepsins (CTS) exhibit numerous functions in tumor biology. Solid tumors are characterized by changes in protease expression levels by tumor and surrounding tissue. Therefore, monitoring protease levels in tissue samples and liquid biopsies is a vital strategy for early cancer detection. Water-dispersable Fe/Fe3O4-core/shell based nanoplatforms for protease detection are capable of detecting protease activity down to sub-femtomolar limits of detection. They feature one dye (tetrakis(carboxyphenyl)porphyrin (TCPP)) that is tethered to the central nanoparticle by means of a protease-cleavable consensus sequence and a second dye (Cy 5.5) that is directly linked. Based on the protease activities of urokinase plasminogen activator (uPA), MMPs 1, 2, 3, 7, 9, and 13, as well as CTS B and L, human breast cancer can be detected at stage I by means of a simple serum test. By monitoring CTS B and L stage 0 detection may be achieved. This initial study, comprised of 46 breast cancer patients and 20 apparently healthy human subjects, demonstrates the feasibility of protease-activity-based liquid biopsies for early cancer diagnosis.

Influence of gravity on the circadian timing system

NASA Technical Reports Server (NTRS)

Fuller, C. A.; Hoban-Higgins, T. M.; Griffin, D. W.; Murakami, D. M.

1994-01-01

The circadian timing system (CTS) is responsible for daily temporal coordination of physiological and behavioral functions both internally and with the external environment. Experiments in altered gravitational environments have revealed changes in circadian rhythms of species ranging from fungi to primates. The altered gravitational environments examined included both the microgravity environment of spaceflight and hyperdynamic environments produced by centrifugation. Acute exposure to altered gravitational environments changed homeostatic parameters such as body temperature. These changes were time of day dependent. Exposure to gravitational alterations of relatively short duration produced changes in both the homeostatic level and the amplitude of circadian rhythms. Chronic exposure to a non-earth level of gravity resulted in changes in the period of the expressed rhythms as well as in the phase relationships between the rhythms and between the rhythms and the external environment. In addition, alterations in gravity appeared to act as a time cue for the CTS. Altered gravity also affected the sensitivity of the pacemaker to other aspects of the environment (i.e., light) and to shifts of time cues. Taken together, these studies lead to the conclusion that the CTS is indeed sensitive to gravity and its alterations. This finding has implications for both basic biology and space medicine.

Early breast cancer screening using iron/iron oxide-based nanoplatforms with sub-femtomolar limits of detection

PubMed Central

Samarakoon, Thilani N; Yapa, Asanka S; Abayaweera, Gayani; Basel, Matthew T; Maynez, Pamela; Ortega, Raquel; Toledo, Yubisela; Bossmann, Leonie; Robinson, Colette; Janik, Katharine E; Koper, Olga B; Li, Ping; Motamedi, Massoud; Higgins, Daniel A; Gadbury, Gary

2016-01-01

Summary Proteases, including matrix metalloproteinases (MMPs), tissue serine proteases, and cathepsins (CTS) exhibit numerous functions in tumor biology. Solid tumors are characterized by changes in protease expression levels by tumor and surrounding tissue. Therefore, monitoring protease levels in tissue samples and liquid biopsies is a vital strategy for early cancer detection. Water-dispersable Fe/Fe3O4-core/shell based nanoplatforms for protease detection are capable of detecting protease activity down to sub-femtomolar limits of detection. They feature one dye (tetrakis(carboxyphenyl)porphyrin (TCPP)) that is tethered to the central nanoparticle by means of a protease-cleavable consensus sequence and a second dye (Cy 5.5) that is directly linked. Based on the protease activities of urokinase plasminogen activator (uPA), MMPs 1, 2, 3, 7, 9, and 13, as well as CTS B and L, human breast cancer can be detected at stage I by means of a simple serum test. By monitoring CTS B and L stage 0 detection may be achieved. This initial study, comprised of 46 breast cancer patients and 20 apparently healthy human subjects, demonstrates the feasibility of protease-activity-based liquid biopsies for early cancer diagnosis. PMID:27335730

Selective biosensing of Staphylococcus aureus using chitosan quantum dots

NASA Astrophysics Data System (ADS)

Abdelhamid, Hani Nasser; Wu, Hui-Fen

2018-01-01

Selective biosensing of Staphylococcus aureus (S. aureus) using chitosan modified quantum dots (CTS@CdS QDs) in the presence of hydrogen peroxide is reported. The method is based on the intrinsic positive catalase activity of S. aureus. CTS@CdS quantum dots provide high dispersion in aqueous media with high fluorescence emission. Staphylococcus aureus causes a selective quenching of the fluorescence emission of CTS@CdS QDs in the presence of H2O2 compared to other pathogens such as Escherichia coli and Pseudomonas aeruginosa. The intrinsic enzymatic character of S. aureus (catalase positive) offers selective and fast biosensing. The present method is highly selective for positive catalase species and requires no expensive reagents such as antibodies, aptamers or microbeads. It could be extended for other species that are positive catalase.

Design, construction and testing of the Communications Technology Satellite protection against spacecraft charging

NASA Technical Reports Server (NTRS)

Gore, J. V.

1977-01-01

Detailed discussions are presented of the measures taken on the Communications Technology Satellite (CTS or Hermes) which provide protection against the effects of spacecraft charging. These measures include: a comprehensive grounding philosophy and implementation; provision of command and data line transmitters and receivers for transient noise immunity; and a fairly restrictive EMI specification. Ground tests were made on materials and the impact of these tests on the CTS spacecraft is described. Hermes, launched on 17 January 1976 on a 2914 Delta vehicle, has successfully completed 10 months of operations. Anomalies observed are being assessed in relation to spacecraft charging, but no definite correlations have yet been established. A list of conclusions with regard to the CTS experience is given and recommendations for future spacecraft are also listed.

Overview of Existing and Future Residential Use Cases for Connected Thermostats

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

Rotondo, Julia; Johnson, Robert; Gonzalez, Nancy

This paper is intended to help inform future technology deployment opportunities for connected thermostats (CTs), based on investigation and review of the U.S. residential housing and CT markets, as well as existing, emerging, and future use cases for CT hardware and CT-generated data. The CT market has experienced tremendous growth over the last 5 years—both in terms of the number of units sold and the number of firms offering competing products—and can be characterized by its rapid pace of technological innovation. Despite many assuming CTs would become powerful tools for increasing comfort while saving energy, there remains a great dealmore » of uncertainty about the actual energy and cost savings that are likely to be realized from deployment of CTs, particularly under different conditions.« less

Polyethylene glycol-assisted growth of Cu2SnS3 promising absorbers for thin film solar cell applications

NASA Astrophysics Data System (ADS)

Kahraman, S.; Çetinkaya, S.; Yaşar, S.; Bilican, İ.

2014-09-01

In this paper, we report, for the first time, the results of the polyethylene glycol- (PEG) assisted preparation and characterization of high-quality and well-crystallized Cu2SnS3 (CTS) thin films obtained using sol-gel spin-coating method and a subsequent annealing in a sulphur atmosphere. Structural, morphological, compositional, electrical and optical investigations were carried out. The X-ray diffraction patterns of the samples proved the polycrystalline nature and preferred crystallization of the films. No peak referring to other binary or ternary phases were detected in the patterns. The intensity of the preferred orientation and crystallite size of the films increased with increasing PEG content. This trend yielded an improvement in photo-transient currents of the PEG-assisted growth of CTS films. The scanning electron microscopy images revealed that the CTS films have continuous, dense and agglomeration-like morphology. Through energy dispersive X-ray spectroscopy studies, it has been deduced that the samples consist of Cu, Sn and S of which atomic percentages were consistent with Cu/Sn and S/metal initial ratios. The agglomerated morphology of the samples has been attributed to increasing PEG content. A remarkable enhancement was observed in photo-transient currents of p-n junction of the produced films along with increasing PEG content. Through resistivity-temperature measurements, three impurity level electrical activation energy values for each film were found. Optical band gap values of the films were estimated via absorbance-wavelength behaviours and decreased with increasing PEG content. It has been revealed that PEG-assisted growth of CTS thin films is a promising way to improve its photovoltaic characteristics.

Efficacy of paraffin wax bath for carpal tunnel syndrome: a randomized comparative study

NASA Astrophysics Data System (ADS)

Ordahan, Banu; Karahan, Ali Yavuz

2017-12-01

Carpal tunnel syndrome (CTS) is the most frequently diagnosed neuropathy of upper extremity entrapment neuropathies. We aimed to investigate the effectiveness of paraffin therapy in patients with CTS. Seventy patients diagnosed with mild or moderate CTS were randomly divided into two groups as splint treatment (during the night and day time as much as possible for 3 weeks) alone and splint (during the night and day time as much as possible for 3 weeks) + paraffin treatment (five consecutive days a week for 3 weeks). Clinical and electrophysiological assessments were performed before and 3 weeks after treatment. The patients were assessed by using visual analog scale (VAS) for pain, electroneuromyography (ENMG), and Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ). The significant improvement was found in VAS scores in both groups when compared with pretreatment values ( p < 0.05). There was no significant improvement in functional capacity score ( p > 0.05), whereas a significant improvement was noted in the BCTQ symptom severity scale score in the splint group ( p < 0.05). Significant improvements were demonstrated in both scorers in the combined treatment group. Similarly, significant improvements were found in the combined treatment group in terms of motor and sensory distal latency, sensory amplitude, and median sensory nerve velocity ( p < 0.05). There was no significant change in electrophysiologic parameters in the splint group ( p > 0.05), and the difference in these parameters between the groups was statistically significant ( p < 0.05). In conclusion, using splinting alone in patients with CTS is an effective treatment for reducing symptoms in the early stages. Paraffin treatment with splint increases the recovery in functional and electrophysiological parameters.

Translation and Validation of the Persian Version the Boston Carpal Tunnel Syndrome Questionnaire.

PubMed

Hassankhani, Golnaz Ghayyem; Moradi, Ali; Birjandinejad, Ali; Vahedi, Ehsan; Kachooei, Amir R; Ebrahimzadeh, Mohammad H

2018-01-01

Carpal tunnel syndrome (CTS) is recognized as the most common type of neuropathies. Questionnaires are the method of choice for evaluating patients with CTS. Boston Carpal Tunnel Syndrome (BCTS) is one of the most famous questionnaires that evaluate the functional and symptomatic aspects of CTS. This study was performed to evaluate the validity and reliability of the Persian version of BCTS questionnaire. First, both parts of the original questionnaire (Symptom Severity Scale and Functional Status Scale) were translated into Persian by two expert translators. The translated questionnaire was revised after merging and confirmed by an orthopedic hand surgeon. The confirmed questionnaire was interpreted back into the original language (English) to check for any possible content inequality between the original questionnaire and its final translated version. The final Persian questionnaire was answered by 10 patients suffering from CTS to elucidate its comprehensibility; afterwards, it was filled by 142 participants along with the Persian version of the Quick-DASH questionnaire. After 2 to 6 days, the translated questionnaire was refilled by some of the previous patients who had not received any substantial medical treatment during that period. Among all 142 patients, 13.4 % were male and 86.6 % were female. The reliability of the questionnaire was tested using Cronbach's alpha and Intraclass correlation coefficient (ICC). Cronbach's alpha was 0.859 for symptom severity scale (SSS) and 0.878 for functional status scale (FSS). Also, ICCs were calculated as 0.538 for SSS and 0.773 for FSS. In addition, construct validity of SSS and FSS against QuickDASH were 0.641 and 0.701, respectively. Based on our results, the Persian version of the BCTQ is valid and reliable. Level of evidence: II.

Large Scale Geomorphic Mapping of Cryoplanation Terraces in Central and Eastern Alaska

NASA Astrophysics Data System (ADS)

Queen, C.; Nyland, K. E.; Nelson, F. E.

2017-12-01

Cryoplanation terraces (CTs) are large periglacial landforms characterized by alternating treads and risers, giving the appearance of giant staircases ascending ridgecrests and hillsides. The risers (scarps) are typically covered with coarse clastic material, while the surfaces of the nearly planar treads are a mosaic of vegetation, rock debris, and surficial periglacial landforms. CTs are best developed in areas of moderate relief across Beringia, the largely unglaciated region between the Lena and Mackenzie rivers, including Bering Sea islands that were formerly highlands on the Bering Land Bridge. CTs are generally thought to develop through locally intensified weathering at the base of scarps by processes associated with late lying bodies of snow. This hypothesis has been the subject of much speculative literature, but until recently there have been few process-oriented field studies performed on them. The work reported here builds on foundational work by R. D. Reger, who inventoried and investigated a large number of CTs in central and western Alaska. The resultant large-scale (1:2000) maps of cryoplanation terraces at Eagle Summit and Mount Fairplay in east-central Alaska were created using traditional and GPS-based mapping methodologies. Pits were excavated at representative locations across treads to obtain information about subsurface characteristics. The resulting maps show the location and morphology of surficial geomorphic features on CT scarps, treads, and sideslopes, superimposed on high-resolution topographic maps and perspective diagrams. GIS-based analysis of the assembled map layers promotes three-dimensional understanding of the spatial relationships between CT morphology, material properties, and erosional processes, and provides key insights into intra- and inter- terrace relationships. In concert with relative and absolute dating of material on the landforms, this research is generally supportive of the "nivation hypothesis of CT development."

The Effects of Gravity on the Circadian Timing System

NASA Technical Reports Server (NTRS)

Fuller, Charles A.

1999-01-01

All vertebrates have a physiological control system that regulates the timing of the rhythms of their daily life. Dysfunction of this system, the circadian timing system (CTS), adversely affects an organism's ability to respond to environmental challenges and has been linked to physiological and psychological disorders. Exposure to altered gravitational environments (the microgravity of space and hyperdynamic environments produced via centrifugation) produces changes in both the functioning of the CTS and the rhythmic variables it controls. The earliest record of primate rhythms in a spaceflight environment come from Biosatellite III. The subject, a pig-tailed macaque, showed a loss of synchronization of the body temperature rhythm and a fragmented sleep-wake cycle. Alterations in the rhythm of body temperature were also seen in rhesus macaques flown on COSMOS 1514. Squirrel monkeys exposed to chronic centrifugation showed an initial decrease in the amplitude and mean of their body temperature and activity rhythms. In a microgravity environment, Squirrel monkeys on Spacelab-3 showed a reduction in the mean and amplitude of their feeding rhythms. Since 1992 we have had the opportunity to participate on three US/Russian sponsored biosatellite missions on which a total of six juvenile male rhesus macaques were flown. These animals uniformly exhibited delays in the phasing of their temperature rhythms, but not their heart rate or activity rhythms during spaceflight. There was also a tendency for changes in waveform mean and amplitude. These data suggest that the spaceflight environment may have a differential effect on the different oscillators controlling different rhythmic variables. Ongoing studies are examining the effects of +G on the CTS. The long-term presence of humans in space highlights the need for effective countermeasures to gravitational effects on the CTS.

Effectiveness of manual therapy versus surgery in pain processing due to carpal tunnel syndrome: A randomized clinical trial.

PubMed

Fernández-de-Las-Peñas, C; Cleland, J; Palacios-Ceña, M; Fuensalida-Novo, S; Alonso-Blanco, C; Pareja, J A; Alburquerque-Sendín, F

2017-08-01

People with carpal tunnel syndrome (CTS) exhibit widespread pressure pain and thermal pain hypersensitivity as a manifestation of central sensitization. The aim of our study was to compare the effectiveness of manual therapy versus surgery for improving pain and nociceptive gain processing in people with CTS. The trial was conducted at a local regional Hospital in Madrid, Spain from August 2014 to February 2015. In this randomized parallel-group, blinded, clinical trial, 100 women with CTS were randomly allocated to either manual therapy (n = 50), who received three sessions (once/week) of manual therapies including desensitization manoeuvres of the central nervous system, or surgical intervention (n = 50) group. Outcomes including pressure pain thresholds (PPT), thermal pain thresholds (HPT or CPT), and pain intensity which were assessed at baseline, and 3, 6, 9 and 12 months after the intervention by an assessor unaware of group assignment. Analysis was by intention to treat with mixed ANCOVAs adjusted for baseline scores. At 12 months, 95 women completed the follow-up. Patients receiving manual therapy exhibited higher increases in PPT over the carpal tunnel at 3, 6 and 9 months (all, p < 0.01) and higher decrease of pain intensity at 3 month follow-up (p < 0.001) than those receiving surgery. No significant differences were observed between groups for the remaining outcomes. Manual therapy and surgery have similar effects on decreasing widespread pressure pain sensitivity and pain intensity in women with CTS. Neither manual therapy nor surgery resulted in changes in thermal pain sensitivity. The current study found that manual therapy and surgery exhibited similar effects on decreasing widespread pressure pain sensitivity and pain intensity in women with carpal tunnel syndrome at medium- and long-term follow-ups investigating changes in nociceptive gain processing after treatment in carpal tunnel syndrome. © 2017 European Pain Federation - EFIC®.

Iterative framework for the joint segmentation and CT synthesis of MR images: application to MRI-only radiotherapy treatment planning

NASA Astrophysics Data System (ADS)

Burgos, Ninon; Guerreiro, Filipa; McClelland, Jamie; Presles, Benoît; Modat, Marc; Nill, Simeon; Dearnaley, David; deSouza, Nandita; Oelfke, Uwe; Knopf, Antje-Christin; Ourselin, Sébastien; Cardoso, M. Jorge

2017-06-01

To tackle the problem of magnetic resonance imaging (MRI)-only radiotherapy treatment planning (RTP), we propose a multi-atlas information propagation scheme that jointly segments organs and generates pseudo x-ray computed tomography (CT) data from structural MR images (T1-weighted and T2-weighted). As the performance of the method strongly depends on the quality of the atlas database composed of multiple sets of aligned MR, CT and segmented images, we also propose a robust way of registering atlas MR and CT images, which combines structure-guided registration, and CT and MR image synthesis. We first evaluated the proposed framework in terms of segmentation and CT synthesis accuracy on 15 subjects with prostate cancer. The segmentations obtained with the proposed method were compared using the Dice score coefficient (DSC) to the manual segmentations. Mean DSCs of 0.73, 0.90, 0.77 and 0.90 were obtained for the prostate, bladder, rectum and femur heads, respectively. The mean absolute error (MAE) and the mean error (ME) were computed between the reference CTs (non-rigidly aligned to the MRs) and the pseudo CTs generated with the proposed method. The MAE was on average 45.7+/- 4.6 HU and the ME -1.6+/- 7.7 HU. We then performed a dosimetric evaluation by re-calculating plans on the pseudo CTs and comparing them to the plans optimised on the reference CTs. We compared the cumulative dose volume histograms (DVH) obtained for the pseudo CTs to the DVH obtained for the reference CTs in the planning target volume (PTV) located in the prostate, and in the organs at risk at different DVH points. We obtained average differences of -0.14 % in the PTV for {{D}98 % } , and between -0.14 % and 0.05% in the PTV, bladder, rectum and femur heads for D mean and {{D}2 % } . Overall, we demonstrate that the proposed framework is able to automatically generate accurate pseudo CT images and segmentations in the pelvic region, potentially bypassing the need for CT scan for accurate RTP.

Effects of Wrist Posture and Fingertip Force on Median Nerve Blood Flow Velocity

PubMed Central

Wilson, Katherine E.; Tat, Jimmy

2017-01-01

Purpose. The purpose of this study was to assess nerve hypervascularization using high resolution ultrasonography to determine the effects of wrist posture and fingertip force on median nerve blood flow at the wrist in healthy participants and those experiencing carpal tunnel syndrome (CTS) symptoms. Methods. The median nerves of nine healthy participants and nine participants experiencing symptoms of CTS were evaluated using optimized ultrasonography in five wrist postures with and without a middle digit fingertip press (0, 6 N). Results. Both wrist posture and fingertip force had significant main effects on mean peak blood flow velocity. Blood flow velocity with a neutral wrist (2.87 cm/s) was significantly lower than flexed 30° (3.37 cm/s), flexed 15° (3.27 cm/s), and extended 30° (3.29 cm/s). Similarly, median nerve blood flow velocity was lower without force (2.81 cm/s) than with force (3.56 cm/s). A significant difference was not found between groups. Discussion. Vascular changes associated with CTS may be acutely induced by nonneutral wrist postures and fingertip force. This study represents an early evaluation of intraneural blood flow as a measure of nerve hypervascularization in response to occupational risk factors and advances our understanding of the vascular phenomena associated with peripheral nerve compression. PMID:28286771

The association of sibling relationship and abuse with later psychological adjustment.

PubMed

Mackey, Amber L; Fromuth, Mary Ellen; Kelly, David B

2010-06-01

This study of 59 undergraduate men and 85 undergraduate women explored how defining emotional and physical sibling abuse affected the frequency of reported sibling abuse. In addition, the current study examined how the emotional context of the sibling relationship (i.e., rivalry and conflict) moderated the relationship between sibling abuse and later psychological adjustment (i.e., depression and anxiety). Respondents completed self-report questionnaires of sibling abuse (CTS2-SP), self-labeling of sibling abuse, quality of sibling relationships (SRQ), depression (CES-D), and anxiety (ZAS). Results indicated differences in frequency of reported abuse depending on how sibling abuse was defined. Also, there were no statistically significant correlations between the CTS2-SP and measures of psychological adjustment. Although self-labeling as emotionally abused correlated with later anxiety, the emotional context of the sibling relationship did not moderate this relationship.

Quality of Care for Work-associated Carpal Tunnel Syndrome

PubMed Central

Nuckols, Teryl; Conlon, Craig; Robbins, Michael; Dworsky, Michael; Lai, Julie; Roth, Carol P.; Levitan, Barbara; Seabury, Seth; Seelam, Rachana; Asch, Steven M.

2017-01-01

Objective To evaluate the quality of care provided to individuals with workers’ compensation claims related to CTS and identify patient characteristics associated with receiving better care. Methods We recruited subjects with new claims for CTS from 30 occupational clinics affiliated with Kaiser Permanente Northern California. We applied 45 process-oriented quality measures to 477 subjects’ medical records, and performed multivariate logistic regression to identify patient characteristics associated with quality. Results Overall, 81.6% of care adhered to recommended standards. Certain tasks related to assessing and managing activity were underused. Patients with classic/probable Katz diagrams, positive electrodiagnostic tests, and higher incomes received better care. However, age, gender, and race/ethnicity were not associated with quality. Conclusions Care processes for work-associated CTS frequently adhered to quality measures. Clinical factors were more strongly associated with quality than demographic and socioeconomic ones. PMID:28045797

Conditional Toxin Splicing Using a Split Intein System.

PubMed

Alford, Spencer C; O'Sullivan, Connor; Howard, Perry L

2017-01-01

Protein toxin splicing mediated by split inteins can be used as a strategy for conditional cell ablation. The approach requires artificial fragmentation of a potent protein toxin and tethering each toxin fragment to a split intein fragment. The toxin-intein fragments are, in turn, fused to dimerization domains, such that addition of a dimerizing agent reconstitutes the split intein. These chimeric toxin-intein fusions remain nontoxic until the dimerizer is added, resulting in activation of intein splicing and ligation of toxin fragments to form an active toxin. Considerations for the engineering and implementation of conditional toxin splicing (CTS) systems include: choice of toxin split site, split site (extein) chemistry, and temperature sensitivity. The following method outlines design criteria and implementation notes for CTS using a previously engineered system for splicing a toxin called sarcin, as well as for developing alternative CTS systems.

A conceptual framework for developing a critical thinking self-assessment scale.

PubMed

Nair, Girija G; Stamler, Lynnette Leeseberg

2013-03-01

Nurses must be talented critical thinkers to cope with the challenges related to the ever-changing health care system, population trends, and extended role expectations. Several countries now recognize critical thinking skills (CTS) as an expected outcome of nursing education programs. Critical thinking has been defined in multiple ways by philosophers, critical thinking experts, and educators. Nursing experts conceptualize critical thinking as a process involving cognitive and affective domains of reasoning. Nurse educators are often challenged with teaching and measuring CTS because of their latent nature and the lack of a uniform definition of the concept. In this review of the critical thinking literature, we examine various definitions, identify a set of constructs that define critical thinking, and suggest a conceptual framework on which to base a self-assessment scale for measuring CTS. Copyright 2013, SLACK Incorporated.

Overview of Existing and Future Residential Use Cases for Connected Thermostats

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

Rotondo, Julia; Johnson, Robert; Gonzales, Nancy

This paper is intended to help inform future technology deployment opportunities for connected thermostats (CTs), based on investigation and review of the U.S. residential housing and CT markets, as well as existing, emerging, and future use cases for CT hardware and CT-generated data. The CT market has experienced tremendous growth over the last five years — both in terms of the number of units sold and the number of firms offering competing products — and can be characterized by its rapid pace of technological innovation. Despite many assuming CTs would become powerful tools for increasing comfort while saving energy, theremore » remains a great deal of uncertainty about the actual energy and cost savings that are likely to be realized from deployment of CTs, particularly under different conditions.« less

A digitally implemented communications experiment utilizing the Hermes (CTS) satellite

NASA Technical Reports Server (NTRS)

Jackson, H. D.; Fiala, J. L.

1977-01-01

The Hermes (CTS) experiment program made possible a significant effort directed toward new developments which will reduce the costs associated with the distribution of satellite services. Advanced satellite transponder technology and small inexpensive earth terminals were demonstrated as part of the Hermes program. Another system element that holds promise for reduced transmission cost is associated with the communication link implementation. An experiment is described which uses CTS to demonstrate digital link implementation and its advantages over conventional analog systems. A Digitally Implemented Communications experiment which demonstrates the flexibility and efficiency of digital transmission of television video and audio, telephone voice and high-bit-rate data is also described. Presentation of the experiment concept which concentrates on the evaluation of full-duplex digital television in the teleconferencing environment is followed by a description of unique equipment that was developed.

Disparities of Shigellosis Rates among California Children by Race/Ethnicity and Census Tract Poverty Level, 2000-2010.

PubMed

Jackson, Rebecca; Smith, Daniel; Tabnak, Farzaneh; Vugia, Duc

2015-08-01

We examined surveillance data for disparities in shigellosis rates among children by census tract (CT) poverty level and race/ethnicity in California. We geocoded addresses of 9740 children younger than 15 years of age from 2000-2010 California shigellosis surveillance data and calculated incidence rate (IR) per 100,000 population by age group and race/ethnicity. We linked geocoded cases to 2006-2010 American Community Survey CT-level poverty data and used IR ratios to compare children in the most impoverished CTs with those in the least impoverished CTs. The contribution of socioeconomic inequalities to age-standardized racial and ethnic disparities was explored using Poisson regression. Per 100,000 population, shigellosis IR was highest among California children less than 5 years old (16.4) and of Hispanic ethnicity (15.2). The age-standardized IR was 22.3 per 100,000 person-years in CTs with more than 40% of the population below the poverty line and 4.1 per 100,000 person-years in CTs with less than 5% of the population below the poverty line, an IR ratio of 5.8 (95% confidence interval: 5.2, 6.5). Shigellosis rates among California children were highest among Hispanics and increased with CT poverty.

Assessing Statistical Competencies in Clinical and Translational Science Education: One Size Does Not Fit All

PubMed Central

Lindsell, Christopher J.; Welty, Leah J.; Mazumdar, Madhu; Thurston, Sally W.; Rahbar, Mohammad H.; Carter, Rickey E.; Pollock, Bradley H.; Cucchiara, Andrew J.; Kopras, Elizabeth J.; Jovanovic, Borko D.; Enders, Felicity T.

2014-01-01

Abstract Introduction Statistics is an essential training component for a career in clinical and translational science (CTS). Given the increasing complexity of statistics, learners may have difficulty selecting appropriate courses. Our question was: what depth of statistical knowledge do different CTS learners require? Methods For three types of CTS learners (principal investigator, co‐investigator, informed reader of the literature), each with different backgrounds in research (no previous research experience, reader of the research literature, previous research experience), 18 experts in biostatistics, epidemiology, and research design proposed levels for 21 statistical competencies. Results Statistical competencies were categorized as fundamental, intermediate, or specialized. CTS learners who intend to become independent principal investigators require more specialized training, while those intending to become informed consumers of the medical literature require more fundamental education. For most competencies, less training was proposed for those with more research background. Discussion When selecting statistical coursework, the learner's research background and career goal should guide the decision. Some statistical competencies are considered to be more important than others. Baseline knowledge assessments may help learners identify appropriate coursework. Conclusion Rather than one size fits all, tailoring education to baseline knowledge, learner background, and future goals increases learning potential while minimizing classroom time. PMID:25212569

Chloroplastic and cytoplasmic overexpression of sheep serotonin N-acetyltransferase in transgenic rice plants is associated with low melatonin production despite high enzyme activity.

PubMed

Byeon, Yeong; Lee, Hyoung Yool; Back, Kyoungwhan

2015-05-01

Serotonin N-acetyltransferase (SNAT), the penultimate enzyme in melatonin biosynthesis, catalyzes the conversion of serotonin into N-acetylserotonin. Plant SNAT is localized in chloroplasts. To test SNAT localization effects on melatonin synthesis, we generated transgenic rice plants overexpressing a sheep (Ovis aries) SNAT (OaSNAT) in their chloroplasts and compared melatonin biosynthesis with that of transgenic rice plants overexpressing OaSNAT in their cytoplasm. To localize the OaSNAT in chloroplasts, we used a chloroplast targeting sequence (CTS) from tobacco protoporphyrinogen IX oxidase (PPO), which expresses in chloroplasts. The purified recombinant CTS:OaSNAT fusion protein was enzymatically functional and localized in chloroplasts as confirmed by confocal microscopic analysis. The chloroplast-targeted CTS:OaSNAT lines and cytoplasm-expressed OaSNAT lines had similarly high SNAT enzyme activities. However, after cadmium and butafenacil treatments, melatonin production in rice leaves was severalfold lower in the CTS:OaSNAT lines than in the OaSNAT lines. Notably, enhanced SNAT enzyme activity was not directly proportional to the production of N-acetylserotonin, melatonin, or 2-hydroxymelatonin, suggesting that plant SNAT has a role in the homeostatic regulation of melatonin rather than in accelerating melatonin synthesis. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Systems-level chromosomal parameters represent a suprachromosomal basis for the non-random chromosomal arrangement in human interphase nuclei

PubMed Central

Fatakia, Sarosh N.; Mehta, Ishita S.; Rao, Basuthkar J.

2016-01-01

Forty-six chromosome territories (CTs) are positioned uniquely in human interphase nuclei, wherein each of their positions can range from the centre of the nucleus to its periphery. A non-empirical basis for their non-random arrangement remains unreported. Here, we derive a suprachromosomal basis of that overall arrangement (which we refer to as a CT constellation), and report a hierarchical nature of the same. Using matrix algebra, we unify intrinsic chromosomal parameters (e.g., chromosomal length, gene density, the number of genes per chromosome), to derive an extrinsic effective gene density matrix, the hierarchy of which is dominated largely by extrinsic mathematical coupling of HSA19, followed by HSA17 (human chromosome 19 and 17, both preferentially interior CTs) with all CTs. We corroborate predicted constellations and effective gene density hierarchy with published reports from fluorescent in situ hybridization based microscopy and Hi-C techniques, and delineate analogous hierarchy in disparate vertebrates. Our theory accurately predicts CTs localised to the nuclear interior, which interestingly share conserved synteny with HSA19 and/or HSA17. Finally, the effective gene density hierarchy dictates how permutations among CT position represents the plasticity within its constellations, based on which we suggest that a differential mix of coding with noncoding genome modulates the same. PMID:27845379

Investigations of rhesus monkey video-task performance: evidence for enrichment

NASA Technical Reports Server (NTRS)

Washburn, D. A.; Rumbaugh, D. M.

1992-01-01

We have developed the Language Research Center's Computerized Test System (LRC-CTS) for psychological research. Basically, the LRC-CTS is a battery of software tasks--computerized versions of many of the classic testing paradigms of cognitive and comparative psychology--and the hardware required to administer them. An XT- or 386-compatible computer is connected to a color monitor, onto which computer-generated stimuli are presented. Sound feedback is delivered through an external speaker/amplifier, and a joystick is used as an input device. The animals reach through the mesh of their home cages to manipulate the joystick, which causes isomorphic movements of a cursor on the screen thereby allowing animals to respond according to the varied demands of the tasks. Correct responses are rewarded with a fruit-flavored chow pellet. Using this technology, we have trained and tested rhesus monkeys, a variety of apes, human adults, and normally developing or mentally retarded human children. Other labs using the LRC-CTS are beginning to report encouraging results with other monkey species as well. From this research, a number of interesting and important psychological findings have resulted. In the present paper, however, evidence will be reviewed which suggests that the LRC-CTS is an effective means of providing environmental enrichment to singly housed rhesus monkeys.

Hormonal regulation of growth and life span of bullfrog tadpole tail epidermal cells cultured in vitro.

PubMed

Nishikawa, A; Yoshizato, K

1986-02-01

Epidermal cells were dissociated from tails of the bullfrog tadpole, Rana catesbeiana, and cultured to investigate their response to steroid and thyroid hormones. Charcoal-treated serum (CTS) was used in the growth medium when cells were to be grown in the absence of steroid and thyroid hormones. The cells could be maintained for 2 weeks with a small increase in cell number in medium that contained CTS (CTS medium). Addition of cortisol to CTS medium increased both cellular attachment to the culture dishes and the proliferation of the attached cells with an optimum concentration of 5 X 10(-7) M. The cells remained viable and attached for at least a week. Cortisol stimulated the rate of protein synthesis 1.8-fold but did not alter the rate of DNA synthesis. The cells did not proliferate in the medium containing triiodothyronine (T3) and detached themselves from the dish within 5 days, which occurred in a dose-dependent manner with a maximum effect at 10(-8) M. It drastically decreased the rate of DNA synthesis but did not influence the rate of protein synthesis. These responses of cells to cortisol and T3 may reflect growth and death of tail epidermal cells in vivo at metamorphosis.