Impact of pH and butyric acid on butanol production during batch fermentation using a new local isolate of Clostridium acetobutylicum YM1.

PubMed

Al-Shorgani, Najeeb Kaid Nasser; Kalil, Mohd Sahaid; Yusoff, Wan Mohtar Wan; Hamid, Aidil Abdul

2018-02-01

The effect of pH and butyric acid supplementation on the production of butanol by a new local isolate of Clostridium acetobutylicum YM1 during batch culture fermentation was investigated. The results showed that pH had a significant effect on bacterial growth and butanol yield and productivity. The optimal initial pH that maximized butanol production was pH 6.0 ± 0.2. Controlled pH was found to be unsuitable for butanol production in strain YM1, while the uncontrolled pH condition with an initial pH of 6.0 ± 0.2 was suitable for bacterial growth, butanol yield and productivity. The maximum butanol concentration of 13.5 ± 1.42 g/L was obtained from cultures grown under the uncontrolled pH condition, resulting in a butanol yield ( Y P / S ) and productivity of 0.27 g/g and 0.188 g/L h, respectively. Supplementation of the pH-controlled cultures with 4.0 g/L butyric acid did not improve butanol production; however, supplementation of the uncontrolled pH cultures resulted in high butanol concentrations, yield and productivity (16.50 ± 0.8 g/L, 0.345 g/g and 0.163 g/L h, respectively). pH influenced the activity of NADH-dependent butanol dehydrogenase, with the highest activity obtained under the uncontrolled pH condition. This study revealed that pH is a very important factor in butanol fermentation by C. acetobutylicum YM1.

40 CFR 63.1361 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... hatches, sampling ports, and gauge wells provided that each opening is closed when not in use. Examples of... uncontrolled organic HAP emissions from the sum of all process vents are greater than or equal to 0.15 Mg/yr... vents are greater than or equal to 6.8 Mg/yr. Group 2 process vent means any process vent that does not...

40 CFR 63.1361 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... hatches, sampling ports, and gauge wells provided that each opening is closed when not in use. Examples of... uncontrolled organic HAP emissions from the sum of all process vents are greater than or equal to 0.15 Mg/yr... vents are greater than or equal to 6.8 Mg/yr. Group 2 process vent means any process vent that does not...

Robust optimization of the billet for isothermal local loading transitional region of a Ti-alloy rib-web component based on dual-response surface method

NASA Astrophysics Data System (ADS)

Wei, Ke; Fan, Xiaoguang; Zhan, Mei; Meng, Miao

2018-03-01

Billet optimization can greatly improve the forming quality of the transitional region in the isothermal local loading forming (ILLF) of large-scale Ti-alloy ribweb components. However, the final quality of the transitional region may be deteriorated by uncontrollable factors, such as the manufacturing tolerance of the preforming billet, fluctuation of the stroke length, and friction factor. Thus, a dual-response surface method (RSM)-based robust optimization of the billet was proposed to address the uncontrollable factors in transitional region of the ILLF. Given that the die underfilling and folding defect are two key factors that influence the forming quality of the transitional region, minimizing the mean and standard deviation of the die underfilling rate and avoiding folding defect were defined as the objective function and constraint condition in robust optimization. Then, the cross array design was constructed, a dual-RSM model was established for the mean and standard deviation of the die underfilling rate by considering the size parameters of the billet and uncontrollable factors. Subsequently, an optimum solution was derived to achieve the robust optimization of the billet. A case study on robust optimization was conducted. Good results were attained for improving the die filling and avoiding folding defect, suggesting that the robust optimization of the billet in the transitional region of the ILLF was efficient and reliable.

Ratiometric analysis of optical coherence tomography-measured in vivo retinal layer thicknesses for the detection of early diabetic retinopathy.

PubMed

Bhaduri, Basanta; Shelton, Ryan L; Nolan, Ryan M; Hendren, Lucas; Almasov, Alexandra; Labriola, Leanne T; Boppart, Stephen A

2017-11-01

Influence of diabetes mellitus (DM) and diabetic retinopathy (DR) on parafoveal retinal thicknesses and their ratios was evaluated. Six retinal layer boundaries were segmented from spectral-domain optical coherence tomography images using open-source software. Five study groups: (1) healthy control (HC) subjects, and subjects with (2) controlled DM, (3) uncontrolled DM, (4) controlled DR and (5) uncontrolled DR, were identified. The one-way analyses of variance (ANOVA) between adjacent study groups (i. e. 1 with 2, 2 with 3, etc) indicated differences in retinal thicknesses and ratios. Overall retinal thickness, ganglion cell layer (GCL) thickness, inner plexiform layer (IPL) thickness, and their combination (GCL+ IPL), appeared to be significantly less in the uncontrolled DM group when compared to controlled DM and controlled DR groups. Although the combination of nerve fiber layer (NFL) and GCL, and IPL thicknesses were not different, their ratio, (NFL+GCL)/IPL, was found to be significantly higher in the controlled DM group compared to the HC group. Comparisons of the controlled DR group with the controlled DM group, and with the uncontrolled DR group, do not show any differences in the layer thicknesses, though several significant ratios were obtained. Ratiometric analysis may provide more sensitive parameters for detecting changes in DR. Picture: A representative segmented OCT image of the human retina is shown. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Novel lipid mediators promote resolution of acute inflammation: impact of aspirin and statins

PubMed Central

Spite, Matthew; Serhan, Charles N.

2010-01-01

The resolution of acute inflammation is a process that allows for inflamed tissues to return to homeostasis. Resolution was held to be a passive process, a concept now overturned with new evidence demonstrating that resolution is actively orchestrated by distinct cellular events and endogenous chemical mediators. Among these, lipid mediators, such as the lipoxins, resolvins, protectins and newly identified maresins, have emerged as a novel genus of potent and stereoselective players that counter-regulate excessive acute inflammation and stimulate molecular and cellular events that define resolution. Given that uncontrolled, chronic inflammation is associated with many cardiovascular pathologies, an appreciation of the endogenous pathways and mediators that control timely resolution can open new terrain for therapeutic approaches targeted at stimulating resolution of local inflammation, as well as correcting the impact of chronic inflammation in cardiovascular disorders. Here, we overview and update the biosynthesis and actions of pro-resolving lipid mediators, highlighting their diverse protective roles relevant to vascular systems and their relation to aspirin and statin therapies. PMID:21071715

Accumulation of Cr, Cd, Pb, Cu, and Zn by plants in tanning sludge storage sites: opportunities for contamination bioindication and phytoremediation

USDA-ARS?s Scientific Manuscript database

The lack of appropriate disposal strategies of tanning sludge (e.g., uncontrolled landfills and disposing sludge to open areas) has led to severe Cr pollution in waters and soils in many developing countries. Excessive Cr can be highly toxic to many living organisms and may damage the ecosystem. In ...

Effects of urban growth controls on intercity commuting.

PubMed

Ogura, Laudo M

2010-01-01

This paper presents an empirical study of the effects of urban growth controls on the intercity commuting of workers. Growth controls (land use regulations that attempt to restrict population growth and urban sprawl) have increased housing prices and diverted population growth to uncontrolled cities. It has been suggested that resulting changes in local labour supply might stimulate intercity commuting from uncontrolled to controlled cities. To test this hypothesis, a gravity model of commuting flows between places in California is estimated using alternative econometric methods (OLS, Heckman selection and count-data). The possibility of spatial dependence in commuting flows is also taken into consideration. Results suggest larger commuting flows to destination places that restrict residential growth.

Galileo Parachute System modification program

NASA Technical Reports Server (NTRS)

Mcmenamin, H. J.; Pochettino, L. R.

1984-01-01

This paper discusses the development program conducted on the Galileo Parachute System following the slow opening performance of the main parachute during the first system drop test. The parachute system is part of the Galileo entry probe that will descend through the Jupiter atmosphere. The uncontrolled parachute opening experienced in this test was not acceptable for the probe system. Therefore, the main parachute design was modified and the system sequence was changed to prevent a recurrence. These alterations and their system effects were evaluated analytically, and in a ground test program. At the conclusion of this phase, the system drop test was successfully repeated.

Developing 21st Century Senior Leaders

DTIC Science & Technology

2010-03-01

idealistic and supernatural qualities that render them capable of leading organizations in the face of uncontrollable operational forces. But, senior...we must change if we are to develop better senior leaders.45 In the Armed Forces Journal article calling to keep the service colleges open, the...SS .., http://ss-peiper.narod.ru/ articles /Beginning_of_the_end-The_Leadership_of_SS-Obersturmbahnfuhrer_Jochen_ Peiper.pdf (accessed March 29

Assessment of leachates from uncontrolled landfill: Tangier case study

NASA Astrophysics Data System (ADS)

Elmaghnougi, I.; Afilal Tribak, A.; Maatouk, M.

2018-05-01

Landfill site of Tangier City is non-engineered low lying open dump. It has neither bottom liner nor leachate collection and treatment system. Therefore, all the leachate generated finds its paths into the surrounding environment Leachate samples of landfill site were collected and analyzed to estimate its pollution potential. The analyzed samples contained a high concentration of organic and inorganic compounds, beyond the permissible limits.

How Are Oil Spills Treated?

ERIC Educational Resources Information Center

Whitmore, William

2005-01-01

No two oil spills are the same. Logistically, oil spills are a nightmare because they are unanticipated and uncontrolled events. Oil spills present a threat to wildlife and coastal resources, concerning everyone from local residents to state environmental agencies and the federal government. Thousands of people may be involved in a significant…

Immunogenicity and safety of the inactivated Japanese encephalitis vaccine IXIARO® in elderly subjects: Open-label, uncontrolled, multi-center, phase 4 study.

PubMed

Cramer, Jakob P; Dubischar, Katrin; Eder, Susanne; Burchard, Gerd D; Jelinek, Tomas; Jilma, Bernd; Kollaritsch, Herwig; Reisinger, Emil; Westritschnig, Kerstin

2016-08-31

IXIARO® is a Vero cell-derived, inactivated Japanese encephalitis (JE) vaccine licensed mainly in western countries for children and adults traveling to JE endemic areas. Limited immunogenicity and safety data in elderly travelers have been available. To evaluate safety and immunogenicity of IXIARO in elderly subjects. Open-label, single arm, multi-centered study. Two-hundred subjects with good general health, including adequately controlled chronic conditions, received two doses of IXIARO®, 28days apart. Protective levels of antibodies were tested 42days after the second dose. Systemic and local adverse events (AEs) were solicited for 7days after each dose, unsolicited AEs were collected up to day 70 and in a phone call at month 7. Subjects were aged 64-83years (median 69.0years). Nineteen percent of subjects had serious or medically attended AEs up to Day 70 (primary endpoint), none of them causally linked to IXIARO. Solicited local AEs were reported by 33.5% (most common: local tenderness) and solicited systemic AEs by 27% (most common: headache) of subjects. The seroprotection rate was 65% with a geometric mean titre (GMT) of 37. Subjects with tick borne encephalitis (TBE) vaccinations in the past 5years (N=29) had a SCR of 90% and GMT of 65. IXIARO is generally well tolerated in the elderly, and the safety profile is largely comparable with younger adults. SCR and GMT are lower compared to younger adults, but SCR is in the range reported in elderly for other vaccines e.g. against TBE, hepatitis-A virus (HAV)/hepatitis-B virus (HBV), influenza. The differences in SCR and GMT from younger to elderly adults were in the range of other vaccines. Duration of protection is uncertain in older persons, therefore a booster dose (third dose) should be considered before any further exposure to JE virus. Copyright © 2016. Published by Elsevier Ltd.

Acetyl-L-Carnitine Augmentation of Clozapine in Partial-Responder Schizophrenia: A 12-Week, Open-Label Uncontrolled Preliminary Study.

PubMed

Bruno, Antonio; Pandolfo, Gianluca; Crucitti, Manuela; Lorusso, Simona; Zoccali, Rocco Antonio; Muscatello, Maria Rosaria Anna

This was the first 12-week, open-label, uncontrolled trial aimed at exploring the efficacy of acetyl-L-carnitine (ALC) add-on pharmacotherapy on clinical symptoms and cognitive functioning in 15 schizophrenia patients with suboptimal clinical response despite receiving clozapine (CLZ) monotherapy at the highest tolerated dosage. After clinical (Positive and Negative Symptoms Scale [PANSS]) and neuropsychological (Wisconsin Card Sorting Test, Stroop Color-Word Test, Verbal Fluency Test) assessments, patients received 1 g/d of ALC for 12 weeks. A final sample of 9 subjects completed the study. Acetyl-L-carnitine augmentation of CLZ significantly reduced only PANSS domains "positive" (P = 0.049); at end point, only 2 subjects (22.2% of the completers) reached a minimal improvement (25% reduction in PANSS total score). No significant differences emerged in cognitive performances at the end of the study; effect sizes were small in each explored cognitive dimension. The findings provide preliminary evidence that ALC added to ongoing CLZ treatment appeared to be ineffective to improve symptoms in schizophrenia patients who have failed to respond sufficiently to CLZ. Further trials with adequately powered methodology are needed to identify which augmentation strategies are more effective in schizophrenia patients showing a suboptimal response to CLZ.

A Complex Multiherbal Regimen Based on Ayurveda Medicine for the Management of Hepatic Cirrhosis Complicated by Ascites: Nonrandomized, Uncontrolled, Single Group, Open-Label Observational Clinical Study.

PubMed

Patel, Manish V; Patel, Kalapi B; Gupta, Shivenarain; Michalsen, Andreas; Stapelfeldt, Elmar; Kessler, Christian S

2015-01-01

Hepatic cirrhosis is one of the leading causes of death worldwide, especially if complicated by ascites. This chronic condition can be related to the classical disease entity jalodara in Traditional Indian Medicine (Ayurveda). The present paper aims to evaluate the general potential of Ayurvedic therapy for overall clinical outcomes in hepatic cirrhosis complicated by ascites (HCcA). In form of a nonrandomized, uncontrolled, single group, open-label observational clinical study, 56 patients fulfilling standardized diagnostic criteria for HCcA were observed during their treatment at the P. D. Patel Ayurveda Hospital, Nadiad, India. Based on Ayurvedic tradition, a standardized treatment protocol was developed and implemented, consisting of oral administration of single and compound herbal preparations combined with purificatory measures as well as dietary and lifestyle regimens. The outcomes were assessed by measuring liver functions through specific clinical features and laboratory parameters and by evaluating the Child-Pugh prognostic grade score. After 6 weeks of treatment and a follow-up period of 18 weeks, the outcomes showed statistically significant and clinically relevant improvements. Further larger and randomized trials on effectiveness, safety, and quality of the Ayurvedic approach in the treatment of HCcA are warranted to support these preliminary findings.

SNMG: a social-level norm-based methodology for macro-governing service collaboration processes

NASA Astrophysics Data System (ADS)

Gao, Ji; Lv, Hexin; Jin, Zhiyong; Xu, Ping

2017-08-01

In order to adapt to the accelerative open tendency of collaborations between enterprises, this paper proposes a Social-level Norm-based methodology for Macro-Governing service collaboration processes, called SNMG, to regulate and control the social-level visible macro-behaviors of the social individuals participating in collaborations. SNMG not only can remove effectively the uncontrollability hindrance confronted with by open social activities, but also enables across-management-domain collaborations to be implemented by uniting the centralized controls of social individuals for respective social activities. Therefore, this paper provides a brand-new system construction mode to promote the development and large-scale deployment of service collaborations.

Virginia Erosion and Sediment Control Handbook. Standards, Criteria and Guidelines.

ERIC Educational Resources Information Center

Virginia State Soil and Water Conservation Commission, Richmond, VA.

Guidelines and technical standards for development of local erosion and sediment control programs and conservation standards to meet the goals established by the Virginia Erosion and Sediment Control law are presented in this handbook. Part I defines natural and manmade erosion, sedimentation, and the hazards of uncontrolled wear and damage to the…

Assessment of theileria equi and babesia caballi infections in equine populations in Egypt by molecular, serological and hematological approaches

USDA-ARS?s Scientific Manuscript database

Background: Equine piroplasmosis caused by Theileria equi, Babesia caballi, or both, cause significant economic losses in the equine industry and remains uncontrolled in Egypt. Methods: T. equi and B. caballi infections were assessed in blood from 88 horses and 51 donkeys from different localities ...

Spacecraft Formation Flying Maneuvers Using Linear-Quadratic Regulation with No Radial Axis Inputs

NASA Technical Reports Server (NTRS)

Starin, Scott R.; Yedavalli, R. K.; Sparks, Andrew G.; Bauer, Frank H. (Technical Monitor)

2001-01-01

Regarding multiple spacecraft formation flying, the observation has been made that control thrust need only be applied coplanar to the local horizon to achieve complete controllability of a two-satellite (leader-follower) formation. A formulation of orbital dynamics using the state of one satellite relative to another is used. Without the need for thrust along the radial (zenith-nadir) axis of the relative reference frame ' propulsion system simplifications and weight reduction may be accomplished. Several linear-quadratic regulators (LQR) are explored and compared based on performance measures likely to be important to many missions, but not directly optimized in the LQR designs. Maneuver simulations are performed using commercial ODE solvers to propagate the Keplerian dynamics of a controlled satellite relative to an uncontrolled leader. These short maneuver simulations demonstrate the capacity of the controller to perform changes from one formation geometry to another. This work focusses on formations in which the controlled satellite has a relative trajectory which projects onto the local horizon of the uncontrolled satellite as a circle. This formation has potential uses for distributed remote sensing systems.

Comparison of Five System Identification Algorithms for Rotorcraft Higher Harmonic Control

NASA Technical Reports Server (NTRS)

Jacklin, Stephen A.

1998-01-01

This report presents an analysis and performance comparison of five system identification algorithms. The methods are presented in the context of identifying a frequency-domain transfer matrix for the higher harmonic control (HHC) of helicopter vibration. The five system identification algorithms include three previously proposed methods: (1) the weighted-least- squares-error approach (in moving-block format), (2) the Kalman filter method, and (3) the least-mean-squares (LMS) filter method. In addition there are two new ones: (4) a generalized Kalman filter method and (5) a generalized LMS filter method. The generalized Kalman filter method and the generalized LMS filter method were derived as extensions of the classic methods to permit identification by using more than one measurement per identification cycle. Simulation results are presented for conditions ranging from the ideal case of a stationary transfer matrix and no measurement noise to the more complex cases involving both measurement noise and transfer-matrix variation. Both open-loop identification and closed- loop identification were simulated. Closed-loop mode identification was more challenging than open-loop identification because of the decreasing signal-to-noise ratio as the vibration became reduced. The closed-loop simulation considered both local-model identification, with measured vibration feedback and global-model identification with feedback of the identified uncontrolled vibration. The algorithms were evaluated in terms of their accuracy, stability, convergence properties, computation speeds, and relative ease of implementation.

Psychogenic Blepharospasm: A Diagnostic Dilemma.

PubMed

DAS, Soumitra; Sreedharan, Roopchand Pandrantil; Remadevi, Prasanth Sudhakaran; Saji, Cheruvallil Velayudhan

2016-12-25

Blepharospasm is an uncontrolled spasmodic contraction of the orbicularis muscles of the eye resulting in an abnormal tic or twitch of eyes. It usually lasts for seconds to minutes but in severe cases eyes may be closed for hours. It may be essentially benign or secondary due to a lesion in basal ganglia, pyramidal tract, and trauma, local pathology in the eyes or drug induced. Here we are presenting a case of psychogenic blepharospasm. A 65 year old woman presented with a history of episodic inability of opening her eyes for the past 6 months. She had repeated abrupt closure of eyes which would persist for 1 hour. It made her socially and interpersonally disabled. Systemic and neurological causes were ruled out by detailed physical examinations and investigations including neuroimaging. Following poor response to oral medications she was injected with 7 units of Botox only in the muscles of the right eye. But within seconds she received relief in both eyes. During the next session she received a needle prick in one eye with no medication and immediately both of her eyes opened from a tightly closed position. In this case the patient reported stress due to increased workload around the house. From our case it depicts that a true movement disorder is often difficult to distinguish from functional disorder. So evaluation and management of patient's external and internal stress will be of immense help before conducting any invasive treatment.

On the stabilization of decentralized control systems.

NASA Technical Reports Server (NTRS)

Wang, S.-H.; Davison, E. J.

1973-01-01

This paper considers the problem of stabilizing a linear time-variant multivariable system by using several local feedback control laws. Each local feedback control law depends only on partial system outputs. A necessary and sufficient condition for the existence of local control laws with dynamic compensation to stabilize a given system is derived. This condition is stated in terms of a new notion, called fixed modes, which is a natural generalization of the well-known concept of uncontrollable modes and unobservable modes that occur in centralized control system problems. A procedure that constructs a set of stabilizing feedback control laws is given.

Global land use change, economic globalization, and the looming land scarcity.

PubMed

Lambin, Eric F; Meyfroidt, Patrick

2011-03-01

A central challenge for sustainability is how to preserve forest ecosystems and the services that they provide us while enhancing food production. This challenge for developing countries confronts the force of economic globalization, which seeks cropland that is shrinking in availability and triggers deforestation. Four mechanisms-the displacement, rebound, cascade, and remittance effects-that are amplified by economic globalization accelerate land conversion. A few developing countries have managed a land use transition over the recent decades that simultaneously increased their forest cover and agricultural production. These countries have relied on various mixes of agricultural intensification, land use zoning, forest protection, increased reliance on imported food and wood products, the creation of off-farm jobs, foreign capital investments, and remittances. Sound policies and innovations can therefore reconcile forest preservation with food production. Globalization can be harnessed to increase land use efficiency rather than leading to uncontrolled land use expansion. To do so, land systems should be understood and modeled as open systems with large flows of goods, people, and capital that connect local land use with global-scale factors.

Global land use change, economic globalization, and the looming land scarcity

PubMed Central

Lambin, Eric F.; Meyfroidt, Patrick

2011-01-01

A central challenge for sustainability is how to preserve forest ecosystems and the services that they provide us while enhancing food production. This challenge for developing countries confronts the force of economic globalization, which seeks cropland that is shrinking in availability and triggers deforestation. Four mechanisms—the displacement, rebound, cascade, and remittance effects—that are amplified by economic globalization accelerate land conversion. A few developing countries have managed a land use transition over the recent decades that simultaneously increased their forest cover and agricultural production. These countries have relied on various mixes of agricultural intensification, land use zoning, forest protection, increased reliance on imported food and wood products, the creation of off-farm jobs, foreign capital investments, and remittances. Sound policies and innovations can therefore reconcile forest preservation with food production. Globalization can be harnessed to increase land use efficiency rather than leading to uncontrolled land use expansion. To do so, land systems should be understood and modeled as open systems with large flows of goods, people, and capital that connect local land use with global-scale factors. PMID:21321211

Export of toxic chemicals - a review of the case of uncontrolled electronic-waste recycling.

PubMed

Wong, M H; Wu, S C; Deng, W J; Yu, X Z; Luo, Q; Leung, A O W; Wong, C S C; Luksemburg, W J; Wong, A S

2007-09-01

This paper reviews the concentrations of persistent organic pollutants such as flame retardants (PBDEs), dioxins/furans (PCDD/Fs), polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs) and heavy metals/metalloid concentrations of different environmental media at Guiyu, a traditional rice-growing village located in southeastern Guangdong Province (PR China), which has turned into an intensive electronic-waste (e-waste) recycling site. Incomplete combustion of e-waste in open air and dumping of processed materials are the major sources of various toxic chemicals. By comparing with existing data available in other areas and also guidelines adopted in different countries, it is obvious that the environment is highly contaminated by these toxic chemicals derived from the recycling processes. For example, the monthly concentration of the sum of 22 PBDE congeners contained in PM(2.5) (16.8ngm(-3)) of air samples at Guiyu was 100 times higher than published data. In order to safeguard the environment and human health, detailed investigations are urgently needed, especially on tracking the exposure pathways of different toxic chemicals which may affect the workers and local residents especially mothers, infants and children.

Guards at the gate: physiological and pathological roles of tissue-resident innate lymphoid cells in the lung.

PubMed

Cheng, Hang; Jin, Chengyan; Wu, Jing; Zhu, Shan; Liu, Yong-Jun; Chen, Jingtao

2017-12-01

The lung is an important open organ and the primary site of respiration. Many life-threatening diseases develop in the lung, e.g., pneumonia, asthma, chronic obstructive pulmonary diseases (COPDs), pulmonary fibrosis, and lung cancer. In the lung, innate immunity serves as the frontline in both anti-irritant response and anti-tumor defense and is also critical for mucosal homeostasis; thus, it plays an important role in containing these pulmonary diseases. Innate lymphoid cells (ILCs), characterized by their strict tissue residence and distinct function in the mucosa, are attracting increased attention in innate immunity. Upon sensing the danger signals from damaged epithelium, ILCs activate, proliferate, and release numerous cytokines with specific local functions; they also participate in mucosal immune-surveillance, immune-regulation, and homeostasis. However, when their functions become uncontrolled, ILCs can enhance pathological states and induce diseases. In this review, we discuss the physiological and pathological functions of ILC subsets 1 to 3 in the lung, and how the pathogenic environment affects the function and plasticity of ILCs.

CEM43°C thermal dose thresholds: a potential guide for magnetic resonance radiofrequency exposure levels?

PubMed

van Rhoon, Gerard C; Samaras, Theodoros; Yarmolenko, Pavel S; Dewhirst, Mark W; Neufeld, Esra; Kuster, Niels

2013-08-01

To define thresholds of safe local temperature increases for MR equipment that exposes patients to radiofrequency fields of high intensities for long duration. These MR systems induce heterogeneous energy absorption patterns inside the body and can create localised hotspots with a risk of overheating. The MRI + EUREKA research consortium organised a "Thermal Workshop on RF Hotspots". The available literature on thresholds for thermal damage and the validity of the thermal dose (TD) model were discussed. The following global TD threshold guidelines for safe use of MR are proposed: 1. All persons: maximum local temperature of any tissue limited to 39 °C 2. Persons with compromised thermoregulation AND (a) Uncontrolled conditions: maximum local temperature limited to 39 °C (b) Controlled conditions: TD < 2 CEM43°C 3. Persons with uncompromised thermoregulation AND (a) Uncontrolled conditions: TD < 2 CEM43°C (b) Controlled conditions: TD < 9 CEM43°C The following definitions are applied: Controlled conditions A medical doctor or a dedicated trained person can respond instantly to heat-induced physiological stress Compromised thermoregulation All persons with impaired systemic or reduced local thermoregulation • Standard MRI can cause local heating by radiofrequency absorption. • Monitoring thermal dose (in units of CEM43°C) can control risk during MRI. • 9 CEM43°C seems an acceptable thermal dose threshold for most patients. • For skin, muscle, fat and bone,16 CEM43°C is likely acceptable.

Efficacy and safety of lacosamide as first add-on or later adjunctive treatment for uncontrolled partial-onset seizures: A multicentre open-label trial.

PubMed

Zadeh, Wendy Waldman; Escartin, Antonio; Byrnes, William; Tennigkeit, Frank; Borghs, Simon; Li, Ting; Dedeken, Peter; De Backer, Marc

2015-09-01

To evaluate the efficacy and safety of lacosamide administered as either first add-on or later add-on antiepileptic drug (AED) therapy for patients with uncontrolled partial-onset seizures (POS). In this open-label, multicentre trial, patients with POS initiated oral lacosamide (titrated to 400 mg/day) either as add-on to first AED monotherapy, or as later add-on to 1-3 concomitant AEDs after ≥ 2 previous AEDs. The primary efficacy variable was the proportion of patients achieving seizure freedom for the first 12 weeks of the 24-week Maintenance Phase. 456 patients received ≥ 1 dose of lacosamide (96 as first add-on, 360 as later add-on). In the first add-on cohort, 27/72 (37.5%) patients completed 12 weeks treatment and remained seizure-free; 18/68 (26.5%) remained seizure-free after 24 weeks. 64/91 (70.3%) patients achieved ≥ 50% reduction in seizure frequency during maintenance treatment. This was accompanied by a mean 7.1 ± 16.00 point improvement from Baseline in the Quality of Life Inventory in Epilepsy (QOLIE-31-P) total score for 24-week completers, with improvement reported in all subscales. Most common treatment-emergent adverse events (TEAEs) were dizziness (31.3%) and headache (13.5%). In the later add-on cohort, 39/261 (14.9%) and 29/249 (11.6%) patients remained seizure-free after completing 12 and 24 weeks' treatment, respectively. 178/353 (50.4%) patients achieved ≥ 50% reduction in seizure frequency during maintenance treatment. Mean change in QOLIE-31-P total score was 4.8 ± 14.74 points among 24-week completers. Common TEAEs were dizziness (33.6%), somnolence (15.0%) and headache (11.4%). Lacosamide initiated as first add-on treatment was efficacious and well tolerated in patients with uncontrolled POS. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

NILES 94; International Conference Held in Cairo, Egypt on 26-30 March 1994

DTIC Science & Technology

1994-03-30

and the extreme against. Medicine, Cairo Uni., But the use of this modality in Anisometropia due to myopia Giza , Egypt. is an ideal indications...uncontrolled open angle Kaser EI-Aini School of glaucoma: IOP 26 mmHg or more despite maximal tolerated Medicine, Cairo Uni., Giza , medical therapy were treatd...of blood inhibited optical Medicine, Cairo Uni., Giza , breakdown and required a pasuse before completion Egypt. iridotomy, or other sitting is

Determination of land use in Minnesota by automatic interpretation of ERTS MSS data

NASA Technical Reports Server (NTRS)

Zirkle, R. E.; Pile, D. R.

1973-01-01

This program aims to determine the feasibility of identifying land use in Minnesota by automatic interpretation of ERTS-MSS data. Ultimate objectives include establishment of land use delineation and quantification by computer processing with a minimum of human operator interaction. This implies not only that reflectivity as a function of calendar time can be catalogued effectively, but also that the effects of uncontrolled variables can be identified and compensated. Clouds are the major uncontrollable data pollutant, so part of the initial effort is devoted to determining their effect and the construction of a model to help correct or justifiably ignore affected data. Other short range objectives are to identify and verify measurements giving results of importance to land managers. Lake-counting is a prominent example. Open water is easily detected in band 7 data with some support from either band 4 or band 5 to remove ambiguities. Land managers and conservationists commission studies periodically to measure water bodies and total water count within specified areas.

Alternatives to lithium and divalproex in the maintenance treatment of bipolar disorder.

PubMed

Gnanadesikan, Mukund; Freeman, Marlene P; Gelenberg, Alan J

2003-06-01

The role of lithium carbonate in the maintenance treatment of bipolar disorder is well established. Unfortunately, many patients fail to respond adequately to this agent or are unable to tolerate its adverse effects. Divalproex has become a commonly used alternative to lithium, but it also is ineffective or poorly tolerated in many patients. This article attempts to review the available data on maintenance therapy in bipolar disorder with a variety of anticonvulsants and antipsychotics (both conventional and novel), with reference to relevant studies in acute mania and bipolar depression as well. Evidence on maintenance therapy and relevant acute-phase data were collected using MEDLINE database searches. Data on maintenance therapy with agents other than lithium and divalproex are sparse, and often derived from open, uncontrolled studies. Implications and flaws of available data are discussed. Other than lithium, there are few robust double-blind data to support the use of a variety of agents in the maintenance phase. However, uncontrolled data suggest that a number of agents merit further study.

Evaluation of municipal solid waste management in egyptian rural areas.

PubMed

El-Messery, Mamdouh A; Ismail, Gaber A; Arafa, Anwaar K

2009-01-01

A two years study was conducted to evaluate the solid waste management system in 143 villages representing the Egyptian rural areas. The study covers the legal responsibilities, service availability, environmental impacts, service providers, financial resources, private sector participation and the quality of collection services. According to UN reports more than 55% of Egyptian population lives in rural areas. A drastic change in the consumption pattern altered the quantity and quality of the generated solid wastes from these areas. Poor solid waste management systems are stigmata in most of the Egyptian rural areas. This causes several environmental and health problems. It has been found that solid waste collection services cover only 27% of the surveyed villages, while, the statistics show that 75% of the surveyed villages are formally covered. The service providers are local villager units, private contractors and civil community associations with a percentage share 71%, 24% and 5% respectively. The operated services among these sectors were 25%, 71% and 100% respectively. The share of private sector in solid waste management in rural areas is still very limited as a result of the poverty of these communities and the lack of recyclable materials in their solid waste. It has been found that direct throwing of solid waste on the banks of drains and canals as well as open dumping and uncontrolled burning of solid waste are the common practice in most of the Egyptian rural areas. The available land for landfill is not enough, pitiable designed, defectively constructed and unreliably operated. Although solid waste generated in rural areas has high organic contents, no composting plant was installed. Shortage in financial resources allocated for valorization of solid waste management in the Egyptian rural areas and lower collection fees are the main points of weakness which resulted in poor solid waste management systems. On the other hand, the farmer's participation in solid waste management through the composting of organic matter and using of food waste as an animal feed are considered strength points. However, throwing of solid waste on the banks of water streams, open dumping and uncontrolled burning of solid waste are environmental damaging behaviors that need to be changed. Integrated solid waste management in the Egyptian rural areas is not yet among the priorities of the Egyptian government.

The Powers of the Feminine. Sacred Images of India and Southeast Asia. Teacher's Packet.

ERIC Educational Resources Information Center

Asian Art Museum of San Francisco, CA.

Sacred women have been portrayed throughout the history of India and Southeast Asia. Some were depicted as consorts to the Hindu gods and regarded as the necessary force that activates male energy. Other images arose out of local fertility cults and represented uncontrolled feminine energy that could be terrifying in aspect. The calmer Buddhist…

Hearing Tests on Mobile Devices: Evaluation of the Reference Sound Level by Means of Biological Calibration.

PubMed

Masalski, Marcin; Kipiński, Lech; Grysiński, Tomasz; Kręcicki, Tomasz

2016-05-30

Hearing tests carried out in home setting by means of mobile devices require previous calibration of the reference sound level. Mobile devices with bundled headphones create a possibility of applying the predefined level for a particular model as an alternative to calibrating each device separately. The objective of this study was to determine the reference sound level for sets composed of a mobile device and bundled headphones. Reference sound levels for Android-based mobile devices were determined using an open access mobile phone app by means of biological calibration, that is, in relation to the normal-hearing threshold. The examinations were conducted in 2 groups: an uncontrolled and a controlled one. In the uncontrolled group, the fully automated self-measurements were carried out in home conditions by 18- to 35-year-old subjects, without prior hearing problems, recruited online. Calibration was conducted as a preliminary step in preparation for further examination. In the controlled group, audiologist-assisted examinations were performed in a sound booth, on normal-hearing subjects verified through pure-tone audiometry, recruited offline from among the workers and patients of the clinic. In both the groups, the reference sound levels were determined on a subject's mobile device using the Bekesy audiometry. The reference sound levels were compared between the groups. Intramodel and intermodel analyses were carried out as well. In the uncontrolled group, 8988 calibrations were conducted on 8620 different devices representing 2040 models. In the controlled group, 158 calibrations (test and retest) were conducted on 79 devices representing 50 models. Result analysis was performed for 10 most frequently used models in both the groups. The difference in reference sound levels between uncontrolled and controlled groups was 1.50 dB (SD 4.42). The mean SD of the reference sound level determined for devices within the same model was 4.03 dB (95% CI 3.93-4.11). Statistically significant differences were found across models. Reference sound levels determined in the uncontrolled group are comparable to the values obtained in the controlled group. This validates the use of biological calibration in the uncontrolled group for determining the predefined reference sound level for new devices. Moreover, due to a relatively small deviation of the reference sound level for devices of the same model, it is feasible to conduct hearing screening on devices calibrated with the predefined reference sound level.

Psychogenic Blepharospasm: A Diagnostic Dilemma

PubMed Central

DAS, Soumitra; SREEDHARAN, Roopchand Pandrantil; REMADEVI, Prasanth Sudhakaran; SAJI, Cheruvallil Velayudhan

2016-01-01

Summary Blepharospasm is an uncontrolled spasmodic contraction of the orbicularis muscles of the eye resulting in an abnormal tic or twitch of eyes. It usually lasts for seconds to minutes but in severe cases eyes may be closed for hours. It may be essentially benign or secondary due to a lesion in basal ganglia, pyramidal tract, and trauma, local pathology in the eyes or drug induced. Here we are presenting a case of psychogenic blepharospasm. A 65 year old woman presented with a history of episodic inability of opening her eyes for the past 6 months. She had repeated abrupt closure of eyes which would persist for 1 hour. It made her socially and interpersonally disabled. Systemic and neurological causes were ruled out by detailed physical examinations and investigations including neuroimaging. Following poor response to oral medications she was injected with 7 units of Botox only in the muscles of the right eye. But within seconds she received relief in both eyes. During the next session she received a needle prick in one eye with no medication and immediately both of her eyes opened from a tightly closed position. In this case the patient reported stress due to increased workload around the house. From our case it depicts that a true movement disorder is often difficult to distinguish from functional disorder. So evaluation and management of patient’s external and internal stress will be of immense help before conducting any invasive treatment. PMID:28638211

Fentanyl by continuous subcutaneous infusion for the management of cancer pain: a retrospective study.

PubMed

Watanabe, S; Pereira, J; Hanson, J; Bruera, E

1998-11-01

Twenty-two patients who received fentanyl by continuous subcutaneous infusion for treatment of cancer pain were evaluated retrospectively. No local toxicities were noted. Five patients were switched from transdermal fentanyl due to uncontrolled pain; three achieved stability, accompanied by improvement in visual analogue scores for pain. Seventeen patients were switched from other opioids due to toxicity; 10 achieved stability, with documented improvement in toxicity in seven. The median dose ratio of opioid prior to switchover (mg/day) to fentanyl at stabilization (mg/day) was 85.4 (range 65-112.5) for morphine and 23.0 (range 10.7-29.7) for hydromorphone. Of six stable patients switched from subcutaneous to transdermal fentanyl, four maintained stability. We conclude that fentanyl by continuous subcutaneous infusion is a useful alternative for cancer patients who experience uncontrolled pain while receiving transdermal fentanyl or who experience toxicity on other opioids.

Automated office and home phone-transmitted blood pressure recordings in uncontrolled hypertension treated with valsartan and hydrochlorothiazide.

PubMed

Girerd, Xavier; Denolle, Thierry; Yau, Caroline; Fiquet, Béatrice; Brunel, Patrick; Moulin, Bruno; Herpin, Daniel

2004-12-01

The study objective was to evaluate, by means of automated office and phone-transmitted home blood pressure (OBP and HBP) recordings, the effects of a fixed combination of valsartan 160 mg and hydrochlorothiazide (HCTZ) 25 mg in hypertensive patients previously uncontrolled with the combination of an angiotensin receptor antagonist and HCTZ. From 241 selected patients, 171 (71%) had uncontrolled hypertension OBP and HBP [mean baseline OBP and HBP systolic and diastolic (SBP/DBP): 157/91 and 152/87 mmHg]. In this open-design study, patients were directly switched from other angiotensin receptor blocker combination products to valsartan/HCTZ for 6 weeks. The same validated automated device was used for OBP and HBP recordings. At baseline, mean HBP was 152 +/- 15/87 +/- 10 mmHg and mean OBP was 157 +/- 12/91 +/- 9 mmHg. After 6 weeks of treatment with valsartan 160 mg and HCTZ 25 mg, a significant decrease in BP was observed both at home (146 +/- 17/83 +/- 12 mmHg) and at the office (151 +/- 18/87 +/- 11 mmHg), with a difference from baseline of -4 mmHg, p < 0.001 for DBP and of -6 mmHg for SBP, p < 0.001. The percentage of patients with office and home control was 24% and 23% respectively, with a kappa index at 0.459. Elevated OBP only (office hypertension) was observed in 3.6% and elevated HBP only (masked hypertension) in 10% of patients. In conclusion, treatment with valsartan and HCTZ 25 mg in patients with confirmed uncontrolled hypertension induced a clinically relevant decrease in BP with approximately 23% of additional patients strictly controlled with a single tablet. The use of an automated oscillometric device at the office and at home allowed the detection of controlled subjects with good agreement.

Systematic use of an intraoperative air leak test at the time of major liver resection reduces the rate of postoperative biliary complications

PubMed Central

Zimmitti, Giuseppe; Vauthey, Jean-Nicolas; Shindoh, Junichi; Tzeng, Ching-Wei D.; Roses, Robert E.; Ribero, Dario; Capussotti, Lorenzo; Giuliante, Felice; Nuzzo, Gennaro; Aloia, Thomas A.

2013-01-01

Objective After hepatectomy, bile leaks remain a major cause of morbidity, cost, and disability. This study was designed to determine if a novel intraoperative Air Leak Test (ALT) would reduce the incidence of post-hepatectomy biliary complications. Study design Rates of postoperative biliary complications were compared between 103 patients who underwent ALT and 120 matched patients operated on before ALT was utilized. All study patients underwent major hepatectomy without bile duct resection at 3 high-volume hepatobiliary centers between 2008 and 2012. ALT was performed by placement of a trans-cystic cholangiogram catheter to inject air into the biliary tree while the upper abdomen was filled with saline and the distal common bile duct was manually occluded. Uncontrolled bile ducts were identified by localization of air bubbles at the transection surface and were directly repaired. Results The 2 groups were similar in diagnosis, chemotherapy use, tumor number and size, resection extent, surgery duration, and blood loss (all p>0.05). Single or multiple uncontrolled bile ducts were intraoperatively detected and repaired in 62.1% of ALT vs. 8.3% of non-ALT patients (p<0.001). This resulted in a lower rate of postoperative bile leaks in ALT (1.9%) vs. non-ALT patients (10.8%, p=0.008). Independent risk factors for postoperative bile leaks included extended hepatectomy (p=0.031), caudate resection (p=0.02), and not performing ALT (p=0.002) [odds ratio (95% Confidence Interval): 3.8 (1.3–11.8), 4.0 (1.1–14.3), and 11.8 (2.4–58.8), respectively]. Conclusion ALT is an easily reproducible test that is highly effective for intraoperative detection and repair of open bile ducts, reducing the rate of postoperative bile leaks. PMID:24246619

Systematic use of an intraoperative air leak test at the time of major liver resection reduces the rate of postoperative biliary complications.

PubMed

Zimmitti, Giuseppe; Vauthey, Jean-Nicolas; Shindoh, Junichi; Tzeng, Ching-Wei D; Roses, Robert E; Ribero, Dario; Capussotti, Lorenzo; Giuliante, Felice; Nuzzo, Gennaro; Aloia, Thomas A

2013-12-01

After hepatectomy, bile leaks remain a major cause of morbidity, cost, and disability. This study was designed to determine if a novel intraoperative air leak test (ALT) would reduce the incidence of post-hepatectomy biliary complications. Rates of postoperative biliary complications were compared among 103 patients who underwent ALT and 120 matched patients operated on before ALT was used. All study patients underwent major hepatectomy without bile duct resection at 3 high-volume hepatobiliary centers between 2008 and 2012. The ALT was performed by placement of a transcystic cholangiogram catheter to inject air into the biliary tree, the upper abdomen was filled with saline, and the distal common bile duct was manually occluded. Uncontrolled bile ducts were identified by localization of air bubbles at the transection surface and were directly repaired. The 2 groups were similar in diagnosis, chemotherapy use, tumor number and size, resection extent, surgery duration, and blood loss (all, p > 0.05). Single or multiple uncontrolled bile ducts were intraoperatively detected and repaired in 62.1% of ALT vs 8.3% of non-ALT patients (p < 0.001). This resulted in a lower rate of postoperative bile leaks in ALT (1.9%) vs non-ALT patients (10.8%; p = 0.008). Independent risk factors for postoperative bile leaks included extended hepatectomy (p = 0.031), caudate resection (p = 0.02), and not performing ALT (p = 0.002) (odds ratio = 3.8; 95% CI, 1.3-11.8; odds ratio = 4.0; 95% CI, 1.1-14.3; and odds ratio = 11.8; 95% CI, 2.4-58.8, respectively). The ALT is an easily reproducible test that is highly effective for intraoperative detection and repair of open bile ducts, reducing the rate of postoperative bile leaks. Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Assessment of the Influence of Fractures on the Dynamics of Coal Seam Fires by Numerical Experiments

NASA Astrophysics Data System (ADS)

Wuttke, Manfred W.; Zeng, Qiang

2016-04-01

Uncontrolled burning coal seam fires still constitute major problems for the coal industry by destroying the resource, a serious hazard for the local people by severe environmental pollution, and a tremendous threat to the global environment by the emission of greenhouse gases and aerosols. In particular when the seams are lying shallow the alteration of the immediate surrounding of the coal seam fire feeds back on the dynamics of the fire. Thermal stress induced fracturing produces direct connections of the fire zone with the atmosphere. This influences the supply with oxygen, the venting of the exhaust gases, and the dissipation of heat. The first two processes are expected to enhance the fire propagation whereas the latter effect should slow it down. With our dedicated coal seam fire code ACME ("Amendable Coal-fire Modeling Exercise") we study these coupled effects of fractures in simulations of typical coal seam fire scenarios based on data from Xinjiang, China. Fractures are predefined as 1D/2D objects in a 2D/3D model geometry and are opened depending on the passage of the heat wave produced by the coal seam fire.

Airborne PCDD/Fs in two e-waste recycling regions after stricter environmental regulations.

PubMed

Zhang, Manwen; Feng, Guixian; Yin, Wenhua; Xie, Bing; Ren, Mingzhong; Xu, Zhencheng; Zhang, Sukun; Cai, Zongwei

2017-12-01

Since the 2010s, the authorities of Guangdong province and local governments have enhanced law enforcement and environmental regulations to abolish open burning, acid washing, and other uncontrolled e-waste recycling activities. In this study, ambient air and indoor dust near different kinds of e-waste recycling processes were collected in Guiyu and Qingyuan to investigate the pollution status of particles and polychlorinated dibenzo-p-dioxins and furans (PCDD/Fs) after stricter environmental regulations. PM 2.5 and PCDD/Fs both showed significantly reduced levels in the two regions compared with the documented data. The congener distribution and principal component analysis results also confirmed the significant differences between the current PCDD/Fs pollution characterizations and the historical ones. The estimated total intake doses via air inhalation and dust ingestion of children in the recycling region of Guiyu ranged from 10 to 32pgTEQ/(kg•day), which far exceeded the tolerable daily intake (TDI) limit (1-4pgTEQ/(kg•day). Although the measurements showed a significant reduction of the release of PCDD/Fs, the pollution status was still considered severe in Guiyu town after stricter regulations were implemented. Copyright © 2017. Published by Elsevier B.V.

MonoSLAM: real-time single camera SLAM.

PubMed

Davison, Andrew J; Reid, Ian D; Molton, Nicholas D; Stasse, Olivier

2007-06-01

We present a real-time algorithm which can recover the 3D trajectory of a monocular camera, moving rapidly through a previously unknown scene. Our system, which we dub MonoSLAM, is the first successful application of the SLAM methodology from mobile robotics to the "pure vision" domain of a single uncontrolled camera, achieving real time but drift-free performance inaccessible to Structure from Motion approaches. The core of the approach is the online creation of a sparse but persistent map of natural landmarks within a probabilistic framework. Our key novel contributions include an active approach to mapping and measurement, the use of a general motion model for smooth camera movement, and solutions for monocular feature initialization and feature orientation estimation. Together, these add up to an extremely efficient and robust algorithm which runs at 30 Hz with standard PC and camera hardware. This work extends the range of robotic systems in which SLAM can be usefully applied, but also opens up new areas. We present applications of MonoSLAM to real-time 3D localization and mapping for a high-performance full-size humanoid robot and live augmented reality with a hand-held camera.

Studies on potential emission of hazardous gases due to uncontrolled open-air burning of waste vehicle tyres and their possible impacts on the environment

NASA Astrophysics Data System (ADS)

Shakya, Pawan R.; Shrestha, Pratima; Tamrakar, Chirika S.; Bhattarai, Pradeep K.

Uncontrolled open-air burning of waste vehicle tyres causing environmental pollution has become a popular practice in Nepal despite official ban considering the environment and public health hazards. In this study, an experimental model was set up in a laboratory scale in an attempt to understand the potential emission of hazardous gases such as CO, SO 2 and NO 2 due to such activities in Kathmandu Valley and their possible impacts on the environment. For this purpose, four types of tyre were collected representing two from passenger car and two from motorbike category. The emission level of CO in the tyre smoke was measured with a CO gas detector tube while SO 2 and NO 2 were determined by UV-visible spectrophotometer. Among the three types of the gases analyzed, SO 2 was emitted in significantly high levels by all the representative tyre samples. The emission levels of CO, SO 2 and NO 2 ranged from 21to 49, 102to 820 and 3to 9 μg g -1, respectively. Results revealed that the emission levels also varied with the tyre types and qualities. The potential emission of the hazardous gases per representative scrap tyre mass was also estimated. Results indicate that the gaseous pollutants due to the tyre fires could make a significant contribution for deterioration of the environmental condition of the Valley or elsewhere.

Efficacy and Tolerability of Nilvadipine in Combination with an Angiotensin II Receptor Antagonist in Patients with Essential Hypertension: A Multicenter, Open-Label, Uncontrolled Study

PubMed Central

Noda, Keita; Ideishi, Munehito; Tashiro, Eiichiro; Nakashima, Yoshiyuki; Imamura, Mitsuhide; Seki, Masahiko; Fujino, Masanori; Sou, Toshimitsu; Kohara, Masaki; Kanaya, Hisashi; Saku, Nishiki; Kamei, Ritsu; Yamasaki, Misao; Sakai, Hiroshi; Gondo, Naoki; Saku, Keijiro

2003-01-01

Background: Combination therapy with different classes of antihypertensive drugs often is needed to achieve controlled blood pressure (BP). The combination of an angiotensin II receptor antagonist (AIIA) and a calcium antagonist is a preferred option for reducing uncontrolled BP. Objective: The aim of this study was to assess the clinical efficacy and tolerability of nilvadipine, a dihydropyridine calcium antagonist, in combination with an AIIA. Methods: Patients with essential hypertension whose BP was not controlled by an AIIA alone were eligible for this multicenter, open-label, uncontrolled study. One of 3 AIIAs (candesartan cilexetil, losartan potassium, or valsartan) was given for at least 10 weeks before the addition of nilvadipine (daily dose, 4 or 8 mg orally). This combination therapy was given for 8 weeks. BP and heart rate were measured between 2 and 4 weeks before and 0, 4, and 8 weeks after the start of combination therapy. Adverse events were monitored at each visit. Results: Thirty-one patients (18 women [58.1%], 13 men [41.9%]; mean [SD] age, 58.5 [10.5] years) were enrolled. At weeks 4 and 8 of combination therapy, mean systolic BP (SBP) and diastolic BP (DBP) were significantly decreased (P<0.01) (at week 8, by 22.0 mm Hg and 12.5 mm Hg, respectively). The mean BP-lowering effect did not differ significantly between the 3 AIIAs tested. Pulse pressure also decreased significantly at week 8, by 9.6 mm Hg (P<0.01). The responder rate (ie, the percentage of patients with DBP <90 mm Hg or a decrease in DBP ≥10 mm Hg) was 72.0% at week 8. Three patients experienced a total of 4 adverse events: mild or severe flushing, mild headache, and mild palpitation. All of these symptoms resolved after nilvadipine treatment was discontinued. Conclusions: Nilvadipine in combination with an AIIA showed good antihypertensive efficacy and was well tolerated in the hypertensive patients in this study. This combination also significantly decreased pulse pressure, suggesting that this combination therapy also may have a beneficial effect in elderly patients with isolated systolic hypertension. PMID:25053855

Uncontrolled hypertension among patients managed in primary healthcare facilities in Kinshasa, Democratic Republic of the Congo.

PubMed

Kika, T M; Lepira, F B; Kayembe, P K; Makulo, J R; Sumaili, E K; Kintoki, E V; M'Buyamba-Kabangu, J R

Uncontrolled hypertension remains an important issue in daily clinical practice worldwide. Although the majority of patients are treated in primary care, most of the data on blood pressure control originate from population-based studies or secondary healthcare. The aim of this study was to evaluate the frequency of uncontrolled hypertension and associated risk factors among hypertensive patients followed at primary care facilities in Kinshasa, the capital city of Democratic Republic of the Congo. A sample of 298 hypertensive patients seen at primary healthcare facilities, 90 men and 208 women, aged ≥ 18 years, were consecutively included in this cross-sectional study. The majority (66%) was receiving monotherapy, and diuretics (43%) were the most used drugs. According to 2007 European Society of Hypertension/European Society of Cardiology hypertension guidelines, uncontrolled hypertension was defined as blood pressure ≥ 140/90 or ≥ 130/80 mmHg (diabetes or chronic kidney disease). Logistic regression analysis was used to identify the determinants of uncontrolled hypertension. Uncontrolled hypertension was observed in 231 patients (77.5%), 72 men and 159 women. Uncontrolled systolic blood pressure (SBP) was more frequent than uncontrolled diastolic blood pressure (DBP) and increased significantly with advancing age (p = 0.002). The proportion of uncontrolled SBP and DBP was significantly higher in patients with renal failure (p = 0.01) and those with high (p = 0.03) to very high (p = 0.02) absolute cardiovascular risk. The metabolic syndrome (OR 2.40; 95% CI 1.01-5.74; p = 0.04) emerged as the main risk factor associated with uncontrolled hypertension. Uncontrolled hypertension was common in this case series and was associated with factors related to lifestyle and diet, which interact with blood pressure control.

Movement - uncontrolled or slow

MedlinePlus

Dystonia; Involuntary slow and twisting movements; Choreoathetosis; Leg and arm movements - uncontrollable; Arm and leg movements - uncontrollable; Slow involuntary movements of large muscle groups; Athetoid movements

Archiving Primary Data: Solutions for Long-Term Studies.

PubMed

Mills, James A; Teplitsky, Céline; Arroyo, Beatriz; Charmantier, Anne; Becker, Peter H; Birkhead, Tim R; Bize, Pierre; Blumstein, Daniel T; Bonenfant, Christophe; Boutin, Stan; Bushuev, Andrey; Cam, Emmanuelle; Cockburn, Andrew; Côté, Steeve D; Coulson, John C; Daunt, Francis; Dingemanse, Niels J; Doligez, Blandine; Drummond, Hugh; Espie, Richard H M; Festa-Bianchet, Marco; Frentiu, Francesca; Fitzpatrick, John W; Furness, Robert W; Garant, Dany; Gauthier, Gilles; Grant, Peter R; Griesser, Michael; Gustafsson, Lars; Hansson, Bengt; Harris, Michael P; Jiguet, Frédéric; Kjellander, Petter; Korpimäki, Erkki; Krebs, Charles J; Lens, Luc; Linnell, John D C; Low, Matthew; McAdam, Andrew; Margalida, Antoni; Merilä, Juha; Møller, Anders P; Nakagawa, Shinichi; Nilsson, Jan-Åke; Nisbet, Ian C T; van Noordwijk, Arie J; Oro, Daniel; Pärt, Tomas; Pelletier, Fanie; Potti, Jaime; Pujol, Benoit; Réale, Denis; Rockwell, Robert F; Ropert-Coudert, Yan; Roulin, Alexandre; Sedinger, James S; Swenson, Jon E; Thébaud, Christophe; Visser, Marcel E; Wanless, Sarah; Westneat, David F; Wilson, Alastair J; Zedrosser, Andreas

2015-10-01

The recent trend for journals to require open access to primary data included in publications has been embraced by many biologists, but has caused apprehension amongst researchers engaged in long-term ecological and evolutionary studies. A worldwide survey of 73 principal investigators (Pls) with long-term studies revealed positive attitudes towards sharing data with the agreement or involvement of the PI, and 93% of PIs have historically shared data. Only 8% were in favor of uncontrolled, open access to primary data while 63% expressed serious concern. We present here their viewpoint on an issue that can have non-trivial scientific consequences. We discuss potential costs of public data archiving and provide possible solutions to meet the needs of journals and researchers. Copyright © 2015 Elsevier Ltd. All rights reserved.

Simulation of laminate composites degradation using mesoscopic non-local damage model and non-local layered shell element

NASA Astrophysics Data System (ADS)

Germain, Norbert; Besson, Jacques; Feyel, Frédéric

2007-07-01

Simulating damage and failure of laminate composites structures often fails when using the standard finite element procedure. The difficulties arise from an uncontrolled mesh dependence caused by damage localization and an increase in computational costs. One of the solutions to the first problem, widely used to predict the failure of metallic materials, consists of using non-local damage constitutive equations. The second difficulty can then be solved using specific finite element formulations, such as shell element, which decrease the number of degrees of freedom. The main contribution of this paper consists of extending these techniques to layered materials such as polymer matrix composites. An extension of the non-local implicit gradient formulation, accounting for anisotropy and stratification, and an original layered shell element, based on a new partition of the unity, are proposed. Finally the efficiency of the resulting numerical scheme is studied by comparing simulation with experimental results.

Effects of Symphytum ointment on muscular symptoms and functional locomotor disturbances.

PubMed

Kucera, M; Kálal, J; Polesná, Z

2000-01-01

In an open, uncontrolled study, 105 patients with locomotor system symptoms were treated twice daily with an ointment containing a Symphytum active substance complex. A clear therapeutic effect was noted on chronic and subacute symptoms that were accompanied mainly by functional disturbances and pain in the musculature. The preparation was most effective against muscle pain, swelling and overstrain, arthralgia/distortions, enthesopathy, and vertebral syndrome. Activity was weaker against degenerative conditions, for which the ointment may have an adjuvant role with the aim of improving muscular dysfunction and alleviating pain.

Urban adults' perceptions of factors influencing asthma control.

PubMed

George, Maureen; Keddem, Shimrit; Barg, Frances K; Green, Sarah; Glanz, Karen

2015-02-01

To identify urban adults' perceptions of facilitators and barriers to asthma control, including the role of self-care, medications, environmental trigger remediation, and primary care. Semi-structured open-ended qualitative interviews were conducted. Audio recordings were transcribed verbatim and entered into NVivo 10.0 (QSR International Pty Ltd, Doncaster, Victoria, Australia) for coding, analysis, and integration with demographic and asthma control data. RESULTS were analyzed by the level of asthma control. A modified grounded theory approach was used in the analysis. Thirty-five adults with persistent asthma (94% Black; 71% female; 71% with uncontrolled asthma) from the five West Philadelphia zip codes with the highest asthma burden participated. Generally, all participants understood the roles of inhaled corticosteroid (ICS) and short-acting β-2 agonist (SABA) therapies in asthma self-care although they attributed systemic side effects to topical ICS administration. Compared with participants with controlled asthma, uncontrolled participants reported overusing SABAs, underusing ICS, rejecting medical and trigger remediation advice, having more negative experiences with primary care providers, and preferring more unconventional strategies to prevent or manage asthma symptoms. Personal health beliefs about control can undermine adherence to medical and environmental remediation advice and likely contributes to high rates of uncontrolled asthma in this population. Clinicians need to know whether, and to what degree, these health beliefs can be modified. It is likely that new models of care, such as patient-centered shared decision-making approaches, and new partners, such as community health workers, may be required to modify these beliefs. This would be an important first step to enhance asthma control in vulnerable populations.

Control of nonlinear systems with applications to constrained robots and spacecraft attitude stabilization

NASA Technical Reports Server (NTRS)

Krishnan, Hariharan

1993-01-01

This thesis is organized in two parts. In Part 1, control systems described by a class of nonlinear differential and algebraic equations are introduced. A procedure for local stabilization based on a local state realization is developed. An alternative approach to local stabilization is developed based on a classical linearization of the nonlinear differential-algebraic equations. A theoretical framework is established for solving a tracking problem associated with the differential-algebraic system. First, a simple procedure is developed for the design of a feedback control law which ensures, at least locally, that the tracking error in the closed loop system lies within any given bound if the reference inputs are sufficiently slowly varying. Next, by imposing additional assumptions, a procedure is developed for the design of a feedback control law which ensures that the tracking error in the closed loop system approaches zero exponentially for reference inputs which are not necessarily slowly varying. The control design methodologies are used for simultaneous force and position control in constrained robot systems. The differential-algebraic equations are shown to characterize the slow dynamics of a certain nonlinear control system in nonstandard singularly perturbed form. In Part 2, the attitude stabilization (reorientation) of a rigid spacecraft using only two control torques is considered. First, the case of momentum wheel actuators is considered. The complete spacecraft dynamics are not controllable. However, the spacecraft dynamics are small time locally controllable in a reduced sense. The reduced spacecraft dynamics cannot be asymptotically stabilized using continuous feedback, but a discontinuous feedback control strategy is constructed. Next, the case of gas jet actuators is considered. If the uncontrolled principal axis is not an axis of symmetry, the complete spacecraft dynamics are small time locally controllable. However, the spacecraft attitude cannot be asymptotically stabilized using continuous feedback, but a discontinuous stabilizing feedback control strategy is constructed. If the uncontrolled principal axis is an axis of symmetry, the complete spacecraft dynamics cannot be stabilized. However, the spacecraft dynamics are small time locally controllable in a reduced sense. The reduced spacecraft dynamics cannot be asymptotically stabilized using continuous feedback, but again a discontinuous feedback control strategy is constructed.

Alternative control techniques document: NOx emissions from industrial/commercial/institutional (ICI) boilers

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

Not Available

1994-03-01

Industrial, commercial, and institutional (ICI) boilers have been identified as a category that emits more than 25 tons of oxides of nitrogen (NOx) per year. This alternative control techniques (ACT) document provides technical information for use by State and local agencies to develop and implement regulatory programs to control NOx emissions from ICI boilers. Additional ACT documents are being developed for other stationary source categories. Chapter 2 summarizes the findings of this study. Chapter 3 presents information on the ICI boiler types, fuels, operation, and industry applications. Chapter 4 discusses NOx formation and uncontrolled NOx emission factors. Chapter 5 coversmore » alternative control techniques and achievable controlled emission levels. Chapter 6 presents the cost and cost effectiveness of each control technique. Chapter 7 describes environmental and energy impacts associated with implementing the NOx control techniques. Finally, Appendices A through G provide the detailed data used in this study to evaluate uncontrolled and controlled emissions and the costs of controls for several retrofit scenarios.« less

Robust, Efficient Depth Reconstruction With Hierarchical Confidence-Based Matching.

PubMed

Sun, Li; Chen, Ke; Song, Mingli; Tao, Dacheng; Chen, Gang; Chen, Chun

2017-07-01

In recent years, taking photos and capturing videos with mobile devices have become increasingly popular. Emerging applications based on the depth reconstruction technique have been developed, such as Google lens blur. However, depth reconstruction is difficult due to occlusions, non-diffuse surfaces, repetitive patterns, and textureless surfaces, and it has become more difficult due to the unstable image quality and uncontrolled scene condition in the mobile setting. In this paper, we present a novel hierarchical framework with multi-view confidence-based matching for robust, efficient depth reconstruction in uncontrolled scenes. Particularly, the proposed framework combines local cost aggregation with global cost optimization in a complementary manner that increases efficiency and accuracy. A depth map is efficiently obtained in a coarse-to-fine manner by using an image pyramid. Moreover, confidence maps are computed to robustly fuse multi-view matching cues, and to constrain the stereo matching on a finer scale. The proposed framework has been evaluated with challenging indoor and outdoor scenes, and has achieved robust and efficient depth reconstruction.

Healthcare utilization and costs in adults with stable and uncontrolled epilepsy.

PubMed

Cramer, Joyce A; Wang, Zhixiao J; Chang, Eunice; Powers, Annette; Copher, Ronda; Cherepanov, Dasha; Broder, Michael S

2014-02-01

Despite the availability of numerous antiepileptic drugs (AEDs), some epilepsies remain resistant to treatment. We compared utilization and costs in patients with uncontrolled epilepsy to those with stable epilepsy. Claims data (2007-2009) were used to identify adults with epilepsy requiring additional AED therapy (having uncontrolled epilepsy) and those not requiring additional AED therapy (having stable epilepsy). The date in 2008 on which an additional AED was started was the index date for patients with uncontrolled epilepsy, and a randomly selected date was used for patients with stable epilepsy, whose AED use was unchanged in the preceding year. In the postindex year, all pharmacy and medical claims were used to estimate overall utilization and costs; claims with epilepsy in any diagnosis field were used to estimate epilepsy-related outcomes. Outcomes were adjusted using multivariate analyses. We identified 1536 patients with uncontrolled epilepsy and 8571 patients with stable epilepsy (mean age: 42.8years; female: 48%). Patients with uncontrolled epilepsy had higher comorbidity rates (p<.02). A greater proportion of patients with uncontrolled epilepsy had ≥1 hospitalization or emergency department visit (p<.001). Patients with uncontrolled epilepsy had a greater mean length of hospital stay and more physician office visits (p<.034). After adjustment, the odds of hospitalization (OR: 1.8, any diagnosis; 2.2, epilepsy-related) and emergency department visit (OR: 1.6, any diagnosis; 1.9, epilepsy-related) were greater for patients with uncontrolled epilepsy. Annual overall ($23,238 vs. $13,839) and epilepsy-related ($12,399 vs. $5511) costs were higher in patients with uncontrolled epilepsy and remained higher after adjustment (p<.001). Patients with uncontrolled epilepsy use more services and incur higher costs compared with those with stable epilepsy. Epilepsy-related costs accounted for <50% of the total costs, suggesting that comorbid conditions and/or underidentification of utilization may substantially contribute to costs. © 2013.

Analysis of vehicular traffic flow in the major areas of Kuala Lumpur utilizing open-traffic

NASA Astrophysics Data System (ADS)

Manogaran, Saargunawathy; Ali, Muhammad; Yusof, Kamaludin Mohamad; Suhaili, Ramdhan

2017-09-01

Vehicular traffic congestion occurs when a large number of drivers are overcrowded on the road and the traffic flow does not run smoothly. Traffic congestion causes chaos on the road and interruption to daily activities of users. Time consumed on road give lots of negative effects on productivity, social behavior, environmental and cost to economy. Congestion is worsens and leads to havoc during the emergency such as flood, accidents, road maintenance and etc., where behavior of traffic flow is always unpredictable and uncontrollable. Real-time and historical traffic data are critical inputs for most traffic flow analysis applications. Researcher attempt to predict traffic using simulations as there is no exact model of traffic flow exists due to its high complexity. Open Traffic is an open source platform available for traffic data analysis linked to Open Street Map (OSM). This research is aimed to study and understand the Open Traffic platform. The real-time traffic flow pattern in Kuala Lumpur area was successfully been extracted and analyzed using Open Traffic. It was observed that the congestion occurs on every major road in Kuala Lumpur and most of it owes to the offices and the economic and commercial centers during rush hours. At some roads the congestion occurs at night due to the tourism activities.

Prospective, open-label, uncontrolled pilot study to study safety and efficacy of sildenafil in systemic sclerosis-related pulmonary artery hypertension and cutaneous vascular complications.

PubMed

Kumar, Uma; Sankalp, Gokhale; Gokhle, Sankalp S; Sreenivas, V; Kaur, Satbir; Misra, Durgaprasanna

2013-04-01

Pulmonary artery hypertension (PAH) remains the leading cause of morbidity and mortality in systemic sclerosis, while Raynaud's phenomenon and digital ulcers significantly add to the morbidity in systemic sclerosis (SSc). This study was undertaken to evaluate the role of sildenafil in PAH, Raynaud's phenomenon, and digital ulcers in systemic sclerosis patients. A prospective, open-label, uncontrolled pilot study was done at a tertiary care centre in India to study the safety and efficacy of oral sildenafil in PAH, Raynaud's phenomenon, digital infarcts, and ulcers in SSc. Seventeen patients fulfilling ACR classification criteria for scleroderma and having PAH were recruited. Six-minute walk test, WHO class of dyspnoea, severity of Raynaud's phenomenon, and 2D ECHO were performed in all the study subjects at baseline and at 3 months post-treatment. All patients were treated with oral sildenafil 25 mg three times a day for a period of 3 months. The pre- and post-treatment values of mean pulmonary artery pressure (PAP), 6-min walk test, WHO class of dyspnoea, and severity of Raynaud's phenomenon were compared to look for any significant change. Sixteen patients who completed 3-month follow-up had shown statistically significant improvement in 6-min walk test, WHO class of dyspnoea, severity of Raynaud's phenomenon, and mPAP. Also, there was no occurrence of new digital infarcts or ulcers, and existing ulcers showed signs of healing. Sildenafil is highly efficacious cheaper and safe alternative to other available therapies for SSc-associated PAH, Raynaud's phenomenon, and digital infarcts/ulcers.

46 CFR 32.63-5 - Barge hull classifications-B/ALL.

Code of Federal Regulations, 2014 CFR

2014-10-01

... the uncontrolled release of the cargo to the waterways and/or atmosphere. (2) Type II barge hull... measures to preclude uncontrolled release to the atmosphere, but whose uncontrolled release to the...

46 CFR 32.63-5 - Barge hull classifications-B/ALL.

Code of Federal Regulations, 2013 CFR

2013-10-01

... the uncontrolled release of the cargo to the waterways and/or atmosphere. (2) Type II barge hull... measures to preclude uncontrolled release to the atmosphere, but whose uncontrolled release to the...

Direct costs of asthma in Brazil: a comparison between controlled and uncontrolled asthmatic patients.

PubMed

Santos, L A; Oliveira, M A; Faresin, S M; Santoro, I L; Fernandes, A L G

2007-07-01

Asthma is a common chronic illness that imposes a heavy burden on all aspects of the patient's life, including personal and health care cost expenditures. To analyze the direct cost associated to uncontrolled asthma patients, a cross-sectional study was conducted to determine costs related to patients with uncontrolled and controlled asthma. Uncontrolled patient was defined by daytime symptoms more than twice a week or nocturnal symptoms during two consecutive nights or any limitations of activities, or need for relief rescue medication more than twice a week, and an ACQ score less than 2 points. A questionnaire about direct cost stratification in health services, including emergency room visits, hospitalization, ambulatory visits, and asthma medications prescribed, was applied. Ninety asthma patients were enrolled (45 uncontrolled/45 controlled). Uncontrolled asthmatics accounted for higher health care expenditures than controlled patients, US$125.45 and US$15.58, respectively [emergency room visits (US$39.15 vs US$2.70) and hospitalization (US$86.30 vs US$12.88)], per patient over 6 months. The costs with medications in the last month for patients with mild, moderate and severe asthma were US$1.60, 9.60, and 25.00 in the uncontrolled patients, respectively, and US$6.50, 19.00 and 49.00 in the controlled patients. In view of the small proportion of uncontrolled subjects receiving regular maintenance medication (22.2%) and their lack of resources, providing free medication for uncontrolled patients might be a cost-effective strategy for the public health system.

[Power generation and ecology: socio-economic collision].

PubMed

Belonogova, M V; Davydov, B I

1999-01-01

The authors make analysis of the socio-economic collision between power generation and ecology. Russia enters the world market in the period of global and local ecological ill-being. The following eight dimensions of the problem have been reviewed: uncontrolled growth of population, limited earth resources, life standards and ecological crisis, national/ecological interests and power safety, eco- and power regionalism, religion and ethnoses (demography and energy reserves), eco-sitting of power installations, sanitary guidelines and standards and the reality.

Evidence of Human Health Impacts from Uncontrolled Coal Fires in Jharia, India

NASA Astrophysics Data System (ADS)

Dhar, U.; Balogun, A. H.; Finkelman, R.; Chakraborty, S.; Olanipekun, O.; Shaikh, W. A.

2017-12-01

Uncontrolled coal fires and burning coal waste piles have been reported from dozens of countries. These fires can be caused by spontaneous combustion, sparks from machinery, lightning strikes, grass or forest fires, or intentionally. Both underground and surface coal fires mobilize potentially toxic elements such as sulfur, arsenic, selenium, fluorine, lead, and mercury as well as dangerous organic compounds such as benzene, toluene, xylene, ethylbenzene and deadly gases such as CO2 and CO. Despite the serious health problems that can be caused by uncontrolled coal fires it is rather surprising that there has been so little research and documentation of their health impacts. Underground coal fires in the Jharia region of India where more than a million people reside, have been burning for 100 years. Numerous villages exist above the underground fires exposing the residents daily to dangerous emissions. Local residents near the fire affected areas do their daily chores without concern about the intensity of nearby fires. During winter children enjoy the heat of the coal fires oblivious to the potentially harmful emissions. To determine if these uncontrolled coal fires have caused health problems we developed a brief questionnaire on general health indices and administered it to residents of the Jharia region. Sixty responses were obtained from residents of two villages, one proximal to the coal fires and one about 5 miles away from the fires. The responses were statistically analyzed using SAS 9.4. It was observed that at a significance level of 5%, villagers who lived more than 5 miles away from the fires had a 98.3% decreased odds of having undesirable health outcomes. This brief survey indicates the risk posed by underground coal fires and how it contributes to the undesirable health impacts. What remains is to determine the specific health issues, what components of the emissions cause the health problems, and what can be done to minimize these problems. Collaboration between geoscientists and public health researchers are essential to assess complex geohealth issues such as those that may be caused by uncontrolled coal fires. This type of multidisciplinary collaboration must be maintained and expanded to include engineers, social scientists, and others to help minimize or avoid these problems.

Modeling posttraumatic growth among cancer patients: The roles of social support, appraisals, and adaptive coping.

PubMed

Cao, Weidan; Qi, Xiaona; Cai, Deborah A; Han, Xuanye

2018-01-01

The purpose of the study was to build a model to explain the relationships between social support, uncontrollability appraisal, adaptive coping, and posttraumatic growth (PTG) among cancer patients in China. The participants who were cancer patients in a cancer hospital in China filled out a survey. The final sample size was 201. Structural equation modeling was used to build a model explaining PTG. Structural equation modeling results indicated that higher levels of social support predicted higher levels of adaptive coping, higher levels of uncontrollability appraisal predicted lower levels of adaptive coping, and higher levels of adaptive coping predicted higher levels of PTG. Moreover, adaptive coping was a mediator between social support and growth, as well as a mediator between uncontrollability and growth. The direct effects of social support and uncontrollability on PTG were insignificant. The model demonstrated the relationships between social support, uncontrollability appraisal, adaptive coping, and PTG. It could be concluded that uncontrollability appraisal was a required but not sufficient condition for PTG. Neither social support nor uncontrollability appraisal had direct influence on PTG. However, social support and uncontrollability might indirectly influence PTG, through adaptive coping. It implies that both internal factors (eg, cognitive appraisal and coping) and external factors (eg, social support) are required in order for growth to happen. Copyright © 2017 John Wiley & Sons, Ltd.

From STEM to STEAM: Toward a Human-Centered Education

NASA Technical Reports Server (NTRS)

Boy, Guy A.

2013-01-01

The 20th century was based on local linear engineering of complicated systems. We made cars, airplanes and chemical plants for example. The 21st century has opened a new basis for holistic non-linear design of complex systems, such as the Internet, air traffic management and nanotechnologies. Complexity, interconnectivity, interaction and communication are major attributes of our evolving society. But, more interestingly, we have started to understand that chaos theories may be more important than reductionism, to better understand and thrive on our planet. Systems need to be investigated and tested as wholes, which requires a cross-disciplinary approach and new conceptual principles and tools. Consequently, schools cannot continue to teach isolated disciplines based on simple reductionism. Science; Technology, Engineering, and Mathematics (STEM) should be integrated together with the Arts1 to promote creativity together with rationalization, and move to STEAM (with an "A" for Arts). This new concept emphasizes the possibility of longer-term socio-technical futures instead of short-term financial predictions that currently lead to uncontrolled economies. Human-centered design (HCD) can contribute to improving STEAM education technologies, systems and practices. HCD not only provides tools and techniques to build useful and usable things, but also an integrated approach to learning by doing, expressing and critiquing, exploring possible futures, and understanding complex systems.

Small bowel enteroclysis in surgically treated obesity.

PubMed

Coppola, V; Verrengia, D; Gatta, G; Alfinito, M; Alfano, L; D'Agostino, F

1998-11-01

To define the indications, technical limitations and diagnostic yeld of small bowel transbuccal enema in the follow-up of surgical jejunoileal shunting in patients with complicated severe essential obesity. Three patients were submitted to surgical diversion: two of them underwent an intestinal bypass after Payne-De Wind (isoperistaltic end-to-side jejunoileostomy) and the other after Scott (end-to-end jejunoileostomy). The latter refers to intestinal recanalization and antiperistaltic lower end-to-side gastroenteric restoration. Radiologic studies are the only means to depict the surgical small bowel. Radiographic follow-up needs barium sulfate administration and therefore cannot be performed any sooner than 30 days postoperatively. In the last three years the classic transbuccal enema has been performed with a Rollandi tube (with a terminal opening and a balloon). Both the anastomosis and the blind loop are difficult to demonstrate. Jejunoileal bypass can be used to treat severe obsity uncontrollable otherwise, to reduce food absorption. Different severe complications may result and small bowel studies may permit to show late local complications. Small bowel enema is also indispensable in bypass reversal. There are no alternatives to this radiologic examination which is however very difficult to perform, because of the changes made by previous operation(s), and to interpret because the anastomosis, the sutured loop and wall changes are often poorly demonstrated.

Dioxins and polyvinylchloride in combustion and fires.

PubMed

Zhang, Mengmei; Buekens, Alfons; Jiang, Xuguang; Li, Xiaodong

2015-07-01

This review on polyvinylchloride (PVC) and dioxins collects, collates, and compares data from selected sources on the formation of polychlorinated dibenzofurans (PCDFs) and dibenzo-p-dioxins (PCDDs), or in brief dioxins, in combustion and fires. In professional spheres, the incineration of PVC as part of municipal solid waste is seldom seen as a problem, since deep flue gas cleaning is required anyhow. Conversely, with its high content of chlorine, PVC is frequently branded as a major chlorine donor and spitefully leads to substantial formation of dioxins during poorly controlled or uncontrolled combustion and open fires. Numerous still ill-documented and diverse factors of influence may affect the formation of dioxins during combustion: on the one hand PVC-compounds represent an array of materials with widely different formulations; on the other hand these may all be exposed to fires of different nature and consequences. Hence, attention should be paid to PVC with respect to the ignition and development of fires, as well as attenuating the emission of objectionable compounds, such as carbon monoxide, hydrogen chloride, polycyclic aromatic hydrocarbons, and dioxins. This review summarises available dioxin emissions data, gathers experimental and simulation studies of fires and combustion tests involving PVC, and identifies and analyses the effects of several local factors of influence, affecting the formation of dioxins during PVC combustion. © The Author(s) 2015.

Emissions of polychlorinated dibenzodioxins and dibenzofurans and polychlorinated biphenyls from uncontrolled burning of garden and domestic waste (backyard burning).

PubMed

Hedman, Björn; Näslund, Morgan; Nilsson, Calle; Marklund, Stellan

2005-11-15

To assess emissions of dioxins (chlorinated dibenzodioxins and dibenzofurans) and PCB from uncontrolled domestic combustion of waste ("backyard burning"), test combustions in barrels and open fires were monitored. The waste fuels used were garden waste, paper, paper and plastic packaging, refuse-derived fuel (RDF), PVC, and electronic scrap. Combustions including PVC and electronic scrap emitted several orders of magnitude more dioxins than the other waste fuels. Emissions from the other fuels had considerable variations, but the levels were difficult to relate to waste composition. Emission factors of PCDD/F and PCB from the backyard burning ranged from 2.2 to 13 000 ng (WHO-TEQ)/kg. The levels found in ash usually were less than 5% of the total. For assessment of total emissions of dioxins and PCB from backyard burning of low and moderately contaminated wastes, an emission factor range of 4-72 ng (WHO-TEQ)/kg is suggested. These figures implythat combusting waste in the backyard could contribute substantially to total emissions, even if the amounts of fuel involved are equivalent to just a few tenths of a percent of the amounts combusted in municipal waste incinerators.

Recommendations on the use of prescribed burning practices in grassland conservation - An evidence-based study from Hungary

NASA Astrophysics Data System (ADS)

Tóthmérész, Béla; Valkó, Orsolya; Török, Péter; Végvári, Zsolt; Deák, Balázs

2015-04-01

Fire as a natural disturbance has been present in most European grasslands. In parallel controlled use of burning was an important part of the traditional landscape management for millennia. It was used to reduce litter and suppress woody vegetation as well as to maintain open landscapes suitable for farming. Recently, human activities have a considerable impact on natural fire regimes through habitat fragmentation, cessation of traditional grassland management and climate change. Nowadays the majority of human-ignited fires are uncontrolled burnings and arson, which have serious negative impacts on human life, property and can be detrimental also from the nature conservation point of view. Despite fire was widely applied in the past and the considerable extension and frequency of current grassland fires, the impact of fire on the grassland biodiversity is still scarcely documented in Europe. The aim of our study was to gather practical knowledge and experiences from Hungary concerning the effects of fire on grasslands. To fulfil this aim we sent questionnaires to experts from Hungarian national park directorates to gather unpublished data and field observations concerning the effects of burning on grasslands. Based on the answers for the questionnaires fire regularly occur in almost every grassland types in Hungary. We found that effects of fire are habitat-specific. One hand uncontrolled burning and arson have serious detrimental impacts on many endangered species (ground-dwelling birds, such as Asio flammeus, Tringa totanus and Vanellus vanellus; or lizards, such as Ablepharus kitaibelii). On the other hand in several cases fire has a positive effect on the habitat structure and favours species of high nature conservation interest (plant species, such as Adonis volgensis, Chamaecytisus supinus and Pulsatilla grandis; butterflies, such as Euphydryas aurinia; bird species such as Circus aeruginosus and Larus cachinnans). Our results suggest that even uncontrolled burning can have positive impacts from a nature conservation point of view by supporting several endangered species, reducing accumulated litter and maintaining open landscapes. Given the fact that due to land use changes and global warming the frequency of fire events are expected to increase in the next future, it is crucial to summarize evidence-based knowledge on fire in a European level and to design prescribed burning experiments in which the effects of fire could be studied in a controlled way.

76 FR 16240 - Mandatory Reliability Standards for Interconnection Reliability Operating Limits

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-23

... Standards. The Reliability Standards were designed to prevent instability, uncontrolled separation, or... designed to prevent instability, uncontrolled separation, or cascading outages that adversely impact the... instability, uncontrolled separation, or cascading outages. See NERC Glossary, available at http://www.nerc...

Nucleocytoplasmic protein translocation during mitosis in the social amoebozoan Dictyostelium discoideum.

PubMed

O'Day, Danton H; Budniak, Aldona

2015-02-01

Mitosis is a fundamental and essential life process. It underlies the duplication and survival of all cells and, as a result, all eukaryotic organisms. Since uncontrolled mitosis is a dreaded component of many cancers, a full understanding of the process is critical. Evolution has led to the existence of three types of mitosis: closed, open, and semi-open. The significance of these different mitotic species, how they can lead to a full understanding of the critical events that underlie the asexual duplication of all cells, and how they may generate new insights into controlling unregulated cell division remains to be determined. The eukaryotic microbe Dictyostelium discoideum has proved to be a valuable biomedical model organism. While it appears to utilize closed mitosis, a review of the literature suggests that it possesses a form of mitosis that lies in the middle between truly open and fully closed mitosis-it utilizes a form of semi-open mitosis. Here, the nucleocytoplasmic translocation patterns of the proteins that have been studied during mitosis in the social amoebozoan D. discoideum are detailed followed by a discussion of how some of them provide support for the hypothesis of semi-open mitosis. © 2014 The Authors. Biological Reviews published by John Wiley & Sons Ltd on behalf of Cambridge Philosophical Society.

Characterization of stress-induced suppression of long-term potentiation in the hippocampal CA1 field of freely moving rats.

PubMed

Hirata, Riki; Togashi, Hiroko; Matsumoto, Machiko; Yamaguchi, Taku; Izumi, Takeshi; Yoshioka, Mitsuhiro

2008-08-21

Several lines of evidence have shown that exposure to stress impairs long-term potentiation (LTP) in the CA1 field of the hippocampus, but the detailed mechanisms for this effect remain to be clarified. The present study elucidated the synaptic mechanism of stress-induced LTP suppression in conscious, freely moving rats using electrophysiological approaches. Open field stress (i.e., novel environment stress) and elevated platform stress (i.e., uncontrollable stress) were employed. Basal synaptic transmission was significantly reduced during exposure to elevated platform stress but not during exposure to open field stress. LTP induction was blocked by elevated platform stress but not influenced by open field stress. Significant increases in serum corticosterone levels were observed in the elevated platform stress group compared with the open field stress group. Furthermore, LTP suppression induced by elevated platform stress was prevented by pretreatment with an anxiolytic drug diazepam (1 mg/kg, i.p.). These results suggest that stress-induced LTP suppression depends on the relative intensity of the stressor. The inhibitory synaptic response induced by an intense psychological stress, such as elevated platform stress, may be attributable to LTP impairment in the CA1 field of the hippocampus.

Upper extremity access for fenestrated endovascular aortic aneurysm repair is not associated with increased morbidity.

PubMed

Knowles, Martyn; Nation, David A; Timaran, David E; Gomez, Luis F; Baig, M Shadman; Valentine, R James; Timaran, Carlos H

2015-01-01

Fenestrated endovascular aortic aneurysm repair (FEVAR) is an alternative to open repair in patients with complex abdominal aortic aneurysms who are neither fit nor suitable for standard open or endovascular repair. Chimney and snorkel grafts are other endovascular alternatives but frequently require bilateral upper extremity access that has been associated with a 3% to 10% risk of stroke. However, upper extremity access is also frequently required for FEVAR because of the caudal orientation of the visceral vessels. The purpose of this study was to assess the use of upper extremity access for FEVAR and the associated morbidity. During a 5-year period, 148 patients underwent FEVAR, and upper extremity access for FEVAR was used in 98 (66%). Outcomes were compared between those who underwent upper extremity access and those who underwent femoral access alone. The primary end point was a cerebrovascular accident or transient ischemic attack, and the secondary end point was local access site complications. The mean number of fenestrated vessels was 3.07 ± 0.81 (median, 3) for a total of 457 vessels stented. Percutaneous upper extremity access was used in 12 patients (12%) and open access in 86 (88%). All patients who required a sheath size >7F underwent high brachial open access, with the exception of one patient who underwent percutaneous axillary access with a 12F sheath. The mean sheath size was 10.59F ± 2.51F (median, 12F), which was advanced into the descending thoracic aorta, allowing multiple wire and catheter exchanges. One hemorrhagic stroke (one of 98 [1%]) occurred in the upper extremity access group, and one ischemic stroke (one of 54 [2%]) occurred in the femoral-only access group (P = .67). The stroke in the upper extremity access group occurred 5 days after FEVAR and was related to uncontrolled hypertension, whereas the stroke in the femoral group occurred on postoperative day 3. Neither patient had signs or symptoms of a stroke immediately after FEVAR. The right upper extremity was accessed six times without a stroke (0%) compared with the left being accessed 92 times with one stroke (1%; P = .8). Four patients (4%) had local complications related to upper extremity access. One (1%) required exploration for an expanding hematoma after manual compression for a 7F sheath, one (1%) required exploration for hematoma and neurologic symptoms after open access for a 12F sheath, and two patients (2%) with small hematomas did not require intervention. Two (two of 12 [17%]) of these complications were in the percutaneous access group, which were significantly more frequent than in the open group (two of 86 [2%]; P = .02). Upper extremity access appears to be a safe and feasible approach for patients undergoing FEVAR. Open exposure in the upper extremity may be safer than percutaneous access during FEVAR. Unlike chimney and snorkel grafts, upper extremity access during FEVAR is not associated with an increased risk of stroke, despite the need for multiple visceral vessel stenting. Copyright © 2015 Society for Vascular Surgery. All rights reserved.

78 FR 68345 - Airworthiness Directives; The Boeing Company Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-14

... of the outboard actuator load path, could result in uncontrolled retraction of the outboard flap... outboard actuator load path, if not corrected, could result in uncontrolled retraction of the outboard flap..., combined with loss of the outboard actuator load path, could result in uncontrolled retraction of the...

Attitude guidance and tracking for spacecraft with two reaction wheels

NASA Astrophysics Data System (ADS)

Biggs, James D.; Bai, Yuliang; Henninger, Helen

2018-04-01

This paper addresses the guidance and tracking problem for a rigid-spacecraft using two reaction wheels (RWs). The guidance problem is formulated as an optimal control problem on the special orthogonal group SO(3). The optimal motion is solved analytically as a function of time and is used to reduce the original guidance problem to one of computing the minimum of a nonlinear function. A tracking control using two RWs is developed that extends previous singular quaternion stabilisation controls to tracking controls on the rotation group. The controller is proved to locally asymptotically track the generated reference motions using Lyapunov's direct method. Simulations of a 3U CubeSat demonstrate that this tracking control is robust to initial rotation errors and angular velocity errors in the controlled axis. For initial angular velocity errors in the uncontrolled axis and under significant disturbances the control fails to track. However, the singular tracking control is combined with a nano-magnetic torquer which simply damps the angular velocity in the uncontrolled axis and is shown to provide a practical control method for tracking in the presence of disturbances and initial condition errors.

Chemical and ecotoxicological analyses of sediments and elutriates of contaminated rivers due to e-waste recycling activities using a diverse battery of bioassays.

PubMed

Wang, F; Leung, A O W; Wu, S C; Yang, M S; Wong, M H

2009-07-01

A multi-trophic, multi-exposure phase assessment approach was applied to characterize the toxicity of sediments collected from two rivers in Guiyu, China, an e-waste recycling centre. Elutriate toxicity tests (bacterium Vibrio fischeri and microalga Selenastrum capricornutum) and whole sediment toxicity test (crustacean Heterocypris incongruens) showed that most sediments exhibited acute toxicity, due to elevated heavy metals and PAHs levels, and low pH caused by uncontrolled acid discharge. The survival rates of crustaceans were negatively (p < 0.05) correlated with total PAHs in sediments (411-1755 mg kg(-1)); EC50s of V. fischeri on the elutriates were significantly correlated with elutriate pH (p < 0.01). Significant (p < 0.05) correlations between the induction of hepatic metallothionein in tilapia (Oreochromis mossambicus) and metal concentrations (Cu, Zn, Pb) in sediments were also observed, when fish were fed with diets containing sediment. The results showed that uncontrolled e-waste recycling activities may bring adverse effects to local aquatic ecosystem.

Illumination-invariant and deformation-tolerant inner knuckle print recognition using portable devices.

PubMed

Xu, Xuemiao; Jin, Qiang; Zhou, Le; Qin, Jing; Wong, Tien-Tsin; Han, Guoqiang

2015-02-12

We propose a novel biometric recognition method that identifies the inner knuckle print (IKP). It is robust enough to confront uncontrolled lighting conditions, pose variations and low imaging quality. Such robustness is crucial for its application on portable devices equipped with consumer-level cameras. We achieve this robustness by two means. First, we propose a novel feature extraction scheme that highlights the salient structure and suppresses incorrect and/or unwanted features. The extracted IKP features retain simple geometry and morphology and reduce the interference of illumination. Second, to counteract the deformation induced by different hand orientations, we propose a novel structure-context descriptor based on local statistics. To our best knowledge, we are the first to simultaneously consider the illumination invariance and deformation tolerance for appearance-based low-resolution hand biometrics. Settings in previous works are more restrictive. They made strong assumptions either about the illumination condition or the restrictive hand orientation. Extensive experiments demonstrate that our method outperforms the state-of-the-art methods in terms of recognition accuracy, especially under uncontrolled lighting conditions and the flexible hand orientation requirement.

Illumination-Invariant and Deformation-Tolerant Inner Knuckle Print Recognition Using Portable Devices

PubMed Central

Xu, Xuemiao; Jin, Qiang; Zhou, Le; Qin, Jing; Wong, Tien-Tsin; Han, Guoqiang

2015-01-01

We propose a novel biometric recognition method that identifies the inner knuckle print (IKP). It is robust enough to confront uncontrolled lighting conditions, pose variations and low imaging quality. Such robustness is crucial for its application on portable devices equipped with consumer-level cameras. We achieve this robustness by two means. First, we propose a novel feature extraction scheme that highlights the salient structure and suppresses incorrect and/or unwanted features. The extracted IKP features retain simple geometry and morphology and reduce the interference of illumination. Second, to counteract the deformation induced by different hand orientations, we propose a novel structure-context descriptor based on local statistics. To our best knowledge, we are the first to simultaneously consider the illumination invariance and deformation tolerance for appearance-based low-resolution hand biometrics. Settings in previous works are more restrictive. They made strong assumptions either about the illumination condition or the restrictive hand orientation. Extensive experiments demonstrate that our method outperforms the state-of-the-art methods in terms of recognition accuracy, especially under uncontrolled lighting conditions and the flexible hand orientation requirement. PMID:25686317

Uncontrolled Hypertension and Its Determinants in Patients with Concomitant Type 2 Diabetes Mellitus (T2DM) in Rural South Africa.

PubMed

Adeniyi, Oladele Vincent; Yogeswaran, Parimalaranie; Longo-Mbenza, Benjamin; Ter Goon, Daniel

2016-01-01

Paucity of data on the prevalence, treatment and control of hypertension in individuals living with type 2 diabetes mellitus (T2DM) in the rural communities of South Africa may undermine efforts to reduce the morbidity and mortality associated with cardiovascular diseases. This study examines the socio-demographic and clinical determinants of uncontrolled hypertension among individuals living with T2DM in the rural communities of Mthatha, South Africa. This cross-sectional study involved a serially selected sample of 265 individuals living with T2DM and hypertension at Mthatha General Hospital, Mthatha. Uncontrolled hypertension was defined as systolic blood pressure greater than or equal to 140 mmHg and diastolic blood pressure greater than or equal to 90mmHg in accordance with the Eight Joint National Committee Report (JNC 8) (2014). We performed univariate and multivariate logistic regression analyses to identify the significant determinants of uncontrolled hypertension. Of the total participants (n = 265), the prevalence of uncontrolled hypertension was 75.5% (n = 200). In univariate analysis of all participants, male gender (p = 0.029), age≥65 years (p = 0.016), unemployed status (p<0.0001), excessive alcohol intake (p = 0.005) and consumption of western-type diet (p<0.0001) were positively associated with uncontrolled hypertension. In multivariate logistic regression (LR method) analysis, unemployed status (p<0.0001), excessive alcohol intake (p = 0.007) and consumption of western-type diet (p<0.0001) were independently and significantly associated with uncontrolled hypertension. There is significant association between increasing number and classes of anti-hypertensive drugs and uncontrolled hypertension (p = 0.05 and 0.02, respectively). Prevalence of uncontrolled hypertension was high in individuals with concomitant hypertension and T2DM in the study population. Male sex, aging, clinic inertia, unemployed status and nutritional transitions are the most important determinants of uncontrolled hypertension in T2DM in Mthatha, South Africa. Treatment to blood pressure targets, though feasible in our setting, would require concerted efforts by addressing these determinants and clinic inertia.

Uncontrollable Stress, Coping, and Subjective Well-Being in Urban Adolescents

ERIC Educational Resources Information Center

Coyle, Laura D.; Vera, Elizabeth M.

2013-01-01

The purpose of this study was to determine whether uncontrollable stress related to levels of subjective well-being (SWB) in a group of ethnically diverse urban adolescents. Additionally, the researchers examined what types of coping skills were utilized in the face of high levels of uncontrollable stress. Finally, a moderation model was proposed,…

Sorafenib in Japanese Patients with Locally Advanced or Metastatic Medullary Thyroid Carcinoma and Anaplastic Thyroid Carcinoma.

PubMed

Ito, Yasuhiro; Onoda, Naoyoshi; Ito, Ken-Ichi; Sugitani, Iwao; Takahashi, Shunji; Yamaguchi, Iku; Kabu, Koki; Tsukada, Katsuya

2017-09-01

Therapeutic options for treating advanced or metastatic medullary thyroid carcinoma (MTC) and anaplastic thyroid carcinoma (ATC) are still limited in Japan, even though vandetanib for MTC and lenvatinib for MTC and ATC have been approved. Sorafenib is an oral multikinase inhibitor approved for the treatment of patients with radioactive iodine-refractory differentiated thyroid cancer (DTC). An uncontrolled, open-label, multicenter, single-arm, Phase 2 clinical study was conducted to evaluate the safety and efficacy of sorafenib in Japanese patients with MTC and ATC. Japanese patients with histologically confirmed ATC and locally advanced or metastatic MTC were enrolled from April to September 2014. The primary endpoint was to evaluate the safety of sorafenib. Treatment efficacy variables including progression-free survival (PFS), overall survival (OS), objective response rate (ORR), disease control rate (DCR), and maximum reduction in tumor size were evaluated as secondary endpoints. Patients received sorafenib 400 mg orally twice daily on a continuous basis and then continued treatment until the occurrence of disease progression, unacceptable toxicity, or withdrawal of consent. A total of 20 patients were screened, and 18 (8 with MTC and 10 with ATC) were enrolled. The most common drug-related adverse events were palmar-plantar erythrodysesthesia (72%), alopecia (56%), hypertension (56%), and diarrhea (44%). In the ATC patients, median PFS was 2.8 months [confidence interval 0.7-5.6], and median OS was 5.0 months [confidence interval 0.7-5.7]; ORR and DCR were 0% and 40%, respectively. In the MTC population, neither median PFS nor OS had been reached at the time of this analysis; ORR was 25% and DCR was 75%. The toxicities reported in this study were consistent with the known safety profile of sorafenib. Sorafenib seems to be effective in the treatment of advanced MTC but not ATC, and could be a new treatment option for locally advanced or metastatic MTC and radioactive iodine-refractory DTC.

75 FR 13454 - Special Local Regulation, Fran Schnarr Open Water Championships, Huntington Bay, NY

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-22

...-AA08 Special Local Regulation, Fran Schnarr Open Water Championships, Huntington Bay, NY AGENCY: Coast... navigable waters of Huntington Bay, New York due to the annual Fran Schnarr Open Water Championships. The..., ``Special Local Regulation, Fran Schnarr Open Water Championships, Huntington Bay, NY'' (Docket number USCG...

Patient Perspectives on Quality of Life With Uncontrolled Type 1 Diabetes Mellitus: A Systematic Review and Qualitative Meta-synthesis.

PubMed

Vanstone, Meredith; Rewegan, Alex; Brundisini, Francesca; Dejean, Deirdre; Giacomini, Mita

2015-01-01

Patients with uncontrolled type 1 diabetes mellitus may be candidates for pancreatic islet cell transplantation. This report synthesizes qualitative research on how patients with uncontrolled type 1 diabetes perceive their quality of life. The objective of this analysis was to examine the perceptions of patients with uncontrolled type 1 diabetes on how it affects their lived experience and quality of life. This report synthesizes 31 primary qualitative studies to examine quality of life from the perspectives of adult patients with type 1 diabetes mellitus and their families or partners. We performed a qualitative meta-synthesis to integrate findings across primary research studies. Long- and short-term negative consequences of uncontrolled type 1 diabetes affect all aspects of patients' lives: physical, emotional, practical, and social. The effect on each domain is far-reaching, and effects interact across domains. Uncontrolled blood sugar levels lead to substantial psychological distress, negative moods, cognitive difficulties, irritable or aggressive behaviour, and closely associated problems with relationships, self-image, and confidence. Emotional distress is pervasive and under-addressed by health care providers. Patients live in fear of complications from diabetes over the long term. In the shorter term, they are anxious about the personal, social, and professional consequences of hypoglycemic episodes (e.g., injury, humiliation), and may curtail normal activities such as driving or socializing because they are worried about having an episode. The quality of life for patients' family members is also negatively impacted by uncontrolled type 1 diabetes. Uncontrolled type 1 diabetes has significant negative impacts on the quality of life of both people with the disease and their families.

Reasons for uncontrolled seizures in children: the impact of pseudointractability.

PubMed

Asadi-Pooya, Ali A; Emami, Mehrdad

2012-11-01

We investigated the various possible reasons for uncontrolled seizures in patients under 18 years of age to determine the impact of pseudointractability. We also investigated the various forms of pseudointractability in children with uncontrolled seizures. In this cross-sectional retrospective chart review study, all patients under 18 years of age with their first seizure occurring at least 6 months prior to the referral date, taking at least one antiepileptic drug (AED), and having at least one seizure in the past 3 months were studied. The presumed reason for uncontrolled seizures was arbitrarily considered to be one of these five categories: poor adherence; wrong medication; wrong dose of the correct medication; diagnosis other than epilepsy; and finally, medically refractory epilepsy. Statistical analyses were performed using Chi-square and Fisher's Exact tests to determine potentially significant differences, and a P value less than 0.05 was considered significant. During the study period, 198 patients were referred to us due to uncontrolled seizures. Ninety patients (45%) were taking one AED, 55 (28%) were taking two AEDs, and 53 (27%) patients were taking more than two AEDs at the time of referral. Four percent of these patients did not have epilepsy. Forty-seven percent of the children with uncontrolled seizures had medically refractory epilepsy; 37% were taking the wrong AEDs; 10% were taking suboptimal doses of AEDs; and 2% had poor drug adherence. Uncontrolled seizures in children are a commonly encountered problem, particularly at epilepsy clinics. One should consider all possible reasons for these uncontrolled seizures, including non-epileptic seizures, pseudointractability, and medically refractory epilepsy. The mainstay for making a correct diagnosis is a detailed clinical history. Copyright © 2012 Elsevier Inc. All rights reserved.

[Endoscopic diagnosis of local chemical burn of mucous membranes of the stomach, induced with the purpose of simulation of gastric ulcer].

PubMed

Byzov, N V; Plekhanov, V N

2013-01-01

With the purpose of improvement of diagnosis of induced gastric ulcer were examined 11 patients who took aggressive agents for simulation of gastric ulcer and 33 patients who took pseudo-aggressive agents. Observables, conduced diagnosis of local chemical burn of mucous coat of stomach during initial 6 days after taking aggressive agents. Stages of ulcerous process, resulting from local chemical burn of mucous coat of stomach, coressponds to real gactric ulcer. Gelatin capsule using as a container for delivery of aggressive agents, melts in stomach in 5-6 minutes after taking. Independent from body position, mucous coat of greater curvature of the stomach is damaged. It is impossible to simulate duodenal bulb ulcer using the gelatine capsule or ball made of breadcrumb. The last method of delivery of aggressive agent can damage the small intestine because of uncontrollability of the place of breaking the ball.

Sexual murderers' implicit theories.

PubMed

Beech, Anthony; Fisher, Dawn; Ward, Tony

2005-11-01

Interviews with 28 sexual murderers were subjected to grounded theory analysis. Five implicit theories (ITs) were identified: dangerous world, male sex drive is uncontrollable, entitlement, women as sexual objects, and women as unknowable. These ITs were found to be identical to those identified in the literature as being present in rapists. The presence of dangerous world and male sex drive is uncontrollable were present, or absent, such that three groups could be identified: (a) dangerous world plus male sex drive is uncontrollable; (b) dangerous world, in the absence of male sex drive is uncontrollable; (c) male sex drive is uncontrollable in the absence of dangerous world. These three groups were found to differ in motivation: (a) were motivated by urges to rape and murder; (b) were motivated by grievance, resentment and/or anger toward women; (c) were motivated to sexually offend but were prepared to kill to avoid detection, or secure compliance.

Contribution of Fugitive Emissions for PM10 Concentrations in an Industrial Area of Portugal

NASA Astrophysics Data System (ADS)

Marta Almeida, Susana; Viana Silva, Alexandra; Garcia, Silvia; Miranda, Ana Isabel

2013-04-01

Significant atmospheric dust arises from the mechanical disturbance of granular material exposed to the air. Dust generated from these open sources is termed "fugitive" because it is not discharged to the atmosphere in a confined flow stream. Common sources of fugitive dust include unpaved roads, agricultural tilling operations, aggregate storage piles, heavy construction and harbor operations. The objective of this work was to identify the likeliness and extend of the PM10 limit value exceedences due to fugitive emissions in a particularly zone where PM fugitive emissions are a core of environmental concerns - Mitrena, Portugal. Mitrena, is an industrial area that coexists with a high-density urban region (Setúbal) and areas with an important environmental concern (Sado Estuary and Arrábida which belongs to the protected area Natura 2000 Network). Due to the typology of industry sited in Mitrena (e.g. power plant, paper mill, cement, pesticides and fertilized productions), there are a large uncontrolled PM fugitive emissions, providing from heavy traffic and handling and storage of raw material on uncover stockyards in the harbor and industries. Dispersion modeling was performed with the software TAPM (The Air Pollution Model) and results were mapped over the study area, using GIS (Geographic Information Systems). Results showed that managing local particles concentrations can be a frustrating affair because the weight of fugitive sources is very high comparing with the local anthropogenic stationary sources. In order to ensure that the industry can continue to meet its commitments in protecting air quality, it is essential to warrant that the characteristics of releases from all fugitive sources are fully understood in order to target future investments in those areas where maximum benefit will be achieved.

Isolation, purification and analysis of dissolved organic carbon from Gohagoda uncontrolled open dumpsite leachate, Sri Lanka.

PubMed

Vithanage, Meththika; Wijesekara, Hasintha; Mayakaduwa, S S

2017-07-01

Extract and analysis of the Dissolved Organic Carbon (DOC) fractions were analyzed from the leachate of an uncontrolled dumpsite at Gohagoda, Sri Lanka. DOC fractions, humic acid (HA), fulvic acid (FA) and the hydrophilic (Hyd) fractions were isolated and purified with the resin techniques. Spectroscopic techniques and elemental analysis were performed to characterize DOCs. Maximum TOC and DOC values recorded were 56,955 and 28,493 mg/L, respectively. Based on the total amount of DOC fractionation, Hyd dominated accounting for ∼60%, and HA and FA constituted ∼22% and ∼17%, respectively, exhibiting the mature phase of the dumpsite. The elemental analysis of DOCs revealed carbon variation following HA > FA > Hyd, while hydrogen and nitrogen were similar in each fraction. The N/C ratio for HA was recorded as 0.18, following a similar trend in old dumpsite leachate elsewhere. The O/C ratios for HA and FA were recorded higher as much as 1.0 and 9.3, respectively, indicating high degree of carbon mineralization in the leachates. High content of carboxylic, phenolic and lactone groups in all DOCs was observed disclosing their potential for toxic substances transportation. The results strongly suggest the risk associated with DOCs in dumpsite leachate to the aquatic and terrestrial environment.

On controllability and system constraints of the linear models of proton exchange membrane and solid oxide fuel cells

NASA Astrophysics Data System (ADS)

Radisavljevic, Verica

2011-10-01

In this paper we first show that the linear models of proton exchange membrane (polymer electrolyte membrane, PEM) and solid oxide (SO) fuel cells, commonly used in power and energy literature, are not controllable. The source of uncontrollability is the equation for pressure of the water vapor that is only affected by the fuel cell current, which in fact is a disturbance in this system and cannot be controlled by the given model inputs: inlet molar flow rates of hydrogen and oxygen. Being uncontrollable these models are not good candidates for studying control of dynamic processes in PEM and SO fuel cells. However, due to their simplicity, they can be used in hybrid configurations with other energy producing devices such as photovoltaic (solar) cells, wind turbine, micro gas turbine, battery (ultra capacitor) to demonstrate some other phenomena, but not for control purposes unless the hybrid models formed in such hybrid configurations are controllable. Testing controllability of such hybrid models is mandatory. Secondly, we introduce some algebraic constraints that follow from the model dynamics and the Nernst open-loop fuel cell voltage formula. These constraints must be satisfied in simulation of considered fuel cell modes, for example, via MATLAB/Simulink or any other computer software package.

Uncontrolled Donation After Circulatory Determination of Death Donors (uDCDDs) as a Source of Lungs for Transplant

PubMed Central

Egan, T. M.; Requard, J. J.

2017-01-01

In April 2014, the American Journal of Transplantation published a report on the first lung transplant in the United States recovered from an uncontrolled donation after circulatory determination of death donor (uDCDD), assessed by ex vivo lung perfusion (EVLP). The article identified logistical and ethical issues related to introduction of lung transplant from uDCDDs. In an open clinical trial, we have Food and Drug Administration and Institutional Review Board approval to transplant lungs recovered from uDCDDs judged suitable after EVLP. Through this project and other experiences with lung recovery from uDCDDs, we have identified solutions to many logistical challenges and have addressed ethical issues surrounding lung transplant from uDCDDs that were mentioned in this case report. Here, we discuss those challenges, including issues related to recovery of other solid organs from uDCDDs. Despite logistical challenges, uDCDDs could solve the critical shortage of lungs for transplant. Furthermore, by avoiding the deleterious impact of brain death and days of positive pressure ventilation, and by using opportunities to treat lungs in the decedent or during EVLP, lungs recovered from uDCDDs may ultimately prove to be better than lungs currently being transplanted from conventional brain-dead organ donors. PMID:25873272

Chronic Health Outcomes and Prescription Drug Copayments in Medicaid.

PubMed

Kostova, Deliana; Fox, Jared

2017-05-01

Prescription drug copayments and cost-sharing have been linked to reductions in prescription drug use and expenditures. However, little is known about their effect on specific health outcomes. To evaluate the association between prescription drug copayments and uncontrolled hypertension, uncontrolled hypercholesterolemia, and prescription drug utilization among Medicaid beneficiaries with these conditions. Select adults aged 20-64 from NHANES 1999-2012 in 18 states. Uncontrolled hypertension, uncontrolled hypercholesterolemia, and taking medication for each of these conditions. A differencing regression model was used to evaluate health outcomes among Medicaid beneficiaries in 4 states that introduced copayments during the study period, relative to 2 comparison groups-Medicaid beneficiaries in 14 states unaffected by shifts in copayment policy, and a within-state counterfactual group of low-income adults not on Medicaid, while controlling for individual demographic factors and unobserved state-level characteristics. Although uncontrolled hypertension and hypercholesterolemia declined among all low-income persons during the study period, the trend was less pronounced in Medicaid beneficiaries affected by copayments. After netting out concurrent trends in health outcomes of low-income persons unaffected by Medicaid copayment changes, we estimated that introduction of drug copayments in Medicaid was associated with an average rise in uncontrolled hypertension and uncontrolled hypercholesterolemia of 7.7 and 13.2 percentage points, respectively, and with reduced drug utilization for hypercholesterolemia. As Medicaid programs change in the years following the Affordable Care Act, prescription drug copayments may play a role as a lever for controlling hypertension and hypercholesterolemia at the population level.

High cleanliness globe valve with sine mechanism drive

NASA Astrophysics Data System (ADS)

Luo, Hu

2018-06-01

This paper gives a new type of quick-opening globe valve for life support pneumatic control system of the safety cabin at underground coal mine. The valve adopts the sine mechanism to transmit the rotating of the handle in the range of 90° to the reciprocating motion of the spool. The mechanism implements the quick-opening function of the valve through controlling the contact and separation between the O-ring and the end face of the valve. Since there is no relative sliding between the sealing interfaces, the valve solute uncontrollable disadvantage wear particles which produced by package ball valve, to ensure high cleanliness in flow path. Traditional transmission mechanism has a reinforcement effect and reduce handle open torque. By the finite element method, the relationship between the contact force and the compression of O-ring is analyzed to provide the boundary condition for the calculation of the rotational torque. Meanwhile the velocity field and pressure field along the flow path are simulated. The caliber size of the valve and the flow resistance coefficient are obtained. There is higher cleanliness, more reliable sealing, smaller handle open torque advantage compared with existing packing ball valve. The above work presents a new technical approach for the design of pneumatic control valve of the safety cabin.

Scaffold Composition Determines the Angiogenic Outcome of Cell-Based Vascular Endothelial Growth Factor Expression by Modulating Its Microenvironmental Distribution.

PubMed

Gaudiello, Emanuele; Melly, Ludovic; Cerino, Giulia; Boccardo, Stefano; Jalili-Firoozinezhad, Sasan; Xu, Lifen; Eckstein, Friedrich; Martin, Ivan; Kaufmann, Beat A; Banfi, Andrea; Marsano, Anna

2017-12-01

Delivery of genetically modified cells overexpressing Vascular Endothelial Growth Factor (VEGF) is a promising approach to induce therapeutic angiogenesis in ischemic tissues. The effect of the protein is strictly modulated by its interaction with the components of the extracellular matrix. Its therapeutic potential depends on a sustained but controlled release at the microenvironmental level in order to avoid the formation of abnormal blood vessels. In this study, it is hypothesized that the composition of the scaffold plays a key role in modulating the binding, hence the therapeutic effect, of the VEGF released by 3D-cell constructs. It is found that collagen sponges, which poorly bind VEGF, prevent the formation of localized hot spots of excessive concentration, therefore, precluding the development of aberrant angiogenesis despite uncontrolled expression by a genetically engineered population of adipose tissue-derived stromal cells. On the contrary, after seeding on VEGF-binding egg-white scaffolds, the same cell population caused aberrantly enlarged vascular structures after 14 d. Collagen-based engineered tissues also induced a safe and efficient angiogenesis in both the patch itself and the underlying myocardium in rat models. These findings open new perspectives on the control and the delivery of proangiogenic stimuli, and are fundamental for the vascularization of engineered tissues/organs. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Assessment of asthma control: the SERENA study.

PubMed

Corrado, Antonio; Renda, Teresa; Polese, Guido; Rossi, Andrea

2013-11-01

Several studies suggest that many asthmatic subjects have uncontrolled asthma. The control of asthma is now considered the major goal of therapy. to ascertain the level of asthma control, by Asthma Control Test (ACT), in "real-life" clinical practice and the potential risk factors for uncontrolled disease in patients treated with inhaled corticosteroids (ICS) and long-acting beta-adrenergic agonists (LABA). SERENA is a multi-centre, cross-sectional, 6-month observational, non-interventional study carried out in 16 Pulmonary Units in Italy. Asthmatic outpatients aged over 18, undergoing treatment with ICS at medium-high daily doses associated with LABA, were enrolled. The patients were divided in 3 subgroups according to the level of asthma control by ACT score (25:controlled; 20-24:partly controlled; <20: uncontrolled). Out of a total of 548 patients, 396 met the inclusion criteria. Only 9.1% of patients had asthma controlled, while partly controlled and uncontrolled asthma accounted for 39.6% and 51.3% respectively. The mean age was 54.5 ± 15.8 and the mean duration of asthma was 16.1 ± 14.1 years. There were more females than males (63% vs 37%) and females had highest prevalence of uncontrolled asthma (63.1%). The mean values of FEV1% predicted were lower in the uncontrolled group (p < 0.001). The percentage of patients with at least 1 exacerbation, unscheduled visit and/or admissions was lower in controlled (22.2%, 8.3%, 8.3%) than in partly controlled (50%, 38.6%, 9.2%) and uncontrolled (83.2%, 66.2%, 27.8%) groups (p < 0.0001). The multivariate ordinal logistic regression analysis identified female sex, FEV1 and exacerbations as the strongest independent factors associated with the uncontrolled disease. This study highlights the importance in clinical practice of a periodic assessment by a validated asthma control instrument and exacerbations/health care contacts during previous year. Clinicians should be aware that a significant proportion of patients can have uncontrolled asthma, despite regular pharmacological treatment. Copyright © 2013 Elsevier Ltd. All rights reserved.

Urinary incontinence

MedlinePlus

Loss of bladder control; Uncontrollable urination; Urination - uncontrollable; Incontinence - urinary ... have diabetes, keep your blood sugar under good control. For urine leaks, wear absorbent pads or undergarments. ...

Movement - uncontrollable

MedlinePlus

... movements; Body movements - uncontrollable; Dyskinesia; Athetosis; Myoclonus; Ballismus Images Central nervous system and peripheral nervous system References Jankovic J, Lang AE. Diagnosis and assessment of Parkinson disease ...

Uncontrolled eating in adolescents: The role of impulsivity and automatic approach bias for food.

PubMed

Booth, Charlotte; Spronk, Desiree; Grol, Maud; Fox, Elaine

2018-01-01

Obesity is a global problem reaching epidemic proportions and can be explained by unhealthy eating and sedentary lifestyles. Understanding the psychological processes underlying unhealthy eating behaviour is crucial for the development of effective obesity prevention programmes. Dual-process models implicate the interplay between impaired cognitive control and enhanced automatic responsivity to rewarding food cues as key risk factors. The current study assessed the influence of four different components of trait impulsivity (reflecting impaired cognitive control) and automatic approach bias for food (reflecting automatic responsivity to food) on uncontrolled eating in a large sample (N = 504) of young adolescents. Of the four impulsivity factors, negative urgency was found to be the strongest predictor of uncontrolled eating. Interestingly, we found that lack of premeditation was a key risk factor for uncontrolled eating, but only when approach bias for food was high, supporting a dual-process model. Lack of perseverance showed a similar interactive pattern to a lesser degree and sensation-seeking did not predict uncontrolled eating. Together, our results show that distinct components of trait impulsivity are differentially associated with uncontrolled eating behaviour in adolescents, and that automatic processing of food cues may be an important factor in modulating this relationship. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Emotional and uncontrolled eating styles and chocolate chip cookie consumption. A controlled trial of the effects of positive mood enhancement.

PubMed

Turner, Sally Ann; Luszczynska, Aleksandra; Warner, Lisa; Schwarzer, Ralf

2010-02-01

The study tested the effects of positive mood enhancement on chocolate chip cookie consumption in the context of emotional and uncontrolled eating styles. The relationship between emotional eating style and chocolate chip cookie intake was assumed to be mediated by uncontrolled eating style. Further, it was hypothesized that the effectiveness of the positive mood enhancement may be more salient among those who have effective control of their eating. In this experimental study, respondents (N=106, 70% women, aged 16-45 years old) were assigned by means of cluster randomization to the control or positive mood enhancement condition (a comedy movie clip). Compared to the control condition, positive mood enhancement resulted in consuming on average 53.86 kcal less. Relationships between emotional eating style and cookie intake were mediated by uncontrolled eating. Moderated mediation analysis indicated that the effect of a mediator (uncontrolled eating) on cookie intake was moderated by the group assignment. Positive mood enhancement resulted in eating on average 3.3 cookies less among individuals with a more controlled eating style. By contrast, among those who presented uncontrolled eating, positive mood enhancement led to consuming an average of 1.7 cookies more. 2009 Elsevier Ltd. All rights reserved.

Increased metabolic activity in the septum and habenula during stress is linked to subsequent expression of learned helplessness behavior.

PubMed

Mirrione, Martine M; Schulz, Daniela; Lapidus, Kyle A B; Zhang, Samuel; Goodman, Wayne; Henn, Fritz A

2014-01-01

Uncontrollable stress can have a profound effect on an organism's ability to respond effectively to future stressful situations. Behavior subsequent to uncontrollable stress can vary greatly between individuals, falling on a spectrum between healthy resilience and maladaptive learned helplessness. It is unclear whether dysfunctional brain activity during uncontrollable stress is associated with vulnerability to learned helplessness; therefore, we measured metabolic activity during uncontrollable stress that correlated with ensuing inability to escape future stressors. We took advantage of small animal positron emission tomography (PET) and 2-deoxy-2[(18)F]fluoro-D-glucose ((18)FDG) to probe in vivo metabolic activity in wild type Sprague Dawley rats during uncontrollable, inescapable, unpredictable foot-shock stress, and subsequently tested the animals response to controllable, escapable, predictable foot-shock stress. When we correlated metabolic activity during the uncontrollable stress with consequent behavioral outcomes, we found that the degree to which animals failed to escape the foot-shock correlated with increased metabolic activity in the lateral septum and habenula. When used a seed region, metabolic activity in the habenula correlated with activity in the lateral septum, hypothalamus, medial thalamus, mammillary nuclei, ventral tegmental area, central gray, interpeduncular nuclei, periaqueductal gray, dorsal raphe, and rostromedial tegmental nucleus, caudal linear raphe, and subiculum transition area. Furthermore, the lateral septum correlated with metabolic activity in the preoptic area, medial thalamus, habenula, interpeduncular nuclei, periaqueductal gray, dorsal raphe, and caudal linear raphe. Together, our data suggest a group of brain regions involved in sensitivity to uncontrollable stress involving the lateral septum and habenula.

Increased metabolic activity in the septum and habenula during stress is linked to subsequent expression of learned helplessness behavior

PubMed Central

Mirrione, Martine M.; Schulz, Daniela; Lapidus, Kyle A. B.; Zhang, Samuel; Goodman, Wayne; Henn, Fritz A.

2013-01-01

Uncontrollable stress can have a profound effect on an organism's ability to respond effectively to future stressful situations. Behavior subsequent to uncontrollable stress can vary greatly between individuals, falling on a spectrum between healthy resilience and maladaptive learned helplessness. It is unclear whether dysfunctional brain activity during uncontrollable stress is associated with vulnerability to learned helplessness; therefore, we measured metabolic activity during uncontrollable stress that correlated with ensuing inability to escape future stressors. We took advantage of small animal positron emission tomography (PET) and 2-deoxy-2[18F]fluoro-D-glucose (18FDG) to probe in vivo metabolic activity in wild type Sprague Dawley rats during uncontrollable, inescapable, unpredictable foot-shock stress, and subsequently tested the animals response to controllable, escapable, predictable foot-shock stress. When we correlated metabolic activity during the uncontrollable stress with consequent behavioral outcomes, we found that the degree to which animals failed to escape the foot-shock correlated with increased metabolic activity in the lateral septum and habenula. When used a seed region, metabolic activity in the habenula correlated with activity in the lateral septum, hypothalamus, medial thalamus, mammillary nuclei, ventral tegmental area, central gray, interpeduncular nuclei, periaqueductal gray, dorsal raphe, and rostromedial tegmental nucleus, caudal linear raphe, and subiculum transition area. Furthermore, the lateral septum correlated with metabolic activity in the preoptic area, medial thalamus, habenula, interpeduncular nuclei, periaqueductal gray, dorsal raphe, and caudal linear raphe. Together, our data suggest a group of brain regions involved in sensitivity to uncontrollable stress involving the lateral septum and habenula. PMID:24550809

Detecting free-living steps and walking bouts: validating an algorithm for macro gait analysis.

PubMed

Hickey, Aodhán; Del Din, Silvia; Rochester, Lynn; Godfrey, Alan

2017-01-01

Research suggests wearables and not instrumented walkways are better suited to quantify gait outcomes in clinic and free-living environments, providing a more comprehensive overview of walking due to continuous monitoring. Numerous validation studies in controlled settings exist, but few have examined the validity of wearables and associated algorithms for identifying and quantifying step counts and walking bouts in uncontrolled (free-living) environments. Studies which have examined free-living step and bout count validity found limited agreement due to variations in walking speed, changing terrain or task. Here we present a gait segmentation algorithm to define free-living step count and walking bouts from an open-source, high-resolution, accelerometer-based wearable (AX3, Axivity). Ten healthy participants (20-33 years) wore two portable gait measurement systems; a wearable accelerometer on the lower-back and a wearable body-mounted camera (GoPro HERO) on the chest, for 1 h on two separate occasions (24 h apart) during free-living activities. Step count and walking bouts were derived for both measurement systems and compared. For all participants during a total of almost 20 h of uncontrolled and unscripted free-living activity data, excellent relative (rho  ⩾  0.941) and absolute (ICC (2,1)   ⩾  0.975) agreement with no presence of bias were identified for step count compared to the camera (gold standard reference). Walking bout identification showed excellent relative (rho  ⩾  0.909) and absolute agreement (ICC (2,1)   ⩾  0.941) but demonstrated significant bias. The algorithm employed for identifying and quantifying steps and bouts from a single wearable accelerometer worn on the lower-back has been demonstrated to be valid and could be used for pragmatic gait analysis in prolonged uncontrolled free-living environments.

A longitudinal analysis of the influence of the neighborhood built environment on walking for transportation: the RESIDE study.

PubMed

Knuiman, Matthew W; Christian, Hayley E; Divitini, Mark L; Foster, Sarah A; Bull, Fiona C; Badland, Hannah M; Giles-Corti, Billie

2014-09-01

The purpose of the present analysis was to use longitudinal data collected over 7 years (from 4 surveys) in the Residential Environments (RESIDE) Study (Perth, Australia, 2003-2012) to more carefully examine the relationship of neighborhood walkability and destination accessibility with walking for transportation that has been seen in many cross-sectional studies. We compared effect estimates from 3 types of logistic regression models: 2 that utilize all available data (a population marginal model and a subject-level mixed model) and a third subject-level conditional model that exclusively uses within-person longitudinal evidence. The results support the evidence that neighborhood walkability (especially land-use mix and street connectivity), local access to public transit stops, and variety in the types of local destinations are important determinants of walking for transportation. The similarity of subject-level effect estimates from logistic mixed models and those from conditional logistic models indicates that there is little or no bias from uncontrolled time-constant residential preference (self-selection) factors; however, confounding by uncontrolled time-varying factors, such as health status, remains a possibility. These findings provide policy makers and urban planners with further evidence that certain features of the built environment may be important in the design of neighborhoods to increase walking for transportation and meet the health needs of residents. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A novel GhBEE1-Like gene of cotton causes anther indehiscence in transgenic Arabidopsis under uncontrolled transcription level.

PubMed

Chen, Eryong; Wang, Xiaoqian; Gong, Qian; Butt, Hamama Islam; Chen, Yanli; Zhang, Chaojun; Yang, Zuoren; Wu, Zhixia; Ge, Xiaoyang; Zhang, Xianlong; Li, Fuguang; Zhang, Xueyan

2017-09-05

Male-sterile lines are very important for selective breeding, and anther dehiscence defect is an effective way to generate male-sterile lines. Although several bHLH-family proteins in Arabidopsis have been characterized, little is known about the role of bHLH-family proteins in cotton. Here, we isolated a novel bHLH protein from cotton (Gossypium hirsutum), named GhBEE1-Like. Protein domain analysis showed that GhBEE1-Like contained a basic domain and an HLH domain. Subcellular localization analysis revealed that GhBEE1-Like was a nuclear-localized protein. Expression pattern analysis showed GhBEE1-Like was highly expressed in floral organs, and its expression was induced by the active brassinosteroid (BR) substance 24-epi-BL. GhBEE1-Like overexpression in Arabidopsis resulted in two types of transgenic lines, one with normal anther dehiscence and the other with defective anther dehiscence. Semi-qRT-PCR and qRT-PCR analyses revealed that GhBEE1-Like transcript levels acted as a check-point determining how anther dehiscence proceeds in these transgenic lines; regulated transcript levels result in normal anther dehiscence, whereas uncontrolled transcript levels lead to anther indehiscence. These results suggest that GhBEE1-Like plays an important role via its accumulation in regulating anther dehiscence. Therefore, controlling the level of GhBEE1-Like expression in cotton could be a convenient tool for generating male-sterile lines to use in selective breeding. Copyright © 2017. Published by Elsevier B.V.

Effectiveness of barnidipine 10 or 20 mg plus losartan 50-mg combination versus losartan 100-mg monotherapy in patients with essential hypertension not controlled by losartan 50-mg monotherapy: A 12-week, multicenter, randomized, open-label, parallel-group study.

PubMed

Parati, Gianfranco; Giglio, Alessia; Lonati, Laura; Destro, Maurizio; Ricci, Alessandra Rossi; Cagnoni, Francesca; Pini, Claudio; Venco, Achille; Maresca, Andrea Maria; Monza, Michela; Grandi, Anna Maria; Omboni, Stefano

2010-07-01

Increasing the dose or adding a second antihypertensive agent are 2 possible therapeutic choices when blood pressure (BP) is poorly controlled with monotherapy. This study investigated the effectiveness and tolerability of barnidipine 10 or 20 mg added to losartan 50 mg versus losartan 100 mg alone in patients with mild to moderate essential hypertension whose BP was uncontrolled by losartan 50-mg monotherapy. This was a 12-week, multicenter, randomized, open-label, parallel-group study. Eligible patients (aged 30-74 years) had uncontrolled hypertension, defined as office sitting diastolic BP (DBP) > or =90 mm Hg and/or systolic BP (SBP) > or =140 mm Hg, and mean daytime DBP > or =85 mm Hg and/or SBP > or =135 mm Hg. All were being treated with losartan 50 mg at enrollment. After a 1-week run-in period while taking losartan 50 mg, patients were randomly assigned to 6 weeks of treatment with open-label barnidipine 10 mg plus losartan 50 mg or losartan 100-mg monotherapy. At the end of this period, patients with uncontrolled BP had barnidipine doubled to 20 mg and continued for an additional 6 weeks, whereas patients not achieving control on treatment with losartan 100 mg were discontinued. Office BP was measured at each visit, whereas 24-hour ambulatory BP monitoring (ABPM) was performed at randomization and at the final visit (ie, after 12 weeks of treatment, or at 6 weeks for patients not controlled on losartan 100 mg). The intent-to-treat population included all randomized patients who received at least one dose of study treatment and had valid ABPM recordings at baseline and the final visit. The primary end point was the change in daytime DBP between baseline and 12 weeks of treatment, compared between the combination treatment and monotherapy. Adverse events (AEs) were evaluated during each study visit. A total of 93 patients were enrolled (age range, 30-75 years; 60% [56/93] men). After the 1-week run-in period, 68 patients were randomly assigned to 6 weeks of treatment with open-label barnidipine 10 mg plus losartan 50 mg (n = 34) or losartan 100-mg monotherapy (n = 34). A total of 53 patients were evaluable (barnidipine plus losartan, n = 28; losartan, n = 25). After 6 weeks of treatment, 18 patients in the combination treatment group (64.3%) had their dose of barnidipine doubled from 10 to 20 mg because BP was not normalized by treatment, whereas 8 patients in the losartan group (32.0%) were discontinued for the same reason. The between-treatment difference (losartan alone - combination treatment) for changes from baseline in daytime DBP was -1.7 mm Hg (95% CI, -5.8 to 2.4 mm Hg; P = NS). A similar result was observed for daytime SBP (-3.2 mm Hg; 95% CI, -8.1 to 1.7 mm Hg; P = NS). Likewise, no significant differences were found for nighttime values (mean [95% CI] DBP, 0.5 mm Hg [-3.7 to 4.7 mm Hg]; SBP, 1.5 mm Hg [-4.1 to 7.1 mm Hg]) or 24-hour values (DBP, -0.9 mm Hg [-4.8 to 2.9 mm Hg]; SBP, -1.6 mm Hg [-5.9 to 2.7 mm Hg]). Combination treatment was associated with a significantly higher rate of SBP responder patients (ie, <140 mm Hg or a reduction of > or =20 mm Hg) compared with monotherapy (82.1% [23/28] vs 56.0% [14/25]; P = 0.044). Drug-related AEs were reported in 4 patients taking combination treatment (total of 7 AEs, including 2 cases of peripheral edema and 1 each of tachycardia, atrial flutter, tinnitus, confusion, and polyuria) and in 2 patients taking losartan alone (total of 2 AEs, both tachycardia). This open-label, parallel-group study found that there was no significant difference in the BP-lowering effect of barnidipine 10 or 20 mg in combination with losartan 50 mg compared with losartan 100-mg monotherapy in these patients with essential hypertension previously uncontrolled by losartan 50-mg monotherapy. However, the percentage of responders for SBP was significantly higher with the combination. Both treatments were generally well tolerated. European Union Drug Regulating Authorities Clinical Trials (EudraCT) no. 2006-001469-41. 2010 Excerpta Medica Inc. All rights reserved.

The metabolic syndrome in a Congolese population and its implications for metabolic syndrome definitions.

PubMed

Longo-Mbenza, B; Kasiam Lasi On'kin, J B; Nge Okwe, A; Kangola Kabangu, N

2011-01-01

Metabolic syndrome defined by International cut-off values are limited to detect people at high cardiometabolic risk in Central Africans in comparison with metabolic syndrome defined by ethnic-specific definition. We examined the relationship between metabolic syndromes, diabetes control, abdominal obesity, HDL-cholesterol groups and atherosclerotic complications. A representative sample of type-2 diabetic central Africans from Kinshasa were studied. Outcome measures included control of diabetes, atherosclerosis, abdominal obesity, insulin resistance, total cholesterol, triglycerides, HDL-cholesterol, metabolic syndromes and atherosclerosis. Of 1266 type-2 diabetic patients (48.8%), (61.8%), (27.1%) and (81%) had uncontrolled diabetes, atherosclerotics, metabolic syndrome (IDF/Europe), and metabolic syndrome (IDF/local) respectively. There was a significant U-shaped relationship between atherosclerotics complications, insulin resistance, delta postprandial glycaemia and HDL-cholesterol stratification. There was also a significant U-shaped relationship between cardiometabolic risk (P<0.01) and atherosclerotic complications. Type-2 diabetic Central Africans exhibit very high rates of uncontrolled diabetes, atherosclerotic complications and metabolic syndrome. Both, abdominal obesity, insulin resistance, low and very high HDL-cholesterol levels are cardiometabolic risk factors. Crown Copyright © 2010. Published by Elsevier Ltd. All rights reserved.

CAPE-OPEN simulation of waste-to-energy technologies for urban cities

NASA Astrophysics Data System (ADS)

Andreadou, Christina; Martinopoulos, Georgios

2018-01-01

Uncontrolled waste disposal and unsustainable waste management not only damage the environment, but also affect human health. In most urban areas, municipal solid waste production is constantly increasing following the everlasting increase in energy consumption. Technologies aim to exploit wastes in order to recover energy, decrease the depletion rate of fossil fuels, and reduce waste disposal. In this paper, the annual amount of municipal solid waste disposed in the greater metropolitan area of Thessaloniki is taken into consideration, in order to size and model a combined heat and power facility for energy recovery. From the various waste-to-energy technologies available, a fluidised bed combustion boiler combined heat and power plant was selected and modelled through the use of COCO, a CAPE-OPEN simulation software, to estimate the amount of electrical and thermal energy that could be generated for different boiler pressures. Although average efficiency was similar in all cases, providing almost 15% of Thessaloniki's energy needs, a great variation in the electricity to thermal energy ratio was observed.

Urban adolescent stress and hopelessness.

PubMed

Landis, Dana; Gaylord-Harden, Noni K; Malinowski, Sara L; Grant, Kathryn E; Carleton, Russell A; Ford, Rebecca E

2007-12-01

This study sought to explore potential mechanisms through which uncontrollable, chronic stressors may lead to hopelessness in low-income, urban adolescents. In particular, the roles of specific coping strategies as moderators and/or mediators of the association between stressors and hopelessness were examined. Results suggest that chronic, uncontrollable stressors were significantly and positively related to hopelessness in this sample. Active coping, distraction coping, and social-support-seeking coping emerged as moderators for males, such that uncontrollable stressors were more highly associated with hopelessness for those boys who reported using more active, distraction, and social-support-seeking coping strategies. An analogous moderating effect was found for ruminative coping for girls. Ruminative coping also emerged as a mediator of the relation between uncontrollable stressors and hopelessness for girls.

Role of Systemic and Local Antibiotics in the Treatment of Open Fractures.

PubMed

Carver, David C; Kuehn, Sean B; Weinlein, John C

2017-04-01

The orthopedic community has learned much about the treatment of open fractures from the tremendous work of Ramon Gustilo, Michael Patzakis, and others; however, open fractures continue to be very difficult challenges. Type III open fractures continue to be associated with high infection rates. Some combination of systemic and local antibiotics may be most appropriate in these high-grade open fractures. Further research is still necessary in determining optimal systemic antibiotic regimens as well as the role of local antibiotics. Any new discoveries related to novel systemic antibiotics or local antibiotic carriers will need to be evaluated related to cost. Copyright © 2016 Elsevier Inc. All rights reserved.

Object Segmentation Methods for Online Model Acquisition to Guide Robotic Grasping

NASA Astrophysics Data System (ADS)

Ignakov, Dmitri

A vision system is an integral component of many autonomous robots. It enables the robot to perform essential tasks such as mapping, localization, or path planning. A vision system also assists with guiding the robot's grasping and manipulation tasks. As an increased demand is placed on service robots to operate in uncontrolled environments, advanced vision systems must be created that can function effectively in visually complex and cluttered settings. This thesis presents the development of segmentation algorithms to assist in online model acquisition for guiding robotic manipulation tasks. Specifically, the focus is placed on localizing door handles to assist in robotic door opening, and on acquiring partial object models to guide robotic grasping. First, a method for localizing a door handle of unknown geometry based on a proposed 3D segmentation method is presented. Following segmentation, localization is performed by fitting a simple box model to the segmented handle. The proposed method functions without requiring assumptions about the appearance of the handle or the door, and without a geometric model of the handle. Next, an object segmentation algorithm is developed, which combines multiple appearance (intensity and texture) and geometric (depth and curvature) cues. The algorithm is able to segment objects without utilizing any a priori appearance or geometric information in visually complex and cluttered environments. The segmentation method is based on the Conditional Random Fields (CRF) framework, and the graph cuts energy minimization technique. A simple and efficient method for initializing the proposed algorithm which overcomes graph cuts' reliance on user interaction is also developed. Finally, an improved segmentation algorithm is developed which incorporates a distance metric learning (DML) step as a means of weighing various appearance and geometric segmentation cues, allowing the method to better adapt to the available data. The improved method also models the distribution of 3D points in space as a distribution of algebraic distances from an ellipsoid fitted to the object, improving the method's ability to predict which points are likely to belong to the object or the background. Experimental validation of all methods is performed. Each method is evaluated in a realistic setting, utilizing scenarios of various complexities. Experimental results have demonstrated the effectiveness of the handle localization method, and the object segmentation methods.

Olfactory source localization in the open field using one or both nostrils.

PubMed

Welge-Lussen, A; Looser, G L; Westermann, B; Hummel, T

2014-03-01

This study aims to examine humans ́ abilities to localize odorants within the open field. Young participants were tested on a localization task using a relatively selective olfactory stimulus (2-phenylethyl-alcohol, PEA) and cineol, an odorant with a strong trigeminal component. Participants were blindfolded and had to localize an odorant source at 2 m distance (far-field condition) and a 0.4 m distance (near-field condition) with either two nostrils open or only one open nostril. For the odorant with trigeminal properties, the number of correct trials did not differ when one or both nostrils were used, while more PEA localization trials were correctly completed with both rather than one nostril. In the near-field condition, correct localization was possible in 72-80% of the trials, irrespective of the odorant and the number of nostrils used. Localization accuracy, measured as spatial deviation from the olfactory source, was significantly higher in the near-field compared to the far-field condition, but independent of the odorant being localized. Odorant localization within the open field is difficult, but possible. In contrast to the general view, humans seem to be able to exploit the two-nostril advantage with increasing task difficulty.

Determinants of Uncontrolled Hypertension in Rural Communities in South Asia - Bangladesh, Pakistan, and Sri Lanka.

PubMed

Jafar, Tazeen H; Gandhi, Mihir; Jehan, Imtiaz; Naheed, Aliya; de Silva, H Asita; Shahab, Hunaina; Alam, Dewan; Luke, Nathasha; Lim, Ching Wee

2018-04-26

Uncontrolled blood pressure (BP) is a leading risk factor for death and disability in South Asia. We aimed to determine the cross-country variation, and the factors associated with uncontrolled BP among adults treated for hypertension in rural South Asia. We enrolled 1718 individuals aged ≥40 years treated for hypertension in a cross-sectional study from rural communities in Bangladesh, Pakistan, and Sri Lanka. Multivariable logistic regression model was used to determine the factors associated with uncontrolled BP (systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg). Among hypertensive individuals, 58.0% (95% confidence interval 55.7, 60.4) had uncontrolled BP: 52.8% (49.0, 56.6) in Bangladesh, 70.6% (65.7, 75.1) in Pakistan, and 56.5% (52.7, 60.1) in Sri Lanka. The odds (odds ratio (95% confidence interval)) of uncontrolled BP were significantly higher in individuals with lower wealth index (1.17 (1.02, 1.35)); single vs married (1.46 (1.10, 1.93)); higher log urine albumin-to-creatinine ratio (1.41 (1.24, 1.60)); lower estimated glomerular filtration rate (1.23 (1.01, 1.49)); low vs high adherence to antihypertensive medication (1.50 (1.16, 1.94)); and Pakistan (2.91 (1.60, 5.28)) vs Sri Lanka. However, the odds were lower in those with vs without self-reported kidney disease (0.51 (0.28, 0.91)); and receiving vs not receiving statins (0.62 (0.44, 0.87)). The majority of individuals with treated hypertension have uncontrolled BP in rural Bangladesh, Pakistan, and Sri Lanka with significant disparities among and within countries. Urgent public health efforts are needed to improve access and adherence to antihypertensive medications in disadvantaged populations in rural South Asia.

Reasons for uncontrolled seizures in adults; the impact of pseudointractability.

PubMed

Asadi-Pooya, Ali A; Emami, Mehrdad; Ashjazadeh, Nahid; Nikseresht, Alireza; Shariat, Abdolhamid; Petramfar, Peyman; Yousefipour, Gholamali; Borhani-Haghighi, Afshin; Izadi, Sadegh; Rahimi-Jaberi, Abbas

2013-05-01

We investigated the various possible reasons for uncontrolled seizures in patients 18 years of age and older to determine the impact of pseudointractability. We also tried to investigate the various forms of pseudointractability. In this cross-sectional study, all patients 18 years of age and older with their first seizure occurring at least six months prior to the referral date, taking at least one antiepileptic drug (AED) and having at least one seizure in the past three months were studied. The presumed reason for uncontrolled seizures was arbitrarily considered to be one of these five categories: Poor compliance; Wrong medication (misclassification); Wrong dose of the correct medication; Diagnosis other than epilepsy; and finally, Medically-refractory epilepsy. Statistical analyses were performed using Chi-square and Fisher's exact tests, and a P value less than 0.05 was considered significant. 350 patients were referred to us due to uncontrolled seizures. One hundred ninety-one (55%) were male and 159 (45%) were female. Twelve percent of the patients had diagnoses other than epilepsy, 40% had indeed medically-refractory epilepsy; 29% were taking the wrong AEDs (misclassified epilepsy); 18% were taking suboptimal doses of AEDs; and 1% had poor drug compliance. The most common reason for uncontrolled seizures among patients with idiopathic generalized epilepsy was taking the wrong AED. However, among patients with focal epilepsy, true medically-refractory epilepsy was the most common reason. Uncontrolled seizures are a commonly encountered problem, especially at epilepsy clinics and one should consider all possible reasons for these uncontrolled seizures. The mainstay for making a correct diagnosis is a detailed clinical history. Copyright © 2013 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Efficacy of FDA-Approved Hemostatic Drugs to Improve Survival and Reduce Bleeding in Rat Models of Uncontrolled Hemorrhage

DTIC Science & Technology

2005-07-01

drugs are used to reduce surgical bleeding. This series of studies tested whether these drugs (aprotinin, desmopressin, tranexamic acid , e- aminocaproic ...desmopressin, tranexamic acid , 8- aminocaproic acid ) could reduce bleeding due to traumatic injuries in two models of uncontrolled hemorrhage in rats... acid ) could reduce bleeding due to traumatic injuries in two models of uncontrolled hemorrhage in rats. In the first phase of each study, a lethal

Glycated hemoglobin correlates with arterial stiffness and endothelial dysfunction in patients with resistant hypertension and uncontrolled diabetes mellitus.

PubMed

Moreno, Beatriz; de Faria, Ana Paula; Ritter, Alessandra Mileni Versuti; Yugar, Lara Buonalumi Tacito; Ferreira-Melo, Silvia Elaine; Amorim, Rivadavio; Modolo, Rodrigo; Fattori, André; Yugar-Toledo, Juan Carlos; Coca, Antonio; Moreno, Heitor

2018-05-01

This study aimed to evaluate the effects of glycated hemoglobin (HbA 1c ) on flow-mediated dilation, intima-media thickness, pulse wave velocity, and left ventricular mass index in patients with resistant hypertension (RHTN) comparing RHTN-controlled diabetes mellitus and RHTN-uncontrolled type 2 diabetes mellitus. Two groups were formed: HbA 1c <7.0% (RHTN-controlled diabetes mellitus: n = 98) and HbA 1c ≥7.0% (RHTN-uncontrolled diabetes mellitus: n = 122). Intima-media thickness and flow-mediated dilation were measured by high-resolution ultrasound, left ventricular mass index by echocardiography, and arterial stiffness by carotid-femoral pulse wave velocity. No differences in blood pressure levels were found between the groups but body mass index was higher in patients with RHTN-uncontrolled diabetes mellitus. Endothelial dysfunction and arterial stiffness were worse in patients with RHTN-uncontrolled diabetes mellitus. Intima-media thickness and left ventricular mass index measurements were similar between the groups. After adjustments, multiple linear regression analyses showed that HbA 1c was an independent predictor of flow-mediated dilation and pulse wave velocity in all patients with RHTN. In conclusion, HbA 1c may predict the grade of arterial stiffness and endothelial dysfunction in patients with RHTN, and superimposed uncontrolled diabetes mellitus implicates further impairment of vascular function. ©2018 Wiley Periodicals, Inc.

Public demand for preserving local open space.

Treesearch

Jeffrey D. Kline

2006-01-01

Increased development results in the loss of forest, farm, range, and other open space lands that contribute to the quality of life of U.S. residents. I describe an economic rationale for growing public support for preserving local open space, based the growing scarcity of open space lands. I test the rationale empirically by correlating the prevalence of open space...

Prevalence of pseudoresistant hypertension due to inaccurate blood pressure measurement

PubMed Central

Bhatt, Hemal; Siddiqui, Mohammed; Judd, Eric; Oparil, Suzanne; Calhoun, David

2016-01-01

Background The prevalence of pseudoresistant hypertension (HTN) due to inaccurate BP measurement remains unknown. Methods Triage BP measurements and measurements obtained at the same clinic visit by trained physicians were compared in consecutive adult patients referred for uncontrolled resistant HTN (RHTN). Triage BP measurements were taken by the clinic staff during normal intake procedures. BP measurements were obtained by trained physicians using the BpTRU device. The prevalence of uncontrolled RHTN and differences in BP measurements were compared. Results Of 130 patients with uncontrolled RHTN, 33.1% (n=43) were falsely identified as having uncontrolled RHTN based on triage BP measurements. The median (IQR) of differences in systolic BP between pseudoresistant and true resistant groups were 23 (17 – 33) mm Hg and 13 (6 – 21) mm Hg, respectively (P=0.0001). The median (IQR) of differences in diastolic BP between the two groups were 12 (7 – 18) mm Hg and 8 (4 – 11) mm Hg, respectively (P=0.001). Conclusion Triage BP technique overestimated the prevalence of uncontrolled RHTN in approximately 33% of the patients emphasizing the importance of obtaining accurate BP measurements. PMID:27129931

Treatment outcomes of open pelvic fractures associated with extensive perineal injuries.

PubMed

Hasankhani, Ebrahim Ghayem; Omidi-Kashani, Farzad

2013-12-01

The main causes of death in patients with open pelviperineal injuries are uncontrollable bleeding and pelvic sepsis. The aim of this study was to evaluate the management outcomes of open pelvic fractures associated with extensive perineal injuries. We retrospectively studied 15 cases with open pelvic fractures associated with extensive perineal injuries (urethral and anal canal laceration) admitted between August 2006 and September 2010. Mechanism of injury, Injury Severity Score, associated injuries, hemodynamic status on arrival, resuscitation and transfusion requirements, operative techniques, intra- and postoperative complications, length of intensive care unit and hospital stay, and mortality were recorded in a computerised database for further evaluation and analysis. The male to female ratio was 12:3 with an average age of 38.6 years (ranged, 11 to 65 years). The average packed red blood cell units used were 8 units (ranged, 4 to 21 units). All patients were initially transferred to the operating room for colostomy, radical debridement and fixation of the pelvic fracture by an external fixator. One patient had acute renal failure, which improved with medical treatment and 2 patients (13.3%) died, one with type III anteroposterior compression fracture due to hemorrhagic shock and the other due to septicemia. Open pelvic fractures with extensive perineal injuries are associated with high mortality rates. Early diagnosis and appropriate treatment, including reanimation, colostomy, cystostomy, vigorous and repeated irrigation and debridement, and fixation by an external fixator can improve the outcomes and reduce the mortality rate.

The dynamics and control of large flexible space structures, 3. Part A: Shape and orientation control of a platform in orbit using point actuators

NASA Technical Reports Server (NTRS)

Bainum, P. M.; Reddy, A. S. S. R.; Krishna, R.; James, P. K.

1980-01-01

The dynamics, attitude, and shape control of a large thin flexible square platform in orbit are studied. Attitude and shape control are assumed to result from actuators placed perpendicular to the main surface and one edge and their effect on the rigid body and elastic modes is modelled to first order. The equations of motion are linearized about three different nominal orientations: (1) the platform following the local vertical with its major surface perpendicular to the orbital plane; (2) the platform following the local horizontal with its major surface normal to the local vertical; and (3) the platform following the local vertical with its major surface perpendicular to the orbit normal. The stability of the uncontrolled system is investigated analytically. Once controllability is established for a set of actuator locations, control law development is based on decoupling, pole placement, and linear optimal control theory. Frequencies and elastic modal shape functions are obtained using a finite element computer algorithm, two different approximate analytical methods, and the results of the three methods compared.

77 FR 23120 - Special Local Regulations; Lowcountry Splash Open Water Swim, Wando River and Cooper River, Mount...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-18

...-AA08 Special Local Regulations; Lowcountry Splash Open Water Swim, Wando River and Cooper River, Mount... at Patriots Point on the Cooper River. Approximately 600 swimmers will be participating in the swim... Special Local Regulations; Lowcountry Splash Open Water Swim, Wando River and Cooper River, Mount Pleasant...

Lacosamide for uncontrolled primary generalized tonic-clonic seizures: An open-label pilot study with 59-week extension.

PubMed

Wechsler, Robert T; Yates, Stephen L; Messenheimer, John; Leroy, Robert; Beller, Cynthia; Doty, Pamela

2017-02-01

Assess the safety of adjunctive lacosamide for the treatment of uncontrolled primary generalized tonic-clonic seizures in patients (16-65 years) with primary generalized (genetic) epilepsy (PGE). An open-label pilot safety study (SP0961; NCT01118949), comprising 12 weeks' historical baseline, 4 weeks' prospective baseline, 3 weeks' titration (target: 400mg/day adjunctive lacosamide) and 6 weeks' maintenance. Patients who continued to the extension study (SP0962; NCT01118962) then received ≤59 weeks of flexible treatment (100-800mg/day lacosamide with flexible dosing of concomitant antiepileptic drugs). The primary outcomes for SP0961 were the mean change (±standard deviation) in absence seizure or myoclonic seizure days per 28days from prospective baseline to maintenance; for SP0962, the incidence of treatment-emergent adverse events (TEAEs) and withdrawals because of TEAEs. Of the 49 patients who enrolled, 40 (82%) completed the pilot study and 9 discontinued (5 because of adverse events). Of the 39 patients who continued to the extension study, 10 discontinued (2 owing to TEAEs) and 29 (74%) completed the study. During the pilot study, patients reported a reduction in mean (±standard deviation) absence and myoclonic seizure days per 28days (-0.37±4.80, -2.19±5.80). Reductions were also observed during the extension study (-2.38±5.54, -2.78±6.43). Five patients in SP0961 and 2 patients in SP0962 experienced TEAEs of new or increased frequency of absence seizures or myoclonic seizures. The most common TEAEs during SP0961 were dizziness (39%) and nausea (27%), and during SP0962 were dizziness (26%) and upper respiratory tract infection (26%). The safety profile of adjunctive lacosamide was similar to that previously published. Adjunctive lacosamide did not systematically worsen absence or myoclonic seizures, and appears to be well tolerated in patients with PGE. Copyright © 2016. Published by Elsevier B.V.

Early and Long-term Outcome after Open Surgical Suprarenal Aortic Fenestration in Patients with Complicated Acute Type B Aortic Dissection.

PubMed

Szeberin, Z; Dósa, E; Fehérvári, M; Csobay-Novák, C; Pintér, N; Entz, L

2015-07-01

The purpose of this retrospective cohort study was to determine the early and long-term mortality and morbidity as well as to reveal risk factors influencing the long-term prognosis in patients with complicated acute type B aortic dissection (CABAD) undergoing open surgical suprarenal aortic fenestration (OSSAF). Fifty-two patients with CABAD, defined as (impending) rupture, acute enlargement of the false lumen, malperfusion, and/or unrelenting back pain or uncontrollable hypertension despite maximum medical therapy were treated with by surgical repair between 2002 and 2008. Ten patients with (impending) rupture had aortic graft replacement, while 42 (33 men, mean age 55 ± 11 years) had OSSAF. Follow up visits were scheduled at 1, 3-6 and 12 months after the surgery and annually thereafter. Clinical examination and computed tomography angiography findings were investigated at baseline and at subsequent visits. The indications for OSSAF were acute enlargement of the false lumen in four (10%), malperfusion in 17 (40%) (11 lower extremity [26%], 6 visceral [14%]), and unrelenting back pain or uncontrollable hypertension in 21 cases (50%). The 30 day mortality was 21.4% (2 multiple organ failure, 2 heart failure, 3 pneumonia, 1 intestinal necrosis, 1 major hemorrhage). The mean follow up was 84 ± 40 months. The 5 year survival was 70.6%. Eight patients (19%) died during the follow up period (6 aortic ruptures, 2 myocardial infarctions). None of the patients became paraplegic after the surgery. Further surgery or stenting was indicated in nine cases (21%). OSSAF has been performed with an acceptable early mortality and low paraplegia rate, but late mortality is frequently related to aortic rupture. Stentgraft coverage of the primary entry tear decreases late aortic related deaths, but suprarenal fenestration remains an option for cases not suitable for endovascular techniques. Copyright © 2015 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Self-management Experiences of Older Korean Women With Urinary Incontinence: A Descriptive Qualitative Study Using Focus Groups.

PubMed

Park, Sunah; Yeoum, SoonGyo; Kim, Yoonjung; Kwon, Hye Jin

The purpose of this study was to explore the self-management experiences of Korean women with urinary incontinence (UI). Descriptive, qualitative study using focus groups. Twenty-two community-dwelling women, 65 years and older, participated in 3 focus-group interviews. Participants were recruited from 2 elderly halls and 1 senior welfare center in South Korea. Three focus group interviews comprising 6 to 8 individuals were conducted in a quiet venue at the elderly hall or senior welfare center. Two investigators performed the interviews; one acted as moderator and one as notetaker; interviews began with scripted open-ended questions. All interviews were electronically recorded and transcribed verbatim. Using an inductive thematic approach, data were first analyzed by the first and second authors; and all 4 authors contributed to coding and agreed on final themes. Korean women perceived UI as a loss of dignity, an odor problem, an uncontrollable disease, and a life impairment. Thematic analysis revealed 4 themes regarding the self-management experience of UI: preserving self-respect in the sociocultural environment, deodorizing the smell, keeping the secret of uncontrollability, and adjusting to an impaired life. Women in this study used various daily-living strategies to manage UI, but they mainly implemented strategies to keep UI a secret, including restrictions in activities of daily living. Educational approaches are needed to inform women with UI about more effective management skills.

Are personality traits associated with white-coat and masked hypertension?

PubMed

Terracciano, Antonio; Scuteri, Angelo; Strait, James; Sutin, Angelina R; Meirelles, Osorio; Marongiu, Michele; Orru, Marco; Pilia, Maria Grazia; Ferrucci, Luigi; Cucca, Francesco; Schlessinger, David; Lakatta, Edward

2014-10-01

Anxiety and other psychological dispositions are thought to be associated with blood pressure. This study tests whether personality traits have long-term associations with masked and white-coat effects. A community-based sample of 2838 adults from Sardinia (Italy) completed the Revised NEO Personality Inventory, and 7 years later, blood pressure was assessed in the clinic and with ambulatory monitoring. Logistic regressions were used to test whether anxiety, neuroticism, extraversion, openness, agreeableness, and conscientiousness predicted the white-coat and masked hypertension phenomena. Age, sex, and antihypertensive medication use were tested as moderators. Significant interactions were found between personality traits and antihypertensive medications in predicting masked and white-coat effects. Only among those taking antihypertensive medication, higher anxiety was associated with a higher risk of pseudo-resistant hypertension due to white-coat effect (odds ratio 1.39, 95% confidence interval 1.01-1.91) and higher conscientiousness was associated with a lower risk of masked uncontrolled hypertension (odds ratio 0.70, 95% confidence interval 0.49-0.99). There were no significant interactions with age or sex. Among those on antihypertensive medications, anxious individuals were more likely to have pseudo-resistant hypertension due to white-coat effect and less conscientious individuals were at increased risk of masked uncontrolled hypertension. Particularly among anxious and less conscientious individuals, ambulatory monitoring may improve the tailoring of pharmacological treatments.

Uncontrolled Donation After Circulatory Determination of Death Donors (uDCDDs) as a Source of Lungs for Transplant.

PubMed

Egan, T M; Requard, J J

2015-08-01

In April 2014, the American Journal of Transplantation published a report on the first lung transplant in the United States recovered from an uncontrolled donation after circulatory determination of death donor (uDCDD), assessed by ex vivo lung perfusion (EVLP). The article identified logistical and ethical issues related to introduction of lung transplant from uDCDDs. In an open clinical trial, we have Food and Drug Administration and Institutional Review Board approval to transplant lungs recovered from uDCDDs judged suitable after EVLP. Through this project and other experiences with lung recovery from uDCDDs, we have identified solutions to many logistical challenges and have addressed ethical issues surrounding lung transplant from uDCDDs that were mentioned in this case report. Here, we discuss those challenges, including issues related to recovery of other solid organs from uDCDDs. Despite logistical challenges, uDCDDs could solve the critical shortage of lungs for transplant. Furthermore, by avoiding the deleterious impact of brain death and days of positive pressure ventilation, and by using opportunities to treat lungs in the decedent or during EVLP, lungs recovered from uDCDDs may ultimately prove to be better than lungs currently being transplanted from conventional brain-dead organ donors. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

Usage Trends of Open Access and Local Journals: A Korean Case Study.

PubMed

Seo, Jeong-Wook; Chung, Hosik; Yun, Jungmin; Park, Jin Young; Park, Eunsun; Ahn, Yuri

2016-01-01

Articles from open access and local journals are important resources for research in Korea and the usage trends of these articles are important indicators for the assessment of the current research practice. We analyzed an institutional collection of published papers from 1998 to 2014 authored by researchers from Seoul National University, and their references from papers published between 1998 and 2011. The published papers were collected from Web of Science or Scopus and were analyzed according to the proportion of articles from open access journals. Their cited references from published papers in Web of Science were analyzed according to the proportion of local (South Korean) or open access journals. The proportion of open access papers was relatively stable until 2006 (2.5 ~ 5.2% in Web of Science and 2.7 ~ 4.2% in Scopus), but then increased to 15.9% (Web of Science) or 18.5% (Scopus) in 2014. We analyzed 2,750,485 cited references from 52,295 published papers. We found that the overall proportion of cited articles from local journals was 1.8% and that for open access journals was 3.0%. Citations of open access articles have increased since 2006 to 4.1% in 2011, although the increase in open access article citations was less than for open access publications. The proportion of citations from local journals was even lower. We think that the publishing / citing mismatch is a term to describe this difference, which is an issue at Seoul National University, where the number of published papers at open access or local journals is increasing but the number of citations is not. The cause of this discrepancy is multi-factorial but the governmental / institutional policies, social / cultural issues and authors' citing behaviors will explain the mismatch. However, additional measures are also necessary, such as the development of an institutional citation database and improved search capabilities with respect to local and open access documents.

Usage Trends of Open Access and Local Journals: A Korean Case Study

PubMed Central

Chung, Hosik; Yun, Jungmin; Park, Jin Young; Park, Eunsun; Ahn, Yuri

2016-01-01

Articles from open access and local journals are important resources for research in Korea and the usage trends of these articles are important indicators for the assessment of the current research practice. We analyzed an institutional collection of published papers from 1998 to 2014 authored by researchers from Seoul National University, and their references from papers published between 1998 and 2011. The published papers were collected from Web of Science or Scopus and were analyzed according to the proportion of articles from open access journals. Their cited references from published papers in Web of Science were analyzed according to the proportion of local (South Korean) or open access journals. The proportion of open access papers was relatively stable until 2006 (2.5 ~ 5.2% in Web of Science and 2.7 ~ 4.2% in Scopus), but then increased to 15.9% (Web of Science) or 18.5% (Scopus) in 2014. We analyzed 2,750,485 cited references from 52,295 published papers. We found that the overall proportion of cited articles from local journals was 1.8% and that for open access journals was 3.0%. Citations of open access articles have increased since 2006 to 4.1% in 2011, although the increase in open access article citations was less than for open access publications. The proportion of citations from local journals was even lower. We think that the publishing / citing mismatch is a term to describe this difference, which is an issue at Seoul National University, where the number of published papers at open access or local journals is increasing but the number of citations is not. The cause of this discrepancy is multi-factorial but the governmental / institutional policies, social / cultural issues and authors' citing behaviors will explain the mismatch. However, additional measures are also necessary, such as the development of an institutional citation database and improved search capabilities with respect to local and open access documents. PMID:27195948

The Role of Neuropeptide Y (NPY) in Uncontrolled Alcohol Drinking and Relapse Behavior Resulting from Exposure to Stressful Events

DTIC Science & Technology

2011-01-01

effects of stressors on excessive and uncontrolled drinking and relapse-like drinking. We proposed to use foot-shock as the stressor to elicit increase...did significantly increase deprivation-induced relapse-like drinking, and that this effect was more robust in mutant mice lacking the NPY Y1R. Thus...ethanol consumption using a models of excessive uncontrolled drinking, and mutant mice lacking NPY or the Y1R were more sensitive to the effects of

Attitude control concepts for precision-pointing nonrigid spacecraft

NASA Technical Reports Server (NTRS)

Likins, P. W.

1974-01-01

Literal criteria are developed for the controllability and observability of general models of flexible spacecraft. Results are interpreted in special cases and in physical terms, permitting in some cases the identification of uncontrollable and unobservable states simply by examination of scalars composed of modal parameters and location matrices for sensors and actuators. A procedure is established for isolation of uncontrollable states, whereby sensor and actuator configurations assure that uncontrollable flexible mode states are also unobservable; in many applications such states can then be removed by coordinate truncation.

Nodular hidradenocarcinoma on the scalp of a young woman: case report and review of literature.

PubMed

Ohta, Masayoshi; Hiramoto, Michiaki; Fujii, Miki; Togo, Takeshi

2004-09-01

Nodular hidradenocarcinoma was first reported as clear-cell eccrine carcinoma by Keasby and Hadley in 1954 (Cancer 1954;7:934-52) and rare malignant tumor. Several synonyms and related terms for nodular hidradenocarcinoma have appeared in the literature. They have potential for uncontrollable local recurrence, tend to metastasize, and often cause death. Most cases have been reported in the pathology literature with limited clinical information. We report a 27-year-old woman with nodular hidradenocarcinoma on the scalp. The management of rare cases is not well defined. In our case, she was only treated with a wide local excision, and no recurrence was observed 2 years after excision. Most authors have concluded that early wide surgical excision of the tumor is the treatment of choice. The efficiency of adjuvant therapy generally has not established.

Burden of uncontrolled epilepsy in patients requiring an emergency room visit or hospitalization.

PubMed

Manjunath, Ranjani; Paradis, Pierre Emmanuel; Parisé, Hélène; Lafeuille, Marie-Hélène; Bowers, Brian; Duh, Mei Sheng; Lefebvre, Patrick; Faught, Edward

2012-10-30

To quantify the clinical and economic burden of uncontrolled epilepsy in patients requiring emergency department (ED) visit or hospitalization. Health insurance claims from a 5-state Medicaid database (1997Q1-2009Q2) and 55 self-insured US companies ("employer," 1999Q1 and 2008Q4) were analyzed. Adult patients with epilepsy receiving antiepileptic drugs (AED) were selected. Using a retrospective matched-cohort design, patients were categorized into cohorts of "uncontrolled" (≥ 2 changes in AED therapy, then ≥ 1 epilepsy-related ED visit/hospitalization within 1 year) and "well-controlled" (no AED change, no epilepsy-related ED visit/hospitalization) epilepsy. Matched cohorts were compared for health care resource utilization and costs using multivariate conditional regression models and nonparametric methods. From 110,312 (Medicaid) and 36,529 (employer) eligible patients, 3,454 and 602 with uncontrolled epilepsy were matched 1:1 to patients with well-controlled epilepsy, respectively. In both populations, uncontrolled epilepsy cohorts presented about 2 times more fractures and head injuries (all p values < 0.0001) and higher health care resource utilization (ranges of adjusted incidence rate ratios [IRRs] [all-cause utilization]: AEDs = 1.8-1.9, non-AEDs = 1.3-1.5, hospitalizations = 5.4-6.7, length of hospital stays = 7.3-7.7, ED visits = 3.7-5.0, outpatient visits = 1.4-1.7, neurologist visits = 2.3-3.1; all p values < 0.0001) than well-controlled groups. Total direct health care costs were higher in patients with uncontrolled epilepsy (adjusted cost difference [95% confidence interval (CI)] Medicaid = $12,258 [$10,482-$14,083]; employer = $14,582 [$12,019-$17,097]) vs well-controlled patients. Privately insured employees with uncontrolled epilepsy lost 2.5 times more work days, with associated indirect costs of $2,857 (95% CI $1,042-$4,581). Uncontrolled epilepsy in patients requiring ED visit or hospitalization was associated with significantly greater health care resource utilization and increased direct and indirect costs compared to well-controlled epilepsy in both publicly and privately insured settings.

Perceptions of diabetes control among people with type 2 diabetes treated with basal insulin in Sweden, Switzerland, and the United Kingdom.

PubMed

Brod, Meryl; Pfeiffer, Kathryn M; Barnett, Anthony H; Berntorp, Kerstin; Vilsbøll, Tina; Weissenberger, Benno

2016-07-11

To investigate perceptions of control among people with uncontrolled and well controlled type 2 diabetes (T2D) treated with basal insulin, as well as differences in perceptions and diabetes management practices between the two groups. Web surveys of 1012 people with uncontrolled T2D (HbA 1c >8.0% or 64 mmol/mol) on basal insulin in Sweden, Switzerland, and the UK and 295 people with well controlled T2D (HbA 1c <7.5% or 58 mmol/mol) on basal insulin in the UK were conducted. People with uncontrolled T2D perceived a wide range of factors as very/extremely important for deciding whether they are well controlled, including diet (80.7%), HbA 1c value (78.9%), times per day insulin taken (78.8%), insulin units taken per day (77.6%), and energy levels (74.5%). Fifty-one percent of uncontrolled respondents considered the past week or more recently when thinking about control. Perceived major obstacles to control included stress (75.4%), other health issues (70.8%), medicine side effects (69.9%), food cravings (69.8%), doctor not understanding individual situation (67.6%), and life crises (66.9%). Many uncontrolled respondents reported that diabetes was very/extremely interfering with their lives, including energy level (71.0%), performance at work (70.0%), general health (69.9%), and doing what one wants (69.3%). Analyses showed significant differences between well controlled and uncontrolled UK respondents. Compared to the uncontrolled, people with well controlled T2D were significantly more likely to consider the last 24 hours/current time when thinking about control (50% vs. 21%, p < 0.001) and reported greater healthcare contact related to diabetes and more frequent glucose measurement. Study limits include potential selection bias of web surveys and possible recall bias in patient-reported data. The results illuminate how people with T2D treated with basal insulin perceive control and show important differences between the well controlled and uncontrolled. Findings may have implications for improving patient and physician education and diabetes management.

Closed-loop thrust and pressure profile throttling of a nitrous oxide/hydroxyl-terminated polybutadiene hybrid rocket motor

NASA Astrophysics Data System (ADS)

Peterson, Zachary W.

Hybrid motors that employ non-toxic, non-explosive components with a liquid oxidizer and a solid hydrocarbon fuel grain have inherently safe operating characteristics. The inherent safety of hybrid rocket motors offers the potential to greatly reduce overall operating costs. Another key advantage of hybrid rocket motors is the potential for in-flight shutdown, restart, and throttle by controlling the pressure drop between the oxidizer tank and the injector. This research designed, developed, and ground tested a closed-loop throttle controller for a hybrid rocket motor using nitrous oxide and hydroxyl-terminated polybutadiene as propellants. The research simultaneously developed closed-loop throttle algorithms and lab scale motor hardware to evaluate the fidelity of the throttle simulations and algorithms. Initial open-loop motor tests were performed to better classify system parameters and to validate motor performance values. Deep-throttle open-loop tests evaluated limits of stable thrust that can be achieved on the test hardware. Open-loop tests demonstrated the ability to throttle the motor to less than 10% of maximum thrust with little reduction in effective specific impulse and acoustical stability. Following the open-loop development, closed-loop, hardware-in-the-loop tests were performed. The closed-loop controller successfully tracked prescribed step and ramp command profiles with a high degree of fidelity. Steady-state accuracy was greatly improved over uncontrolled thrust.

Targeted therapy for localized non-small-cell lung cancer: a review

PubMed Central

Paleiron, Nicolas; Bylicki, Olivier; André, Michel; Rivière, Emilie; Grassin, Frederic; Robinet, Gilles; Chouaïd, Christos

2016-01-01

Targeted therapies have markedly improved the management of patients with advanced non-small-cell lung cancer (NSCLC), but their efficacy in localized NSCLC is less well established. The aim of this review is to analyze trials of targeted therapies in localized NSCLC. In patients with wild-type EGFR, tyrosine kinase inhibitors have shown no efficacy in Phase III trials. Few data are available for EGFR-mutated localized NSCLC, as routine biological profiling is not recommended. Available studies are small, often retrospectives, and/or conducted in a single-center making it difficult to draw firm conclusions. Ongoing prospective Phase III trials are comparing adjuvant tyrosine kinase inhibitor administration versus adjuvant chemotherapy. By analogy with the indication of bevacizumab in advanced NSCLC, use of antiangiogenic agents in the perioperative setting is currently restricted to nonsquamous NSCLC. Several trials of adjuvant or neoadjuvant bevacizumab are planned or ongoing, but for the moment there is no evidence of efficacy. Data on perioperative use of biomarkers in early-stage NSCLC come mainly from small, retrospective, uncontrolled studies. Assessment of customized adjuvant or neoadjuvant therapy in localized NSCLC (with or without oncogenic driver mutations) is a major challenge. PMID:27462164

Effectiveness of dust control methods for crystalline silica and respirable suspended particulate matter exposure during manual concrete surface grinding.

PubMed

Akbar-Khanzadeh, Farhang; Milz, Sheryl A; Wagner, Cynthia D; Bisesi, Michael S; Ames, April L; Khuder, Sadik; Susi, Pam; Akbar-Khanzadeh, Mahboubeh

2010-12-01

Concrete grinding exposes workers to unacceptable levels of crystalline silica dust, known to cause diseases such as silicosis and possibly lung cancer. This study examined the influence of major factors of exposure and effectiveness of existing dust control methods by simulating field concrete grinding in an enclosed workplace laboratory. Air was monitored during 201 concrete grinding sessions while using a variety of grinders, accessories, and existing dust control methods, including general ventilation (GV), local exhaust ventilation (LEV), and wet grinding. Task-specific geometric mean (GM) of respirable crystalline silica dust concentrations (mg/m³ for LEV:HEPA-, LEV:Shop-vac-, wet-, and uncontrolled-grinding, while GV was off/on, were 0.17/0.09, 0.57/0.13, 1.11/0.44, and 23.1/6.80, respectively. Silica dust concentrations (mg/m³ using 100-125 mm (4-5 inch) and 180 mm (7 inch) grinding cups were 0.53/0.22 and 2.43/0.56, respectively. GM concentrations of silica dust were significantly lower for (1) GV on (66.0%) vs. off, and (2) LEV:HEPA- (99.0%), LEV:Shop-vac- (98.1%) or wet- (94.4%) vs. uncontrolled-grinding. Task-specific GM of respirable suspended particulate matter (RSP) concentrations (mg/m³ for LEV:HEPA-, LEV:Shop-vac-, wet-, and uncontrolled grinding, while GV was off/on, were 1.58/0.63, 7.20/1.15, 9.52/4.13, and 152/47.8, respectively. GM concentrations of RSP using 100-125 mm and 180 mm grinding cups were 4.78/1.62 and 22.2/5.06, respectively. GM concentrations of RSP were significantly lower for (1) GV on (70.2%) vs. off, and (2) LEV:HEPA- (98.9%), LEV:Shop-vac- (96.9%) or wet- (92.6%) vs. uncontrolled grinding. Silica dust and RSP were not significantly affected by (1) orientation of grinding surfaces (vertical vs. inclined); (2) water flow rates for wet grinding; (3) length of task-specific sampling time; or, (4) among cup sizes of 100, 115 or 125 mm. No combination of factors or control methods reduced an 8-hr exposure level to below the recommended criterion of 0.025 mg/m³ for crystalline silica, requiring further refinement in engineering controls, administrative controls, or the use of respirators.

Pilot preference and procedures at uncontrolled airports

NASA Technical Reports Server (NTRS)

Parker, L. C.

1975-01-01

The report presents the results of a pilot questionnaire utilized at the 1974 Reading, Pennsylvania Air Show to obtain data on pilot procedures and preference in the terminal airspace of uncontrolled airports.

Effects of user training with electronically-modulated sound transmission hearing protectors and the open ear on horizontal localization ability.

PubMed

Casali, John G; Robinette, Martin B

2015-02-01

To determine if training with electronically-modulated hearing protection (EMHP) and the open ear results in auditory learning on a horizontal localization task. Baseline localization testing was conducted in three listening conditions (open-ear, in-the-ear (ITE) EMHP, and over-the-ear (OTE) EMHP). Participants then wore either an ITE or OTE EMHP for 12, almost daily, one-hour training sessions. After training was complete, participants again underwent localization testing in all three listening conditions. A computer with a custom software and hardware interface presented localization sounds and collected participant responses. Twelve participants were recruited from the student population at Virginia Tech. Audiometric requirements were 35 dBHL at 500, 1000, and 2000 Hz bilaterally, and 55 dBHL at 4000 Hz in at least one ear. Pre-training localization performance with an ITE or OTE EMHP was worse than open-ear performance. After training with any given listening condition, including open-ear, performance in that listening condition improved, in part from a practice effect. However, post-training localization performance showed near equal performance between the open-ear and training EMHP. Auditory learning occurred for the training EMHP, but not for the non-training EMHP; that is, there was no significant training crossover effect between the ITE and the OTE devices. It is evident from this study that auditory learning (improved horizontal localization performance) occurred with the EMHP for which training was performed. However, performance improvements found with the training EMHP were not realized in the non-training EMHP. Furthermore, localization performance in the open-ear condition also benefitted from training on the task.

Laboratory-induced learned helplessness attenuates approach motivation as indexed by posterior versus frontal theta activity.

PubMed

Reznik, Samantha J; Nusslock, Robin; Pornpattananangkul, Narun; Abramson, Lyn Y; Coan, James A; Harmon-Jones, Eddie

2017-08-01

Research suggests that midline posterior versus frontal electroencephalographic (EEG) theta activity (PFTA) may reflect a novel neurophysiological index of approach motivation. Elevated PFTA has been associated with approach-related tendencies both at rest and during laboratory tasks designed to enhance approach motivation. PFTA is sensitive to changes in dopamine signaling within the fronto-striatal neural circuit, which is centrally involved in approach motivation, reward processing, and goal-directed behavior. To date, however, no studies have examined PFTA during a laboratory task designed to reduce approach motivation or goal-directed behavior. Considerable animal and human research supports the hypothesis put forth by the learned helplessness theory that exposure to uncontrollable aversive stimuli decreases approach motivation by inducing a state of perceived uncontrollability. Accordingly, the present study examined the effect of perceived uncontrollability (i.e., learned helplessness) on PFTA. EEG data were collected from 74 participants (mean age = 19.21 years; 40 females) exposed to either Controllable (n = 26) or Uncontrollable (n = 25) aversive noise bursts, or a No-Noise Condition (n = 23). In line with prediction, individuals exposed to uncontrollable aversive noise bursts displayed a significant decrease in PFTA, reflecting reduced approach motivation, relative to both individuals exposed to controllable noise bursts or the No-Noise Condition. There was no relationship between perceived uncontrollability and frontal EEG alpha asymmetry, another commonly used neurophysiological index of approach motivation. Results have implications for understanding the neurophysiology of approach motivation and establishing PFTA as a neurophysiological index of approach-related tendencies.

Helplessness and perceived pain intensity: relations to cortisol concentrations after electrocutaneous stimulation in healthy young men

PubMed Central

2011-01-01

Background Uncontrollable aversive events are associated with feelings of helplessness and cortisol elevation and are suitable as a model of depression. The high comorbidity of depression and pain symptoms and the importance of controllability in both conditions are clinically well-known but empirical studies are scarce. The study investigated the relationship of pain experience, helplessness, and cortisol secretion after controllable vs. uncontrollable electric skin stimulation in healthy male individuals. Methods Sixty-four male volunteers were randomly assigned to receive 30 controllable (self-administered) or uncontrollable (experimenter-administered) painful electric skin stimuli. Perceived pain intensity (PPI), subjective helplessness ratings, and salivary cortisol concentrations were assessed. PPI was assessed after stress exposure. For salivary cortisol concentrations and subjective helplessness ratings, areas under the response curve (AUC) were calculated. Results After uncontrollable vs. controllable stress exposure significantly higher PPI ratings (P = 0.023), higher subjective helplessness AUC (P < 0.0005) and higher salivary cortisol AUC (P = 0.004, t-tests) were found. Correlation analyses revealed a significant correlation between subjective helplessness AUC and PPI (r = 0.500, P < 0.0005), subjective helplessness AUC and salivary cortisol AUC (r = 0.304, P = 0.015) and between PPI and salivary cortisol AUC (r = 0.298, P = 0.017). Conclusions The results confirm the impact of uncontrollability on stress responses in humans; the relationship of PPI with subjective helplessness and salivary cortisol suggests a cognitive-affective sensitization of pain perception, particularly under uncontrollable conditions. PMID:21718526

Sportsmen's Groin-Diagnostic Approach and Treatment With the Minimal Repair Technique: A Single-Center Uncontrolled Clinical Review.

PubMed

Muschaweck, Ulrike; Berger, Luise Masami

2010-05-01

Sportsmen's groin, also called sports hernia and Gilmore groin, is one of the most frequent sports injuries in athletes and may place an athletic career at risk. It presents with acute or chronic groin pain exacerbated with physical activity. So far, there is little consensus regarding pathogenesis, diagnostic criteria, or treatment. There have been various attempts to explain the cause of the groin pain. The assumption is that a circumscribed weakness in the posterior wall of the inguinal canal, which leads to a localized bulge, induces a compression of the genital branch of the genitofemoral nerve, considered responsible for the symptoms. The authors developed an innovative open suture repair-the Minimal Repair technique-to fit the needs of professional athletes. With this technique, the circumscribed weakness of the posterior wall of the inguinal canal is repaired by an elastic suture; the compression on the nerve is abolished, and the cause of the pain is removed. In contrast with that of common open suture repairs, the defect of the posterior wall is not enlarged, the suture is nearly tension free, and the patient can return to full training and athletic activity within a shorter time. The outcome of patients undergoing operations with the Minimal Repair technique was compared with that of commonly used surgical procedures. THE FOLLOWING ADVANTAGES OF THE MINIMAL REPAIR TECHNIQUE WERE FOUND: no insertion of prosthetic mesh, no general anesthesia required, less traumatization, and lower risk of severe complications with equal or even faster convalescence. In 2009, a prospective cohort of 129 patients resumed training in 7 days and experienced complete pain relief in an average of 14 days. Professional athletes (67%) returned to full activity in 14 days (median). The Minimal Repair technique is an effective and safe way to treat sportsmen's groin.

Extensive rill erosion and gullying on abandoned pit mining sites in Lusatia, Germany

NASA Astrophysics Data System (ADS)

Kunth, Franziska; Kaiser, Andreas; Vláčilová, Markéta; Schindewolf, Marcus; Schmidt, Jürgen

2015-04-01

As the major economic driver in the province of Lusatia, Eastern Germany, the large open-cast lignite mining sites characterize the landscape and leave vast areas of irreversible changed post-mining landscapes behind. Cost-intensive renaturation projects have been implemented in order to restructure former mine sites into stabile self-sustaining ecosystems and local recreation areas. With considerable expenditure the pits are stabilized, flooded and surrounding areas are restructured. Nevertheless, heavy soil erosion, extensive gullying and slope instability are challenges for the restructuring and renaturation of the abandoned open-cast mining sites. The majority of the sites remain inaccessible to the public due to instable conditions resulting in uncontrolled slides and large gullies. In this study a combined approach of UAV-based aerial imagery, 3D multi-vision surface reconstruction and physically-based soil erosion modelling is carried out in order to document, quantify and better understand the causes of erosion processes on mining sites. Rainfall simulations have been carried out in lausatian post mining areas to reproduce soil detachment processes and observe the responsible mechanisms for the considerable erosion rates. Water repellency and soil sealing by biological crusts were hindering infiltration and consequently increasing runoff rates despite the mainly sandy soil texture. On non-vegetated experimental plots runoff coefficients up to 87 % were measured. In a modelling routine for a major gully catchment regarding a 50 years rainfall event, simulation results reveal runoff coefficients of up to 84% and erosion rates of 118 Mg*ha^-1. At the sediment pass over point 450Mg of sediments enter the surface water bodies. A system response of this order of magnitude were unexpected by the authorities. By applying 3D multi-vision surface reconstruction a model validation is now possible and further may illustrate the great importance of soil conservation measures under the described conditions.

Mice subjected to uncontrollable electric shocks show depression-like behaviors irrespective of their state of helplessness.

PubMed

Kim, Jin Yong; Yang, Soo Hyun; Kwon, Jihyun; Lee, Hyun Woo; Kim, Hyun

2017-03-30

The unpredictable and inescapable electric shock-induced "learned helplessness" paradigm has long been used to produce an animal model of depression to identify the molecules associated with depressive symptoms or to assess the efficacy of pharmacological treatments for depression. After exposure to unpredictable and inescapable shocks (uncontrollable stress), most of mice showed defect in escape behavior in active avoidance test (learned helplessness, LH), while others did not (non-learned helplessness, NLH). Here, we investigated whether mice with LH or NLH exhibited depressive symptoms, including anhedonia, anxiety, and despair. We found that compared with control naïve mice, both uncontrollable shocks-induced LH and NLH mice showed increased anhedonia- and anxiety- but not despair-like behaviors. Notably, mice subjected to uncontrollable shocks showed similar behaviors, irrespective of whether they also showed LH or NLH. Furthermore, since both LH and NLH mice showed only anhedonia- and anxiety- but not despair-like behaviors, this model may be generally inadequate for classic depression-like behavior assessment. In conclusion, uncontrollable electric shock induces depression-like behavior, irrespective of the state of helplessness. Copyright © 2017 Elsevier B.V. All rights reserved.

[Ionizing and non-ionizing radiation (comparative risk estimations)].

PubMed

Grigor'ev, Iu G

2012-01-01

The population has widely used mobile communication for already more than 15 years. It is important to note that the use of mobile communication has sharply changed the conditions of daily exposure of the population to EME We expose our brain daily for the first time in the entire civilization. The mobile phone is an open and uncontrollable source of electromagnetic radiation. The comparative risk estimation for the population of ionizing and non-ionizing radiation was carried out taking into account the real conditions of influence. Comparison of risks for the population of ionizing and non-ionizing radiation leads us to a conclusion that EMF RF exposure in conditions of wide use of mobile communication is potentially more harmful than ionizing radiation influence.

[Antihypertensive Efficacy of Fixed Combination Azilsartan Medoxomil / Chlorthalidone in Patients With Uncontrolled Arterial Hypertension].

PubMed

Kobalava, Z D; Villevalde, S V; Kulakov, V V

2017-11-01

To study effects of a fixed azilsartan medoxomil/chlorthalidone combination (Edarbi Clo) on clinical, ambulatory and central blood pressure (BP) in patients with uncontrolled arterial hypertension (AH)). Patients (n=25) with uncontrolled AH were given fixed azilsartan medoxomil/chlorthalidone combination (40 / 12.5 mg / day) for 4 weeks. After 4 weeks, in patients who did not achieve target BP levels the dose was increased up to 40 / 25 mg / day. Duration of the study was 12 weeks. After 12 weeks of treatment 88 % of patients achieved target clinical BP (.

Uncontrolled asthma: assessing quality of life and productivity of children and their caregivers using a cross-sectional Internet-based survey.

PubMed

Dean, Bonnie B; Calimlim, Brian C; Sacco, Patricia; Aguilar, Daniel; Maykut, Robert; Tinkelman, David

2010-09-08

Results of a national survey of asthmatic children that evaluated management goals established in 2004 by the National Asthma Education and Prevention Program (NAEPP) indicated that asthma symptom control fell short on nearly every goal. An Internet-based survey was administered to adult caregivers of children aged 6-12 years with moderate to severe asthma. Asthma was categorized as uncontrolled when the caregiver reported pre-specified criteria for daytime symptoms, nighttime awakening, activity limitation, or rescue medication based on the NAEPP guidelines. Children's health-related quality of life (HRQOL) and caregivers' quality of life (QOL) were assessed using the Child Health Questionnaire Parent Form 28 (CHQ-PF28) and caregiver's work productivity using a modified Work Productivity and Activity Impairment Questionnaire. Children with uncontrolled vs. controlled asthma were compared. 360 caregivers of children with uncontrolled asthma and 113 of children with controlled asthma completed the survey. Children with uncontrolled asthma had significantly lower CHQ-PF28 physical (mean 38.1 vs 49.8, uncontrolled vs controlled, respectively) and psychosocial (48.2 vs 53.8) summary measure scores. They were more likely to miss school (5.5 vs 2.2 days), arrive late or leave early (26.7 vs 7.1%), miss school-related activities (40.6 vs 6.2%), use a rescue inhaler at school (64.2 vs 31.0%), and visit the health office or school nurse (22.5 vs 8.8%). Caregivers of children with uncontrolled asthma reported significantly greater work and activity impairment and lower QOL for emotional, time-related and family activities. Poorly controlled asthma symptoms impair HRQOL of children, QOL of their caregivers, and productivity of both. Proper treatment and management to improve symptom control may reduce humanistic and economic burdens on asthmatic children and their caregivers.

EMISSIONS OF PCDD/F FROM UNCONTROLLED, DOMESTIC WASTE BURNING

EPA Science Inventory

Emissions of polychlorinated bibenzodioxin and dibenzofuran (PCDD/F) result from inefficiencies of combustion processes, most typically waste combustion. Uncontrolled combustion, such as occurs during so-called "backyard burning" of domestic waste, may therefore produce optimal ...

Young-age gender differences in mathematics mediated by independent control or uncontrollability.

PubMed

Zirk-Sadowski, Jan; Lamptey, Charlotte; Devine, Amy; Haggard, Mark; Szűcs, Dénes

2014-05-01

We studied whether the origins of math anxiety can be related to a biologically supported framework of stress induction: (un)controllability perception, here indicated by self-reported independent efforts in mathematics. Math anxiety was tested in 182 children (8- to 11-year-olds). Latent factor modeling was used to test hypotheses on plausible causal processes and mediations within competing models in quasi-experimental contrasts. Uncontrollability perception in mathematics, or (in)dependence of efforts, best fit the data as an antecedent of math anxiety. In addition, the relationship of math anxiety with gender was fully mediated by adaptive perception of control (i.e. controllability). That is, young boys differ from girls in terms of their experience of control in mathematics learning. These differences influence math anxiety. Our findings are consistent with recent suggestions in clinical literature according to which uncontrollability makes women more susceptible to fear and anxiety disorders. © 2014 John Wiley & Sons Ltd.

Topical Botanical Agents for the Treatment of Psoriasis: A Systematic Review.

PubMed

Farahnik, Benjamin; Sharma, Divya; Alban, Joseph; Sivamani, Raja K

2017-08-01

Patients with psoriasis often enquire about the use of numerous botanical therapeutics. It is important for dermatologists to be aware of the current evidence regarding these agents. We conducted a systematic literature search using the PubMed, MEDLINE, and EMBASE databases for controlled and uncontrolled clinical trials that assessed the use of topical botanical therapeutics for psoriasis. The search included the following keywords: 'psoriasis' and 'plant' or 'herbal' or 'botanical'. We also reviewed citations within articles to identify additional relevant sources. We then further refined the results by route of administration and the topical botanical agents are reviewed herein. A total of 27 controlled and uncontrolled clinical trials addressing the use of topical botanical agents for psoriasis were assessed in this review. We found that the most highly studied and most efficacious topical botanical therapeutics were Mahonia aquifolium, indigo naturalis, aloe vera, and, to a lesser degree, capsaicin. The most commonly reported adverse effects were local skin irritation, erythema, pruritus, burning, and pain. However, the overall evidence for these therapeutics remains limited in quantity and quality. The literature addresses a large number of studies in regard to botanicals for the treatment of psoriasis. While most agents appear to be safe, further research is necessary before topical botanical agents can be consistently recommended to patients.

47 CFR 76.1514 - Bundling of video and local exchange services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 4 2014-10-01 2014-10-01 false Bundling of video and local exchange services... RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Open Video Systems § 76.1514 Bundling of video and local exchange services. An open video system operator may offer video and local exchange...

47 CFR 76.1514 - Bundling of video and local exchange services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 4 2013-10-01 2013-10-01 false Bundling of video and local exchange services... RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Open Video Systems § 76.1514 Bundling of video and local exchange services. An open video system operator may offer video and local exchange...

47 CFR 76.1514 - Bundling of video and local exchange services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 4 2012-10-01 2012-10-01 false Bundling of video and local exchange services... RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Open Video Systems § 76.1514 Bundling of video and local exchange services. An open video system operator may offer video and local exchange...

47 CFR 76.1514 - Bundling of video and local exchange services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 4 2010-10-01 2010-10-01 false Bundling of video and local exchange services... RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Open Video Systems § 76.1514 Bundling of video and local exchange services. An open video system operator may offer video and local exchange...

47 CFR 76.1514 - Bundling of video and local exchange services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 4 2011-10-01 2011-10-01 false Bundling of video and local exchange services... RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Open Video Systems § 76.1514 Bundling of video and local exchange services. An open video system operator may offer video and local exchange...

Localization of Open Educational Resources (OER) in Nepal: Strategies of Himalayan Knowledge-Workers

ERIC Educational Resources Information Center

Ivins, Tiffany Zenith

2011-01-01

This dissertation examines localization of Open Educational Resources (OER) in Himalayan community technology centers of Nepal. Specifically, I examine strategies and practices that local knowledge-workers utilize in order to localize educational content for the disparate needs, interests, and ability-levels of learners in rural villages. This…

Eating traits questionnaires as a continuum of a single concept. Uncontrolled eating.

PubMed

Vainik, Uku; Neseliler, Selin; Konstabel, Kenn; Fellows, Lesley K; Dagher, Alain

2015-07-01

Research on eating behaviour has identified several potentially relevant eating-related traits captured by different questionnaires. Often, these questionnaires predict Body Mass Index (BMI), but the relationship between them has not been explicitly studied. We studied the unity and diversity of questionnaires capturing five common eating-related traits: Power of Food, Eating Impulsivity, emotional eating, Disinhibition, and binge eating in women from Estonia (n = 740) and Canada (n = 456). Using bifactor analysis, we showed that a) these questionnaires are largely explained by a single factor, and b) relative to this shared factor, only some questionnaires offered additional variance in predicting BMI. Hence, these questionnaires seemed to characterise a common factor, which we label Uncontrolled Eating. Item Response Theory techniques were then applied to demonstrate that c) within this common factor, the questionnaires could be placed on a continuum of Uncontrolled Eating. That is, Eating Impulsivity focused on the milder degree, Power of Food Scale, emotional eating scales, and Disinhibition on intermediate degrees, and the Binge Eating Scale on the most severe degrees of Uncontrolled Eating. In sum, evidence from two samples showed that questionnaires capturing five common BMI-related traits largely reflected the same underlying latent trait - Uncontrolled Eating. In Estonia, some questionnaires focused on different severities of this common construct, supporting a continuum model of Uncontrolled Eating. These findings provide a starting point for developing better questionnaires of the neurobehavioural correlates of obesity, and provide a unifying perspective from which to view the existing literature. R scripts and data used for the analysis are provided. Copyright © 2015 Elsevier Ltd. All rights reserved.

Deficits in episodic memory are related to uncontrolled eating in a sample of healthy adults.

PubMed

Martin, A A; Davidson, T L; McCrory, M A

2018-05-01

Despite a substantial amount of animal data linking deficits in memory inhibition to the development of overeating and obesity, few studies have investigated the relevance of memory inhibition to uncontrolled eating in humans. Further, although memory for recent eating has been implicated as an important contributor to satiety and energy intake, the possibility that variations in episodic memory relate to individual differences in food intake control has been largely neglected. To examine these relationships, we recruited ninety-three adult subjects to attend a single lab session where we assessed body composition, dietary intake, memory performance, and eating behaviors (Three Factor Eating Questionnaire). Episodic recall and memory inhibition were assessed using a well-established measure of memory interference (Retrieval Practice Paradigm). Hierarchical regression analyses indicated that memory inhibition was largely unrelated to participants' eating behaviors; however, episodic recall was reliably predicted by restrained vs. uncontrolled eating: recall was positively associated with strategic dieting (β = 2.45, p = 0.02), avoidance of fatty foods (β = 3.41, p = 0.004), and cognitive restraint (β = 1.55, p = 0.04). In contrast, recall was negatively associated with uncontrolled eating (β = -1.15, p = 0.03) and emotional eating (β = -2.46, p = 0.04). These findings suggest that episodic memory processing is related to uncontrolled eating in humans. The possibility that deficits in episodic memory may contribute to uncontrolled eating by disrupting memory for recent eating is discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Quantifying Uncontrolled Air Emissions from Two Florida Landfills

EPA Science Inventory

Landfill gas emissions, if left uncontrolled, contribute to air toxics, climate change, trospospheric ozone, and urban smog. Measuring emissions from landfills presents unique challenges due to the large and variable source area, spatial and temporal variability of emissions, and...

Establishing procedures and guidelines for pedestrian treatments at uncontrolled locations

DOT National Transportation Integrated Search

2017-08-01

Pedestrians are the most vulnerable road users. The risks to pedestrians crossing at uncontrolled locations are much higher than at signalized intersections. There has been an increasing trend in pedestrian deaths during the past decade. Specifically...

Radiation shielding of the Fermilab 16 GeV proton driver

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

Nikolai V. Mokhov, Alexander I. Drozhdin and Oleg E. Krivosheev

2001-07-12

The radiation transport analysis in the proposed Fermi-lab 1.2 MWProton Driver (PD) [1] is fundamentally important because of the impact on machine performance, conventional facility design, maintenance operations, and related costs. The strategy adopted in the PD design is that the beam losses in the machine are localized and controlled as much as possible via the dedicated beam collimation system, with a high loss rate localized in that section and drastically lower uncontrolled beam loss rate in the rest of the lattice. Results of thorough Monte Carlo calculations of prompt and residual radiation in and around the PD components aremore » presented for realistic assumptions and geometry under normal operation and accidental conditions. This allowed one to conduct shielding design and analysis to meet regulatory requirements [2] for external shielding, hands-on maintenance and ground-water activation.« less

Understanding resistant effect of mosquito on fumigation strategy in dengue control program

NASA Astrophysics Data System (ADS)

Aldila, D.; Situngkir, N.; Nareswari, K.

2018-01-01

A mathematical model of dengue disease transmission will be introduced in this talk with involving fumigation intervention into mosquito population. Worsening effect of uncontrolled fumigation in the form of resistance of mosquito to fumigation chemicals will also be included into the model to capture the reality in the field. Deterministic approach in a 9 dimensional of ordinary differential equation will be used. Analytical result about the existence and local stability of the equilibrium points followed with the basic reproduction number will be discussed. Some numerical result will be performed for some scenario to give a better interpretation for the analytical results.

Analysis of potential hazards associated with 241Am loaded resins from nitrate media

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

Schulte, Louis D.; Rubin, Jim; Fife, Keith William

2016-02-19

LANL has been contacted to provide possible assistance in safe disposition of a number of 241Am-bearing materials associated with local industrial operations. Among the materials are ion exchange resins which have been in contact with 241Am and nitric acid, and which might have potential for exothermic reaction. The purpose of this paper is to analyze and define the resin forms and quantities to the extent possible from available data to allow better bounding of the potential reactivity hazard of the resin materials. An additional purpose is to recommend handling procedures to minimize the probability of an uncontrolled exothermic reaction.

A Worldwide Web-portal for Aquatic Mesocosm Facilities: WWW.MESOCOSM.EU

NASA Astrophysics Data System (ADS)

Berger, S. A.; Nejstgaard, J. C.

2016-02-01

Experimental mesocosms are valuable tools to fill the gap between highly controlled/replicated lab experiments and uncontrolled/non-replicated natural environments such as rivers, lakes and oceans. WWW.MESOCOSM.EU is an open web-portal for leading aquatic mesocosm facilities around the world. It was created within the FP7 EU-project MESOAQUA (A network of leading MESOcosm facilities to advance the studies of future AQUAtic ecosystems from the Arctic to the Mediterranean). The goal of the portal is to increase international knowledge about existing mesocosm facilities, including information on locations, environment, equipment, contacts, research opportunities and mesocosm-based publications. MESOCOSM.EU specifically aims to be a tool to enhance the quality of research by facilitating international cooperative network building, announcement of new research initiatives, transfer of best practice, and dissemination of knowledge, public information and press releases. As an open platform for all aquatic ecosystem scale science (marine and freshwater), MESOCOSM.EU aims to fill the lack of a centralized, coordinating virtual infrastructure for international aquatic mesocosm research, from the mountains to the ocean and from polar to tropical regions.

Assessment of groundwater contamination by landfill leachate: a case in México.

PubMed

Reyes-López, Jaime A; Ramírez-Hernández, Jorge; Lázaro-Mancilla, Octavio; Carreón-Diazconti, Concepción; Garrido, Miguel Martín-Loeches

2008-01-01

In México, uncontrolled landfills or open-dumps are regularly used as "sanitary landfills". Interactions between landfills/open-dumps and shallow unconfined aquifers have been widely documented. Therefore, evidence showing the occurrence of aquifer contamination may encourage Mexican decision makers to enforce environmental regulations. Traditional methods such as chemical analysis of groundwater, hydrological descriptions, and geophysical studies including vertical electrical sounding (VES) and ground penetrating radar (GPR) were used for the identification and delineation of a contaminant plume in a shallow aquifer. The Guadalupe Victoria landfill located in Mexicali is used as a model study site. This landfill has a shallow aquifer of approximately 1m deep and constituted by silty sandy soil that may favor the transport of landfill leachate. Geophysical studies show a landfill leachate contaminant plume that extends for 20 and 40 m from the SE and NW edges of the landfill, respectively. However, the zone of the leachate's influence stretches for approximately 80 m on both sides of the landfill. Geochemical data corroborates the effects of landfill leachate on groundwater.

Concurrent Improvement in Both Binge Eating and Depressive Symptoms with Naltrexone/Bupropion Therapy in Overweight or Obese Subjects with Major Depressive Disorder in an Open-Label, Uncontrolled Study.

PubMed

Guerdjikova, Anna I; Walsh, Brandon; Shan, Kevin; Halseth, Amy E; Dunayevich, Eduardo; McElroy, Susan L

2017-10-01

Binge eating disorder (BED) is associated with obesity and major depressive disorder (MDD). Naltrexone extended-release (ER)/bupropion ER (NB) is approved as an adjunct to diet and physical activity for chronic weight management. In a prospectively designed 24-week open-label, single-arm, single-site trial of 25 women with MDD and overweight/obesity, NB reduced weight and depressive symptoms. This post hoc analysis investigated the relationship between change in self-reported binge eating behavior (evaluated with the Binge Eating Scale [BES]) and changes in weight, control of eating, and depressive symptoms. At baseline, 91% of subjects had moderate or severe BES scores, suggesting BED. BES scores were significantly improved from week 4, and by week 24, 83% reported "little or no problem." Improvement in BES scores correlated with improvement in depressive symptoms and control of eating. NB may be effective in reducing binge eating symptoms associated with MDD and overweight/obesity. Evaluation of NB in BED appears warranted. Orexigen Therapeutics, Inc.

26 CFR 1.482-6 - Profit split method.

Code of Federal Regulations, 2012 CFR

2012-04-01

... consistency between the controlled and uncontrolled taxpayers in accounting practices that materially affect... result. Thus, for example, if differences in inventory and other cost accounting practices would... between the controlled and uncontrolled transactions increases, the relative weight accorded the analysis...

26 CFR 1.482-6 - Profit split method.

Code of Federal Regulations, 2013 CFR

2013-04-01

... consistency between the controlled and uncontrolled taxpayers in accounting practices that materially affect... result. Thus, for example, if differences in inventory and other cost accounting practices would... between the controlled and uncontrolled transactions increases, the relative weight accorded the analysis...

26 CFR 1.482-6 - Profit split method.

Code of Federal Regulations, 2014 CFR

2014-04-01

... consistency between the controlled and uncontrolled taxpayers in accounting practices that materially affect... result. Thus, for example, if differences in inventory and other cost accounting practices would... between the controlled and uncontrolled transactions increases, the relative weight accorded the analysis...

26 CFR 1.482-6 - Profit split method.

Code of Federal Regulations, 2011 CFR

2011-04-01

... consistency between the controlled and uncontrolled taxpayers in accounting practices that materially affect... result. Thus, for example, if differences in inventory and other cost accounting practices would... between the controlled and uncontrolled transactions increases, the relative weight accorded the analysis...

Schockmed Valve: A Novel Surgical Option for Uncontrolled Glaucoma in Eyes with Poor Conjunctiva and Encircling Bands.

PubMed

Fleischman, David; Kim, Bryan

2017-01-01

Surgical management of elevated intraocular pressure (IOP) in an eye with scarred conjunctiva, an encircling band, and silicone oil has limited options. By combining the flow restrictor of the Ahmed Glaucoma Valve (New World Medical, Rancho Cucamonga, California) and the capsule of the encircling band as a conduit for aqueous flow, immediate pressure reduction could theoretically be achieved in eyes with limited conjunctival mobilization. This is a description of a surgical technique in a case of a patient with multiple ocular surgeries with uncontrolled multimechanism glaucoma despite using all available topical and oral glaucoma medications. A combination of the Ahmed valve with a modification of the Schocket shunt technique was used in this case of an encircling band and poor conjunctiva. At 10-month follow-up, the patient maintains controlled pressures on dorzolamide-timolol drops. The combined Ahmed-Schocket (or Schockmed) technique may be another surgical option for management of uncontrolled IOP in cases of scarred conjunctiva and encircling bands needing immediate pressure reduction. A novel surgical option for uncontrolled glaucoma in eyes with poor conjunctiva and encircling bands. How to cite this article: Fleischman D, Kim B. Schockmed Valve: A Novel Surgical Option for Uncontrolled Glaucoma in Eyes with Poor Conjunctiva and Encircling Bands. J Curr Glaucoma Pract 2017;11(3):120-124.

Effect of acute tryptophan depletion on the response to controllable and uncontrollable noise stress.

PubMed

Richell, Rebecca A; Deakin, J F William; Anderson, Ian M

2005-02-01

Previous research provides evidence linking serotonin (5-hydroxytryptamine, 5-HT) with stress and depression. The controllable/uncontrollable (C/UC) stress paradigm aims to generate a state/condition, namely a feeling of lack of control in the context of a stressor, which might be an important factor in precipitating a negative mood state. Acute tryptophan depletion (ATD) is a technique that produces a decrease in central 5-HT levels in vivo. This study investigated the role of 5-HT in the behavioral response to a C/UC stress paradigm with ATD. Healthy adult volunteers were randomly assigned to receive either a TRP-supplemented (n = 15) or TRP-deficient (n = 13) amino acid drink. At 5 hours postdrink, volunteers were subjected to sessions of controllable and uncontrollable noise stress (100-dB white noise). Subjective ratings of mood were obtained before and after the interventions. Participants who received the tryptophan-depleting drink had greater self-report ratings of negative mood on visual analogue scales and the Profile of Mood States after the uncontrollable stress than did participants who received the balanced drink. The results suggest that 5-HT might play a role in providing resilience to uncontrollable stress. Additional studies with specific 5-HT pharmacologic probes will further clarify the results.

Associations of metabolic disorder factors with the risk of uncontrolled hypertension: a follow-up cohort in rural China.

PubMed

Xiao, Jing; Hua, Tianqi; Shen, Huan; Zhang, Min; Wang, Xiao-Jian; Gao, Yue-Xia; Lu, Qinyun; Wu, Chuanli

2017-04-07

We evaluated how metabolic disorders affected antihypertension therapy. 2,912 rural Chinese patients with hypertension who provided blood samples, demographic and clinical data at baseline and after 1 year of antihypertension therapy were evaluated. At baseline, 1,515 patients (52.0%) were already receiving drug therapy and 11.4% of them had controlled blood pressure (BP). After 1 year, all 2,912 patients were receiving antihypertension therapy that was administered by community physicians, and 59.42% of them had controlled BP. Central obesity and abnormal triglyceride, high-density lipoprotein cholesterol, and glucose were associated with 15-70% higher risks of uncontrolled hypertension. Metabolic syndrome using the JIS criteria was associated with poor BP control (odds ratio: 1.71 and 1.54 for the baseline and follow-up datasets, respectively). The risk of uncontrolled hypertension increased with the number of metabolic disorders (p for trend <0.01). The presence of ≥3 metabolic disorder factors was associated with higher risks of poor BP control. The associations of metabolic factors and uncontrolled hypertension were stronger for the standard and modified ATP III criteria, compared to the IDF and JIS criteria. Metabolic factors were associated with less effective antihypertension therapy, and all definitions of metabolic syndrome helped identify patients with elevated risks of uncontrolled hypertension.

Ab Interno Trabeculectomy With the Trabectome as a Valuable Therapeutic Option for Failed Filtering Blebs.

PubMed

Wecker, Thomas; Neuburger, Matthias; Bryniok, Laura; Bruder, Kathrin; Luebke, Jan; Anton, Alexandra; Jordan, Jens F

2016-09-01

Uncontrolled intraocular pressure (IOP) after glaucoma filtration surgery is a challenging problem in the management of glaucoma patients. The Trabectome is a device for selective electroablation of the trabecular meshwork through a clear cornea incision without affecting the conjunctiva. Minimally invasive glaucoma surgery using the Trabectome is safe and effective as primary glaucoma surgery. Here we investigate the results of ab interno trabeculectomy with the Trabectome for IOP control in patients with a failed filtering bleb. A total of 60 eyes of 60 consecutive patients with primary open-angle glaucoma (POAG) or pseudoexfoliative glaucoma (PXG) were enrolled in this single center observational study. Trabectome surgery was performed alone or in combination with phacoemulsification by 2 experienced surgeons. IOP readings and number of IOP lowering medication as primary outcome parameters were taken by an independent examiner. Intraoperative and postoperative medication were recorded systematically. Mean IOP before surgery was 24.5±3.5 mm Hg and decreased to 15.7±3.4 (-36%) after mean follow-up of 415 days. The number of necessary IOP lowering medication dropped from 2.1±1.3 to 1.8±1.2 (14% reduction from baseline). A total of 25% (n=15) of cases reported here needed additional surgery after 517 days (range: 6 to 1563 d). No major complications were observed. After mean follow-up, we found a qualified success rate for PXG of 87% and 50% for POAG as revealed by the Kaplan-Meier analysis according to the definitions for success in advanced glaucoma cases according to the World Glaucoma Association (40% reduction from baseline IOP and maximum IOP of 15 mm Hg). Trabectome surgery for uncontrolled IOP after trabeculectomy is safe and effective especially in PXG patients. Given the demanding subgroup of patients studied here, it is not surprising that success rates are lower compared with previous studies investigating the Trabectome for primary glaucoma surgery. The number of necessary IOP lowering medication drops at first, but seems to reach preoperative values after 20 months of follow-up. Trabectome surgery should be considered as a valuable escape procedure for patients with failed filtering blebs and uncontrolled IOP.

Efficacy of an amlodipine/olmesartan treatment algorithm in patients with or without type 2 diabetes and hypertension (a secondary analysis of the BP-CRUSH study).

PubMed

Nesbitt, S D; Shojaee, A; Maa, J-F; Weir, M R

2013-07-01

A prespecified subgroup analysis of an open-label, multicenter, single-arm, dose-titration study is presented. The efficacy and safety of 20-week treatment with an amlodipine (AML)/olmesartan medoxomil (OM)±hydrochlorothiazide (HCTZ) algorithm were assessed in patients with hypertension and type 2 diabetes mellitus (T2DM) who were uncontrolled by antihypertensive monotherapy. Eligible patients received AML/OM 5/20 mg for 4 weeks, followed by stepwise uptitration to AML/OM 5/40 mg, AML/OM 10/40 mg, AML/OM 10/40 mg+HCTZ 12.5 mg and AML/OM 10/40 mg+HCTZ 25 mg at 4-week intervals if blood pressure (BP) remained uncontrolled. The primary end point was the achievement of the seated cuff systolic BP (SeSBP) goal (<140 mm Hg, or <130 mm Hg for patients with T2DM) at week 12. Seated cuff BP was significantly reduced from baseline at all titration dose periods. At week 12, the cumulative SeSBP goal was achieved by 57.9% and 80.1% of patients in the T2DM and non-T2DM subgroups, respectively. Treatment was well tolerated, with low rates of peripheral edema. In summary, switching to a treatment algorithm based on AML/OM±HCTZ after failed monotherapy was safe and improved BP control in patients with hypertension and T2DM.

A first telecoupling analysis of multi-species poaching trade in Nepal: When outside demands seek and distribute a local resource in times of globalization

NASA Astrophysics Data System (ADS)

Regmi, G. R.; Lama, R. P.; Puri, G.; Huettmann, F.

2016-12-01

Asia remains one of the last wilderness resources in the world. It's widely praised for those resources and they are in a global appreciation and demand. Considering open borders, many of them virtually uncontrollable in Asia, and globalization in full swing, precious local resources become available to a global audience without much constraint though. Nepal and its unique biodiversity presents us with one of such cases while hard data remain elusive. Here we present a first telecoupling analysis based on poaching and crime statistics presented in the public print national daily newspapers (Kantipur and Gorkhapatra) in Nepal. This review highlights a few high-profile species (timber: Sal Shorea robusta , Sissoo Dalbergia sissoo, Pine Pinus species; aromatic and medicinal plants: Red Sandal Wood Santalum album, Orchid Orchid species, Paris Paris polyphylla, Jatamashi Nardostachys grandiflora, Kutki Picrorhyza scrophulariiflora and wildlife: Royal Bengal Tiger Panthera tigris tigris, Rhino Rhinoceros unicornis, Pangolin Manis species, Common Leopard Panthera pardus, Red Panda Ailurus fulgens, Snow Leopard Panthera uncia) in Nepal, traded out directly and illegally to India and China. We provide a wider perspective regarding sending, receiving and spill-over agents. Arguably, the western world as the spill-over agent set up a globalization framework that allows for items, virtually any items, to be shipped across borders, e.g. done on foot, by car or plane. It further allows to create and satisfy a demand by the receiver (=nations in wider Asia), and a system that circumvents the legal structure in the sending location (=Nepal and its biodiversity hotspots and wilderness). We extend the traditional telecoupling analysis with a flow analysis of money, remittance payments and banking networks. This research describes for the first time such a system which is by now essentially found worldwide, how it operates, what devastating impacts it leaves behind on landscapes, and how to resolve it for betterment.

Role of Hemichannels in CNS Inflammation and the Inflammasome Pathway.

PubMed

Kim, Yeri; Davidson, Joanne O; Gunn, Katherine C; Phillips, Anthony R; Green, Colin R; Gunn, Alistair J

2016-01-01

Neurodegenerative, cardiovascular, and metabolic disorders, once triggered, share a number of common features, including sustained inflammatory cell activation and vascular disruption. These shared pathways are induced independently of any genetic predisposition to the disease or the precise external stimulus. Glial cells respond to injury with an innate immune response that includes release of proinflammatory cytokines and chemokines. Vascular endothelial cells may also be affected, leading to opening of the blood-brain barrier that facilitates invasion by circulating inflammatory cells. Inflammation can trigger acute neural injury followed by chronic inflammation that plays a key role in neurodegenerative conditions. Gap junction channels normally allow direct cell-to-cell communication. They are formed by the docking of two hemichannels, one contributed by each of the neighboring cells. While the opening probability of these channels is tightly controlled under resting conditions, hemichannels can open in response to injury or inflammatory factors, forming a large, relatively nonselective membrane pore. In this review, we consider the CNS immune system from the perspective that modulating connexin hemichannel opening can prevent tissue damage arising from excessive and uncontrolled inflammation. We discuss connexin channel roles in microglia, astrocytes, and endothelial cells in both acute and chronic inflammatory conditions, and in particular describe the role of connexin hemichannels in the inflammasome pathway where they contribute to both its activation and its spread to neighboring cells. Finally, we describe the benefits of hemichannel block in animal models of brain injury. © 2016 Elsevier Inc. All rights reserved.

Dynamics of heart rate variability in patients with type 2 diabetes mellitus during spinal anaesthesia: prospective observational study.

PubMed

Lee, Su Hyun; Lee, Dong Hoon; Ha, Dong Hoon; Oh, Young Jun

2015-10-08

Little is known about the changes in autonomic function during spinal anaesthesia in type 2 diabetic patients. The purpose of the study was to assess the influence of spinal anaesthesia on the heart rate variability in type 2 diabetic patients according to the glycated hemoglobin (HbA1c) level. Sixty-six patients who were scheduled for elective orthostatic lower limb surgery were assigned to three groups (n = 22, each) according to HbA1c; controlled diabetes mellitus (HbA1c < 7 %), uncontrolled diabetes mellitus (HbA1c > 7 %) and the control group. The heart rate variability was measured 10 min before (T0), and at10 min (T1), 20 min (T2) and 30 min (T3) after spinal anaesthesia. Before spinal anaesthesia, total, low-and high-frequency power were significantly lower in the uncontrolled diabetec group than in other group (p < 0.05). During spinal anaesthesia, total, low- and high-frequency powers were did not change in the uncontrolled diabetec group while the low-frequency power in the controlled diabetec group was significantly depressed (p < 0.05). The ratio of low-to high-frequency was comparable among the groups, while it was reduced at T1-2 than at T0 in all the groups. The blood pressures were higher in the uncontrolled diabetec group than in the other groups. Spinal anaesthesia had an influence on the cardiac autonomic modulation in controlled diabetec patients, but not in uncontrolled diabetec patients. There were no differences in all haemodynamic variables during an adequate level of spinal anaesthesia in controlled and uncontrolled type 2 DM. ClinicalTrials.gov NCT02137057.

Impact of Behavioral Control on the Processing of Nociceptive Stimulation

PubMed Central

Grau, James W.; Huie, J. Russell; Garraway, Sandra M.; Hook, Michelle A.; Crown, Eric D.; Baumbauer, Kyle M.; Lee, Kuan H.; Hoy, Kevin C.; Ferguson, Adam R.

2012-01-01

How nociceptive signals are processed within the spinal cord, and whether these signals lead to behavioral signs of neuropathic pain, depends upon their relation to other events and behavior. Our work shows that these relations can have a lasting effect on spinal plasticity, inducing a form of learning that alters the effect of subsequent nociceptive stimuli. The capacity of lower spinal systems to adapt, in the absence of brain input, is examined in spinally transected rats that receive a nociceptive shock to the tibialis anterior muscle of one hind leg. If shock is delivered whenever the leg is extended (controllable stimulation), it induces an increase in flexion duration that minimizes net shock exposure. This learning is not observed in subjects that receive the same amount of shock independent of leg position (uncontrollable stimulation). These two forms of stimulation have a lasting, and divergent, effect on subsequent learning: controllable stimulation enables learning whereas uncontrollable stimulation disables it (learning deficit). Uncontrollable stimulation also enhances mechanical reactivity. We review evidence that training with controllable stimulation engages a brain-derived neurotrophic factor (BDNF)-dependent process that can both prevent and reverse the consequences of uncontrollable shock. We relate these effects to changes in BDNF protein and TrkB signaling. Controllable stimulation is also shown to counter the effects of peripheral inflammation (from intradermal capsaicin). A model is proposed that assumes nociceptive input is gated at an early sensory stage. This gate is sensitive to current environmental relations (between proprioceptive and nociceptive input), allowing stimulation to be classified as controllable or uncontrollable. We further propose that the status of this gate is affected by past experience and that a history of uncontrollable stimulation will promote the development of neuropathic pain. PMID:22934018

Asthma control in Saudi Arabia: Gender implications.

PubMed

Torchyan, Armen A

2017-05-01

Gender-related factors in asthma control should be considered in clinical consultations to substantially improve asthma control in women. Meanwhile, a limited number of studies have been reported on gender differences in factors related to asthma control, especially in Saudi Arabia. To study the potential gender differences in factors associated with asthma control among adult patients with physician-diagnosed asthma. A cross-sectional study was conducted in adult patients with asthma who attended primary care clinics at three major hospitals in Riyadh, Saudi Arabia. Asthma control was measured by using the Asthma Control Test. Asthma control status was classified as either controlled (Asthma Control Test score of >19) or uncontrolled (Asthma Control Test score of ≤19). Multiple logistic regression analysis was performed. In this study, 58.9% of men and 77.0% of women had uncontrolled asthma (p = 0.002). Factors associated with uncontrolled asthma were different between men and women, except for household income. Reporting higher levels of stress (odds ratio [OR] 4.3 [95% confidence interval {CI}, 1.7-11.1]), daily tobacco smoking (OR 5.8 [95% CI, 1.5-23.5]), and a monthly household income of <15,000 Saudi Arabian Riyals (OR 4.5 [95% CI, 1.9-10.5]) were associated with uncontrolled asthma in men. Being unemployed (OR 3.4 [95% CI, 1.3-9.4]), being obese (OR 3.2 [95% CI, 1.1-9.2]), or having a monthly household income of <15,000 Saudi Arabian Riyals (OR 3.1 [95% CI, 1.2-8.0]) were associated with uncontrolled asthma in women. This study demonstrated that many factors, such as stress, occupation, and obesity, had a differential relationship with uncontrolled asthma among men and women in Saudi Arabia that could provide more insight into methods of improving asthma control, especially in women.

APPROACHES FOR REMEDIATION OF UNCONTROLLED WOOD PRESERVING SITES

EPA Science Inventory

This document provides an overview of remediation of uncontrolled wood preserving sites. It is, in part, a distillation of discussions that took place at a Forum on Wood Preserving Waste that was held in San Francisco, California, in October 1988. Information from this workshop h...

36 CFR 228.108 - Surface use requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... authorized in an approved surface use plan of operations, protect such resources. (e) Fire prevention and control. To the extent practicable, the operator shall take measures to prevent uncontrolled fires on the area of operation and to suppress uncontrolled fires resulting from the operations. (f) Fisheries...

36 CFR 228.108 - Surface use requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... authorized in an approved surface use plan of operations, protect such resources. (e) Fire prevention and control. To the extent practicable, the operator shall take measures to prevent uncontrolled fires on the area of operation and to suppress uncontrolled fires resulting from the operations. (f) Fisheries...

36 CFR 228.108 - Surface use requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... authorized in an approved surface use plan of operations, protect such resources. (e) Fire prevention and control. To the extent practicable, the operator shall take measures to prevent uncontrolled fires on the area of operation and to suppress uncontrolled fires resulting from the operations. (f) Fisheries...

Localizing people in crosswalks with a moving handheld camera: proof of concept

NASA Astrophysics Data System (ADS)

Lalonde, Marc; Chapdelaine, Claude; Foucher, Samuel

2015-02-01

Although people or object tracking in uncontrolled environments has been acknowledged in the literature, the accurate localization of a subject with respect to a reference ground plane remains a major issue. This study describes an early prototype for the tracking and localization of pedestrians with a handheld camera. One application envisioned here is to analyze the trajectories of blind people going across long crosswalks when following different audio signals as a guide. This kind of study is generally conducted manually with an observer following a subject and logging his/her current position at regular time intervals with respect to a white grid painted on the ground. This study aims at automating the manual logging activity: with a marker attached to the subject's foot, a video of the crossing is recorded by a person following the subject, and a semi-automatic tool analyzes the video and estimates the trajectory of the marker with respect to the painted markings. Challenges include robustness to variations to lighting conditions (shadows, etc.), occlusions, and changes in camera viewpoint. Results are promising when compared to GNSS measurements.

The effects of 5% imiquimod cream on high-grade vulval intraepithelial neoplasia.

PubMed

Todd, Richard W; Etherington, Ian J; Luesley, David M

2002-04-01

The aim of this study was to investigate the effects of topical 5% Imiquimod (3M Pharmaceuticals, St. Paul, Minnessota) on high-grade vulval intraepithelial neoplasia (VIN). A prospective uncontrolled observational study was performed. Fifteen patients with histologically confirmed VIN 3 were asked to self-administer 5% Imiquimod cream to their vulval lesions up to three times weekly for 16 weeks. Review was conducted at 1, 2, 3, 4, 6, and 9 months postrecruitment. Lesions were photodocumented and at 4 months any areas demonstrating a clinical response were biopsied. Of 15 patients recruited, 4 demonstrated a clinical improvement in their disease, 3 of whom had negative biopsies posttreatment. Local side effects limited the frequency of application such that 7 patients applied the cream once weekly, 6 twice weekly, and 2 three times weekly. 5% Imiquimod cream appears to have an effect when used on high-grade VIN. The frequency of application was limited by local side effects which may have reduced the clinical responses seen. Measures to alleviate local side effects may allow more aggressive use of Imiquimod and lead to improved responses.

The influence of type 1 and type 2 diabetes on periodontal disease progression: prospective results from the Study of Health in Pomerania (SHIP).

PubMed

Demmer, Ryan T; Holtfreter, Birte; Desvarieux, Moïse; Jacobs, David R; Kerner, Wolfgang; Nauck, Matthias; Völzke, Henry; Kocher, Thomas

2012-10-01

To explore associations between diabetes etiology (type 1 diabetes mellitus [T1DM] vs. T2DM) and glycemic control in the prediction of 5-year periodontal status change. The Study of Health in Pomerania (SHIP) is a population-based stratified sample of German men and women. Healthy participants and those determined to have T2DM arose from the SHIP cohort, and T1DM participants were recruited from diabetes clinics in the catchment area that gave rise to SHIP. Dentate participants (n = 2,626; 53% women; 20-81 years of age) were included. Diabetes was determined via physician diagnosis and/or HbA(1c) ≥6.5% (uncontrolled diabetes >7.0%). Examiners blinded to diabetes status performed random half-mouth periodontal examinations, assessing probing depth (PD) and attachment loss (AL) (four sites/tooth) at baseline and follow-up. Participants were categorized into six groups as follows: 1) diabetes free (n = 2,280), 2) incident T2DM (n = 79), 3) controlled T2DM (n = 80), 4) uncontrolled T2DM (n = 72), 5) controlled T1DM (n = 43), and 6) uncontrolled T1DM (n = 72). In multivariable regressions, mean PD change (ΔMPD), mean AL change (ΔMAL), or incident tooth-loss values were regressed across the aforementioned diabetes categories. Mean (SD) ΔMPD and ΔMAL values among all participants were -0.08 ± 0.5 mm and 0.08 ± 1.03 mm, respectively, and 34% lost one or more teeth. Relative to diabetes-free participants, those with uncontrolled T2DM experienced greater ΔMPD ± SE (P < 0.05), whereas participants with either uncontrolled T1DM or uncontrolled T2DM realized greater ΔMAL (P < 0.05). Uncontrolled T1DM and T2DM were both associated with an increased risk of future tooth loss (P < 0.05). Diabetes control, but not etiology, was associated with future tooth loss and accelerated AL progression.

Whose Knowledge, Whose Development? Use and Role of Local and External Knowledge in Agroforestry Projects in Bolivia

NASA Astrophysics Data System (ADS)

Jacobi, Johanna; Mathez-Stiefel, Sarah-Lan; Gambon, Helen; Rist, Stephan; Altieri, Miguel

2017-03-01

Agroforestry often relies on local knowledge, which is gaining recognition in development projects. However, how local knowledge can articulate with external and scientific knowledge is little known. Our study explored the use and integration of local and external knowledge in agroforestry projects in Bolivia. In 42 field visits and 62 interviews with agroforestry farmers, civil society representatives, and policymakers, we found a diverse knowledge base. We examined how local and external knowledge contribute to livelihood assets and tree and crop diversity. Projects based predominantly on external knowledge tended to promote a single combination of tree and crop species and targeted mainly financial capital, whereas projects with a local or mixed knowledge base tended to focus on food security and increased natural capital (e.g., soil restoration) and used a higher diversity of trees and crops than those with an external knowledge base. The integration of different forms of knowledge can enable farmers to better cope with new challenges emerging as a result of climate change, fluctuating market prices for cash crops, and surrounding destructive land use strategies such as uncontrolled fires and aerial fumigation with herbicides. However, many projects still tended to prioritize external knowledge and undervalue local knowledge—a tendency that has long been institutionalized in the formal educational system and in extension services. More dialogue is needed between different forms of knowledge, which can be promoted by strengthening local organizations and their networks, reforming agricultural educational institutions, and working in close interaction with policymakers.

Whose Knowledge, Whose Development? Use and Role of Local and External Knowledge in Agroforestry Projects in Bolivia.

PubMed

Jacobi, Johanna; Mathez-Stiefel, Sarah-Lan; Gambon, Helen; Rist, Stephan; Altieri, Miguel

2017-03-01

Agroforestry often relies on local knowledge, which is gaining recognition in development projects. However, how local knowledge can articulate with external and scientific knowledge is little known. Our study explored the use and integration of local and external knowledge in agroforestry projects in Bolivia. In 42 field visits and 62 interviews with agroforestry farmers, civil society representatives, and policymakers, we found a diverse knowledge base. We examined how local and external knowledge contribute to livelihood assets and tree and crop diversity. Projects based predominantly on external knowledge tended to promote a single combination of tree and crop species and targeted mainly financial capital, whereas projects with a local or mixed knowledge base tended to focus on food security and increased natural capital (e.g., soil restoration) and used a higher diversity of trees and crops than those with an external knowledge base. The integration of different forms of knowledge can enable farmers to better cope with new challenges emerging as a result of climate change, fluctuating market prices for cash crops, and surrounding destructive land use strategies such as uncontrolled fires and aerial fumigation with herbicides. However, many projects still tended to prioritize external knowledge and undervalue local knowledge-a tendency that has long been institutionalized in the formal educational system and in extension services. More dialogue is needed between different forms of knowledge, which can be promoted by strengthening local organizations and their networks, reforming agricultural educational institutions, and working in close interaction with policymakers.

Rodent models of depression: learned helplessness induced in mice.

PubMed

Anisman, H; Merali, Z

2001-05-01

Uncontrollable stressors induce a variety of behavioral disturbances that are in many ways reminiscent of the symptoms that characterize clinical depression. These deficits are evident across a range of species, including mice. Given the increasing focus on genetic techniques involving mice to identify the mechanisms subserving these behavioral disturbances (e.g., recombinant, knockout, and transgenic strains), it is of particular interest to provide a detailed description of the method to induce behavioral deficits in response to uncontrollable stressors. This unit describes the procedure used to assess the effects of controllable and uncontrollable shock on subsequent shock escape performance in mice using an escape-delay procedure.

DECONTAMINATION OF HAZARDOUS WASTE SUBSTANCES FROM SPILLS AND UNCONTROLLED WASTE SITES BY RADIO FREQUENCY IN SITU HEATING

EPA Science Inventory

The radio frequency (RF) heating process can be used to volumetrically heat and thus decontaminate uncontrolled landfills and hazardous substances from spills. After the landfills are heated, decontamination of the hazardous substances occurs due to thermal decomposition, vaporiz...

26 CFR 1.482-5 - Comparable profits method.

Code of Federal Regulations, 2010 CFR

2010-04-01

... operating profit represents a return for the investment of resources and assumption of risks. Therefore... from a sufficient number of years of data to reasonably measure returns that accrue to uncontrolled... party and uncontrolled comparables include the following— (i) Rate of return on capital employed. The...

Effects of Prolonged Deprivation on Learned Helplessness.

ERIC Educational Resources Information Center

Mal, Suraj; And Others

1990-01-01

Investigated influence of prolonged deprivation on responses to uncontrollable outcome among 104 Indian students in the tenth grade. Finds high-deprived and female students displayed greater helplessness than did their low-deprived and male counterparts. Females and high-deprives students attributed uncontrollable outcome more to internal, stable,…

Obstructive sleep apnea syndrome and arterial hypertension--a complicated relationship? The role of controlling blood pressure values in patients with OSAS.

PubMed

Deleanu, Oana-Claudia; Mălăuţ, Andra Elena; Nebunoiu, Ana Maria; Micheu, Miruna Mihaela; Mihălţan, Florin Dumitru

2014-01-01

Arterial hypertension (HT) and obstructive sleep apnea syndrome (OSAS) are associated through cause-effect relationship. We aimed to study the effect of medication controlled hypertension on OSAS patients. From 483 followed patients with OSAS, 252 associating HT; 142 patients of them (56.34%) received antihypertensive medication, 59 patients (41.54%) had controlled HT, 83 patients (58.46%) had uncontrolled HT. Demographic and anthropometric data, OSAS symptoms, comorbidities, apnea index (IA), apnea-hypopnea index (IAH), desaturation index, CPAP titration, CPAP failure rate were studiated regarding differences between patients with controlled and uncontrolled HT. Fifty nine patients with controlled HT were: 20 women (33.9%), 39 men (66.1%), with mean age of 56.08 years +/- 11.33, with an average AHI of 53.61 +/- 34.42/hour, an average of CPAP pressure prediction of 10.15 +/- 243 cm H2O. Eighty three patients with uncontrolled HT were: 18 women (21.7%), 65 men (78.3%), with mean age 55 +/- 9.06 years, with an average AHl of 61.91 +/- 43.61/hour, an average of CPAP pressure prediction of 10.47 +/- 2cm H2O. Comparing with the controlled HT group, patients with uncontrolled HT reported morning headaches, morning fatigue and impotency in a higher rate (p = 0.020, 0.018, 0.011 respectively); Epworth Sleepiness Scale was under 10 (cut-off for daytime sleepiness) in patients with controlled HT(p = 0.001) and higher in those with uncontrolled HT. Patients with uncontrolled HT were diagnosed with HT for a longer period (p = 0.006), had higher values of systolic and diastolic blood pressure at the time of the presentation. Statistically significant differences were found only for AHI post-CPAP (11.89/h vs. 22.30/h, p = 0.013) and nocturnal desaturation index post-CPAP (6.03/h vs. 16.55/h, p = 0.017), both higher in patients with uncontrolled HT. The hypothesis regarding existing differences related to the cardiovascular comorbidities was not supported. Controlled blood pressure deletes sleepiness, a defining symptom for OSAS and reduces remaining symptoms (headaches, impotency and morning fatigue). Presence of OSAS symptoms is less common in the controlled HT group, making the OSAS more difficult to suspect. These patients may have a grater benefit from CPAP therapy--they have AHI post-CPAP and desaturations post-CPAP significantly lower than patients with uncontrolled HT.

Nitrate-rich beetroot juice selectively lowers ambulatory pressures and LDL cholesterol in uncontrolled but not controlled hypertension: a pilot study.

PubMed

Kerley, C P; Dolan, E; Cormican, L

2017-11-01

Dietary nitrate has been shown to increase nitrate/nitrite levels in multiple populations, with potential blood pressure lowering effects. However, there are few reports among hypertensives. We aimed to assess the effect of daily nitrate in subjects with controlled hypertension vs. uncontrolled hypertension. On day 0, hypertensives wore an ambulatory BP monitor (ABPM) for 24 h and fasting blood was taken. Subjects then consumed concentrated beetroot juice (12.9 mmol nitrate) for 14 consecutive days. On day 14 subjects consumed their last nitrate dose after fasting blood was drawn and again had an ABPM for 24 h. According to baseline ABPM, 11 subjects had controlled BP while 8 had uncontrolled BP. There were similar, significant increases in serum nitrate/nitrite in both groups. We observed little change in BP variables among controlled hypertensives. However, there were reductions in BP variables in uncontrolled hypertensives where decreases in nighttime DBP (-6 ± 4.8 mmHg), arterial stiffness (-0.08 ± 0.03 ambulatory arterial stiffness index) and LDL (-0.36 ± 0.42 mmol/L) reached significance (p = 003, 0.05 and 0.046, respectively). Our results support the existing data suggesting an anti-hypertensive effect of nitrate-containing beetroot juice, but only among those with uncontrolled hypertension.

Factors Associated with Uncontrolled Hypertension among Renal Transplant Recipients Attending Nephrology Clinics in Nairobi, Kenya

PubMed Central

Kubo, Mary N.; Kayima, Joshua K.; Were, Anthony J.; McLigeyo, Seth O.; Ogola, Elijah N.

2015-01-01

Objective. To determine the factors associated with poor blood pressure control among renal transplant recipients in a resource-limited setting. Methods. A cross-sectional study was carried out on renal transplant recipients at the Kenyatta National Hospital. Sociodemographic details, blood pressure, urine albumin : creatinine ratio, and adherence using the MMAS-8 questionnaire were noted. Independent factors associated with uncontrolled hypertension were determined using logistic regression analysis. Results. 85 subjects were evaluated. Mean age was 42.4 (SD ± 12.2) years, with a male : female ratio of 1.9 : 1. Fifty-five patients (64.7%) had uncontrolled hypertension (BP ≥ 130/80 mmHg). On univariate analysis, male sex (OR 3.7, 95% CI 1.4–9.5, p = 0.006), higher levels of proteinuria (p = 0.042), and nonadherence to antihypertensives (OR 18, 95% CI 5.2–65.7, p < 0.001) were associated with uncontrolled hypertension. On logistic regression analysis, male sex (adjusted OR 4.6, 95% CI 1.1–19.0, p = 0.034) and nonadherence (adjusted OR 33.8, 95% CI 8.6–73.0, p < 0.001) were independently associated with uncontrolled hypertension. Conclusion. Factors associated with poor blood pressure control in this cohort were male sex and nonadherence to antihypertensives. Emphasis on adherence to antihypertensive therapy must be pursued within this population. PMID:26257920

Physical and chemical characteristics of the longissimus dorsi from swine reared in climate-controlled and uncontrolled environments

NASA Astrophysics Data System (ADS)

de Mello, Juliana Lolli Malagoli; Berton, Mariana Piatto; de Cassia Dourado, Rita; Giampietro-Ganeco, Aline; de Souza, Rodrigo Alves; Ferrari, Fábio Borba; de Souza, Pedro Alves; Borba, Hirasilva

2017-10-01

The aim of this study was to evaluate the effect of ambient temperature on the physical and chemical characteristics of the longissimus dorsi muscle by comparing the quality of meat from pigs reared in a controlled and in an uncontrolled environment, the latter provided with a shallow pool. Twenty castrated male pigs of the Topigs line were randomly allotted to two treatments: a controlled environment, with constant temperature (22 °C) and relative humidity (70%); and an uncontrolled environment in a conventional shed for rearing pigs equipped with a shallow pool, where pigs were subject to climatic variations. Meat from pigs kept in the controlled environment showed a greater capacity to retain intracellular water, higher tenderness, and lower cholesterol levels than meat from pigs reared in the uncontrolled environment, but displayed higher lipid oxidation and a lower concentration of DHA. Treatments had no effect on color, pH, chemical composition, or fatty acid profile (except DHA concentration). Rearing pigs in sheds equipped with a shallow pool minimizes the effects of environmental heat on meat quality, allowing the production of high-quality meat in warm climate regions without expensive investments. Animals reared in an uncontrolled environment equipped with a shallow pool are able to produce meat with characteristics within the quality standards and with similar quality to that of meat from animals raised in controlled environment.

Lipid peroxidation and antioxidant enzymes activity in controlled and uncontrolled Type 2 diabetic patients.

PubMed

Zarei, Mahnaz; Farahnak, Zahra; Hosseinzadeh-Attar, Mohammad Javad; Javanbakht, Mohammad Hassan; Hosseinzadeh, Payam; Derakhshanian, Hoda; Farahbakhsh-Farsi, Payam; Djalali, Mahmoud

2016-05-01

This study was designed to compare lipid peroxidation and antioxidant enzymes activity in Type 2 diabetes patients with good or weak glycemic control. In this case-control study, 62 Type 2 diabetic patients with glycated hemoglobin (HbA1c) between 6 and 8 were enrolled as the controlled group and 55 patients with HbA1c > 8 were selected as an uncontrolled group. Patients were all referred to Iranian Diabetes Association in Tehran, Iran, from 2010 onward. Groups were chosen by convenience sampling and were matched based on age, sex and duration of disease. Demographic questionnaire, two 24-hour food recall, HbA1c, insulin, malondialdehyde (MDA), superoxide dismutase (SOD), and catalase were measured in blood samples. Data were analyzed by Food Processor II and SPSS software. A mean daily consumption of energy, carbohydrate, protein, and fat was not significantly different between two groups. MDA in the uncontrolled group was significantly higher than controlled group (2.03 ± 0.88 vs. 1.65 ± 1.01 nmol/ml; P = 0.030). A mean SOD was slightly higher in the uncontrolled group comparing to the control group (843.3 ± 101.9 vs. 828.0 ± 127.3 U/g Hb; P = 0.400). These data suggest that MDA as a lipid peroxidation indicator is higher in uncontrolled diabetes probably due to chronic high blood sugar followed by higher oxidative stress.

Physical and chemical characteristics of the longissimus dorsi from swine reared in climate-controlled and uncontrolled environments.

PubMed

de Mello, Juliana Lolli Malagoli; Berton, Mariana Piatto; de Cassia Dourado, Rita; Giampietro-Ganeco, Aline; de Souza, Rodrigo Alves; Ferrari, Fábio Borba; de Souza, Pedro Alves; Borba, Hirasilva

2017-10-01

The aim of this study was to evaluate the effect of ambient temperature on the physical and chemical characteristics of the longissimus dorsi muscle by comparing the quality of meat from pigs reared in a controlled and in an uncontrolled environment, the latter provided with a shallow pool. Twenty castrated male pigs of the Topigs line were randomly allotted to two treatments: a controlled environment, with constant temperature (22 °C) and relative humidity (70%); and an uncontrolled environment in a conventional shed for rearing pigs equipped with a shallow pool, where pigs were subject to climatic variations. Meat from pigs kept in the controlled environment showed a greater capacity to retain intracellular water, higher tenderness, and lower cholesterol levels than meat from pigs reared in the uncontrolled environment, but displayed higher lipid oxidation and a lower concentration of DHA. Treatments had no effect on color, pH, chemical composition, or fatty acid profile (except DHA concentration). Rearing pigs in sheds equipped with a shallow pool minimizes the effects of environmental heat on meat quality, allowing the production of high-quality meat in warm climate regions without expensive investments. Animals reared in an uncontrolled environment equipped with a shallow pool are able to produce meat with characteristics within the quality standards and with similar quality to that of meat from animals raised in controlled environment.

VARIABLES AFFECTING EMISSIONS OF PCDDS/FS FROM UNCONTROLLED COMBUSTION OF HOUSEHOLD WASTE IN BARRELS

EPA Science Inventory

The uncontrolled burning of household waste in barrels has recently been implicated as a major source of airborne emissions of polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDDs/Fs). Based on the need to generate a more accurate emission factor for burn ba...

40 CFR 63.1386 - Notification, recordkeeping, and reporting requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... temperature above the molten glass in an uncontrolled cold top electric furnace, including any period when the... glass surface, the date and time of the exceedance, when corrective actions were initiated, the cause of... was corrected; (iv) Uncontrolled glass-melting furnace (that is not a cold top electric furnace...

40 CFR 63.1386 - Notification, recordkeeping, and reporting requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... temperature above the molten glass in an uncontrolled cold top electric furnace, including any period when the... glass surface, the date and time of the exceedance, when corrective actions were initiated, the cause of... was corrected; (iv) Uncontrolled glass-melting furnace (that is not a cold top electric furnace...

40 CFR 63.1386 - Notification, recordkeeping, and reporting requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... temperature above the molten glass in an uncontrolled cold top electric furnace, including any period when the... glass surface, the date and time of the exceedance, when corrective actions were initiated, the cause of... was corrected; (iv) Uncontrolled glass-melting furnace (that is not a cold top electric furnace...

40 CFR 63.1386 - Notification, recordkeeping, and reporting requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... temperature above the molten glass in an uncontrolled cold top electric furnace, including any period when the... glass surface, the date and time of the exceedance, when corrective actions were initiated, the cause of... was corrected; (iv) Uncontrolled glass-melting furnace (that is not a cold top electric furnace...

Outdoor and indoor particle characterization from a large and uncontrolled combustion of a tire landfill.

PubMed

Artíñano, B; Gómez-Moreno, F J; Díaz, E; Amato, F; Pandolfi, M; Alonso-Blanco, E; Coz, E; García-Alonso, S; Becerril-Valle, M; Querol, X; Alastuey, A; van Drooge, B L

2017-09-01

A large and uncontrolled fire of a tire landfill started in Seseña (Toledo, Spain) on May 13, 2016. An experimental deployment was immediately launched in the area for measuring regulated and non-standard air quality parameters to assess the potential impact of the plume at local and regional levels. Outdoor and indoor measurements of different parameters were carried out at a near school, approximately 700m downwind the burning tires. Real time measurements of ambient black carbon (BC) and total number particle concentrations were identified as good tracers of the smoke plume. Simultaneous peaks allowed us to characterize situations of the plume impact on the site. Outdoor total particle number concentrations reached in these occasions 3.8×10 5 particlescm -3 (on a 10min resolution) whereas the indoor concentration was one order of magnitude lower. BC mass concentrations in ambient air were in the range of 2 to 7μgm -3 , whereas concentrations<2μgm -3 were measured indoor. Indoor and outdoor deposited inhalable dust was sampled and chemically characterized. Both indoor and outdoor dust was enriched in tire components (Zn, sulfate) and PAHs associated to the tire combustion process. Infiltration processes have been documented for BC and particle number concentrations causing increases in indoor concentrations. Copyright © 2017 Elsevier B.V. All rights reserved.

Surface heat loads on the ITER divertor vertical targets

NASA Astrophysics Data System (ADS)

Gunn, J. P.; Carpentier-Chouchana, S.; Escourbiac, F.; Hirai, T.; Panayotis, S.; Pitts, R. A.; Corre, Y.; Dejarnac, R.; Firdaouss, M.; Kočan, M.; Komm, M.; Kukushkin, A.; Languille, P.; Missirlian, M.; Zhao, W.; Zhong, G.

2017-04-01

The heating of tungsten monoblocks at the ITER divertor vertical targets is calculated using the heat flux predicted by three-dimensional ion orbit modelling. The monoblocks are beveled to a depth of 0.5 mm in the toroidal direction to provide magnetic shadowing of the poloidal leading edges within the range of specified assembly tolerances, but this increases the magnetic field incidence angle resulting in a reduction of toroidal wetted fraction and concentration of the local heat flux to the unshadowed surfaces. This shaping solution successfully protects the leading edges from inter-ELM heat loads, but at the expense of (1) temperatures on the main loaded surface that could exceed the tungsten recrystallization temperature in the nominal partially detached regime, and (2) melting and loss of margin against critical heat flux during transient loss of detachment control. During ELMs, the risk of monoblock edge melting is found to be greater than the risk of full surface melting on the plasma-wetted zone. Full surface and edge melting will be triggered by uncontrolled ELMs in the burning plasma phase of ITER operation if current models of the likely ELM ion impact energies at the divertor targets are correct. During uncontrolled ELMs in pre-nuclear deuterium or helium plasmas at half the nominal plasma current and magnetic field, full surface melting should be avoided, but edge melting is predicted.

Fast words boundaries localization in text fields for low quality document images

NASA Astrophysics Data System (ADS)

Ilin, Dmitry; Novikov, Dmitriy; Polevoy, Dmitry; Nikolaev, Dmitry

2018-04-01

The paper examines the problem of word boundaries precise localization in document text zones. Document processing on a mobile device consists of document localization, perspective correction, localization of individual fields, finding words in separate zones, segmentation and recognition. While capturing an image with a mobile digital camera under uncontrolled capturing conditions, digital noise, perspective distortions or glares may occur. Further document processing gets complicated because of its specifics: layout elements, complex background, static text, document security elements, variety of text fonts. However, the problem of word boundaries localization has to be solved at runtime on mobile CPU with limited computing capabilities under specified restrictions. At the moment, there are several groups of methods optimized for different conditions. Methods for the scanned printed text are quick but limited only for images of high quality. Methods for text in the wild have an excessively high computational complexity, thus, are hardly suitable for running on mobile devices as part of the mobile document recognition system. The method presented in this paper solves a more specialized problem than the task of finding text on natural images. It uses local features, a sliding window and a lightweight neural network in order to achieve an optimal algorithm speed-precision ratio. The duration of the algorithm is 12 ms per field running on an ARM processor of a mobile device. The error rate for boundaries localization on a test sample of 8000 fields is 0.3

GODAN Local Farming Challenge 2017 - Encourage Geo-Innovation Solutions for Zero Hunger

NASA Astrophysics Data System (ADS)

Anand, Suchith; Hogan, Patrick; Brovelli, Maria; Schaap, Ben; Musker, Ruthie; Laperrière, André

2017-04-01

The initial ideas for Open Geospatial Science [1] were presented nearly a decade ago. They build upon the proposition of Open science which argues that scientific knowledge develops more rapidly and productively if openly shared (as early as is practical in the discovery process). The key ingredients that make Open Geospatial Science possible are enshrined in Open Principles, i.e.: open source geospatial software, open data, open standards, open educational resources, and open access to research publications. OpenCitySmart[2] is an initiative of Geo for All [3] that aims to develop a suite of tools for city-related infrastructure management (utilities, traffic, services, etc.). Its purpose will be to continually refine and add functionality that not only streamlines operational efficiency but also considers the need for sustainability and quality of urban life. OpenCitySmart employs Open solutions to build richer tools that empower organisations and individuals to utilizespatial and non-spatial data alike. This will create opportunities for innovation both globally and locally. As the population of cities grow, the concern of food security will shift from rural to urban areas. Currently, nearly 800 million people struggle with debilitating hunger and malnutrition and can be found in every corner of the globe. That's one in every nine people, with the majority being women and children. The Global Open Data for Agriculture and Nutrition (GODAN) [4] supports the proactive sharing of open data to make information about agriculture and nutrition available, accessible and usable to deal with the urgent challenge of ensuring world food security. A core principle behind GODAN is that a solution to Zero Hunger lies within existing, but often unavailable, agriculture and nutrition data. Through an online survey, GODAN found that the most needed data type across its 430+ partner network was geospatial data. Through the GODAN Europa Challenge we want to bring together researchers and students to work collaboratively on innovative ideas to create change using agriculture and nutrition data. The Europa Challenge is a World Challenge, though we use the wisdom of Europe's INSPIRE Directive to guide project development. The Europa Challenge is asking the world's *best and brightest* to deliver solutions serving city needs. With support from the NASA Europa Challenge[5], GODAN is launching a Local Farming Challenge. We welcome students to create innovative ideas that will help tackle the solutions of local farming in growing cities, using some aspect of the OpenCitySmart Design and uses NASA's open source virtual globe technology, WebWorldWind. Ideas may include ways for optimally linking local farming communities directly with potential customers, tools for visualising spatio-temporal aspects of local farming, tools for helping reducing wastage (for example linking with local food banks), and any number of solutions for helping our goal of Zero Hunger. 1. http://www.mdpi.com/journal/ijgi/special_issues/science-applications 2. http://www.geoforall.org/ 3. https://wiki.osgeo.org/wiki/Opencitysmart 4. http://www.godan.info 5. http://eurochallenge.como.polimi.it

Opening the black box: a study of the process of NICE guidelines implementation.

PubMed

Spyridonidis, Dimitrios; Calnan, Michael

2011-10-01

This study informs 'evidence-based' implementation by using an innovative methodology to provide further understanding of the implementation process in the English NHS using two distinctly different NICE clinical guidelines as exemplars. The implementation process was tracked retrospectively and prospectively using a comparative case-study and longitudinal design. 74 unstructured interviews were carried out with 48 key informants (managers and clinicians) between 2007 and 2009. This study has shown that the NICE guidelines implementation process has both planned and emergent components, which was well illustrated by the use of the prospective longitudinal design in this study. The implementation process might be characterised as strategic and planned to begin with but became uncontrolled and subject to negotiation as it moved from the planning phase to adoption in everyday practice. The variations in the implementation process could be best accounted for in terms of differences in the structure and nature of the local organisational context. The latter pointed to the importance of managers as well as clinicians in decision-making about implementation. While national priorities determine the context for implementation the shape of the process is influenced by the interactions between doctors and managers, which influence the way they respond to external policy initiatives such as NICE guidelines. NICE and other national health policy-makers need to recognise that the introduction of planned change 'initiatives' in clinical practice are subject to social and political influences at the micro level as well as the macro level. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Infant feeding concerns in times of natural disaster: lessons learned from the 2014 flood in Kelantan, Malaysia.

PubMed

Sulaiman, Zaharah; Mohamad, Noraini; Ismail, Tengku Alina Tengku; Johari, Nazirah; Hussain, Nik Hazlina Nik

2016-01-01

The flood that hit Kelantan in December 2014 was the worst in Malaysian history. Women and their infants accounted for a large proportion of the people at risk who were badly affected, as almost half of the population in Kelantan was in the reproductive age group. This report serves to raise awareness that breastfeeding mothers and infants are a special population with unique needs during a disaster. Four of their concerns were identified during this massive flood: first, the negative impact of flood on infant nutritional status and their health; second, open space and lack of privacy for the mothers to breastfeed their babies comfortably at temporary shelters for flood victims; third, uncontrolled donations of infant formula, teats, and feeding bottles that are often received from many sources to promote formula feeding; and lastly, misconceptions related to breastfeeding production and quality that may be affected by the disaster. The susceptibility of women and their infant in a natural disaster enhances the benefits of promoting the breastfeeding rights of women. Women have the right to be supported which enables them to breastfeed. These can be achieved through monitoring the distribution of formula feeding, providing water, electricity and medical care for breastfeeding mothers and their infants. A multifaceted rescue mission team involving various agencies comprising of local government, including the health and nutrition departments, private or non-governmental organizations and individual volunteers have the potential to improve a satisfactory condition of women and infants affected by floods and other potential natural disasters.

Delta-9-tetrahydrocannabinol (THC) in the treatment of end-stage open-angle glaucoma.

PubMed

Flach, Allan J

2002-01-01

Evidence exists that the administration of cannabinoid derivatives can lower intraocular pressure. Some patients with glaucoma believe they are being deprived of a potentially beneficial treatment. Therefore, the Research Advisory Panel of California instituted the Cannabis Therapeutic Research Program to permit compassionate access to cannabinoid derivatives. Data about the potential therapeutic usefulness and toxicity of these agents were collected. This study reviews the results of this program with the specific aim of providing further direction for these investigational efforts. A survey of local ophthalmologists indicated an impressive interest in participating in and contributing patients with glaucoma unresponsive to treatment to this study. Appropriate patients were treated with either orally administered delta-9-tetrahydrocannabinol capsules or inhaled marijuana in addition to their existing therapeutic regimen. Although 20 ophthalmologists were approved as investigators, only nine patients were enrolled in the study. An initial decrease in intraocular pressure was observed in all patients, and the investigator's therapeutic goal was met in four of the nine patients. However, the decreases in intraocular pressure were not sustained, and all patients elected to discontinue treatment within 1 to 9 months for various reasons. This uncontrolled, unmasked, nonrandomized study does not permit definitive conclusions about the efficacy or toxicity of cannabinoids in the treatment of glaucoma. There is an impression that this treatment can lower intraocular pressure, but the development of tolerance and significant systemic toxicity appears to limit the usefulness of this potential treatment. Both patients and ophthalmologists greatly appreciated the opportunity to participate in this study.

Addressing the Local in Localization: A Case Study of Open Textbook Adoption by Three South African Teachers

ERIC Educational Resources Information Center

Jimes, Cynthia; Weiss, Shenandoah; Keep, Renae

2013-01-01

This article presents a case study of the adoption and use of open textbooks by three high school teachers in the KwaZulu-Natal province of South Africa. The textbooks, collaboratively authored and distributed through the South African initiative, Siyavula, are available online and are openly licensed, allowing teachers to freely use, modify,…

Knowledge regarding noncytotoxic medication extravasation among registered nurses working in western Saudi Arabia.

PubMed

Sisan, Mo'men; Rayan, Ahmad; Elmorsy, Soha; Elyan, Hamza; Salahat, Mosab

2018-03-01

Extravasation and infiltration are among the most common intravenous therapy complications. For noncytotoxic agents, the incidence of extravasation remains unknown. There has been little research into extravasation due to ethical considerations limiting controlled research; most evidences are based on small, uncontrolled trials or case reports. The purpose of this study was to assess the knowledge level regarding noncytotoxic medications extravasation and its associated factors among staff nurses.A descriptive correlational design using self-administered questionnaire was employed. A convenience sample of 387 nurses completed a questionnaire about noncytotoxic medication extravasation. Statistical Package for Social Sciences version 21 was used to analyze data by applying the chi-square test, t test, and the Mann-Whitney test to assess the knowledge difference between open and closed units' nurses.The results indicate that only 19.6% of nurses have a good knowledge about noncytotoxic medications extravasation. There was consistently poor staff knowledge regarding noncytotoxic medications extravasation. Although the closed units' nurses reported relatively higher level of knowledge than open units' nurses, their level of knowledge still inadequate. Health care organizations must consider developing specific policies regarding extravasation. Closed and open units' nurses should be enrolled in special education programs to improve their level of knowledge regarding noncytotoxic medication extravasation. Copyright © 2017 Society for Vascular Nursing, Inc. Published by Elsevier Inc. All rights reserved.

Efficacy, safety and risk of augmentation of rotigotine for treating restless legs syndrome.

PubMed

Inoue, Yuichi; Hirata, Koichi; Hayashida, Kenichi; Hattori, Nobutaka; Tomida, Takayuki; Garcia-Borreguero, Diego

2013-01-10

The present study aimed to examine the long-term efficacy and safety of rotigotine treatment for restless legs syndrome (RLS), as well as the rate of clinically significant augmentation, in a 1-year open-label study of Japanese subjects. Japanese patients with RLS who had been treated with rotigotine or placebo in a double-blind trial were enrolled in a 1-year, open-label, uncontrolled extension study and treated with rotigotine at a dose of up to 3 mg/24 h after an 8-week titration phase. Outcomes included International Restless Legs Syndrome Study Group rating scale (IRLS scale), Pittsburgh Sleep Quality Index (PSQI), safety, and investigator-/expert panel-assessed augmentation (including Augmentation Severity Rating Scale). Overall, 185 patients entered the open-label study and 133 completed the study. IRLS and PSQI total scores improved throughout the 52-week treatment period (IRLS, from 23.2±5.1 to 7.8±7.6 and PSQI, from 8.0±3.1 to 5.0±2.9). Treatment-emergent adverse events were mild to moderate in severity, and included application site reactions (52.4%) and nausea (28.6%). Clinically significant augmentation occurred in five patients (2.7%). These results indicate a good long-term efficacy of rotigotine for treating RLS, with a relatively low risk of clinically significant augmentation. Copyright © 2012 Elsevier Inc. All rights reserved.

Unpredictable and Uncontrollable Events: A New Perspective on Experimental Neurosis

ERIC Educational Resources Information Center

Kihlstrom, John F.; Mineka, Susan

1978-01-01

Recent work has shown that unpredictable and/or uncontrollable events can produce a variety of cognitive, affective, and somatic disturbances to the organism. These disturbances are compared to and found to be quite similar to the symptoms of the classic cases of experimental neurosis described by Pavlov, Gantt, Liddell, Masserman, and Wolpe.…

Term Based Comparison Metrics for Controlled and Uncontrolled Indexing Languages

ERIC Educational Resources Information Center

Good, B. M.; Tennis, J. T.

2009-01-01

Introduction: We define a collection of metrics for describing and comparing sets of terms in controlled and uncontrolled indexing languages and then show how these metrics can be used to characterize a set of languages spanning folksonomies, ontologies and thesauri. Method: Metrics for term set characterization and comparison were identified and…

Glutathione synthesis is diminished in patients with uncontrolled diabetes and restored by dietary supplementation with cysteine and glycine

USDA-ARS?s Scientific Manuscript database

Sustained hyperglycemia is associated with low cellular levels of the antioxidant glutathione (GSH), which leads to tissue damage attributed to oxidative stress. We tested the hypothesis that diminished GSH in adult patients with uncontrolled type 2 diabetes is attributed to decreased synthesis and ...

Conditions that Influence Drivers' Yielding Behavior for Uncontrolled Crossings

ERIC Educational Resources Information Center

Bourquin, Eugene; Emerson, Robert Wall; Sauerburger, Dona

2011-01-01

Pedestrians with visual impairments need to cross streets where traffic signals and traffic signage are not present. This study examined the influences of several interventions, including a pedestrian's use of a mobility cane, on the behavior of drivers when they were expected to yield to a pedestrian crossing at an uncontrolled crossing.…

Outcome of patients undergoing open heart surgery at the Uganda heart institute, Mulago hospital complex.

PubMed

Aliku, Twalib O; Lubega, Sulaiman; Lwabi, Peter; Oketcho, Michael; Omagino, John O; Mwambu, Tom

2014-12-01

Heart disease is a disabling condition and necessary surgical intervention is often lacking in many developing countries. Training of the superspecialties abroad is largely limited to observation with little or no opportunity for hands on experience. An approach in which open heart surgeries are conducted locally by visiting teams enabling skills transfer to the local team and helps build to build capacity has been adopted at the Uganda Heart Institute (UHI). We reviewed the progress of open heart surgery at the UHI and evaluated the postoperative outcomes and challenges faced in conducting open heart surgery in a developing country. Medical records of patients undergoing open heart surgery at the UHI from October 2007 to June 2012 were reviewed. A total of 124 patients underwent open heart surgery during the study period. The commonest conditions were: venticular septal defects (VSDs) 34.7% (43/124), Atrial septal defects (ASDs) 34.7% (43/124) and tetralogy of fallot (TOF) in 10.5% (13/124). Non governmental organizations (NGOs) funded 96.8% (120/124) of the operations, and in only 4 patients (3.2%) families paid for the surgeries. There was increasing complexity in cases operated upon from predominantly ASDs and VSDs at the beginning to more complex cases like TOFs and TAPVR. The local team independently operated 19 patients (15.3%). Postoperative morbidity was low with arrhythmias, left ventricular dysfunction and re-operations being the commonest seen. Post operative sepsis occurred in only 2 cases (1.6%). The overall mortality rate was 3.2. Open heart surgery though expensive is feasible in a developing country. With increased direct funding from governments and local charities to support open heart surgeries, more cardiac patients access surgical treatment locally.

A 12-year prognosis of adult-onset asthma: Seinäjoki Adult Asthma Study.

PubMed

Tuomisto, Leena E; Ilmarinen, Pinja; Niemelä, Onni; Haanpää, Jussi; Kankaanranta, Terhi; Kankaanranta, Hannu

2016-08-01

Long-term prognosis of adult-onset asthma is poorly known. To evaluate 12-year prognosis of adult-onset asthma and the factors associated with disease prognosis. Seinäjoki Adult-onset Asthma Study (SAAS) is a 12-year real-life single-center follow-up study of new-onset asthma diagnosed at adult age and treated in primary and specialized care. Remission was defined by no symptoms and no asthma medication use for 6 months. Asthma control was evaluated according to Global Initiative for Asthma 2010. Factors associated with current asthma control were analyzed by multinomial multivariate logistic regression. A total of 203 patients (79% of the baseline population) were followed for 12 years. Remission occurred in 6 (3%) patients. In 34% asthma was controlled, in 36% it was partially controlled and in 30% uncontrolled. Uncontrolled asthma was predicted by elevated body-mass index at baseline, smoking (pack-years) and current allergic or persistent rhinitis. Elevated blood eosinophils and good lung function (FEV1) at baseline protected from uncontrolled asthma. In contrast, gender, age at the onset or baseline symptoms (Airways Questionnaire 20) were not significant predictors of uncontrolled disease. During a 12-year follow-up, remission of adult-onset asthma was rare occurring in only 3% of patients. The majority of patients (66%) presented either with uncontrolled or partially controlled asthma. This study is registered at ClinicalTrials.gov with identifier number NCT02733016. Copyright © 2016 Elsevier Ltd. All rights reserved.

Cross-sectional study of patients with type 2 diabetes in OR Tambo district, South Africa

PubMed Central

Yogeswaran, Parimalaranie; Longo-Mbenza, Benjamin; Ter Goon, Daniel; Ajayi, Anthony Idowu

2016-01-01

Objectives South Africa has pledged to the sustainable development goal of promoting good health and well-being to all residents. While this is laudable, paucity of reliable epidemiological data for different regions on diabetes and treatment outcomes may further widen the inequalities of access and quality of healthcare services across the country. This study examines the sociodemographic and clinical determinants of uncontrolled type 2 diabetes mellitus (T2DM) in individuals attending primary healthcare in OR Tambo district, South Africa. Design A cross-sectional analytical study. Setting Primary healthcare setting in OR Tambo district, South Africa. Participants Patients treated for T2DM for 1 or more years (n=327). Primary outcome measure Prevalence of uncontrolled T2DM. Secondary outcome measure Determinants of uncontrolled T2DM (glycosylated haemoglobin (HbA1c) ≥7%). Results Out of the 327 participants, 274 had HbA1c≥7% (83.8%). Female sex (95% CI 1.3 to 4.2), overweight/obesity (95% CI 1.9 to 261.2), elevated low-density lipoprotein cholesterol (95% CI 4.4 to 23.8), sedentary habits (95% CI 7.2 to 61.3), lower monthly income (95% CI 1.3 to 6.5), longer duration of T2DM (95% CI 4.4 to 294.2) and diabetes information from non-health workers (95% CI 1.4 to 7.0) were the significant determinants of uncontrolled T2DM. There was a significant positive correlation of uncontrolled T2DM with increasing duration of T2DM, estimated glomerular filtration rate and body mass index. However, a significant negative correlation exists between monthly income and increasing HbA1c. Conclusions We found a significantly high prevalence (83.8%) of uncontrolled T2DM among the patients, possibly attributable to overweight/obesity, sedentary living, lower income and lack of information on diabetes. Addressing these determinants will require re-engineering of primary healthcare in the district. PMID:27473948

Poor sleep quality has an adverse effect on childhood asthma control and lung function measures.

PubMed

Sheen, Youn Ho; Choi, Sun Hee; Jang, Sun Jung; Baek, Ji Hyeon; Jee, Hye Mi; Kim, Mi Ae; Chae, Kyu Young; Han, Man Yong

2017-08-01

It is unclear as to whether sleep respiratory breathing disorder (SRBD) is a risk factor for uncontrolled asthma in children. The aim of this study was therefore to investigate whether SRBD may have an adverse effect on childhood asthma control and lung function measures. This was a cross-sectional study of 220 children with well-controlled (n = 108), partly controlled (n = 92), and uncontrolled asthma (n = 20) according to the Global Initiative for Asthma guideline. SRBD was assessed using the Pediatric Sleep Questionnaire (PSQ). The association of SRBD with partly controlled/uncontrolled asthma was investigated on multivariate logistic regression analysis. Of 220 children with asthma, 43 (19.6%) had SRBD: well-controlled, 16.7% (18/108); partly controlled, 21.7% (20/92); and uncontrolled, 25.0% (5/20; P = 0.54). There was a significant difference in forced expiratory volume in 1 s/forced vital capacity (FEV 1 /FVC; P = 0.007) and childhood asthma control test (C-ACT) score (P < 0.001) according to asthma control status, but not in PSQ score (P = 0.18). Children with obstructive sleep apnea (PSQ >0.33) had a lower C-ACT score compared with controls (PSQ ≤0.33; 19.6 ± 5.1 vs 22.0 ± 4.2, P = 0.002). PSQ score was negatively correlated with FEV 1 /FVC (r = -0.16, P = 0.02). On multivariate logistic regression analysis, high PSQ score increased the odds of having partly controlled/uncontrolled asthma by 9.12 (95% CI: 1.04-79.72, P = 0.046) after adjusting for confounding factors. SRBD is an independent risk factor for partly controlled/uncontrolled asthma and has an adverse effect on lung function measures in children. Further research is warranted to determine whether the improvement of sleep quality may also enhance level of asthma control and lung function in children. © 2017 Japan Pediatric Society.

Impact of 5-HT(3) RA selection within triple antiemetic regimens on uncontrolled highly emetogenic chemotherapy-induced nausea/vomiting.

PubMed

Schwartzberg, Lee; Jackson, James; Jain, Gagan; Balu, Sanjeev; Buchner, Deborah

2011-08-01

It is recommended that patients initiate triple antiemetic therapy with one of the 5-hydroxytryptamine receptor antagonists (5-HT(3) RAs), aprepitant (or its intravenous prodrug fosaprepitant) and dexamethasone prior to the start of highly emetogenic chemotherapy (HEC). However, the impact of 5-HT(3) RA selection within triple antiemetic regimens on the risk of uncontrolled chemotherapy-induced nausea and vomiting (CINV) with HEC has not been well studied. To assess the likelihood of an uncontrolled CINV event following antiemetic prophylaxis with the 5-HT(3) RA palonosetron + aprepitant/fosaprepitant + dexamethasone (palonosetron cohort) versus any of the other 5-HT(3) RAs + aprepitant/fosaprepitant + dexamethasone (other 5-HT(3) RA cohort) among single-day HEC cycles. Single-day HEC cycles (a gap of at least 5 days between two administrations) among patients with a cancer diagnosis and receiving antiemetic prophylaxis with the aforementioned regimens between 1/1/2006 and 6/30/2010 were identified from the IMS LifeLink claims database. Uncontrolled CINV events were identified through ICD-9-CM codes (nausea and vomiting), Current Procedural Terminology codes (hydration), rescue medications and/or use of antiemetic therapy from days 2-5 following HEC administration. Risks for an uncontrolled CINV event among all patients, and within breast cancer and multiple cancer subpopulations, were analyzed at cycle level using logistic multivariate regression models. A total of 8018 cycles for the palonosetron cohort and 1926 cycles for the other 5-HT(3) RA cohort (3574 and 978 patients, respectively) were analyzed. Single-day HEC cycles received by the palonosetron cohort had a significantly lower unadjusted risk of an uncontrolled CINV event (17.5 vs 20.7% for the other 5-HT(3) RA cohort; p = 0.0010), with a 17% lower adjusted risk for palonosetron-administered cycles (odds ratio: 0.83; 95% CI: 0.73-0.94; p = 0.0042). Results in the breast cancer and multiple cancer subgroups were consistent with those for the overall population. In this retrospective claims data analysis, single-day HEC cycles administered with palonosetron + aprepitant/fosaprepitant + dexamethasone had a lower risk for an uncontrolled CINV event versus other 5-HT(3) RAs + aprepitant/fosaprepitant + dexamethasone.

78 FR 33700 - Special Local Regulations for Marine Events, Pleasantville Aquatics 15th Annual 5K Open Water...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-05

...-AA08 Special Local Regulations for Marine Events, Pleasantville Aquatics 15th Annual 5K Open Water Swim... from operating while a swim event is taking place. This special local regulation is necessary to... Docket Management Facility in Room W12-140 on the ground floor of the Department of Transportation West...

Acceptability and feasibility of the 'DASH for Asthma' intervention in a randomized controlled trial pilot study.

PubMed

Blonstein, Andrea C; Lv, Nan; Camargo, Carlos A; Wilson, Sandra R; Buist, A Sonia; Rosas, Lisa G; Strub, Peg; Ma, Jun

2016-08-01

'DASH for Asthma' (n 90) was a 6-month randomized controlled trial that demonstrated potential benefits of a DASH (Dietary Approaches to Stop Hypertension) behavioural intervention for improving diet quality and asthma control by comparing intervention to usual care in adults with uncontrolled asthma. The present study examined acceptability and feasibility of the intervention from the perspective of intervention participants and lifestyle coaches. Grounded in Social Cognitive Theory, the 3-month intensive stage, including three individual and eight group sessions, focused on diet modifications and behavioural self-regulation. The 3-month maintenance stage contained telephone consultations. Participants and lifestyle coaches completed surveys including 5-point Likert scales and open-ended questions. We analysed data using descriptive and inductive content analyses. Forty-six intervention participants (survey response rate was 65-72 %) and two lifestyle coaches. Participants and lifestyle coaches were highly satisfied (all mean ratings >4) with individual and group sessions. Participants identified mastery of knowledge and skills (awareness, goal setting, self-monitoring, problem solving), social learning (class members sharing experiences and ideas) and good coaching skills (reflective listening, empathy, motivational counselling) as important contributors to self-efficacy and programme satisfaction. Participants also valued personalized feedback received in individual sessions. Lifestyle coaches viewed participant engagement as a facilitator to effective sessions. Finally, participants and lifestyle coaches identified food tasting as beneficial for observational learning and facilitation of participant engagement. High class attendance and self-monitoring rate also reflected the high engagement among participants. The DASH behavioural intervention was feasible and highly acceptable to participants with uncontrolled asthma and lifestyle coaches.

Aripiprazole plus topiramate in opioid-dependent patients with schizoaffective disorder: an 8-week, open-label, uncontrolled, preliminary study.

PubMed

Bruno, Antonio; Romeo, Vincenzo M; Pandolfo, Gianluca; Scimeca, Giuseppe; Zoccali, Rocco A; Muscatello, Maria Rosaria A

2014-01-01

The aims of this study were to evaluate a combination of aripiprazole and topiramate in the treatment of opioid-dependent patients with schizoaffective disorder undergoing methadone maintenance therapy (MMT) and, further, to taper off patients from methadone treatment. Twenty patients who met DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) criteria for opioid dependence and schizoaffective disorder receiving MMT (80 mg/day) were given aripiprazole (10 mg/day) plus topiramate (up to 200 mg/day) for 8 weeks. A methadone dose reduction of 3 mg/day until suspension at week 4 was established. Aripiprazole plus topiramate was effective in reducing clinical symptoms, and a rapid tapering off of MMT was achieved. Combining aripiprazole and topiramate may be effective in patients with a dual diagnosis of opioid dependency and schizoaffective disorder.

Outcomes, Approaches, and Challenges to Developing and Passing a Countywide Mandatory Vaccination Policy: St. Louis County's Experience with Hepatitis A Vaccine for Food Service Personnel.

PubMed

Rebmann, Terri; Wilson, Kristin D; Loux, Travis; Iqbal, Ayesha Z; Peters, Eleanor B; Peavler, Olivia

2016-01-01

In the early 1990s, St. Louis County had multiple foodservice worker-related hepatitis A outbreaks uncontrolled by standard outbreak interventions. Restaurant interest groups and the general public applied political pressure to local public health officials for more stringent interventions, including a mandatory vaccination policy. Local health departments can enact mandatory vaccination policies, but this has rarely been done. The study objectives were to describe the approach used to pass a mandatory vaccination policy at the local jurisdiction level and illustrate the outcome from this ordinance 15 years later. A case study design was used. In-depth, semi-structured interviews using guided questions were conducted in spring, 2015, with six key informants who had direct knowledge of the mandatory vaccination policy process. Meeting minutes and/or reports were also analyzed. A Poisson distribution analysis was used to calculate the rate of outbreaks before and after mandatory vaccination policy implementation. The policy appears to have reduced the number of hepatitis A outbreaks, lowering the morbidity and economic burden in St. Louis County. The lessons learned by local public health officials in passing a mandatory hepatitis A vaccination policy are important and relevant in today's environment. The experience and lessons learned may assist other local health departments when faced with the potential need for mandatory policies for any vaccine preventable disease.

Outcomes, Approaches, and Challenges to Developing and Passing a Countywide Mandatory Vaccination Policy: St. Louis County's Experience with Hepatitis A Vaccine for Food Service Personnel

PubMed Central

Rebmann, Terri; Wilson, Kristin D.; Loux, Travis; Iqbal, Ayesha Z.; Peters, Eleanor B.; Peavler, Olivia

2016-01-01

In the early 1990s, St. Louis County had multiple foodservice worker-related hepatitis A outbreaks uncontrolled by standard outbreak interventions. Restaurant interest groups and the general public applied political pressure to local public health officials for more stringent interventions, including a mandatory vaccination policy. Local health departments can enact mandatory vaccination policies, but this has rarely been done. The study objectives were to describe the approach used to pass a mandatory vaccination policy at the local jurisdiction level and illustrate the outcome from this ordinance 15 years later. A case study design was used. In-depth, semi-structured interviews using guided questions were conducted in spring, 2015, with six key informants who had direct knowledge of the mandatory vaccination policy process. Meeting minutes and/or reports were also analyzed. A Poisson distribution analysis was used to calculate the rate of outbreaks before and after mandatory vaccination policy implementation. The policy appears to have reduced the number of hepatitis A outbreaks, lowering the morbidity and economic burden in St. Louis County. The lessons learned by local public health officials in passing a mandatory hepatitis A vaccination policy are important and relevant in today's environment. The experience and lessons learned may assist other local health departments when faced with the potential need for mandatory policies for any vaccine preventable disease. PMID:29546151

Taming of a Wild Research Well in Yellowstone National Park during November 1992

USGS Publications Warehouse

Fournier, Robert O.; Moore, Michael M.

2008-01-01

Much of our current understanding of Yellowstone's geothermal areas comes from research drilling by the USGS during 1967 and 1968. Thirteen wells were drilled in thermal areas around the park. Scientists collected waters and rocks, measured temperatures and pressures and performed other tests to characterize the shallow subsurface at Yellowstone. Most wells were plugged and abandoned, but a few were left open for future scientific tests and sampling. One of those wells, the Y8, was located at Biscuit Basin, 2 miles north of Old Faithful. In November 1992, a valve at the ground surface failed, leading to a blowout, an uncontrolled eruption of steam and hot water. The USGS and Yellowstone National Park worked with a drilling contractor to control the flow and plug the well. The lead scientist, Robert Fournier, used video taken by the drilling contractor, Tonto Services, to create this fascinating 28-minute-long film. It is followed by a short news story by CNN, also from November 1992. Fifteen years later, we felt that the video was of sufficient scientific and historical interest that it was worth publishing as a USGS Open-file report, where it can be accessed into the future. Enjoy!

Local epitaxial growth of ZrO2 on Ge (100) substrates by atomic layer epitaxy

NASA Astrophysics Data System (ADS)

Kim, Hyoungsub; Chui, Chi On; Saraswat, Krishna C.; McIntyre, Paul C.

2003-09-01

High-k dielectric deposition processes for gate dielectric preparation on Si surfaces usually result in the unavoidable and uncontrolled formation of a thin interfacial oxide layer. Atomic layer deposition of ˜55-Å ZrO2 film on a Ge (100) substrate using ZrCl4 and H2O at 300 °C was found to produce local epitaxial growth [(001) Ge//(001) ZrO2 and [100] Ge//[100] ZrO2] without a distinct interfacial layer, unlike the situation observed when ZrO2 is deposited using the same method on Si. Relatively large lattice mismatch (˜10%) between ZrO2 and Ge produced a high areal density of interfacial misfit dislocations. Large hysteresis (>200 mV) and high frequency dispersion were observed in capacitance-voltage measurements due to the high density of interface states. However, a low leakage current density, comparable to values obtained on Si substrates, was observed with the same capacitance density regardless of the high defect density.

SERS-Active Nanoinjector for Intracellular Spectroscopy

NASA Astrophysics Data System (ADS)

Vitol, Elina; Orynbayeva, Zulfiya; Bouchard, Michael; Azizkhan-Clifford, Jane; Friedman, Gary; Gogotsi, Yury

2009-03-01

We developed a multifunctional nanopipette which allows simultaneous cell injection and intacellular surface-enhanced Raman spectroscopy (SERS) analysis. SERS spectra contain the characteristic frequencies of molecular bond vibrations. This is a unique method for studying cell biochemistry and physiology on a single organelle level. Unlike the fluorescence spectroscopy, it does not require any specific staining. The principle of SERS is based on very large electromagnetic field enhancement localized around a nano-rough metallic surface. Gold colloids are widely used SERS substrates. Previously, the colloidal nanoparticles were introduced into a cell by the mechanism of endocytosis. The disadvantage of this method is the uncontrollable aggregation and distribution of gold nanoparticles inside a cell which causes a significant uncertainty in the origin of the acquired data. At the same time, the nanoparticle uptake is irreversible. We present a SERS-active nanoinjector, coated with gold nanoparticles, which enables selective signal acquisition from any point-of-interest inside a cell. The nanoinjector provides a highly localized SERS signal with sub-nanometer resolution in real time.

Diagnosis and treatment of clear cell hidradenocarcinoma of the scalp.

PubMed

Shu, Kai; Xiao, Qungen; Büchele, Fabian; Zhang, Suojun; Jiang, Wei; Lei, Ting

2012-12-01

Clear cell hidradenocarcinoma (CCH) is an exceedingly rare and highly malignant tumor of the eccrine sweat glands. Its treatment is extremely difficult due to the characteristically aggressive clinical course including repeated local recurrence and uncontrollable distal metastasis coming along with a very poor prognosis. Most published case studies recommend a wide surgical excision followed by adjuvant conservative therapy, which is generally considered to be the standard treatment. Two cases of nodular CCH of the scalp either presenting as a singular primary lesion or at an already metastatic stage were analyzed retrospectively. Wide local excision of the tumor couldn't prevent the primary carcinoma from recurring and metastasizing. Both cases received various therapies but the results were unsatisfactory. Although most authors have recommended that early wide surgical excision of the tumor is a feasible therapeutic measurement, our results raise doubts on the efficacy of this treatment strategy. As alternative approaches (i.e. chemotherapy, radiotherapy) are similarly controversial, further studies and a wide exchange of clinical experiences are crucial.

Controlled and Uncontrolled Subject Descriptions in the CF Database: A Comparison of Optimal Cluster-Based Retrieval Results.

ERIC Educational Resources Information Center

Shaw, W. M., Jr.

1993-01-01

Describes a study conducted on the cystic fibrosis (CF) database, a subset of MEDLINE, that investigated clustering structure and the effectiveness of cluster-based retrieval as a function of the exhaustivity of the uncontrolled subject descriptions. Results are compared to calculations for controlled descriptions based on Medical Subject Headings…

40 CFR Table 3 to Subpart Uuuu of... - Initial Compliance With Emission Limits and Work Practice Standards

Code of Federal Regulations, 2012 CFR

2012-07-01

...) you prepare a material balance that includes the pertinent data used to determine the percent... uncontrolled total sulfide emissions were reduced by at least 75%; (3) you prepare a material balance that... uncontrolled total sulfide emissions were reduced by at least 35%; (3) you prepare a material balance that...

40 CFR Table 3 to Subpart Uuuu of... - Initial Compliance With Emission Limits and Work Practice Standards

Code of Federal Regulations, 2013 CFR

2013-07-01

...) you prepare a material balance that includes the pertinent data used to determine the percent... uncontrolled total sulfide emissions were reduced by at least 75%; (3) you prepare a material balance that... uncontrolled total sulfide emissions were reduced by at least 35%; (3) you prepare a material balance that...

40 CFR Table 3 to Subpart Uuuu of... - Initial Compliance With Emission Limits and Work Practice Standards

Code of Federal Regulations, 2014 CFR

2014-07-01

...) you prepare a material balance that includes the pertinent data used to determine the percent... uncontrolled total sulfide emissions were reduced by at least 75%; (3) you prepare a material balance that... uncontrolled total sulfide emissions were reduced by at least 35%; (3) you prepare a material balance that...

Young-Age Gender Differences in Mathematics Mediated by Independent Control or Uncontrollability

ERIC Educational Resources Information Center

Zirk-Sadowski, Jan; Lamptey, Charlotte; Devine, Amy; Haggard, Mark; Szucs, Dénes

2014-01-01

We studied whether the origins of math anxiety can be related to a biologically supported framework of stress induction: (un)controllability perception, here indicated by self-reported independent efforts in mathematics. Math anxiety was tested in 182 children (8- to 11-year-olds). "Latent factor modeling" was used to test hypotheses on…

40 CFR Table 2 to Subpart Ffff of... - Emission Limits and Work Practice Standards for Batch Process Vents

Code of Federal Regulations, 2012 CFR

2012-07-01

... Pollutants: Miscellaneous Organic Chemical Manufacturing Pt. 63, Subpt. FFFF, Table 2 Table 2 to Subpart FFFF... Group 1 batch process vents a. Reduce collective uncontrolled organic HAP emissions from the sum of all... a flare); or Not applicable. b. Reduce collective uncontrolled organic HAP emissions from the sum of...

Job strain, blood pressure and response to uncontrollable stress.

PubMed

Steptoe, A; Cropley, M; Joekes, K

1999-02-01

The association between cardiovascular disease risk and job strain (high-demand, low-control work) may be mediated by heightened physiological stress responsivity. We hypothesized that high levels of job strain lead to increased cardiovascular responses to uncontrollable but not controllable stressors. Associations between job strain and blood pressure reductions after the working day (unwinding) were also assessed. Assessment of cardiovascular responses to standardized behavioral tasks, and ambulatory monitoring of blood pressure and heart rate during a working day and evening. We studied 162 school teachers (60 men, 102 women) selected from a larger survey as experiencing high or low job strain. Blood pressure, heart rate and electrodermal responses to an externally paced (uncontrollable) task and a self-paced (controllable) task were assessed. Blood pressure was monitored using ambulatory apparatus from 0900 to 2230 h on a working day. The groups of subjects with high and low job strain did not differ in demographic factors, body mass or resting cardiovascular activity. Blood pressure reactions to the uncontrollable task were greater in high than low job-strain groups, but responses to the controllable task were not significantly different between groups. Systolic and diastolic blood pressure did not differ between groups over the working day, but decreased to a greater extent in the evening in subjects with low job strain. Job strain is associated with a heightened blood pressure response to uncontrollable but not controllable tasks. The failure of subjects with high job strain to show reduced blood pressure in the evening may be a manifestation of chronic allostatic load.

An attributional analysis of excuse giving: studies of a naive theory of emotion.

PubMed

Weiner, B; Amirkhan, J; Folkes, V S; Verette, J A

1987-02-01

We conducted four studies that pertained to excuses given for a broken social contract. In an initial field investigation, participants recalled occasions in which they had given true and false reasons for not fulfilling a social obligation. Communicated reasons tended to be external to the person, uncontrollable, and unintentional (e.g., "My car broke down"), whereas withheld reasons tended to be internal, controllable, and either intentional (e.g., "I did not want to go") or unintentional (e.g., "I forgot"). The external uncontrollable excuses were anticipated to lessen the anger of the wronged party. In a subsequent simulation study, excuses based on the categories detected in Experiment 1 were manipulated and related to anger ratings. The same pattern of results was displayed, with intent and negligence provoking the highest anger ratings. The final two studies involved laboratory manipulation of a communicated reason for coming late to an experiment. In Experiment 3, a confederate conveyed either an internal controllable, an external uncontrollable, or no reason for making a subject wait, whereas in Experiment 4, subjects were detained and created their own good, bad, any, or no excuse for being tardy, which was communicated to a second, waiting subject. A consistent pattern of good excuse/external uncontrollable reason and bad excuse/internal controllable reason was displayed; offering no excuse resulted in the same judgments as giving a poor excuse. Relative to the external uncontrollable reasons, internal controllable excuses for being late augmented aversive emotional reactions, increased negative personality ratings, and resulted in a desire for no further social contact.(ABSTRACT TRUNCATED AT 250 WORDS)

[Primary care physicians behaviour on hypertensive patients with poor blood pressure control. The PRESCAP 2006 study].

PubMed

Alonso-Moreno, F J; Llisterri Caro, J L; Rodríguez-Roca, G C; Ferreiro Madueño, M; González-Segura Alsina, D; Divisón Garrote, J A; Banegas, J R; Barrios Alonso, V; Lou Arnal, S; Sánchez Ruiz, T; Santos Rodríguez, J A; Durá Belinchón, R

2008-09-01

There is little information available on Therapeutic Inertia in Primary Care (PC). This study aimed to know the therapeutic behavior of the physician for uncontrolled hypertensive patients. Cross-sectional, multicenter study that included hypertensive patients of both genders, under pharmacological treatment who were recruited consecutively in the PC out-patient clinic in all of Spain. Social-demographic, clinical and treatment data were recorded, as well as the motives for eventual therapeutic modification. Adequate BP control was considered when BP values were below 140/90 mmHg in general, and below 130/80 mmHg in diabetes, renal insufficiency or cardiovascular disease. A total of 10,520 patients (53.7% women) were included with average age of 64.6 (11.3 years). Of these, 44.4% the patients were receiving monotherapy and 55.6% were treated with combined therapy (two drugs 41.2%, three drugs 11.7%, and more than three 2.8%). Uncontrolled hypertension was found in 58.6% (95% CI. 57.6-59.5) of the patients. Treatment was modified by physicians in 30.4% (95% CI. 29.2-31.6) of the uncontrolled patients, combination with another drug being the most frequent behavior (46.3%), followed by dose increase (26.1%), and antihypertensive drug switch (22.8%). The perception of the physician of good BP control was the factor most associated with not modifying the treatment in uncontrolled patients. Study results showed that the PC physician modified antihypertensive treatment in only 3 out of 10 uncontrolled patients. When treatment modification was made, association of drugs was the most frequent behavior.

Color correction with blind image restoration based on multiple images using a low-rank model

NASA Astrophysics Data System (ADS)

Li, Dong; Xie, Xudong; Lam, Kin-Man

2014-03-01

We present a method that can handle the color correction of multiple photographs with blind image restoration simultaneously and automatically. We prove that the local colors of a set of images of the same scene exhibit the low-rank property locally both before and after a color-correction operation. This property allows us to correct all kinds of errors in an image under a low-rank matrix model without particular priors or assumptions. The possible errors may be caused by changes of viewpoint, large illumination variations, gross pixel corruptions, partial occlusions, etc. Furthermore, a new iterative soft-segmentation method is proposed for local color transfer using color influence maps. Due to the fact that the correct color information and the spatial information of images can be recovered using the low-rank model, more precise color correction and many other image-restoration tasks-including image denoising, image deblurring, and gray-scale image colorizing-can be performed simultaneously. Experiments have verified that our method can achieve consistent and promising results on uncontrolled real photographs acquired from the Internet and that it outperforms current state-of-the-art methods.

Percutaneous laser ablation of benign and malignant thyroid nodules.

PubMed

Papini, Enrico; Bizzarri, Giancarlo; Pacella, Claudio M

2008-10-01

Percutaneous image-guided procedures, largely based on thermal ablation, are at present under investigation for achieving a nonsurgical targeted cytoreduction in benign and malignant thyroid lesions. In several uncontrolled clinical trials and in two randomized clinical trials, laser ablation has demonstrated a good efficacy and safety for the shrinkage of benign cold thyroid nodules. In hyperfunctioning nodules, laser ablation induced a nearly 50% volume reduction with a variable frequency of normalization of thyroid-stimulating hormone levels. Laser ablation has been tested for the palliative treatment of poorly differentiated thyroid carcinomas, local recurrences or distant metastases. Laser ablation therapy is indicated for the shrinkage of benign cold nodules in patients with local pressure symptoms who are at high surgical risk. The treatment should be performed only by well trained operators and after a careful cytological evaluation. Laser ablation does not seem to be consistently effective in the long-term control of hyperfunctioning thyroid nodules and is not an alternative treatment to 131I therapy. Laser ablation may be considered for the cytoreduction of tumor tissue prior to external radiation therapy or chemotherapy of local or distant recurrences of thyroid malignancy that are not amenable to surgical or radioiodine treatment.

40 CFR Table 2 to Subpart Ffff of... - Emission Limits and Work Practice Standards for Batch Process Vents

Code of Federal Regulations, 2010 CFR

2010-07-01

...: Miscellaneous Organic Chemical Manufacturing Pt. 63, Subpt. FFFF, Table 2 Table 2 to Subpart FFFF of Part 63... vents a. Reduce collective uncontrolled organic HAP emissions from the sum of all batch process vents... applicable. b. Reduce collective uncontrolled organic HAP emissions from the sum of all batch process vents...

40 CFR Table 2 to Subpart Ffff of... - Emission Limits and Work Practice Standards for Batch Process Vents

Code of Federal Regulations, 2011 CFR

2011-07-01

...: Miscellaneous Organic Chemical Manufacturing Pt. 63, Subpt. FFFF, Table 2 Table 2 to Subpart FFFF of Part 63... vents a. Reduce collective uncontrolled organic HAP emissions from the sum of all batch process vents... applicable. b. Reduce collective uncontrolled organic HAP emissions from the sum of all batch process vents...

Automated Pilot Advisory System

NASA Technical Reports Server (NTRS)

Parks, J. L., Jr.; Haidt, J. G.

1981-01-01

An Automated Pilot Advisory System (APAS) was developed and operationally tested to demonstrate the concept that low cost automated systems can provide air traffic and aviation weather advisory information at high density uncontrolled airports. The system was designed to enhance the see and be seen rule of flight, and pilots who used the system preferred it over the self announcement system presently used at uncontrolled airports.

Level of asthma control and its relationship with medication use in asthma patients in Brazil*

PubMed Central

Marchioro, Josiane; Gazzotti, Mariana Rodrigues; Nascimento, Oliver Augusto; Montealegre, Federico; Fish, James; Jardim, José Roberto

2014-01-01

OBJECTIVE: To assess asthma patients in Brazil in terms of the level of asthma control, compliance with maintenance treatment, and the use of rescue medication. METHODS: We used data from a Latin American survey of a total of 400 asthma patients in four Brazilian state capitals, all of whom completed a questionnaire regarding asthma control and treatment. RESULTS: In that sample, the prevalence of asthma was 8.8%. Among the 400 patients studied, asthma was classified, in accordance with the Global Initiative for Asthma criteria, as controlled, partially controlled, and uncontrolled in 37 (9.3%), 226 (56.5%), and 137 (34.3%), respectively. In those three groups, the proportion of patients on maintenance therapy in the past four weeks was 5.4%, 19.9%, and 41.6%, respectively. The use of rescue medication was significantly more common in the uncontrolled asthma group (86.9%; p < 0.001). CONCLUSIONS: Our findings suggest that, in accordance with the established international criteria, asthma is uncontrolled in the vast majority of asthma patients in Brazil. Maintenance medications are still underutilized in Brazil, and patients with partially controlled or uncontrolled asthma are more likely to use rescue medications and oral corticosteroids. PMID:25410836

Long-term effect of pH on short-chain fatty acids accumulation and microbial community in sludge fermentation systems.

PubMed

Yuan, Yue; Wang, Shuying; Liu, Ye; Li, Baikun; Wang, Bo; Peng, Yongzhen

2015-12-01

Long-term effect of pH (4, 10, and uncontrolled) on short-chain fatty acid (SCFA) accumulation, microbial community and sludge reduction were investigated in waste activated sludge (WAS) fermentors for over 90days. The average SCFAs accumulation was 1721.4 (at pH 10), 114.2 (at pH 4), and 58.1 (at uncontrolled pH) mg chemical oxygen demand (COD)/L. About 31.65mgCOD/L was produced at pH 10, accounting for 20% of the influent COD. Illumina MiSeq sequencing revealed that Alcaligenes (hydrolic bacteria) and Erysipelothrix (acidogenic bacteria) were enriched at pH 10, while less acidogenic bacteria existed at pH 4 than pH 10, and no acidogenic bacteria were detected at the uncontrolled pH. The ratios of archaea to bacteria were 1:41, 1:16, and 1:9 at the pH of 10, 4, and uncontrolled. This study elucidated the effects of pH on WAS fermentation, and established the correlation of microbial structure with SCFAs accumulations and sludge reduction. Copyright © 2015 Elsevier Ltd. All rights reserved.

Creatinine plasma at uncontrolled type 2 diabetes mellitus and controlled type 2 diabetes mellitus patients at primary health care in Binjai city, Indonesia

NASA Astrophysics Data System (ADS)

Rusdiana; Savira, M.; Syahputra, M.; Santoso, A.

2018-03-01

The aim of the study knowing the comparison creatinine plasma levels at uncontrolled type 2 diabetes mellitus and controlled type 2 diabetes mellitus patients at Primary Health Care in Binjai city of North Sumatera in Indonesia. This cross-sectional study was conductedon 40 type 2 Diabetes Mellitus patients who attended Primary Health Care in Binjai. Patients with age > 40 years old, (both sexes) were included in the study. We recorded different demographic parameter as age, Body Mass Index, Blood Pressure, and personal history status. And we examined the biochemicalparameters including Hba1c, Fasting Blood Sugar Levels (FBL) and creatinine serum. We separated into two groups base on HbA1c test, controlled type 2 diabetes mellitus and uncontrolled type 2 diabetes mellitus. We measured FBL by using the portable measuring instrument, and Thamrin clinical laboratory measured Hba1c, andwe measured creatinine plasmaby spectrophotometry in Biochemistry laboratory. With statistical analysis using T-test found that there was asignificant differencein creatinine plasma levels between uncontrolled type 2 diabetes mellitus with controlled type 2 diabetes mellitus (p<0.005).

The Comparison of Dietary Behaviors among Rural Controlled and Uncontrolled Hypertensive Patients.

PubMed

Kamran, Aziz; Shekarchi, Ali Akbar; Sharifian, Elham; Heydari, Heshmatolah

2016-01-01

Nutrition is a dominant peripheral factor in increasing blood pressure; however, little information is available about the nutritional status of hypertensive patients in Iran. This study aimed to compare nutritional behaviors of the rural controlled and uncontrolled hypertensive patients and to determine the predictive power of nutritional behaviors from blood pressure. This cross-sectional study was conducted on 671 rural hypertensive patients, using multistage random sampling method in Ardabil city in 2013. Data were collected by a 3-day food record questionnaire. Nutritional data were extracted by Nutritionist 4 software and analyzed by the SPSS 18 software using Pearson correlation, multiple linear regression, ANOVA, and independent t-test. A significant difference was observed in the means of fat intake, cholesterol, saturated fat, sodium, energy, calcium, vitamin C, fiber, and nutritional knowledge between controlled and uncontrolled groups. In the controlled group, sodium, saturated fats, vitamin C, calcium, and energy intake explained 30.6% of the variations in blood pressure and, in the uncontrolled group, sodium, carbohydrate, fiber intake, and nutritional knowledge explained 83% of the variations in blood pressure. There was a significant difference in the nutritional behavior between the two groups and changes in blood pressure could be explained significantly by nutritional behaviors.

Assessment of tools for protection of quality of water: Uncontrollable discharges of pollutants.

PubMed

Dehghani Darmian, Mohsen; Hashemi Monfared, Seyed Arman; Azizyan, Gholamreza; Snyder, Shane A; Giesy, John P

2018-06-06

Selecting an appropriate crisis management plans during uncontrollable loading of pollution to water systems is crucial. In this research the quality of water resources against uncontrollable pollution is protected by use of suitable tools. Case study which was chosen in this investigation was a river-reservoir system. Analytical and numerical solutions of pollutant transport equation were considered as the simulation strategy to calculate the efficient tools to protect water quality. These practical instruments are dilution flow and a new tool called detention time which is proposed and simulated for the first time in this study. For uncontrollable pollution discharge which was approximately 130% of the river's assimilation capacity, as long as the duration of contact (T c ) was considered as a constraint, by releasing 30% of the base flow of the river from the upstream dilution reservoir, the unallowable pollution could be treated. Moreover, when the affected distance (X c ) was selected as a constraint, the required detention time that the rubber dam should detained the water to be treated was equal to 187% of the initial duration of contact. Copyright © 2018 Elsevier Inc. All rights reserved.

Association of Controlled and Uncontrolled Hypertension With Workplace Productivity.

PubMed

Unmuessig, Victoria; Fishman, Paul A; Vrijhoef, Hubertus J M; Elissen, Arianne M J; Grossman, David C

2016-03-01

The authors estimated the lost productive time (LPT) due to absenteeism and presenteeism among employees at the Group Health Cooperative with controlled and uncontrolled hypertension compared with normotensive patients. The patients responded to a survey inquiring about health behaviors with links to their medical record to identify diagnoses, blood pressure measurement, and prescription drug dispenses. Individuals with controlled hypertension were more likely to report any LPT relative to individuals with uncontrolled hypertension (40.6% vs 32.6%, P<.05). There were no significant differences in the average hours of LPT due to presenteeism among individuals regardless of their hypertension status but individuals with hypertension were more likely to report hours of LPT due to absenteeism compared with normotensive individuals (1.04 vs 0.59 hours; P=.001). Individuals with uncontrolled hypertension were more likely to report LPT due to absenteeism compared with individuals with controlled hypertension (1.35 vs 0.72 hours; P=.001). There were no significant differences between individuals with hypertension whose blood pressure was controlled and normotensive individuals with respect to the likelihood of reporting any LPT or in the amounts of absenteeism and presenteeism. © 2015 Wiley Periodicals, Inc.

Hypertensive Crisis, Burden, Management, and Outcome at a Tertiary Care Center in Karachi.

PubMed

Almas, Aysha; Ghouse, Ayaz; Iftikhar, Ahmed Raza; Khursheed, Munawwar

2014-01-01

Objectives. Hypertension, if uncontrolled, can lead to hypertensive crisis. We aim to determine the prevalence of hypertensive crisis, its management, and outcome in patients presenting to a tertiary care center in Karachi. Methods. This was a cross-sectional study conducted at the Aga Khan University, Karachi, Pakistan. Adult inpatients (>18 yrs) presenting to the ER who were known hypertensive and had uncontrolled hypertension were included. Results. Out of 1336 patients, 28.6% (387) had uncontrolled hypertension. The prevalence of hypertensive crisis among uncontrolled hypertensive was 56.3% (218). Per oral calcium channel blocker; 35.4% (137) and intravenous nitrate; 22.7% (88) were the most commonly administered medication in the ER. The mean (SD) drop in SBP in patients with hypertensive crisis on intravenous treatment was 53.1 (29) mm Hg and on per oral treatment was 43 (27) mm Hg. The maximum mean (SD) drop in blood pressure was seen by intravenous sodium nitroprusside; 80 (51) mm Hg in SBP. Acute renal failure was the most common complication with a prevalence of 11.5% (24). Conclusion. The prevalence of hypertensive crisis is high. Per oral calcium channel blocker and intravenous nitrate are the most commonly administered medications in our setup.

Orientation-resolved domain mapping in tetragonal SrTiO 3 using polarized Raman spectroscopy

DOE PAGES

Gray, Jr., Dodd J.; Merz, Tyler A.; Hikita, Yasuyuki; ...

2016-12-16

Here, we present microscopically resolved, polarized spectroscopy of Raman scattering collected from tetragonal SrTiO 3. The anisotropic response of first-order Raman peaks within a single tetragonal domain has been measured. From these data, we assign symmetries to the phonons seen in the first-order Raman spectrum which is normally complicated by uncontrolled domain structure. Using a translation stage, we map the local domain orientation of a 3–μm 3 crystal volume near the laser focus and compare it to wide-field polarized images. This technique can be performed with readily available instruments and is relevant to the study of a wide range ofmore » related materials, interfaces, and devices.« less

Epithelial IgG and its relationship to the loss of F508 in the common mutant form of the cystic fibrosis transmembrane conductance regulator.

PubMed

Treharne, Kate J; Cassidy, Diane; Goddard, Catharine; Colledge, William H; Cassidy, Andrew; Mehta, Anil

2009-08-06

The most debilitating feature of cystic fibrosis (CF) disease is uncontrolled inflammation of respiratory epithelium. The relationship between the commonest mutated form of CFTR (F508del or DeltaF508) and inflammation has not yet been elucidated. Here, we present a new paradigm suggesting that CFTR can interact with intra-epithelial IgG, establishing a direct link between normal CFTR and the immune system. Further, our data show that the amino-acid sequence local to F508 can bind IgG with high affinity, dependent on F508, such that loss of F508 abolishes this link both in vitro and in the intact cell.

External and interstitial radiation therapy of carcinoma of the oral tongue. A review of 32 years' experience.

PubMed

Fu, K K; Ray, J W; Chan, E K; Phillips, T L

1976-01-01

In 204 patients with squamous cell carcinoma of the oral tongue treated with radiation therapy, the most significant prognostic factors appeared to be the presence of neck lymph node metastasis on presentation and the status of the disease three months after treatment. The most common site of failure was the primary lesion, either alone or with neck disease. External irradiation alone was seldom successful. Use of peroral cone irradiation or interstitial implants, either alone or in combination with external irradiation, achieved good local control in early lesions. When the primary tumor was uncontrolled by radiation therapy, salvage with surgery was rare. When failure occurred in the neck alone, radical neck dissection was successful in the majority of cases.

Studies of uncontrolled air traffic patterns, phase 1

NASA Technical Reports Server (NTRS)

Baxa, E. G., Jr.; Scharf, L. L.; Ruedger, W. H.; Modi, J. A.; Wheelock, S. L.; Davis, C. M.

1975-01-01

The general aviation air traffic flow patterns at uncontrolled airports are investigated and analyzed and traffic pattern concepts are developed to minimize the midair collision hazard in uncontrolled airspace. An analytical approach to evaluate midair collision hazard probability as a function of traffic densities is established which is basically independent of path structure. Two methods of generating space-time interrelationships between terminal area aircraft are presented; one is a deterministic model to generate pseudorandom aircraft tracks, the other is a statistical model in preliminary form. Some hazard measures are presented for selected traffic densities. It is concluded that the probability of encountering a hazard should be minimized independently of any other considerations and that the number of encounters involving visible-avoidable aircraft should be maximized at the expense of encounters in other categories.

Clinical and Economic Burden of Elevated Blood Eosinophils in Patients With and Without Uncontrolled Asthma.

PubMed

Casciano, Julian; Krishnan, Jerry; Dotiwala, Zenobia; Li, Chenghui; Sun, Shawn X

2017-01-01

The European Respiratory Society and American Thoracic Society (ERS/ATS) published guidelines in 2014 for the evaluation and treatment of asthma. These guidelines draw attention to management of patients with asthma that remains uncontrolled despite therapy. One phenotypic characteristic of therapy-resistant asthma is eosinophil elevation. It is important to better understand the burden of care gaps in this patient subgroup in order to support improved treatment strategies in the future. To quantify the economic burden of asthma patients with and without peripheral blood eosinophil elevation. A retrospective cohort study was conducted using data from patients aged 12 years or older with a diagnosis of asthma using electronic health records of over 2 million patients between 2004-2010. Patients with a diagnosis of chronic obstructive pulmonary disease, Churg Strauss syndrome/Wegener's granulomatosis, eosinophilia, cystic/pulmonary fibrosis, allergic bronchopulmonary aspergillosis, or lung cancer in the 12-month period before the date of asthma diagnosis were excluded. Patients with asthma were followed for 12 months after their initial asthma diagnosis to identify those with controlled versus uncontrolled asthma based on ERS/ATS criteria. Patients with at least 1 peripheral blood eosinophil test result of ≥ 400 cells/µL were classified as those with elevated eosinophils. Total annual paid-claim cost was compared by eosinophil levels within the controlled and uncontrolled asthma subgroups. Costs were adjusted to 2015 U.S. dollars. Patients were stratified by control level, and generalized linear modeling regressions were used to assess the magnitude of increase in cost of the elevated eosinophil group. A total of 2,701 patients were included in the study, of which 17% had uncontrolled asthma and 21% had elevated eosinophils. The mean total annual cost of patients with uncontrolled asthma was more than 2 times the cost of those with controlled asthma ($18,341 vs. $8,670, P < 0.001). Patients with uncontrolled asthma in the elevated eosinophil group had almost double the total cost ($28,644 vs. $14,188, P = 0.008) compared with those with blood eosinophil levels in a normal range. Similarly, patients classified as those with controlled asthma in the elevated eosinophil group had almost twice the average costs as those without elevated eosinophils ($14,754 vs. $7,203, P < 0.001). Uncontrolled asthma with elevated eosinophils had 4 times greater hospital admissions and over 4 times higher total costs than controlled asthma without elevated eosinophils. Among patients with uncontrolled asthma, patients with elevated eosinophils had a 53% increase in mean cost ($17,723 vs. $11,581, P < 0.001) compared with patients without elevated eosinophils. Among patients with controlled asthma, patients with elevated eosinophils had a 62% increase in mean cost ($8,897 vs. $5,486, P < 0.001) compared with patients without elevated eosinophils. Elevated peripheral blood eosinophil level is associated with higher cost irrespective of disease control status. This study was funded by Teva Pharmaceuticals. Dotiwala and Casciano report consulting and writing fees from Teva Pharmaceuticals for work on this study. Sun is an employee and stockholder of Teva Pharmaceuticals. Li reports consulting fees from eMAX Health. All authors contributed to study design. Dotiwala took the lead in data collection, along with the other authors, and data interpretation was performed primarily by Krishnan, Sun, and Li, along with Casciano and Dotiwala. The manuscript was written by Casciano, Dotiwala, and Li, along with Sun and Krishnan, and revised by Casciano, Dotiwala, Sun, and Li, with assistance from Krishnan.

Boundary conditions for the solution of the three-dimensional Poisson equation in open metallic enclosures

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

Biswas, Debabrata; Singh, Gaurav; Kumar, Raghwendra

2015-09-15

Numerical solution of the Poisson equation in metallic enclosures, open at one or more ends, is important in many practical situations, such as high power microwave or photo-cathode devices. It requires imposition of a suitable boundary condition at the open end. In this paper, methods for solving the Poisson equation are investigated for various charge densities and aspect ratios of the open ends. It is found that a mixture of second order and third order local asymptotic boundary conditions is best suited for large aspect ratios, while a proposed non-local matching method, based on the solution of the Laplace equation,more » scores well when the aspect ratio is near unity for all charge density variations, including ones where the centre of charge is close to an open end or the charge density is non-localized. The two methods complement each other and can be used in electrostatic calculations where the computational domain needs to be terminated at the open boundaries of the metallic enclosure.« less

Open Air Silicon Deposition by Atmospheric Pressure Plasma under Local Ambient Gas Control

NASA Astrophysics Data System (ADS)

Naito, Teruki; Konno, Nobuaki; Yoshida, Yukihisa

2015-09-01

In this paper, we report open air silicon (Si) deposition by combining a silane free Si deposition technology and a newly developed local ambient gas control technology. Recently, material processing in open air has been investigated intensively. While a variety of materials have been deposited, there were only few reports on Si deposition due to the susceptibility to contamination and the hazardous nature of source materials. Since Si deposition is one of the most important processes in device fabrication, we have developed open air silicon deposition technologies in BEANS project. For a clean and safe process, a local ambient gas control head was designed. Process gas leakage was prevented by local evacuation, and air contamination was shut out by inert curtain gas. By numerical and experimental investigations, a safe and clean process condition with air contamination less than 10 ppm was achieved. Si film was deposited in open air by atmospheric pressure plasma enhanced chemical transport under the local ambient gas control. The film was microcrystalline Si with the crystallite size of 17 nm, and the Hall mobility was 2.3 cm2/V .s. These properties were comparable to those of Si films deposited in a vacuum chamber. This research has been conducted as one of the research items of New Energy and Industrial Technology Development Organization ``BEANS'' project.

Orbital apex syndrome secondary to a fungal nasal septal abscess caused by Scedosporium apiospermum in a patient with uncontrolled diabetes: a case report.

PubMed

Kishimoto, Ippei; Shinohara, Shogo; Ueda, Tetsuhiro; Tani, Shoichi; Yoshimura, Hajime; Imai, Yukihiro

2017-09-26

Orbital apex syndrome is a localized type of orbital cellulitis, where mass lesions occur at the apex of the cranial nerves. Although nasal septal abscess is uncommon, the organism most likely to cause nasal septal abscess is Staphylococcus aureus, and fungal septal abscesses are rare. Here we present an extremely rare and serious case of orbital apex syndrome secondary to fungal nasal septal abscess caused by Scedosporium apiospermum in a patient with uncontrolled diabetes. A 59-year-old man with a 1-month history of headache underwent consultation in an otolaryngological clinic of a general hospital. He was diagnosed with nasal septal abscess and was treated with incisional drainage and 1 month of an antibiotic drip; however, his symptoms persisted. The patient later complained of diplopia due to bilateral abducens nerve palsy, and was then referred to the department of Otolaryngology - Head and Neck Surgery, Kobe City Medical Center General Hospital. The septal lesion was biopsied under general anesthesia, and S. apiospermum was detected using polymerase chain reaction. The patient was treated with an antifungal drug and surgical resection of the lesion was performed. Although the patient survived, he lost his eyesight. This patient represents the second reported case of nasal septal abscess and orbital apex syndrome caused by S. apiospermum. If not treated properly, septal abscess can be life-threatening and cause severe complications, such as ablepsia.

Improving Blood Pressure Control Using Smart Technology.

PubMed

Ciemins, Elizabeth L; Arora, Anupama; Coombs, Nicholas C; Holloway, Barbara; Mullette, Elizabeth J; Garland, Robin; Walsh Bishop-Green, Shannon; Penso, Jerry; Coon, Patricia J

2018-03-01

The authors sought to determine if wireless oscillometric home blood pressure monitoring (HBPM) that integrates with smartphone technology improves blood pressure (BP) control among patients with new or existing uncontrolled hypertension (HTN). A prospective observational cohort study monitored BP control before and after an educational intervention and introduction to HBPM. Patients in the intervention group were instructed to track their BP using a smartphone device three to seven times per week. Cases were matched to controls at a 1:3 allocation ratio on several clinical characteristics over the same period and received usual care. The proportion of patients with controlled BP was compared between groups at pre- and postintervention, ∼9 months later. Results and Materials: The total study population included 484 patients with mean age 60 years (range 23-102 years), 47.7% female, and 84.6% Caucasian. Mean preintervention BP was 137.8 mm Hg systolic and 81.4 mm Hg diastolic. Mean BP control rates improved for patients who received HBPM from 42% to 67% compared with matched control patients who improved from 59% to 67% (p < 0.01). HBPM with smartphone technology has the potential to improve HTN management among patients with uncontrolled or newly diagnosed HTN. Technology needs to be easy to use and operate and would work best when integrated into local electronic health record systems. In systems without this capability, medical assistants or other personnel may be trained to facilitate the process. Nurse navigator involvement was instrumental in bridging communication between the patients and provider.

A Few Meters Matter: Local Habitats Drive Reproductive Cycles in a Tropical Lizard.

PubMed

Otero, Luisa M; Huey, Raymond B; Gorman, George C

2015-09-01

Reproductive phenology often varies geographically within species, driven by environmental gradients that alter growth and reproduction. However, environments can differ between adjacent habitats at single localities. In lowland Puerto Rico, both open (sunny, warm) and forested (shady, cool) habitats may be only meters apart. The lizard Anolis cristatellus lives in both habitats: it thermoregulates carefully in the open but is a thermoconformer in the forest. To determine whether reproduction differs between habitats, we compared reproductive cycles of females in open versus forest habitats at two localities for over 2 years. Open females were more likely than forest females to be reproductive throughout the year, probably because open females were able to bask and thereby achieve warmer body temperatures. These between-habitat differences in reproduction were especially marked in cool months and are equivalent in magnitude to those between populations separated by elevation. Thus, environmental differences (even on a microlandscape scale) matter to reproduction and probably to demography.

40 CFR Table 2 to Subpart Mmm of... - Standards for New and Existing PAI Sources

Code of Federal Regulations, 2010 CFR

2010-07-01

... TOC. Processes having uncontrolled HCl and chlorine emissions ≥6.8 Mg/yr 94% for HCl and chlorine per... November 10, 1997 98% gaseous organic HAP control per vent or ≤20 ppmv TOC outlet limit. New: Processes having uncontrolled organic HAP emissions ≥0.15 Mg/yr 98% for organic HAP per process or ≤20 ppmv TOC...

Molecular genetics of the glaucomas: Mapping of the first five {open_quotes}GLC{close_quotes} loci

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

Raymond, V.

1997-02-01

Glaucoma encompasses a complex of ocular-disease entities characterized by an optic neuropathy in which degeneration of retinal ganglion cells leads to a characteristic excavation of the head of the optic nerve. Such damage causes progressive narrowing of the visual fields and, when uncontrolled, blindness. Affected people often have ocular hypertension defined as intraocular pressures consistently >21 mm Hg in both eyes. Although ocular hypertension is no longer an obligatory diagnostic criterion for glaucoma, it is still recognized as one of the most important risk factors. A diagnosis of glaucoma is made after observation of the characteristic atrophy of the opticmore » nerve, which is associated with typical visual field defects. In 1992, the World Health Organization estimated that, in the global population, 5.2 million people were blind as a result of glaucoma, making it the third leading cause of blindness worldwide. The most common form is adult-onset primary open-angle glaucoma, which represents {ge}50% of all cases of glaucoma. Among Caucasians, this form of the disorder affects {approximately}2% of the population >45 years old. In African Americans, prevalence of adult-onset open-angle glaucoma is three to four times higher than that observed in White Americans. More than 15 million North Americans may have some form of glaucoma, but at least half of them may not be aware of it. 43 refs., 1 tab.« less

INFORMATIONAL STRESS AS A DEPRESSION INDUCING FACTOR (EXPERIMENTAL STUDY).

PubMed

Matitaishvili, T; Domianidze, T; Burdjanadze, G; Nadareishvili, D; Khananashvili, M

2017-01-01

Chronic psychogenic stress represents the major initiating agent of psychoneural diseases including depression. We used informational stress model for the purpose of modelling chronic psychogenic stress and depression. The aim of the research was to study behavior of dominant and submissive rats at different stages of informational stress and during depression state. In order to study anxiety and depressive behavior of rats we used "forced swim", "elevated cross maze" and "open-field" tests. The obtained results showed that chronic stressing procedure performed on rats by using the mentioned "informational" stress model led to the development of depression both in dominant and submissive rats. Stressing procedure caused sharp increase of serotonin concentration in hypothalamus of dominant and submissive rats. Under behavioral depression background, sharp increase of serotonin concentration in hypothalamus has been revealed which is caused by the peculiarities of stress model (by uncontrollable stressor. Specifically, by inevitable electric painful irritation).

Laparoscopic inguinal hernioplasty after robot-assisted laparoscopic radical prostatectomy.

PubMed

Sakon, M; Sekino, Y; Okada, M; Seki, H; Munakata, Y

2017-10-01

To evaluate the efficacy and safety of laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair in patients who have undergone robot-assisted laparoscopic radical prostatectomy (RALP). From July 2014 to December 2016, TAPP inguinal hernia repair was conducted in 40 consecutive patients who had previously undergone RALP. Their data were retrospectively analyzed as an uncontrolled case series. The mean operation time in patients who had previously undergone RALP was 99.5 ± 38.0 min. The intraoperative blood loss volume was small, and the duration of hospitalization was 2.0 ± 0.5 days. No intraoperative complications or major postoperative complications occurred. During the average 11.2-month follow-up period, no patients who had previously undergone prostatectomy developed recurrence. Laparoscopic TAPP inguinal hernia repair after RALP was safe and effective. TAPP inguinal hernia repair may be a valuable alternative to open hernioplasty.

Clinical Evaluation of Kshara sutra Therapy in the management of Bhagandara( Fistula- in-Ano)- A prospective study.

PubMed

Panigrahi, Hemanta Kumar; Rani, Rakesh; Padhi, M M; Lavekar, G S

2009-01-01

A prospective study of 50 patients suffering from Bhagandara(Fistula in Ano) (age ranging from 18-54years) treated by Kshara sutra therapy Kshara sutra unit, Central research Unit, Punjabi bagh, New Delhi January 2007 to July 2008. To determine the incidence of low or high anal fistula, recurrence rate following Kshara sutra therapy and effect of Ksharasutra therapy on the Bhagandara. The fifty patients (50) were selected randomly in the Out Patient Department. Uncontrolled open level Study. Patients were followed to see the incidence of recurrence, effect of Kshara Sutra Therapy on incontinence. Overall recurrence rate was only 5.88 %. Minor incontinence was observed only following Kshara sutra Therapy for high variety for which no treatment was given. No such complication occurred in low variety. Bhagandara (Fistula in Ano) can be treated by Kshara Sutra Therapy with minimal loss of sphincter muscle and low reoccurrence rate.

Noise Response Data Reveal Novel Controllability Gramian for Nonlinear Network Dynamics

PubMed Central

Kashima, Kenji

2016-01-01

Control of nonlinear large-scale dynamical networks, e.g., collective behavior of agents interacting via a scale-free connection topology, is a central problem in many scientific and engineering fields. For the linear version of this problem, the so-called controllability Gramian has played an important role to quantify how effectively the dynamical states are reachable by a suitable driving input. In this paper, we first extend the notion of the controllability Gramian to nonlinear dynamics in terms of the Gibbs distribution. Next, we show that, when the networks are open to environmental noise, the newly defined Gramian is equal to the covariance matrix associated with randomly excited, but uncontrolled, dynamical state trajectories. This fact theoretically justifies a simple Monte Carlo simulation that can extract effectively controllable subdynamics in nonlinear complex networks. In addition, the result provides a novel insight into the relationship between controllability and statistical mechanics. PMID:27264780

Ashtanga yoga for children and adolescents for weight management and psychological well being: an uncontrolled open pilot study.

PubMed

Benavides, Sandra; Caballero, Joshua

2009-05-01

The objective of this pilot study was to determine the effect of yoga on weight in youth at risk for developing type 2 diabetes. Secondarily, the impact of participation in yoga on self-concept and psychiatric symptoms was measured. A 12-week prospective pilot Ashtanga yoga program enrolled twenty children and adolescents. Weight was measured before and after the program. All participants completed self-concept, anxiety, and depression inventories at the initiation and completion of the program. Fourteen predominately Hispanic children, ages 8-15, completed the program. The average weight loss was 2kg. Weight decreased from 61.2+/-20.2kg to 59.2+/-19.2kg (p=0.01). Four of five children with low self-esteem improved, although two had decreases in self-esteem. Anxiety symptoms improved in the study. Ashtanga yoga may be beneficial as a weight loss strategy in a predominately Hispanic population.

A novel permeabilization protocol to obtain intracellular 3D immunolabeling for electron tomography.

PubMed

Jiménez, Nuria; Post, Jan A

2014-01-01

Electron tomography (ET) is a very important high-resolution tool for 3D imaging in cell biology. By combining the technique with immunolabeling, ET can provide essential insights into both cellular architecture and dynamics. We recently developed a protocol to achieve 3D immunolabeling of intracellular antigens without the need for uncontrolled permeabilization steps that cause random, extensive cell membrane disruption. Here we describe this novel method based on well-controlled permeabilization by targeted laser cell perforation. Mechanical permeabilization of the plasma membrane can be applied at specific sites without affecting other parts of the plasma membrane and intracellular membranes. Despite the relatively small opening created in the plasma membrane, the method allows specific 3D immunolocalization of cytoplasmic antigens in cultured cells by a pre-embedment protocol. The approach is unique and leads to a superior ultrastructural preservation for transmission electron microscopy and electron tomography.

Delayed diagnosis of xanthogranulomatous pyelonephritis in a quadriplegic patient with uncontrolled cutaneous fistula

PubMed Central

Yang, Jae-Hyuk; Shin, Jin Yong; Roh, Si-Gyun; Chang, Suk-Choo; Lee, Nae-Ho

2018-01-01

Abstract Rationale: Xanthogranulomatous pyelonephritis (XGP) is a chronic destructive granulomatous inflammation that is characterized by urinary tract obstruction and invasion of the renal parenchyma. Although rare, XGP can lead to fatal complications, including perinephric inflammation, psoas abscess, and cutaneous fistula. Patient concerns: A quadriplegic patient initially presented to the hospital with a chronic open wound and cutaneous fistula. Diagnoses: Abdominal computed tomography revealed a renal obstructing stone and enlarged right kidney with a perinephric fluid collection that communicated with the cutaneous fistula. Interventions: The patient underwent a right nephrectomy at the department of urology. Outcomes: Two months after surgery, the patient was clinically well with no discharging fistula. Lessons: The XGP accompanied by complications requires an immediate evaluation and early diagnosis. In this case, the diagnosis was delayed because the state of quadriplegia rendered no symptoms of XGP. PMID:29480882

UK technical activities associated with the return to Earth of the MIR space station

NASA Astrophysics Data System (ADS)

Crowther, Richard; Tremayne-Smith, Richard

2002-11-01

The British National Space Centre (BNSC) acts as the focus in the United Kingdom (UK) for space-related activities. With the anticipated return to Earth of the MIR space station, BNSC established a group of technical experts to consider the associated implications for the UK, and to address both national and international activities relating to the planned de-orbit. In particular, the risk to the UK of an uncontrolled re-entry was considered in contingency planning and the means for the provision of accurate information to the public and media were established to ensure balanced view of the potential hazards that MIR posed to persons and property on the ground. The MIR de-orbit was exemplary, both in terms of the technical activities of the Rosaviakosmos and the safe disposal of MIR in the Pacific, and in relation to the open and effective communication between agencies and the positive reporting by the media.

Ideal resuscitation pressure for uncontrolled hemorrhagic shock in different ages and sexes of rats

PubMed Central

2013-01-01

Introduction Our previous studies demonstrated that 50-60 mmHg mean arterial blood pressure was the ideal target hypotension for uncontrolled hemorrhagic shock during the active hemorrhage in sexually mature rats. The ideal target resuscitation pressure for immature and older rats has not been determined. Methods To elucidate this issue, using uncontrolled hemorrhagic-shock rats of different ages and sexes (6 weeks, 14 weeks and 1.5 years representing pre-adult, adult and older rats, respectively), the resuscitation effects of different target pressures (40, 50, 60, 70 and 80 mmHg) on uncontrolled hemorrhagic shock during active hemorrhage and the age and sex differences were observed. Results Different target resuscitation pressures had different resuscitation outcomes for the same age and sex of rats. The optimal target resuscitation pressures for 6-week-old, 14-week-old and 1.5-year-old rats were 40 to 50 mmHg, 50 to 60 mmHg and 70 mmHg respectively. Ideal target resuscitation pressures were significantly superior to other resuscitation pressures in improving the hemodynamics, blood perfusion, organ function and animal survival of uncontrolled hemorrhagic-shock rats (P < 0.01). For same target resuscitation pressures, the beneficial effect on hemorrhagic shock had a significant age difference (P < 0.01) but no sex difference (P > 0.05). Different resuscitation pressures had no effect on coagulation function. Conclusion Hemorrhagic-shock rats at different ages have different target resuscitation pressures during active hemorrhage. The ideal target resuscitation hypotension for 6-week-old, 14-week-old and 1.5-year-old rats was 40 to 50 mmHg, 50 to 60 mmHg and 70 mmHg, respectively. Their resuscitation effects have significant age difference but had no sex difference. PMID:24020401

Recognizing Disordered Eating in Primary Care Patients with Obesity

PubMed Central

Chacko, Sara A.; Chiodi, Sarah N.; Wee, Christina C.

2015-01-01

Objective In clinical practice, behavioral approaches to obesity treatment focus heavily on diet and exercise recommendations. However, these approaches may not be effective for patients with disordered eating behaviors. Little is known about the prevalence of disordered eating behaviors in primary care patients with obesity or whether they affect difficulty making dietary changes. Methods We conducted a telephone interview of 337 primary care patients aged 18–65 years with BMI≥35kg/m2 in Greater-Boston, 2009–2011 (58% response rate, 69% women). We administered the Three-Factor Eating Questionnaire R-18 (Scores 0–100) and the Impact of Weight on Quality of Life-Lite (IWQOL-lite) (Scores 0–100). We measured difficulty making dietary changes using four questions regarding perceived difficulty changing diet (Scores 0–10). Results 50% of patients reported high emotional eating (score>50) and 28% reported high uncontrolled eating (score>50). Women were more likely to report emotional [OR=4.14 (2.90, 5.92)] and uncontrolled eating [OR=2.11 (1.44, 3.08)] than men. African Americans were less likely than Caucasians to report emotional [OR=0.29 (95% CI: 0.19, 0.44)] and uncontrolled eating [OR=0.11 (0.07, 0.19)]. For every 10-point reduction in QOL score (IWQOL-lite), emotional and uncontrolled eating scores rose significantly by 7.82 and 5.48, respectively. Furthermore, participants who reported emotional and uncontrolled eating reported greater difficulty making dietary changes. Conclusions Disordered eating behaviors are prevalent among obese primary care patients and disproportionately affect women, Caucasians, and patients with poor QOL. These eating behaviors may impair patients' ability to make clinically recommended dietary changes. Clinicians should consider screening for disordered eating behaviors and tailoring obesity treatment accordingly. PMID:25572624

White-Coat Effect Is Uncommon in Patients With Refractory Hypertension.

PubMed

Siddiqui, Mohammed; Judd, Eric K; Oparil, Suzanne; Calhoun, David A

2017-09-01

Refractory hypertension is a recently described phenotype of antihypertensive treatment failure defined as uncontrolled blood pressure (BP) despite the use of ≥5 different antihypertensive agents, including chlorthalidone and spironolactone. Recent studies indicate that refractory hypertension is uncommon, with a prevalence of ≈5% to 10% of patients referred to a hypertension specialty clinic for uncontrolled hypertension. The prevalence of white-coat effect, that is, uncontrolled automated office BP ≥135/85 mm Hg and controlled out-of-office BP <135/85 mm Hg, by awake ambulatory BP monitor in hypertensive patients overall is ≈30% to 40%. The prevalence of white-coat effect among patients with refractory hypertension has not been previously reported. In this prospective evaluation, consecutive patients referred to the University of Alabama at Birmingham Hypertension Clinic for uncontrolled hypertension were enrolled. Refractory hypertension was defined as uncontrolled automated office BP ≥135/85 mm Hg with the use of ≥5 antihypertensive agents, including chlorthalidone and spironolactone. Automated office BP measurements were based on 6 serial readings, done automatically with the use of a BpTRU device unobserved in the clinic. Out-of-office BP measurements were done by 24-hour ambulatory BP monitor. Thirty-four patients were diagnosed with refractory hypertension, of whom 31 had adequate ambulatory BP monitor readings. White-coat effect was present in only 2 patients, or 6.5% of the 31 patients with refractory hypertension, suggesting that white-coat effect is largely absent in patients with refractory hypertension. These findings suggest that white-coat effect is not a common cause of apparent lack of BP control in patients failing maximal antihypertensive treatment. © 2017 American Heart Association, Inc.

Freewheel running prevents learned helplessness/behavioral depression: role of dorsal raphe serotonergic neurons.

PubMed

Greenwood, Benjamin N; Foley, Teresa E; Day, Heidi E W; Campisi, Jay; Hammack, Sayamwong H; Campeau, Serge; Maier, Steven F; Fleshner, Monika

2003-04-01

Serotonin (5-HT) neurons in the dorsal raphe nucleus (DRN) are implicated in mediating learned helplessness (LH) behaviors, such as poor escape responding and expression of exaggerated conditioned fear, induced by acute exposure to uncontrollable stress. DRN 5-HT neurons are hyperactive during uncontrollable stress, resulting in desensitization of 5-HT type 1A (5-HT1A) inhibitory autoreceptors in the DRN. 5-HT1A autoreceptor downregulation is thought to induce transient sensitization of DRN 5-HT neurons, resulting in excessive 5-HT activity in brain areas that control the expression of learned helplessness behaviors. Habitual physical activity has antidepressant/anxiolytic properties and results in dramatic alterations in physiological stress responses, but the neurochemical mediators of these effects are unknown. The current study determined the effects of 6 weeks of voluntary freewheel running on LH behaviors, uncontrollable stress-induced activity of DRN 5-HT neurons, and basal expression of DRN 5-HT1A autoreceptor mRNA. Freewheel running prevented the shuttle box escape deficit and the exaggerated conditioned fear that is induced by uncontrollable tail shock in sedentary rats. Furthermore, double c-Fos/5-HT immunohistochemistry revealed that physical activity attenuated tail shock-induced activity of 5-HT neurons in the rostral-mid DRN. Six weeks of freewheel running also resulted in a basal increase in 5-HT1A inhibitory autoreceptor mRNA in the rostral-mid DRN. Results suggest that freewheel running prevents behavioral depression/LH and attenuates DRN 5-HT neural activity during uncontrollable stress. An increase in 5-HT1A inhibitory autoreceptor expression may contribute to the attenuation of DRN 5-HT activity and the prevention of LH in physically active rats.

Spatial hearing in Cope’s gray treefrog: I. Open and closed loop experiments on sound localization in the presence and absence of noise

PubMed Central

Caldwell, Michael S.; Bee, Mark A.

2014-01-01

The ability to reliably locate sound sources is critical to anurans, which navigate acoustically complex breeding choruses when choosing mates. Yet, the factors influencing sound localization performance in frogs remain largely unexplored. We applied two complementary methodologies, open and closed loop playback trials, to identify influences on localization abilities in Cope’s gray treefrog, Hyla chrysoscelis. We examined localization acuity and phonotaxis behavior of females in response to advertisement calls presented from 12 azimuthal angles, at two signal levels, in the presence and absence of noise, and at two noise levels. Orientation responses were consistent with precise localization of sound sources, rather than binary discrimination between sources on either side of the body (lateralization). Frogs were unable to discriminate between sounds arriving from forward and rearward directions, and accurate localization was limited to forward sound presentation angles. Within this region, sound presentation angle had little effect on localization acuity. The presence of noise and low signal-to-noise ratios also did not strongly impair localization ability in open loop trials, but females exhibited reduced phonotaxis performance consistent with impaired localization during closed loop trials. We discuss these results in light of previous work on spatial hearing in anurans. PMID:24504182

Comparison of long-term prognosis of laparoscopic and open adrenalectomy for local adrenal neuroblastoma in children.

PubMed

Yao, Wei; Dong, Kuiran; Li, Kai; Zheng, Shan; Xiao, Xianmin

2018-06-07

To investigate and compare long-term outcomes in children undergoing laparoscopic or open adrenalectomy for local adrenal neuroblastoma. A retrospective review was conducted of 37 children with local adrenal neuroblastoma treated between January 2005 and December 2013 in our hospital. These patients met inclusion criteria for having adrenal neuroblastoma and undergoing operative resection. All patients were successfully followed up until December 2017. The local adrenal neuroblastoma cases included 25 males and 12 females with an average age of 37.24 ± 37.55 months (range from 5 days to 158 months). Left adrenal lesions were present in 13 cases, the right in 24 cases. According to the INSS staging system, 27 patients were classified as stage I and 10 as stage II. Open adrenalectomy was performed in 24 patients. Laparoscopic adrenalectomy was performed in the other 13 patients, 2 of whom were converted to open surgery because of adhesions to renal vessels and diaphragmatic rupture. Significant differences were observed between the laparoscopic surgery and open surgery groups regarding tumor size (P = 0.005). There were two recurrence cases in open surgery, but there was no recurrence in laparoscopic surgery. The average follow-up time was 86.78 ± 24.52 months. The overall 5-year survival rate of open and laparoscopic surgery were 86.2 and 100% (P = 0.316). Laparoscopic adrenalectomy for neuroblastoma is feasible and can be performed with equivalent recurrence and mortality rates with open resection. For small tumor size and absence of vascular encasement, the adrenal neuroblastoma may be preferred laparoscopic surgery.

Measurement of air pollutant emissions from Lome, Cotonou and Accra

NASA Astrophysics Data System (ADS)

Lee, James; Vaughan, Adam; Nelson, Bethany; Young, Stuart; Evans, Mathew; Morris, Eleanor; Ladkin, Russel

2017-04-01

High concentrations of airborne pollutants (e.g. the oxides of nitrogen, sulphur dioxide and carbon monoxide) in existing and evolving cities along the Guinea Coast cause respiratory diseases with potentially large costs to human health and the economic capacity of the local workforce. It is important to understand the rate of emission of such pollutants in order to model current and future air quality and provide guidance to the potential outcomes of air pollution abatement strategies. Often dated technologies and poor emission control strategies lead to substantial uncertainties in emission estimates calculated from vehicle and population number density statistics. The unreliable electrical supply in cities in the area has led to an increased reliance on small-scale diesel powered generators and these potentially present a significant source of emissions. The uncontrolled open incineration of waste adds a further very poorly constrained emission source within the cities. The DACCIWA (Dynamics-Aerosol-Chemistry-Cloud Interactions in West Africa) project involved a field campaign which used highly instrumented aircraft capable of in situ measurements of a range of air pollutants. Seven flights using the UK British Antarctic Survey's Twin Otter aircraft specifically targeted air pollution emissions from cities in West Africa (4 x Accra, Ghana; 2 x Lome, Togo and 1 x Cotonou, Benin). Measurements of NO, NO2, SO2, CO, CH4 and CO2 were made at multiple altitudes upwind and downwind of the cities, with the mass balance technique used to calculate emission rates. These are then compared to the Emissions Database for Global Atmospheric Research (EDGAR) estimates. Ultimately the data will be used to inform on and potentially improve the emission estimates, which in turn should lead to better forecasting of air pollution in West African cities and help guide future air pollution abatement strategy.

Vancomycin Ophthalmic Ointment 1% for methicillin-resistant Staphylococcus aureus or methicillin-resistant Staphylococcus epidermidis infections: a case series

PubMed Central

Sotozono, Chie; Fukuda, Masahiko; Ohishi, Masao; Yano, Keiko; Origasa, Hideki; Saiki, Yoshinori; Shimomura, Yoshikazu; Kinoshita, Shigeru

2013-01-01

Objectives To investigate the efficacy and safety of Vancomycin Ophthalmic Ointment 1% (Toa Pharmaceutical Co., Ltd, Toyama, Japan) in patients with external ocular infections caused by methicillin-resistant Staphylococcus aureus (MRSA) or methicillin-resistant Staphylococcus epidermidis (MRSE). Design A case series. Setting This study was a multicentre, open-label, uncontrolled study in Japan approved as orphan drug status. Participants Patients with MRSA or MRSE external ocular infections unresponsive to the treatment of fluoroquinolone eye drops. Interventions Vancomycin Ophthalmic Ointment 1% was administered four times daily. Primary and secondary outcome measures The subjective and objective clinical scores and bacterial cultures were collected at days 0 (baseline), 3, 7 and 14. The primary outcome was clinical response evaluation (efficacy rate) determined as complete response, partial response, no response and worsening. Secondary outcome was the eradication of the bacteria. Safety was assessed by adverse events including cases in which neither MRSA nor MRSE was detected. Results Twenty-five cases with MRSA (20) or MRSE (5) infections were enrolled. Of these 25 cases, 4 discontinued the treatment due to the negative results for bacterial culture during screening or at baseline. Of the 21 cases with conjunctivitis (14), blepharitis (3), meibomitis (1), dacryocystitis (2) or keratitis (1), 14 (66.7%) cases were evaluated as being excellently (complete response, 2 cases) or well (partial response, 12 cases) treated. The eradication rates were 68.4% in MRSA (13 of 19 cases) and 100% in MRSE (2 of 2 cases). Ten adverse events occurred in 7 (28.0%) of 25 cases at the local administration site. Conclusions Vancomycin Ophthalmic Ointment 1% was considered to be useful for the treatment of intractable ocular MRSA/MRSE infections. PMID:23364319

Using borehole flow logging to optimize hydraulic-test procedures in heterogeneous fractured aquifers

USGS Publications Warehouse

Paillet, F.L.

1995-01-01

Hydraulic properties of heterogeneous fractured aquifers are difficult to characterize, and such characterization usually requires equipment-intensive and time-consuming applications of hydraulic testing in situ. Conventional coring and geophysical logging techniques provide useful and reliable information on the distribution of bedding planes, fractures and solution openings along boreholes, but it is often unclear how these locally permeable features are organized into larger-scale zones of hydraulic conductivity. New boreholes flow-logging equipment provides techniques designed to identify hydraulically active fractures intersecting boreholes, and to indicate how these fractures might be connected to larger-scale flow paths in the surrounding aquifer. Potential complications in interpreting flowmeter logs include: 1) Ambient hydraulic conditions that mask the detection of hydraulically active fractures; 2) Inability to maintain quasi-steady drawdowns during aquifer tests, which causes temporal variations in flow intensity to be confused with inflows during pumping; and 3) Effects of uncontrolled background variations in hydraulic head, which also complicate the interpretation of inflows during aquifer tests. Application of these techniques is illustrated by the analysis of cross-borehole flowmeter data from an array of four bedrock boreholes in granitic schist at the Mirror Lake, New Hampshire, research site. Only two days of field operations were required to unambiguously identify the few fractures or fracture zones that contribute most inflow to boreholes in the CO borehole array during pumping. Such information was critical in the interpretation of water-quality data. This information also permitted the setting of the available string of two packers in each borehole so as to return the aquifer as close to pre-drilling conditions as possible with the available equipment.

Mapping disturbances in a mangrove forest using multi-date landsat TM imagery.

PubMed

Kovacs, J M; Wang, J; Blanco-Correa, M

2001-05-01

To evaluate the accounts of local fishermen, Landsat TM images (1986, 1993, 1999) were examined to assess potential losses in the mangrove forests of the Teacapán-Agua Brava lagoon system, Mexico. A binary change mask derived from image differencing of a band 4/3 ratio was employed to calculate any changes within this forested wetland. The results indicate that by 1986 approximately 18% (or 86 km2) of the mangrove area under study was either dead or in poor condition. The majority of this damage had occurred in the eastern section of the Agua Brava basin, which coincides, with the reports of the elderly fishermen. Examination of aerial photographs from 1970 revealed no adverse impacts in this area and would suggest, as postulated by the fishermen and other scientists, that modifications in environmental conditions following the opening of a canal, Cuautlá canal, in 1972 may have initiated the large-scale mortality. Although these areas of impact are still developing, the results from the satellite data indicate that the majority of the more recent changes are occurring elsewhere in the system. Obvious in the 1999 satellite data, but not so in the 1993, are large areas of mangrove degradation in the northern section of the Teacapán region. In the Agua Brava basin, the more recent transformations are appearing on the western side of the basin. Since long-term records of environmental conditions are absent, it is difficult to determine why these latest changes are occurring or even if the earlier losses were the result of the canal. Potential agents of change that have recently been observed include a hurricane, a second canal, and the uncontrolled expansion of the Cuautlá canal since 1994.

Uncontrolled combustion of shredded tires in a landfill - Part 1: Characterization of gaseous and particulate emissions

NASA Astrophysics Data System (ADS)

Downard, Jared; Singh, Ashish; Bullard, Robert; Jayarathne, Thilina; Rathnayake, Chathurika M.; Simmons, Donald L.; Wels, Brian R.; Spak, Scott N.; Peters, Thomas; Beardsley, Douglas; Stanier, Charles O.; Stone, Elizabeth A.

2015-03-01

In summer 2012, a landfill liner comprising an estimated 1.3 million shredded tires burned in Iowa City, Iowa. During the fire, continuous monitoring and laboratory measurements were used to characterize the gaseous and particulate emissions and to provide new insights into the qualitative nature of the smoke and the quantity of pollutants emitted. Significant enrichments in ambient concentrations of CO, CO2, SO2, particle number (PN), fine particulate (PM2.5) mass, elemental carbon (EC), and polycyclic aromatic hydrocarbons (PAH) were observed. For the first time, PM2.5 from tire combustion was shown to contain PAH with nitrogen heteroatoms (a.k.a. azaarenes) and picene, a compound previously suggested to be unique to coal-burning. Despite prior laboratory studies' findings, metals used in manufacturing tires (i.e. Zn, Pb, Fe) were not detected in coarse particulate matter (PM10) at a distance of 4.2 km downwind. Ambient measurements were used to derive the first in situ fuel-based emission factors (EF) for the uncontrolled open burning of tires, revealing substantial emissions of SO2 (7.1 g kg-1), particle number (3.5 × 1016 kg-1), PM2.5 (5.3 g kg-1), EC (2.37 g kg-1), and 19 individual PAH (totaling 56 mg kg-1). A large degree of variability was observed in day-to-day EF, reflecting a range of flaming and smoldering conditions of the large-scale fire, for which the modified combustion efficiency ranged from 0.85 to 0.98. Recommendations for future research on this under-characterized source are also provided.

Simultaneous Implantation of an Ahmed and Baerveldt Glaucoma Drainage Device for Uncontrolled Intraocular Pressure in Advanced Glaucoma.

PubMed

Rao, Veena S; Christenbury, Joseph; Lee, Paul; Allingham, Rand; Herndon, Leon; Challa, Pratap

2017-02-01

To evaluate efficacy and safety of a novel technique, simultaneous implantation of Ahmed and Baerveldt shunts, for improved control of intraocular pressure (IOP) in advanced glaucoma with visual field defects threatening central fixation. Retrospective case series; all patients receiving simultaneous Ahmed and Baerveldt implantation at a single institution between October 2004 and October 2009 were included. Records were reviewed preoperatively and at postoperative day 1, week 1, month 1, month 3, month 6, year 1, and yearly until year 5. Outcome measures included IOP, best-corrected visual acuity, visual field mean deviation, cup to disc ratio, number of glaucoma medications, and complications. Fifty-nine eyes were identified; mean (±SD) follow-up was 26±23 months. Primary open-angle glaucoma was most common (n=37, 63%). Forty-six eyes (78%) had prior incisional surgery. Mean preoperative IOP was 25.5±9.8 mm Hg. IOP was reduced 50% day 1 (P<0.001, mean 12.7±7.0 mm Hg), which persisted throughout follow-up. At year 1, cup to disc ratio and mean deviation were stable with decreased best-corrected visual acuity from logMAR 0.72±0.72(20/100) to 1.06±1.13(20/200) (P=0.007). The Kaplan-Meier survival analysis showed median and mean survival of 1205 and 829±91 days, respectively. Complication rate was 47%. IOP is markedly reduced postoperative day 1 following double glaucoma tube implantation with effects persisting over postoperative year 1 and up to year 5. Complications were higher than that seen in reports of single shunt implantation, which may be explained by patient complexity in this cohort. This technique may prove a promising novel approach for management of uncontrolled IOP in advanced glaucoma.

Fixed-dose combination of losartan and hydrochlorothiazide significantly improves endothelial function in uncontrolled hypertension by low-dose amlodipine: a randomized study.

PubMed

Takase, Bonpei; Nagata, Masayoshi

2014-12-01

Flow-mediated dilation (FMD) and nitroglycerin-mediated dilation (NMD) in the brachial artery are well-known indices for evaluating endothelial function (ECF). The blood pressure-lowering effects of the combination of losartan (ARB) and low-dose hydrochlorothiazide (H: ARB-H; ARB, 50 mg and H, 12.5 mg) are useful. The aim of the present study was to examine whether the combination of losartan and low-dose hydrochlorothiazide could improve ECF. To investigate the effect of ARB-H on ECF in patients with uncontrolled hypertension despite the use of amlodipine (2.5 mg daily), we performed a randomized controlled open-labeled study by using the envelope method and assigned 42 patients to either a control (CTRL) group or an ARB-H combination group, both of which received amlodipine 2.5 mg daily during the treatment period. In addition, both the CTRL (n=21, 69±7 years old) and ARB-H groups (n=21, 69±7 years old) received additional behavioral modification. Before and after 8 weeks of therapy, FMD and NMD were measured in both groups using novel FMD equipment (UNEXEF18G). Although baseline FMD was not different between the two groups, post-therapy FMD increased in the ARB-H group (2.97±1.56 to 3.95±1.86%, p<0.05) but did not change significantly in the CTRL group (2.95±1.43 to 3.11±1.27%, NS). No significant change was seen in NMD when comparing baseline and post-therapy values in either group. No treatment complications were observed. A fixed-dose combination of losartan and hydrochlorothiazide enhances ECF, suggesting that this combination might have both anti-hypertensive and anti-atherosclerotic effects in patients with hypertension.

Social stress alters inhibitory synaptic input to distinct subpopulations of raphe serotonin neurons.

PubMed

Crawford, LaTasha K; Rahman, Shumaia F; Beck, Sheryl G

2013-01-16

Anxiety disorders are among the most prevalent psychiatric disorders, yet much is unknown about the underlying mechanisms. The dorsal raphe (DR) is at the crux of the anxiety-inducing effects of uncontrollable stress, a key component of models of anxiety. Though DR serotonin (5-HT) neurons play a prominent role, anxiety-associated changes in the physiology of 5-HT neurons remain poorly understood. A 5-day social defeat model of anxiety produced a multifaceted, anxious phenotype in intruder mice that included increased avoidance behavior in the open field test, increased stress-evoked grooming, and increased bladder and heart weights when compared to control mice. Intruders were further compared to controls using electrophysiology recordings conducted in midbrain slices wherein recordings targeted 5-HT neurons of the ventromedial (vmDR) and lateral wing (lwDR) subfields of the DR. Though defining membrane characteristics of 5-HT neurons were unchanged, γ-aminobutyric-acid-mediated (GABAergic) synaptic regulation of 5-HT neurons was altered in a topographically specific way. In the vmDR of intruders, there was a decrease in the frequency and amplitude of GABAergic spontaneous inhibitory postsynaptic currents (sIPSCs). However, in the lwDR, there was an increase in the strength of inhibitory signals due to slower sIPSC kinetics. Synaptic changes were selective for GABAergic input, as glutamatergic synaptic input was unchanged in intruders. The distinct inhibitory regulation of DR subfields provides a mechanism for increased 5-HT output in vmDR target regions and decreased 5-HT output in lwDR target regions, divergent responses to uncontrollable stress that have been reported in the literature but were previously poorly understood.

Regulation of Romantic Love Feelings: Preconceptions, Strategies, and Feasibility.

PubMed

Langeslag, Sandra J E; van Strien, Jan W

2016-01-01

Love feelings can be more intense than desired (e.g., after a break-up) or less intense than desired (e.g., in long-term relationships). If only we could control our love feelings! We present the concept of explicit love regulation, which we define as the use of behavioral and cognitive strategies to change the intensity of current feelings of romantic love. We present the first two studies on preconceptions about, strategies for, and the feasibility of love regulation. Questionnaire responses showed that people perceive love feelings as somewhat uncontrollable. Still, in four open questions people reported to use strategies such as cognitive reappraisal, distraction, avoidance, and undertaking (new) activities to cope with break-ups, to maintain long-term relationships, and to regulate love feelings. Instructed up-regulation of love using reappraisal increased subjective feelings of attachment, while love down-regulation decreased subjective feelings of infatuation and attachment. We used the late positive potential (LPP) amplitude as an objective index of regulation success. Instructed love up-regulation enhanced the LPP between 300-400 ms in participants who were involved in a relationship and in participants who had recently experienced a romantic break-up, while love down-regulation reduced the LPP between 700-3000 ms in participants who were involved in a relationship. These findings corroborate the self-reported feasibility of love regulation, although they are complicated by the finding that love up-regulation also reduced the LPP between 700-3000 ms in participants who were involved in a relationship. To conclude, although people have the preconception that love feelings are uncontrollable, we show for the first time that intentional regulation of love feelings using reappraisal, and perhaps other strategies, is feasible. Love regulation will benefit individuals and society because it could enhance positive effects and reduce negative effects of romantic love.

High Trait Impulsivity Predicts Food Addiction-Like Behavior in the Rat

PubMed Central

Velázquez-Sánchez, Clara; Ferragud, Antonio; Moore, Catherine F; Everitt, Barry J; Sabino, Valentina; Cottone, Pietro

2014-01-01

Impulsivity is a behavioral trait frequently seen not only in drug-addicted individuals but also in individuals who pathologically overeat. However, whether impulsivity predates the development of uncontrollable feeding is unknown. In this study, we hypothesized that a high impulsivity trait precedes and confers vulnerability for food addiction-like behavior. For this purpose, we trained ad libitum-fed male Wistar rats in a differential reinforcement of low rates of responding (DRL) task to select Low- and High-impulsive rats. Then, we allowed Low- and High-impulsive rats to self-administer a highly palatable diet (Palatable group) or a regular chow diet (Chow group) in 1-h daily sessions, under fixed ratio (FR) 1, FR3, FR5, and under a progressive ratio (PR) schedules of reinforcement. In addition, we tested the compulsiveness for food in Low- and High-impulsive rats by measuring the food eaten in the aversive, open compartment of a light/dark conflict test. Finally, we measured the expression of the transcription factor ΔFosB in the shell and the core of the nucleus accumbens, which is a marker for neuroadaptive changes following addictive drug exposure. The data we obtained demonstrate that impulsivity is a trait that predicts the development of food addiction-like behaviors, including: (i) excessive intake, (ii) heightened motivation for food, and (iii) compulsive-like eating, when rats are given access to highly palatable food. In addition, we show that the food addiction phenotype in high impulsive subjects is characterized by an increased expression of the transcription factor ΔFosB in the nucleus accumbens shell. These results reveal that impulsivity confers an increased propensity to develop uncontrollable overeating of palatable food. PMID:24776685

High trait impulsivity predicts food addiction-like behavior in the rat.

PubMed

Velázquez-Sánchez, Clara; Ferragud, Antonio; Moore, Catherine F; Everitt, Barry J; Sabino, Valentina; Cottone, Pietro

2014-09-01

Impulsivity is a behavioral trait frequently seen not only in drug-addicted individuals but also in individuals who pathologically overeat. However, whether impulsivity predates the development of uncontrollable feeding is unknown. In this study, we hypothesized that a high impulsivity trait precedes and confers vulnerability for food addiction-like behavior. For this purpose, we trained ad libitum-fed male Wistar rats in a differential reinforcement of low rates of responding (DRL) task to select Low- and High-impulsive rats. Then, we allowed Low- and High-impulsive rats to self-administer a highly palatable diet (Palatable group) or a regular chow diet (Chow group) in 1-h daily sessions, under fixed ratio (FR) 1, FR3, FR5, and under a progressive ratio (PR) schedules of reinforcement. In addition, we tested the compulsiveness for food in Low- and High-impulsive rats by measuring the food eaten in the aversive, open compartment of a light/dark conflict test. Finally, we measured the expression of the transcription factor ΔFosB in the shell and the core of the nucleus accumbens, which is a marker for neuroadaptive changes following addictive drug exposure. The data we obtained demonstrate that impulsivity is a trait that predicts the development of food addiction-like behaviors, including: (i) excessive intake, (ii) heightened motivation for food, and (iii) compulsive-like eating, when rats are given access to highly palatable food. In addition, we show that the food addiction phenotype in high impulsive subjects is characterized by an increased expression of the transcription factor ΔFosB in the nucleus accumbens shell. These results reveal that impulsivity confers an increased propensity to develop uncontrollable overeating of palatable food.

Protection of pulmonary graft from thrombosis in donation after cardiac death: effect of warm ischaemia versus cold ischaemia.

PubMed

Pierre, Leif; Lindstedt, Sandra; Ingemansson, Richard

2016-11-01

The use of donation after cardiac death (DCD) to overcome organ shortage is slowly moving into the clinic. In this study, we compare the protective effect of warm ischaemia versus cold ischaemia on thrombotic formation in non-heparinized pulmonary grafts. Twelve Landrace pigs were randomized into two groups: warm ischaemia and cold ischaemia. Ventricular fibrillation without the administration of heparin was induced to mimick an uncontrolled DCD situation. The animals were then exposed to either 1 h of cold ischaemia (insertion of drain and installation of cold fluid in the pleuras) or warm ischaemia (body temperature). After 1 h, the pulmonary artery was opened and the pulmonary arterial branches were then macroscopically studied for thrombotic material. After 60 min, the temperature was 36.6 ± 0.0°C in the warm ischaemic group and 14.6 ± 0.1°C in the cold ischaemic group (P < 0.001). In the warm ischaemic group, no thrombotic material could be found in the pulmonary artery in the animals examined and in the cold ischaemic group 6.8 ± 0.2 ml thrombotic material was found in the pulmonary artery (P < 0.001). In the warm ischaemic group, no thrombotic material could be found in the arterial branches of the pulmonary artery and in the cold ischaemic group 2.3 ± 0.1 ml thrombotic material was found in the arterial branches of the pulmonary artery (P < 0.001). Warm ischaemia rather than cold ischaemia seems to protect the pulmonary graft from thrombosis in uncontrolled non-heparinized DCD pigs. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Long-term (52-week) safety and efficacy of Sacubitril/valsartan in Asian patients with hypertension.

PubMed

Supasyndh, Ouppatham; Sun, Ningling; Kario, Kazuomi; Hafeez, Kudsia; Zhang, Jack

2017-05-01

Sacubitril/valsartan (LCZ696), a first-in-class angiotensin receptor-neprilysin inhibitor, demonstrated significant reductions in office and 24 h ambulatory blood pressure (BP) over 8 weeks in Asian patients with hypertension. This 52-week extension to the 8-week core study was aimed at evaluating the long-term safety, tolerability and efficacy of sacubitril/valsartan. Patients who completed an 8-week randomized study (the core study) were enrolled in this 52-week open-label study and received sacubitril/valsartan 200 mg QD. The sacubitril/valsartan dose was uptitrated to 400 mg QD if BP was uncontrolled (>140/90 mm Hg) after 4 weeks. Subsequently, in patients with uncontrolled BP, treatment was intensified every 4 weeks with amlodipine 5-10 mg followed by hydrochlorothiazide 6.25-25 mg. Of the 341 patients enrolled, 7 (2.1%) discontinued the study drug due to adverse events (AEs). The incidence of AEs and serious AEs were 63.9 and 3.8%, respectively, and no deaths were reported in this study. The most frequent AEs were nasopharyngitis (18.2%) and dizziness (8.8%). Events that were potentially indicative of low BP were infrequent. One patient reported mild transient angioedema (lasting 2.5 h) that resolved without treatment but led to study drug discontinuation. The sacubitril/valsartan-based regimen provided clinically significant mean sitting systolic BP (msSBP) and mean sitting diastolic BP (msDBP) reductions from baseline (-24.7/-16.2 mm Hg). The overall BP control, msSBP and msDBP response rates were 75.3, 90.6 and 87.6%, respectively. Long-term use of sacubitril/valsartan was generally safe and well-tolerated in patients with hypertension and provided significant BP reductions from baseline.

Uncontrolled combustion of shredded tires in a landfill – Part 1: Characterization of gaseous and particulate emissions

PubMed Central

Downard, Jared; Singh, Ashish; Bullard, Robert; Jayarathne, Thilina; Rathnayake, Chathurika; Simmons, Donald L.; Wels, Brian R.; Spak, Scott N.; Peters, Thomas; Beardsley, Douglas; Stanier, Charles; Stone, Elizabeth A.

2014-01-01

In summer 2012, a landfill liner comprising an estimated 1.3 million shredded tires burned in Iowa City, Iowa. During the fire, continuous monitoring and laboratory measurements were used to characterize the gaseous and particulate emissions and to provide new insights into the qualitative nature of the smoke and the quantity of pollutants emitted. Significant enrichments in ambient concentrations of CO, CO2, SO2, particle number (PN), fine particulate (PM2.5) mass, elemental carbon (EC), and polycyclic aromatic hydrocarbons (PAH) were observed. For the first time, PM2.5 from tire combustion was shown to contain PAH with nitrogen heteroatoms (a.k.a. azaarenes) and picene, a compound previously suggested to be unique to coal-burning. Despite prior laboratory studies’ findings, metals used in manufacturing tires (i.e. Zn, Pb, Fe) were not detected in coarse particulate matter (PM10) at a distance of 4.2 km downwind. Ambient measurements were used to derive the first in situ fuel-based emission factors (EF) for the uncontrolled open burning of tires, revealing substantial emissions of SO2 (7.1 g kg−1), particle number (3.5×1016 kg−1), PM2.5 (5.3 g kg−1), EC (2.37 g kg−1), and 19 individual PAH (totaling 56 mg kg−1). A large degree of variability was observed in day-to-day EF, reflecting a range of flaming and smoldering conditions of the large-scale fire, for which the modified combustion efficiency ranged from 0.85-0.98. Recommendations for future research on this under-characterized source are also provided. PMID:25663800

Effectiveness of chlorthalidone/amiloride versus losartan in patients with stage I hypertension: results from the PREVER-treatment randomized trial.

PubMed

Fuchs, Flávio D; Scala, Luiz César N; Vilela-Martin, José F; de Mello, Renato Bandeira; Mosele, Francisca; Whelton, Paul K; Poli-de-Figueiredo, Carlos E; de Alencastro, Paulo Ricardo; E Silva, Ricardo Pereira; Gus, Miguel; Bortolotto, Luiz Aparecido; Schlatter, Rosane; Cesarino, Evandro José; Castro, Iran; Neto, José A Figueiredo; Chaves, Hilton; Steffens, André Avelino; Alves, João Guilherme; Brandão, Andréa Araujo; de Sousa, Marcos R; Jardim, Paulo Cesar; Moreira, Leila B; Franco, Roberto Silva; Gomes, Marco Mota; Neto, Abrahão Afiune; Fuchs, Felipe Costa; Filho, Dario C Sobral; Nóbrega, Antônio C; Nobre, Fernando; Berwanger, Otávio; Fuchs, Sandra C

2016-04-01

To compare the blood pressure (BP)-lowering efficacy of a chlorthalidone/amiloride combination pill with losartan, during initial management of stage I hypertension. In a randomized, double-blind, controlled trial, 655 participants were followed for 18 months in 21 Brazilian academic centers. Trial participants were adult volunteers aged 30-70 years with stage I hypertension (BP 140-159 or 90-99 mmHg) following 3 months of a lifestyle intervention. Participants were randomized to 12.5/2.5 mg of chlorthalidone/amiloride (N = 333) or 50 mg of losartan (N = 322). If BP remained uncontrolled after 3 months, study medication dose was doubled, and if uncontrolled after 6 months, amlodipine (5 and 10 mg) and propranolol (40 and 80 mg twice daily) were added as open-label drugs in a progressive fashion. At the end of follow-up, 609 (93%) participants were evaluated. The difference in SBP during 18 months of follow-up was 2.3 (95% confidence interval: 1.2 to 3.3) mmHg favoring chlorthalidone/amiloride. Compared with those randomized to diuretic, more participants allocated to losartan had their initial dose doubled and more of them used add-on antihypertensive medication. Levels of blood glucose, glycosilated hemoglobin, and incidence of diabetes were no different between the two treatment groups. Serum potassium was lower and serum cholesterol was higher in the diuretic arm. Microalbuminuria tended to be higher in patients with diabetes allocated to losartan (28.5 ± 40.4 versus 16.2 ± 26.7 mg, P = 0.09). Treatment with a combination of chlorthalidone and amiloride compared with losartan yielded a greater reduction in BP. NCT00971165.

Prospective direct comparison of antihypertensive effect and safety between high-dose amlodipine or indapamide in hypertensive patients uncontrolled by standard doses of angiotensin receptor blockers and amlodipine.

PubMed

Okamura, Keisuke; Shirai, Kazuyuki; Totake, Nao; Okuda, Tetsu; Urata, Hidenori

2018-01-01

When hypertension is uncontrolled by routine treatment with an angiotensin II receptor blocker (ARB) and the calcium channel blocker amlodipine (5 mg), the dose of amlodipine can be increased or a diuretic can be added. We investigated the more effective option in a prospective multicenter open-label study. Hypertensive patients were recruited if the target blood pressure (BP) in The Japanese Society of Hypertension 2009 guideline could not be achieved with standard-dose ARB therapy and amlodipine (5 mg). Patients were divided into three groups. Group-1 was switched to a combination of irbesartan (100 mg) and amlodipine (10 mg). Group-2A was changed to a combination of irbesartan (100 mg), amlodipine (5 mg), and indapamide, while Group-2B received a standard-dose ARB and amlodipine (5 mg) plus indapamide. Patients were assigned by their attending physicians and were followed for 6 months. The primary endpoint was the antihypertensive effect of each regimen. Group-1 contained 85 patients, Group-2A had 49 patients, and Group-2B had 4 patients. We only analyzed Group-1 and Group-2A due to the small size of Group-2B. In both groups, systolic BP and diastolic BP were significantly decreased up to 6 months (all p < 0.001). Reduction of systolic BP was greater in Group-1 than Group-2A after 1 month and 6 months (both p < 0.05). Uric acid was increased in Group-2A after 3 months, but not at 6 months. Although both regimens were effective for reducing BP, increasing amlodipine to 10 mg daily controlled hypertension without elevation of serum uric acid.

Relative importance of current and past landscape structure and local habitat conditions for plant species richness in dry grassland-like forest openings.

PubMed

Husáková, Iveta; Münzbergová, Zuzana

2014-01-01

In fragmented landscapes, plant species richness may depend not only on local habitat conditions but also on landscape structure. In addition, both present and past landscape structure may be important for species richness. There are, however, only a few studies that have investigated the relative importance of all of these factors. The aim of this study was to examine the effect of current and past landscape structures and habitat conditions on species richness at dry grassland-like forest openings in a forested landscape and to assess their relative importance for species richness. We analyzed information on past and present landscape structures using aerial photographs from 1938, 1973, 1988, 2000 and 2007. We calculated the area of each locality and its isolation in the present and in the past and the continuity of localities in GIS. At each locality, we recorded all vascular plant species (296 species in 110 forest openings) and information on abiotic conditions of the localities. We found that the current species richness of the forest openings was significantly determined by local habitat conditions as well as by landscape structure in the present and in the past. The highest species richness was observed on larger and more heterogeneous localities with rocks and shallow soils, which were already large and well connected to other localities in 1938. The changes in the landscape structure in the past can thus have strong effects on current species richness. Future studies attempting to understand determinants of species diversity in fragmented landscapes should also include data on past landscape structure, as it may in fact be more important than the present structure.

Shock progression and survival after use of a condom uterine balloon tamponade package in women with uncontrolled postpartum hemorrhage.

PubMed

Burke, Thomas F; Danso-Bamfo, Sandra; Guha, Moytrayee; Oguttu, Monica; Tarimo, Vincent; Nelson, Brett D

2017-10-01

To examine the outcomes of women in advanced shock from uncontrolled postpartum hemorrhage (PPH) who underwent placement of an Every Second Matters for Mothers and Babies Uterine Balloon Tamponade (ESM-UBT) device. In a prospective case series, data were collected for women who received an ESM-UBT device at healthcare facilities in Kenya, Senegal, Sierra Leone, and Tanzania between September 1, 2012, and September 30, 2016. Shock class was assigned on the basis of recorded blood pressures and mental status at the time of UBT placement. Data for 306 women with uncontrolled PPH from uterine atony across 117 facilities were analyzed. Normal vital signs or class I/II shock were reported for 166 (54.2%). In this group, one death occurred and was attributed to PPH (survival rate 99.4%). There were no cases of shock progression. One hundred and eleven (36.3%) were in class III shock and 29 (9.5%) in class IV shock; the respective survival rates were 97.3% (n=108) and 86.2% (n=25). The ESM-UBT device arrests hemorrhage, prevents shock progression, and is associated with high survival rates among women with uncontrolled PPH from uterine atony. © 2017 International Federation of Gynecology and Obstetrics.

Learned helplessness: effects of response requirement and interval between treatment and testing.

PubMed

Hunziker, M H L; Dos Santos, C V

2007-11-01

Three experiments investigated learned helplessness in rats manipulating response requirements, shock duration, and intervals between treatment and testing. In Experiment 1, rats previously exposed to uncontrollable or no shocks were tested under one of four different contingencies of negative reinforcement: FR 1 or FR 2 escape contingency for running, and FR1 escape contingency for jumping (differing for the maximum shock duration of 10s or 30s). The results showed that the uncontrollable shocks produced a clear operant learning deficit (learned helplessness effect) only when the animals were tested under the jumping FR 1 escape contingency with 10-s max shock duration. Experiment 2 isolated of the effects of uncontrollability from shock exposure per se and showed that the escape deficit observed using the FR 1 escape jumping response (10-s shock duration) was produced by the uncontrollability of shock. Experiment 3 showed that using the FR 1 jumping escape contingency in the test, the learned helplessness effect was observed one, 14 or 28 days after treatment. These results suggest that running may not be an appropriate test for learned helplessness, and that many diverging results found in the literature might be accounted for by the confounding effects of respondent and operant contingencies present when running is required of rats.

Hypertensive Crisis, Burden, Management, and Outcome at a Tertiary Care Center in Karachi

PubMed Central

Almas, Aysha; Ghouse, Ayaz; Iftikhar, Ahmed Raza; Khursheed, Munawwar

2014-01-01

Objectives. Hypertension, if uncontrolled, can lead to hypertensive crisis. We aim to determine the prevalence of hypertensive crisis, its management, and outcome in patients presenting to a tertiary care center in Karachi. Methods. This was a cross-sectional study conducted at the Aga Khan University, Karachi, Pakistan. Adult inpatients (>18 yrs) presenting to the ER who were known hypertensive and had uncontrolled hypertension were included. Results. Out of 1336 patients, 28.6% (387) had uncontrolled hypertension. The prevalence of hypertensive crisis among uncontrolled hypertensive was 56.3% (218). Per oral calcium channel blocker; 35.4% (137) and intravenous nitrate; 22.7% (88) were the most commonly administered medication in the ER. The mean (SD) drop in SBP in patients with hypertensive crisis on intravenous treatment was 53.1 (29) mm Hg and on per oral treatment was 43 (27) mm Hg. The maximum mean (SD) drop in blood pressure was seen by intravenous sodium nitroprusside; 80 (51) mm Hg in SBP. Acute renal failure was the most common complication with a prevalence of 11.5% (24). Conclusion. The prevalence of hypertensive crisis is high. Per oral calcium channel blocker and intravenous nitrate are the most commonly administered medications in our setup. PMID:26464857

Oromucosal delta9-tetrahydrocannabinol/cannabidiol for neuropathic pain associated with multiple sclerosis: an uncontrolled, open-label, 2-year extension trial.

PubMed

Rog, David J; Nurmikko, Turo J; Young, Carolyn A

2007-09-01

Central neuropathic pain (CNP), pain initiated or caused by a primary lesion or dysfunction of the central nervous system, occurs in ~28% of patients with multiple sclerosis (MS). Delta(9)-Tetrahydrocannabinol/cannabidiol (THC/CBD), an endocannabinoid system modulator, has demonstrated efficacy for up to 4 weeks in randomized controlled trials in the treatment of CNP in patients with MS. The purpose of this extension was to establish long-term tolerability and effectiveness profiles for THC/CBD (Sativex (R), GW Pharmaceuticals plc, Salisbury, United Kingdom) oromucosal spray in CNP associated with MS. This uncontrolled, open-label trial was an indefinite-duration extension of a previously reported 5-week randomized study in patients with MS and CNP. In the initial trial, patients were randomized to placebo or THC/CBD. Patients were only required to maintain their existing analgesia in the randomized study. In the open-label trial they could vary their other analgesia as required. All patients (placebo and THC/CBD) who completed the randomized trial commenced the open-label follow-up on THC/CBD (27 mg/mL: 25 mg/mL). Patients titrated their dosage, maintaining their existing analgesia. The primary end point of the trial was the number, frequency, and type of adverse events (AEs) reported by patients. Secondary end points included changes from baseline in 11-point numerical rating scale (NRS-11) neuropathic pain score, hematology and clinical chemistry test results, vital signs, trial drug usage, and intoxication visual analogue scale scores. Sixty-six patients were enrolled in the randomized trial; 64 (97%) completed the randomized trial and 63 (95%) entered the open-label extension (race, white, 100%; sex, male, 14 [22%]; mean [SD] age, 49 [8.4] years [range, 27-71 years[). The mean (SD) duration of open-label treatment was 463 (378) days (median, 638 days; range, 3-917 days), with 34 (54%) patients completing >1 year of treatment with THC/CBD and 28 (44%) patients completing the open-label trial with a mean (SD) duration of treatment of 839 (42) days (median, 845 days; range, 701-917 days). Mean NRS-11 pain scores in the final week of the randomized trial were 3.8 in the treatment group and 5.0 in the placebo group. In the 28 (44%) patients who completed the 2-year follow up, the mean (SD) NRS-11 pain score in the final week of treatment was 2.9 (2.0) (range, 0-8.0). Fifty-eight (92%) patients experienced > or =1 treatment-related AE. These AEs were rated by the investigator as mild in 47 (75%) patients, moderate in 49 (78%), and severe in 32 (51%). The most commonly reported AEs were dizziness (27%), nausea (18 %), and feeling intoxicated (11%). Two treatment-related serious AEs (ventricular bigeminy and circulatory collapse) were judged to be treatment-related. Both serious AEs occurred in the same patient and resolved completely following a period of discontinuation. Eleven (17%) patients experienced oral discomfort, 4 persistently. Regular oral examinations revealed that 7 (11%) patients developed white buccal mucosal patches and 2 (3%) developed red buccal mucosal patches; all cases were deemed mild and resolved. Seventeen (25%) patients withdrew due to AEs. The mean number of sprays and patients experiencing intoxication remained stable throughout the follow-up trial. THC/CBD was effective, with no evidence of tolerance, in these select patients with CNP and MS who completed approximately 2 years of treatment (n = 28). Ninety-two percent of patients experienced an AE, the most common of which were dizziness and nausea. The majority of AEs were deemed to be of mild to moderate severity by the investigators.

Use of directional median openings on urban roadways.

DOT National Transportation Integrated Search

2014-05-01

Over the past decades, many states and local transportation agencies have installed directional median openings on : divided roadways to improve arterial safety and operational performance. A directional opening is normally used to : restrict crossin...

Occupant Interactions and Effectiveness of Natural Ventilation Strategies in Contemporary New Housing in Scotland, UK.

PubMed

Sharpe, Tim; Farren, Paul; Howieson, Stirling; Tuohy, Paul; McQuillan, Jonathan

2015-07-21

The need to reduce carbon emissions and fuel poverty has led to increased building envelope air tightness, intended to reduce uncontrolled ventilation heat losses. Ventilation strategies in dwellings still allow the use of trickle ventilators in window frames for background ventilation. The extent to which this results in "healthy" Indoor Air Quality (IAQ) in recently constructed dwellings was a concern of regulators in Scotland. This paper describes research to explore this. First a review of literature was conducted, then data on occupant interactions with ventilation provisions (windows, doors, trickle vents) gathered through an interview-based survey of 200 recently constructed dwellings, and measurements made on a sample of 40 of these. The main measured parameter discussed here is CO2 concentration. It was concluded after the literature review that 1000 ppm absolute was a reasonable threshold to use for "adequate" ventilation. The occupant survey found that there was very little occupant interaction with the trickle ventilators e.g., in bedrooms 63% were always closed, 28% always open, and in only 9% of cases occupants intervened to make occasional adjustments. In the measured dwellings average bedroom CO2 levels of 1520 ppm during occupied (night time) hours were observed. Where windows were open the average bedroom CO2 levels were 972 ppm. With windows closed, the combination of "trickle ventilators open plus doors open" gave an average of 1021 ppm. "Trickle ventilators open" gave an average of 1571 ppm. All other combinations gave averages of 1550 to 2000 ppm. Ventilation rates and air change rates were estimated from measured CO2 levels, for all dwellings calculated ventilation rate was less than 8 L/s/p, in 42% of cases calculated air change rate was less than 0.5 ach. It was concluded that trickle ventilation as installed and used is ineffective in meeting desired ventilation rates, evidenced by high CO2 levels reported across the sampled dwellings. Potential implications of the results are discussed.

Development and implementation of a navigator-facilitated care coordination algorithm to improve clinical outcomes of underserved Latino patients with uncontrolled diabetes.

PubMed

Congdon, Heather Brennan; Eldridge, Barbara Hoffman; Truong, Hoai-An

2013-11-01

Development and implementation of an interprofessional navigator-facilitated care coordination algorithm (NAVCOM) for low-income, uninsured patients with uncontrolled diabetes at a safety-net clinic resulted in improvement of disease control as evidenced by improvement in hemoglobin A1C. This report describes the process and lessons learned from the development and implementation of NAVCOM and patient success stories.

Patient preference for a new growth hormone injection device: results of an open-label study in Japanese pediatric patients.

PubMed

Kappelgaard, Anne-Marie; Mikkelsen, Søren; Knudsen, Thomas Kamp; Fuchs, Gitte Schøning

2011-01-01

Growth hormone deficiency (GHD) in children is treated with daily subcutaneous injections of GH. Poor adherence, resulting in suboptimal treatment outcomes, is common due to long-term treatment. Injection devices that are considered easy to use by patients or guardians could improve adherence. This study assessed the usability of the Norditropin FlexPro pen injector and NovoTwist needles (both Novo Nordisk A/S, Bagsvaerd, Denmark) in Japanese children and adolescents with GHD. This open-label, uncontrolled usability test included patients aged 6 to < or = 18 years with GHD currently receiving daily injections of GH with pen injectors. Patients performed repeated injections of test medium into a foam cushion. Patients or guardians completed a questionnaire on pen handling. A total of 73/74 patients (99%) rated Norditropin FlexPro easy to handle, reporting no technical complaints. In total, 60 (81%) preferred Norditropin FlexPro over their current device, with 12% preferring their current device and 7% not sure. Norditropin FlexPro was perceived as easy to use and reliable, and was well accepted and preferred over the current device for the administration of GH in children and adolescents. Patients were more confident that Norditropin FlexPro delivered the right dose compared with their current device.

Ensocopic-endoluminal therapies. A critical appraisal.

PubMed

Louis, Hubert; Devière, Jacques

2010-12-01

Due to its large prevalence, gastro-oesophageal reflux disease is an ideal target for companies developing medical devices designed to cure reflux. Indeed, because medications leave part of the patients unsatisfied, there is a potential place for alternative therapies, capable of restoring an efficacious anti-reflux barrier, but without the drawbacks of surgery. For more than a decade, several novel endoluminal therapies were developed, clinically evaluated, put on the market and, for many of them, withdrawn due to economic considerations, lack of efficacy or complications. These therapies were designed to act on the gastro-oesophageal junction and reinforce mechanically the anti-reflux barrier by three different ways: suturing, radiofrequency energy application, or implantation of foreign materials. Most of the published data come from open uncontrolled studies with short-term enthusiastic results. There are a few randomized control trials assessing the true efficacy of these modalities, showing often less impressive results than the open studies did, due to a high placebo effect in mild gastro-oesophageal reflux disease. Although endoscopic treatment of gastro-oesophageal disease is still an interesting topic of investigation, one can draw some lessons from the recent experiences and foresee which place these techniques could find in the management of patients suffering from reflux. Copyright © 2010 Elsevier Ltd. All rights reserved.

Trust Information and Privacy Policies - Enablers for pHealth and Ubiquitous Health.

PubMed

Ruotsalainen, Pekka; Blobel, Bernd

2014-01-01

pHealth occurs in uncontrolled and unsecure environment where predefined organizational trust does not exist. To be accepted by users, pHealth requires a privacy model where privacy is a personal property, i.e., a person can perform own will and define policies which regulate how personal health information (PHI) is used. Privacy and trust are interconnected concepts. Therefore, before beginning to use pHealth services, the person needs practical and reliable information that enables her or him to determine the trustworthiness level of services. To avoid the use of blind trust, organizations, researchers, policymakers, and standardization organizations have proposed the use of dynamic context-aware policies for privacy management in pHealth. To make meaningful privacy decision, a person should understand the impact of selected policy rules on the processing of PHI in different situations. In this paper, the use of computational trust information for defining privacy polies and reducing their number is proposed. A trust value and understandable trust attributes enable a person to tailor privacy policies requested for trustworthy use of pHealth services. Trust attributes proposed are derived from privacy concerns existing in open ubiquitous environment. These attributes also force pHealth services providers to publish information needed for trust calculation and in this way to support openness and transparency.

SET: a pupil detection method using sinusoidal approximation

PubMed Central

Javadi, Amir-Homayoun; Hakimi, Zahra; Barati, Morteza; Walsh, Vincent; Tcheang, Lili

2015-01-01

Mobile eye-tracking in external environments remains challenging, despite recent advances in eye-tracking software and hardware engineering. Many current methods fail to deal with the vast range of outdoor lighting conditions and the speed at which these can change. This confines experiments to artificial environments where conditions must be tightly controlled. Additionally, the emergence of low-cost eye tracking devices calls for the development of analysis tools that enable non-technical researchers to process the output of their images. We have developed a fast and accurate method (known as “SET”) that is suitable even for natural environments with uncontrolled, dynamic and even extreme lighting conditions. We compared the performance of SET with that of two open-source alternatives by processing two collections of eye images: images of natural outdoor scenes with extreme lighting variations (“Natural”); and images of less challenging indoor scenes (“CASIA-Iris-Thousand”). We show that SET excelled in outdoor conditions and was faster, without significant loss of accuracy, indoors. SET offers a low cost eye-tracking solution, delivering high performance even in challenging outdoor environments. It is offered through an open-source MATLAB toolkit as well as a dynamic-link library (“DLL”), which can be imported into many programming languages including C# and Visual Basic in Windows OS (www.eyegoeyetracker.co.uk). PMID:25914641

Risk Assessment During the Final Phase of an Uncontrolled Re-Entry

NASA Astrophysics Data System (ADS)

Gaudel, A.; Hourtolle, C.; Goester, J. F.; Fuentes, N.

2013-09-01

As French National Space Agency, CNES is empowered to monitor compliance with technical regulations of the French Space Operation Act, FSOA, and to take all necessary measures to ensure the safety of people, property, public health and environment for all space operations involving French responsibility at international level.Therefore, CNES developed ELECTRA that calculates the risk for ground population involved in three types of events: rocket launching, controlled re-entry and uncontrolled re-entry. For the first two cases, ELECTRA takes into account degraded cases due to a premature stop of propulsion.Major evolutions were implemented recently on ELECTRA to meet new users' requirements, like the risk assessment during the final phase of uncontrolled re-entry, that can be combined with the computed risk for each country involved by impacts.The purpose of this paper is to provide an overview of the ELECTRA method and main functionalities, and then to highlight these recent improvements.

Acute compartment syndrome caused by uncontrolled hypothyroidism.

PubMed

Modi, Anar; Amin, Hari; Salzman, Matthew; Morgan, Farah

2017-06-01

Acute compartment syndrome is increased tissue pressure exceeding perfusion pressure in a closed compartment resulting in nerve and muscle ischemia. Common precipitating causes are crush injuries, burns, substance abuse, osseous or vascular limb trauma. This is a case of 42year old female with history of hypothyroidism who presented to emergency room with acute onset of severe pain and swelling in right lower extremity. Physical examination was concerning for acute compartment syndrome of right leg which was confirmed by demonstration of elevated compartmental pressures. No precipitating causes were readily identified. Further laboratory testing revealed uncontrolled hypothyroidism. Management included emergent fasciotomy and initiating thyroid hormone replacement. This case represents a rare association between acute compartment syndrome and uncontrolled hypothyroidism. We also discuss the pathogenesis of compartment syndrome in hypothyroid patients and emphasize the importance of evaluating for less common causes, particularly in setting of non-traumatic compartment syndrome. Copyright © 2016 Elsevier Inc. All rights reserved.

Counterfactual reasoning for regretted situations involving controllable versus uncontrollable events: the modulating role of contingent self-esteem.

PubMed

Wilkinson, Meredith R; Ball, Linden J; Alford, David

2015-01-01

We report a study that examined the modulating impact of contingent self-esteem on regret intensity for regretted outcomes associated with controllable versus uncontrollable events. The Contingent Self-Esteem Scale (e.g., Kernis & Goldman, 2006) was used to assess the extent to which a person's sense of self-worth is based on self and others' expectations. We found that there was an influence of self-esteem contingency for controllable but not for uncontrollable regret types. For controllable regret types individuals with a high contingent (i.e., unstable) self-esteem reported greater regret intensity than those with a low contingent (i.e., stable) self-esteem. We interpret this finding as reflecting a functional and adaptive role of high contingent self-esteem in terms of mobilizing the application of counterfactual reasoning and planning mechanisms that can enable personal expectations to be achieved in the future.

Ethical, legal, and societal issues and recommendations for controlled and uncontrolled DCD.

PubMed

Haase, Bernadette; Bos, Michael; Boffa, Catherine; Lewis, Penney; Rudge, Chris; Valero, Ricard; Wind, Tineke; Wright, Linda

2016-07-01

This report deals with organ retrieval procedures in both controlled and uncontrolled DCD, looking at the ethical, legal, and psychosocial aspects during the different phases of the process. A recently published report by the UK Donation Ethics Committee (UKDEC) has served as an important reference document to outline the steps in the controlled DCD patient-donor pathway (Academy of Medical Royal Colleges. UK Donation Ethics Committee. An ethical framework for controlled donation after circulatory death. December 2011). For uncontrolled DCD, the UKDEC pathway description was adapted. At the 6th International Conference in Organ Donation held in Paris in 2013, an established expert European Working Group reviewed the UKDEC reports, which were then considered along with the available published literature. Along this pathway, the crucial ethical, legal, and psychosocial aspects have been flagged, and relevant recommendations have been formulated based on a consensus of the working group. © 2015 Steunstichting ESOT.

Counterfactual Reasoning for Regretted Situations Involving Controllable Versus Uncontrollable Events: The Modulating Role of Contingent Self-Esteem

PubMed Central

Wilkinson, Meredith R.; Ball, Linden J.; Alford, David

2015-01-01

We report a study that examined the modulating impact of contingent self-esteem on regret intensity for regretted outcomes associated with controllable versus uncontrollable events. The Contingent Self-Esteem Scale (e.g., Kernis & Goldman, 2006) was used to assess the extent to which a person’s sense of self-worth is based on self and others’ expectations. We found that there was an influence of self-esteem contingency for controllable but not for uncontrollable regret types. For controllable regret types individuals with a high contingent (i.e., unstable) self-esteem reported greater regret intensity than those with a low contingent (i.e., stable) self-esteem. We interpret this finding as reflecting a functional and adaptive role of high contingent self-esteem in terms of mobilizing the application of counterfactual reasoning and planning mechanisms that can enable personal expectations to be achieved in the future. PMID:25883697

Social Network Resources and Management of Hypertension*

PubMed Central

Cornwell, Erin York; Waite, Linda J.

2013-01-01

Hypertension is one of the most prevalent chronic diseases among older adults, but rates of blood pressure control are low. In this paper, we explore the role of social network ties and network-based resources (e.g., information and support) in hypertension diagnosis and management. We use data from the National Social Life, Health, and Aging Project (NSHAP) to identify older adults with undiagnosed or uncontrolled hypertension. We find that network characteristics and emotional support are associated with hypertension diagnosis and control. Importantly, the risks of undiagnosed and uncontrolled hypertension are lower among those with larger social networks -- if they discuss health issues with their network members. When these lines of communication are closed, network size is associated with greater risk of undiagnosed and uncontrolled hypertension. Health care utilization partially mediates associations with diagnosis, but the benefits of network resources for hypertension control do not seem to stem from health-related behaviors. PMID:22660826

A successful treatment of life-threatening bleeding from polycystic kidneys with antifibrinolytic agent tranexamic acid.

PubMed

Vujkovac, Bojan; Sabovic, Miso

2006-10-01

We describe a successful treatment of a severe, persistent bleeding from both kidneys in a patient with autosomal dominant polycystic kidney disease (ADPKD) with tranexamic acid (TXA), a potent antifibrinolytic agent. The bleeding could not be controlled by intensive conservative treatment, it became life-threatening and urgent bilateral nephrectomy was intended. Since local and systemic hyperfibrinolysis play a role in bleeding in ADPKD patients, we tried TXA treatment. In fact, the massive bleeding promptly stopped, and haematuria gradually ceased. Removal of both kidneys was prevented. After 5 days both ureters became obstructed by blood clots, but placing J-catheters in each pyelon successfully solved this complication. Our case shows that it is reasonable to try antifibrinolytic treatment with TXA in such devastating uncontrolled bleeding.

A sensitivity model for energy consumption in buildings. Part 1: Effect of exterior environment

NASA Technical Reports Server (NTRS)

Lansing, F. L.

1981-01-01

A simple analytical model is developed for the simulation of seasonal heating and cooling loads of any class of buildings to complement available computerized techniques which make hourly, daily, and monthly calculations. An expression for the annual energy utilization index, which is a common measure of rating buildings having the same functional utilization, is derived to include about 30 parameters for both building interior and exterior environments. The sensitivity of a general class building to either controlled or uncontrolled weather parameters is examined. A hypothetical office type building, located at the Goldstone Space Communication Complex, Goldstone, California, is selected as an example for the numerical sensitivity evaluations. Several expressions of variations in local outside air temperature, pressure, solar radiation, and wind velocity are presented.

New clinical trial opens to determine safety and efficacy of PROSTVAC, nivolumab and ipilimumab in men with localized prostate cancer | Center for Cancer Research

Cancer.gov

A new study is now open to evaluate the safety and effectiveness of a treatment regimen that combines PROSTVAC with ipilimumab and/or nivolumab in men with localized prostate cancer who have elected to undergo surgical resection (prostatectomy).  Learn more...

Ethnobotanical approaches of traditional medicine studies: some experiences from Asia.

PubMed

Sheng-Ji, P

2001-01-01

Ethnobotany, as a research field of science, has been widely used for the documentation of indigenous knowledge on the use of plants and for providing an inventory of useful plants from local flora in Asian countries. Plants that are used for traditional herbal medicine in different countries are an important part of these studies. However, in some countries in recent years, ethnobotanical studies have been used for the discovery of new drugs and new drug development. In general, experiences gained from ethnobotanical approaches of traditional medicinal studies in China and Himalayan countries have helped drug production and new drug development. At the same time, in many cases, over-harvesting, degradation of medical plants, and loss of traditional medical knowledge in local communities are common problems in these resource areas. Issues of indigenous knowledge, intellectual property rights, and uncontrolled transboundary trade in medicinal plants occur frequently in the region. This paper discusses ethnobotanical approaches of traditional medicinal studies, in reference to experiences from China and Himalayan countries, with an emphasis on the conservation of traditional medical knowledge and medical plant resources.

Environmental effects of heavy metals derived from the e-waste recycling activities in China: a systematic review.

PubMed

Song, Qingbin; Li, Jinhui

2014-12-01

As the world's leading manufacturing country, China has become the largest dumping ground for e-waste, resulting in serious pollution of heavy metals in China. This study reviews recent studies on environmental effects of heavy metals from the e-waste recycling sites in China, especially Taizhou, Guiyu, and Longtang. The intensive uncontrolled processing of e-waste in China has resulted in the release of large amounts of heavy metals in the local environment, and caused high concentrations of metals to be present in the surrounding air, dust, soils, sediments and plants. Though the pollution of many heavy metals was investigated in the relevant researches, the four kinds of heavy metals (Cu, Pb, Cd and Cr) from e-waste recycling processes attracted more attention. The exceedance of various national and international standards imposed negative effects to the environment, which made the local residents face with the serious heavy metal exposure. In order to protect the environment and human health, there is an urgent need to control and monitor the informal e-waste recycling operations. Copyright © 2014 Elsevier Ltd. All rights reserved.

Salvage surgery in the treatment of local recurrences of nasopharyngeal carcinomas.

PubMed

Salom, María Cecilia; López, Fernando; Pacheco, Esteban; Muñoz, Gabriela; García-Cabo, Patricia; Fernández, Laura; Suárez, Vanessa; Llorente, José Luis

2018-04-03

Chemoradiotherapy is the treatment of choice for nasopharyngeal carcinoma. Local recurrences are one of the leading causes of death in these patients, and surgical salvage the treatment of choice. Our goal was to evaluate and compare the results of salvage surgery in the treatment of local recurrence of nasopharyngeal carcinomas comparing endoscopic to open approaches. Twenty patients with local recurrence of nasopharyngeal carcinomas underwent surgery: 12 patients underwent open surgery and 8 endoscopic endonasal transpterygoid nasopharyngectomy. One patient was classified as rT1; 3 as rT2;2 as rT3; and 6 as rT4 in the group of open approaches; in the endoscopic series, 2 patients were rT1, 5 rT2 and one rT3. In 3 patients (25%) operated by an open approach (one rT4, one rT3 and one rT2) a complete gross resection was not achieved. Gross total resection was achieved in patients operated by endoscopic surgery. The complication rate in the group operated by an open approach was 92% (5 minor complications, 5 moderate complications, and one serious complication) and in the group that underwent endoscopic surgery all patients had some complication (7 had minor complications and one patient developed a severe complication). Survival at 3 and 5 years was 53% and 42% with the open approach and 100% and 50% with the endoscopic approach, respectively. Endoscopic approaches decrease the morbidity associated with open approaches and allow for favourable oncological control. Copyright © 2018 Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. Publicado por Elsevier España, S.L.U. All rights reserved.

Identifying the driving forces of urban expansion and its environmental impact in Jakarta-Bandung mega urban region

NASA Astrophysics Data System (ADS)

Pravitasari, A. E.; Rustiadi, E.; Mulya, S. P.; Setiawan, Y.; Fuadina, L. N.; Murtadho, A.

2018-05-01

The socio-economic development in Jakarta-Bandung Mega Urban Region (JBMUR) caused the increasing of urban expansion and led to a variety of environmental damage such as uncontrolled land use conversion and raising anthropogenic disaster. The objectives of this study are: (1) to identify the driving forces of urban expansion that occurs on JBMUR and (2) to analyze the environmental quality decline on JBMUR by producing time series spatial distribution map and spatial autocorrelation of floods and landslide as the proxy of anthropogenic disaster. The driving forces of urban expansion in this study were identified by employing Geographically Weighted Regression (GWR) model using 6 (six) independent variables, namely: population density, percentage of agricultural land, distance to the center of capital city/municipality, percentage of household who works in agricultural sector, distance to the provincial road, and distance to the local road. The GWR results showed that local demographic, social and economic factors including distance to the road spatially affect urban expansion in JBMUR. The time series spatial distribution map of floods and landslide event showed the spatial cluster of anthropogenic disaster in some areas. Through Local Moran Index, we found that environmental damage in one location has a significant impact on the condition of its surrounding area.

Task shifting in the management of hypertension in Kinshasa, Democratic Republic of Congo: a cross-sectional study.

PubMed

Lulebo, Aimée M; Kaba, Didine K; Atake, Silvestre E-H; Mapatano, Mala A; Mafuta, Eric M; Mampunza, Julien M; Coppieters, Yves

2017-12-04

The Democratic Republic of the Congo (DRC) is characterized by a high prevalence of hypertension (HTN) and a high proportion of uncontrolled HTN, which is indicative of poor HTN management. Effective management of HTN in the African region is challenging due to limited resources, particularly human resources for health. To address the shortage of health workers, the World Health Organization (WHO) recommends task shifting for better disease management and treatment. Although task shifting from doctors to nurses is being implemented in the DRC, there are no studies, to the best of our knowledge, that document the association between task shifting and HTN control. The aim of this study was to investigate the association between task shifting and HTN control in Kinshasa, DRC. We conducted a cross-sectional study in Kinshasa from December 2015 to January 2016 in five general referral hospitals (GRHs) and nine health centers (HCs). A total of 260 hypertensive patients participated in the study. Sociodemographic, clinical, health care costs and perceived health care quality assessment data were collected using a structured questionnaire. To examine the association between task shifting and HTN control, we assessed differences between GRH and HC patients using bivariate and multivariate analyses. Almost half the patients were female (53.1%), patients' mean age was 59.5 ± 11.4 years. Over three-fourths of patients had uncontrolled HTN. There was no significant difference in the proportion of GRH and HC patients with uncontrolled HTN (76.2% vs 77.7%, p = 0.771). Uncontrolled HTN was associated with co-morbidity (OR = 10.3; 95% CI: 3.8-28.3) and the type of antihypertensive drug used (OR = 4.6; 95% CI: 1.3-16.1). The mean healthcare costs in the GRHs were significantly higher than costs in the HCs (US$ 34.2 ± US$3.34 versus US$ 7.7 ± US$ 0.6, respectively). Uncontrolled HTN was not associated with the type of health facility. This finding suggests that the management of HTN at primary healthcare level might be just as effective as at secondary level. However, the high proportion of patients with uncontrolled HTN underscores the need for HTN management guidelines at all healthcare levels.

Progression to Uncontrolled Severe Asthma: A Novel Risk Equation.

PubMed

Casciano, Julian; Krishnan, Jerry; Small, Mary Buatti; Li, Chenghui; Dotiwala, Zenobia; Martin, Bradley C

2017-01-01

Recently published asthma guidelines by the European Respiratory Society and the American Thoracic Society (ERS-ATS) define severe disease based on medication use and control level. These guidelines also emphasize that asthma severity involves certain biomarker phenotypes, one of them being eosinophilic phenotype. The quantification of the influence of eosinophil level toward predicting disease severity can help decision makers manage therapy better earlier. To develop a risk-scoring algorithm to identify patients at greater risk of developing uncontrolled severe asthma as defined by ERS-ATS guidelines. Data on asthma patients were extracted from the EMRClaims + database from January 2004 to July 2011. Patients with continuous enrollment 12 months before and after the date of the first encounter with a diagnosis of asthma (index date) with at least 1 blood eosinophil test result in the 12 months after the index date, but before the development of uncontrolled severe asthma or the study end date, were included. Uncontrolled severe asthma was defined as the first date on which all criteria of the ERS-ATS definition were first satisfied in the 12 months after the index date. Age (≥ 50 years vs. < 50 years), race, and sex were measured at index, and the Charlson Comorbidity Index (CCI) score (> 0 vs. 0) was measured in the pre-index period. Elevated eosinophil level was defined as a test result with ≥ 400 cells/µL. The study cohort was randomly split 50-50 into derivation and validation samples. Cox proportional hazards regression was used to develop the risk score for uncontrolled severe asthma using the derivation cohort with independent variables of eosinophil level, age, sex, race, and CCI. A bootstrapping procedure was used to generate 1,000 samples from the derivation cohort. Variables significant in ≥ 50% of the samples were retained in the final regression model. A risk score was then calculated based on the coefficient estimates of the final model. C-statistic was used to test the model's discrimination power. The study included 2,405 patients, 147 (6%) of whom developed uncontrolled severe asthma. Higher eosinophil level and CCI score > 0 were significantly and independently associated with an increased risk of uncontrolled severe asthma in the derivation cohort (HR = 1.90, 95% CI = 1.17-3.08 and HR = 2.00, 95% CI = 1.28-3.13, respectively); findings were similar in the validation cohort. Total risk score was categorized as 0, 2, and 4. All models showed good C-statistics (0.79-0.80), indicating favorable model discrimination. There was a significantly greater number of patients with uncontrolled severe asthma in the risk score segments of 2 and 4 compared with 0 (each P < 0.0001). A risk stratification tool using peripheral eosinophil counts and CCI can be used to predict the development of uncontrolled severe asthma. This study was funded by Teva Pharmaceuticals. eMAX Health Systems was a consultant to Teva Pharmaceuticals for this study and received payment from Teva Pharmaceuticals for work on this study. Casciano and Dotiwala are employed by eMAX Health Systems. Krishnan, Li, and Martin received payment from eMAX Health Systems for work on this study. Small was employed by Teva Pharmaceuticals at the time of this study. Study concept and design were contributed primarily by Casciano, Krishnan, Small, and Martin, along with Li and Dotiwala. Dotiwala, Casciano, Small, and Li collected the data, along with Martin and Li and Krishnan. Data interpretation was provided by Martin, Casciano, and Li, with assistance from the other authors. The manuscript was written by Li, Casciano, Dotiwala, and Small, with assistance from the other authors, and revised by Dotiwala, Small, Li, and Martin, with assistance from Krishnan and Casciano.

Reducing or stopping the uncontrolled flow of fluid such as oil from a well

DOEpatents

Hermes, Robert E

2014-02-18

The uncontrolled flow of fluid from an oil or gas well may be reduced or stopped by injecting a composition including 2-cyanoacrylate ester monomer into the fluid stream. Injection of the monomer results in a rapid, perhaps instantaneous, polymerization of the monomer within the flow stream of the fluid. This polymerization results in formation of a solid plug that reduces or stops the flow of additional fluid from the well.

Endo-Perio Lesion and Uncontrolled Diabetes.

PubMed

Dhoum, Sara; Laslami, Kaoutar; Rouggani, Fatimazahraa; El Ouazzani, Amal; Jabri, Mouna

2018-01-01

This work is to discuss the management of an endo-perio lesion, which represents a challenge to clinicians when it comes to diagnosis and prognosis of the involved teeth and especially with an altered general condition. A 50-year-old female patient with uncontrolled diabetes type 2 is suffering from a purulent discharge coming from the upper right canine. Endodontic and periodontal treatments were realized with 36 months radiological and clinical follow-up with the collaboration of her internist doctor.

Mucormycosis pulmonary abscess, containment in a patient with uncontrolled diabetes mellitus.

PubMed

Jaffer, Faraz; Beatty, Norman; Ahmad, Kareem

2017-01-18

A 56-year-old Hispanic male with solo risk factor of uncontrolled diabetes mellitus presented with recurrent haemoptysis. Initial concern was for malignancy with postobstructive pneumonia; however, invasive testing and biopsy confirmed infectious mass of fungal aetiology requiring surgical resection followed by a prolonged course of anti-fungal therapy. Discussion centred on approach to, progression of and course of action in the management of pulmonary abscess due to mucormycosis. 2017 BMJ Publishing Group Ltd.

[Application of classic formulae in treatment of hypertension].

PubMed

Xiong, Xing-Jiang; Wang, Jie

2013-06-01

Classic formulae have a wide prospect in the treatment of hypertension with such advantages as symposium relief, improvement of body constitution and uncontrollable blood pressure factors. The paper systematically reviews the application of classic formula in pre-hypertension, different stages of hypertension, special type of hypertension, secondary hypertension, and uncontrollable blood pressure factors. It is believed that classic formulae are effective under the premise of their in-depth understanding of objective indications, modern pathogenesis and evolvement regularity.

Dispositional mindfulness and reward motivated eating: The role of emotion regulation and mental habit.

PubMed

Fisher, Naomi R; Mead, Bethan R; Lattimore, Paul; Malinowski, Peter

2017-11-01

Evidence regarding the effectiveness of mindfulness based interventions (MBIs) for eating disorders, weight management and food craving is emerging and further studies are required to understand the underlying mechanisms of MBIs in these domains. The current study was designed to establish the role of specific mechanisms underlying the putative relationship between mindfulness and reward motivated eating. We predicted that mindfulness would be negatively related to features of reward motivated eating and that this association would be mediated by emotion regulation and habitual negative self-thinking. A cross-sectional survey measuring uncontrolled and emotional eating, mindfulness, emotion regulation and habitual negative self-thinking was completed by female and male meditators and non-meditators (N = 632). Lower levels of dispositional mindfulness were associated with difficulties in emotion regulation, habitual negative self-thinking and both emotional and uncontrolled eating. Difficulties in emotion regulation significantly mediated the mindfulness-uncontrolled eating relationship. Habitual negative self-thinking significantly mediated the mindfulness-emotional eating relationship. Participants with meditation experience reported greater levels of dispositional mindfulness, fewer difficulties with emotion regulation and habitual negative self-thinking and reduced uncontrolled eating tendencies, compared to non-meditators. The findings suggest that MBIs designed to change reward motivated eating and weight control should focus on emotion regulation and mental habits as underlying mechanisms. Copyright © 2017. Published by Elsevier Ltd.

Candida species and other yeasts in the oral cavities of type 2 diabetic patients in Cali, Colombia

PubMed Central

Álvarez, María Inés; de Bernal, Matilde; Collazos, Andrés

2013-01-01

Objective: To determine the prevalence of Candida species and to study factors associated to oral cavity colonization in patients with type 2 diabetes mellitus. Methods: A total of 107 diabetics were classified into controlled and uncontrolled according to glycosylated hemoglobin values. Each patient was assessed for stimulated salivary flow rates, pH, and an oral rinse to search for yeast. The study also determined the state of oral health via Klein and Palmer CPO indexes for permanent dentition, dental plaque by O'Leary, and a periodontal chart. Results: We found yeasts in 74.8% of the patients. A total of 36 of the 52 subjects with controlled diabetes presented yeasts and 44 in the uncontrolled; no significant differences (p = 0.2) were noted among the presence of yeasts and the control of blood glucose. The largest number of isolates corresponded to C. albicans, followed by C. parapsilosis. Uncontrolled individuals presented a significantly higher percentage of yeast different from C. albicans (p = 0.049). Conclusions: We found a high percentage of Candida colonization and uncontrolled individuals had greater diversity of species. The wide range of CFU/mL found both in patients with oral candidiasis, as well as in those without it did not permit distinguishing between colonization and disease. We only found association between isolation of yeasts and the low rate of salivary flow. PMID:24892318

Dietary nitrate lowers ambulatory blood pressure in treated, uncontrolled hypertension: a 7-d, double-blind, randomised, placebo-controlled, cross-over trial.

PubMed

Kerley, Conor P; Dolan, Eamon; James, Philip E; Cormican, Liam

2018-03-01

Dietary nitrate has been shown to increase nitrate/nitrite levels and decrease blood pressure (BP) in multiple populations. There are few reports among hypertensives and these reports have provided conflicting evidence. We aimed to assess the effect of daily nitrate compared with placebo in subjects with uncontrolled hypertension (HTN). On day 0, hypertensives wore an ambulatory BP monitor (ABPM) for 24 h and blood was taken. Subjects were then randomised to 7-d nitrate-rich beetroot juice (NO3 -) (12·9 mmol nitrate) followed by 7-d nitrate-depleted beetroot juice (0·5 mmol nitrate) or vice versa. ABPM and blood were assessed before and after both conditions. In all, twenty subjects with treated yet uncontrolled HTN entered and completed the trial (mean age=62·5 years, mean BMI=30·7 kg/m2). Baseline BP was 137/80 (sd 7/7) mmHg. Dietary nitrate was well tolerated and resulted in significantly increased plasma nitrite (P=0·0004) and decreased 24-h systolic BP and diastolic BP compared with placebo (-8 mmHg; P=0·012 and -4 mmHg; P=0·018, respectively). Our results support the existing data suggesting an anti-hypertensive effect of dietary nitrate in treated yet uncontrolled hypertensives. Targeted dietary strategies appear promising contributors to BP control.

Out of control mortality matters: the effect of perceived uncontrollable mortality risk on a health-related decision.

PubMed

Pepper, Gillian V; Nettle, Daniel

2014-01-01

Prior evidence from the public health literature suggests that both control beliefs and perceived threats to life are important for health behaviour. Our previously presented theoretical model generated the more specific hypothesis that uncontrollable, but not controllable, personal mortality risk should alter the payoff from investment in health protection behaviours. We carried out three experiments to test whether altering the perceived controllability of mortality risk would affect a health-related decision. Experiment 1 demonstrated that a mortality prime could be used to alter a health-related decision: the choice between a healthier food reward (fruit) and an unhealthy alternative (chocolate). Experiment 2 demonstrated that it is the controllability of the mortality risk being primed that generates the effect, rather than mortality risk per se. Experiment 3 showed that the effect could be seen in a surreptitious experiment that was not explicitly health related. Our results suggest that perceptions about the controllability of mortality risk may be an important factor in people's health-related decisions. Thus, techniques for adjusting perceptions about mortality risk could be important tools for use in health interventions. More importantly, tackling those sources of mortality that people perceive to be uncontrollable could have a dual purpose: making neighbourhoods and workplaces safer would have the primary benefit of reducing uncontrollable mortality risk, which could lead to a secondary benefit from improved health behaviours.

A dimension reduction method for flood compensation operation of multi-reservoir system

NASA Astrophysics Data System (ADS)

Jia, B.; Wu, S.; Fan, Z.

2017-12-01

Multiple reservoirs cooperation compensation operations coping with uncontrolled flood play vital role in real-time flood mitigation. This paper come up with a reservoir flood compensation operation index (ResFCOI), which formed by elements of flood control storage, flood inflow volume, flood transmission time and cooperation operations period, then establish a flood cooperation compensation operations model of multi-reservoir system, according to the ResFCOI to determine a computational order of each reservoir, and lastly the differential evolution algorithm is implemented for computing single reservoir flood compensation optimization in turn, so that a dimension reduction method is formed to reduce computational complexity. Shiguan River Basin with two large reservoirs and an extensive uncontrolled flood area, is used as a case study, results show that (a) reservoirs' flood discharges and the uncontrolled flood are superimposed at Jiangjiaji Station, while the formed flood peak flow is as small as possible; (b) cooperation compensation operations slightly increase in usage of flood storage capacity in reservoirs, when comparing to rule-based operations; (c) it takes 50 seconds in average when computing a cooperation compensation operations scheme. The dimension reduction method to guide flood compensation operations of multi-reservoir system, can make each reservoir adjust its flood discharge strategy dynamically according to the uncontrolled flood magnitude and pattern, so as to mitigate the downstream flood disaster.

48 CFR 614.402-70 - Waiver of public opening of bids.

Code of Federal Regulations, 2010 CFR

2010-10-01

... of public opening of bids. Overseas posts may request waiver of the public opening of bids if that activity is inconsistent with local law or legal practice, or with post security. For that purpose, the...

Does Wildfire Open a Policy Window? Local Government and Community Adaptation After Fire in the United States

Treesearch

Miranda H. Mockrin; Hillary K. Fishler; Susan I Stewart

2018-01-01

Becoming a fire adapted community that can coexist with wildfire is envisioned as a continuous, iterative process of adaptation, but it is unclear how communities may pursue adaptation. Experience with wildfire and other natural hazards suggests that disasters may open a "window of opportunity" leading to local government policy changes. We examined how...

Measuring Link-Resolver Success: Comparing 360 Link with a Local Implementation of WebBridge

ERIC Educational Resources Information Center

Herrera, Gail

2011-01-01

This study reviewed link resolver success comparing 360 Link and a local implementation of WebBridge. Two methods were used: (1) comparing article-level access and (2) examining technical issues for 384 randomly sampled OpenURLs. Google Analytics was used to collect user-generated OpenURLs. For both methods, 360 Link out-performed the local…

One year in review 2016: Behçet's syndrome.

PubMed

Hatemi, Gulen; Seyahi, Emire; Fresko, Izzet; Talarico, Rosaria; Hamuryudan, Vedat

2016-01-01

Several articles highlighting the epidemiology, pathogenesis, clinical features, treatment modalities and disease assessment of Behçet's syndrome (BS) have been published during the last year. Clinical and radiological features of lower extremity deep vein thrombosis due to BS can be quite different than those found in thrombosis due to other causes; additionally, frequency of post-thrombotic syndrome is significantly increased in BS. Some clinical and colonoscopic features are useful in differentiating BS from Crohn's disease. Barkhof criteria may be helpful in differentiating neurologic involvement due to BS from multiple sclerosis. Anatomical localization of papulopustular lesions but not histology has been found to be helpful in differentiating papulopustular lesions of BS from those found in acne vulgaris. Several studies looked at the ovarian reserve with contradicting results. A population-based cohort study found higher risk of hematological malignancies only among female BS patients living in Taiwan. The role of genetic factors and environment is discussed and both autoimmune and autoinflammatory features are underlined in the pathogenesis of BS. New data on the epistatic interactions between ERAP and HLA B51 is available and information on the microbiome have started to appear. New uncontrolled data suggest beneficial effects of anti-TNFs for refractory extra-ocular complications of BS such as pulmonary artery, gastrointestinal and central nervous system involvement. Uncontrolled studies suggest promising results with interleukin-1 inhibition but gevokizumab, a humanised anti IL-1β antibody, failed to meet the primary endpoint of time to first ocular exacerbation in a phase III trial. The debate on anticoagulation continues with new observational data.

The effects of a novel psychological attribution and emotional awareness and expression therapy for chronic musculoskeletal pain: A preliminary, uncontrolled trial.

PubMed

Burger, Amanda J; Lumley, Mark A; Carty, Jennifer N; Latsch, Deborah V; Thakur, Elyse R; Hyde-Nolan, Maren E; Hijazi, Alaa M; Schubiner, Howard

2016-02-01

Current psychological and behavioral therapies for chronic musculoskeletal pain only modestly reduce pain, disability, and distress. These limited effects may be due to the failure of current therapies: a) to help patients learn that their pain is influenced primarily by central nervous system psychological processes; and b) to enhance awareness and expression of emotions related to psychological trauma or conflict. We developed and conducted a preliminary, uncontrolled test of a novel psychological attribution and emotional awareness and expression therapy that involves an initial individual consultation followed by 4 group sessions. A series of 72 patients with chronic musculoskeletal pain had the intervention and were assessed at baseline, post-treatment, and 6-month follow-up. Participation and satisfaction were high and attrition was low. Intent-to-treat analyses found significant improvements in hypothesized change processes: psychological attributions for pain, emotional awareness, emotional approach coping, and alexithymia. Pain, interference, depression, and distress showed large effect size improvements at post-treatment, which were maintained or even enhanced at 6 months. Approximately two-thirds of the patients improved at least 30% in pain and other outcomes, and one-third of the patients improved 70%. Changes in attribution and emotional processes predicted outcomes. Higher baseline depressive symptoms predicted greater improvements, and outcomes were comparable for patients with widespread vs. localized pain. This novel intervention may lead to greater benefits than available psychological interventions for patients with chronic musculoskeletal pain, but needs controlled testing. Copyright © 2015 Elsevier Inc. All rights reserved.

75 FR 23587 - Annual Seattle Yacht Club's “Opening Day” Marine Parade

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-04

... Seattle Yacht Club's ``Opening Day'' Marine Parade AGENCY: Coast Guard, DHS. ACTION: Notice of enforcement..., Portage Cut (Montlake Cut), and Union Bay, WA during the Annual Seattle Yacht Club's ``Opening Day... Special Local Regulation for the annual Seattle Yacht Club's ``Opening Day'' Marine Parade in 33 CFR 100...

Impact of lengthening open water season on food security in Alaska coastal communities: Global impacts may outweigh local "frontline" effects

NASA Astrophysics Data System (ADS)

Rolph, R.; Mahoney, A. R.

2015-12-01

Using ice concentration data from the Alaska Sea Ice Atlas from 1953-2013 for selected communities in Alaska, we find a consistent trend toward later freeze up and earlier breakup, leading a lengthened open water period. Such changes are often considered to bring a variety of "frontline" local impacts to Arctic coastal communities such as increased rates of coastal erosion. However, direct consequences of these changes to local food security (e.g. through impacts on subsistence activities and marine transport of goods) may be outweighed at least in the short term by the effects of large scale Arctic sea ice change coupled with global oil markets. For example, a later freeze-up might delay local hunters' transition from boats to snow-machines, but whether this trend will affect hunting success, especially in the next few years, is uncertain. Likewise, the magnitude of change in open water season length is unlikely to be sufficient to increase the frequency with which communities are served by barges. However, an expanding open water season throughout the Arctic has implications for the global economy, which can have indirect effects on local communities. In the Chukchi and Beaufort Seas, where rapid sea ice change has been accompanied by increased interest in oil and gas development, the U.S. Bureau of Ocean Energy Management currently requires drilling operations to cease 38 days prior to freeze up. Taking this into account, the lengthening open water season has effectively extended the drilling season for oil companies by 184% since the 1950s. If oil development goes ahead, local communities will likely experience a range of indirect impacts on food security due to increased vessel traffic and demand on infrastructure coupled with changes in local economies and employment opportunities. Increased likelihood of an oil spill in coastal waters also poses a significant threat to local food security. Thus, while Arctic coastal communities are already experiencing direct impacts of reduced sea ice extent, these may be over-shadowed by the indirect effects of global impacts.

Analysis of a Panel of 48 Cytokines in BAL Fluids Specifically Identifies IL-8 Levels as the Only Cytokine that Distinguishes Controlled Asthma from Uncontrolled Asthma, and Correlates Inversely with FEV1

PubMed Central

Qi, Huibin; Kurosky, Alexander; Jennings, Kristofer; Sun, Qian; Boldogh, Istvan; Sur, Sanjiv

2015-01-01

We sought to identify cells and cytokines in bronchoalveolar lavage (BAL) fluids that distinguish asthma from healthy control subjects and those that distinguish controlled asthma from uncontrolled asthma. Following informed consent, 36 human subjects were recruited for this study. These included 11 healthy control subjects, 15 subjects with controlled asthma with FEV1≥80% predicted and 10 subjects with uncontrolled asthma with FEV1 <80% predicted. BAL fluid was obtained from all subjects. The numbers of different cell types and the levels of 48 cytokines were measured in these fluids. Compared to healthy control subjects, patients with asthma had significantly more percentages of eosinophils and neutrophils, IL-1RA, IL-1α, IL-1β, IL-2Rα, IL-5, IL-6, IL-7, IL-8, G-CSF, GROα (CXCL1), MIP-1β (CCL4), MIG (CXCL9), RANTES (CCL5) and TRAIL in their BAL fluids. The only inflammatory markers that distinguished controlled asthma from uncontrolled asthma were neutrophil percentage and IL-8 levels, and both were inversely correlated with FEV1. We examined whether grouping asthma subjects on the basis of BAL eosinophil % or neutrophil % could identify specific cytokine profiles. The only differences between neutrophil-normal asthma (neutrophil≤2.4%) and neutrophil-high asthma (neutrophils%>2.4%) were a higher BAL fluid IL-8 levels, and a lower FEV1 in the latter group. By contrast, compared to eosinophil-normal asthma (eosinophils≤0.3%), eosinophil-high asthma (eosinophils>0.3%) had higher levels of IL-5, IL-13, IL-16, and PDGF-bb, but same neutrophil percentage, IL-8, and FEV1. Our results identify neutrophils and IL-8 are the only inflammatory components in BAL fluids that distinguish controlled asthma from uncontrolled asthma, and both correlate inversely with FEV1. PMID:26011707

Risk factors and predictors of uncontrolled hyperglycemia and diabetic ketoacidosis in children and adolescents with type 1 diabetes mellitus in Jeddah, western Saudi Arabia.

PubMed

Sayed, Mohamed Hesham; Hegazi, Moustafa Abdelaal; Abdulwahed, Khairyah; Moussa, Khairya; El-Deek, Basem Salama; Gabel, Hala; Ragheb, Rana

2017-02-01

Little is known about levels of glycemic control and risk factors for uncontrolled hyperglycemia in Saudi children with type 1 diabetes mellitus (T1DM). The aim of the present study was to identify levels of glycemic control, risk factors and predictors of uncontrolled hyperglycemia (HG) and diabetic ketoacidosis (DKA) in children with T1DM. A retrospective study was performed on Saudi children and adolescents with confirmed T1DM who were followed at the Pediatric Endocrinology Clinic of the Maternity and Children Hospital, Jeddah, from 2000 to 2014. Data collection included all possible factors that may be associated with uncontrolled T1DM. Patients were classified according to American Diabetes Association guidelines for target HbA1c levels per age group. Comparisons were made between well-controlled (WC) patients, HG patients, and DKA patients. Calculation of odds ratios and logistic regression allowed for estimation of the role of each risk factor in uncontrolled T1DM. Only 31.2 % of children and adolescents with T1DM were well controlled. Better glycemic control was associated with age < 6 years, urban residence, and T1DM duration <5 years. Glycemic control was not affected by gender, insulin therapy, or comorbidities. The most significant independent predictors of hyperglycemia and DKA were poor compliance with a healthy lifestyle (adjusted hazards ratio [AHR] 28.94; 95 % confidence interval [CI] 8.37-100.04) and an excess intake of sweets (AHR 3.31; 95 % CI 1.54-7.11). The most significant independent predictor for poor glycemic control (particularly DKA rather than hyperglycemia) in Saudi children and adolescents was poor compliance with a healthy lifestyle with an excessive intake of sweets. © 2016 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

An Electronic Adherence Measurement Intervention to Reduce Clinical Inertia in the Treatment of Uncontrolled Hypertension: The MATCH Cluster Randomized Clinical Trial.

PubMed

Kronish, Ian M; Moise, Nathalie; McGinn, Thomas; Quan, Yan; Chaplin, William; Gallagher, Benjamin D; Davidson, Karina W

2016-11-01

To appropriately manage uncontrolled hypertension, clinicians must decide whether blood pressure (BP) is above goal due to a need for additional medication or to medication nonadherence. Yet, clinicians are poor judges of adherence, and uncertainty about adherence may promote inertia with respect to medication modification. We aimed to determine the effect of sharing electronically-measured adherence data with clinicians on the management of uncontrolled hypertension. This was a cluster randomized trial. Twenty-four primary care providers (12 intervention, 12 usual care; cluster units) and 100 patients with uncontrolled hypertension (65 intervention, 35 usual care) were included in the study. At one visit per patient, clinicians in the intervention group received a report summarizing electronically measured adherence to the BP regimen and recommended clinical actions. Clinicians in the control group did not receive a report. The primary outcome was the proportion of visits with appropriate clinical management (i.e., treatment intensification among adherent patients and adherence counseling among nonadherent patients). Secondary outcomes included patient-rated quality of care and communication during the visit. The proportion of visits with appropriate clinical management was higher in the intervention group than the control group (45 out of 65; 69 %) versus (12 out of 35; 34 %; p = 0.001). A higher proportion of adherent patients in the intervention group had their regimen intensified (p = 0.01), and a higher proportion of nonadherent patients in the intervention group received adherence counseling (p = 0.005). Patients in the intervention group were more likely to give their clinician high ratings on quality of care (p = 0.05), and on measures of patient-centered (p = 0.001) and collaborative communication (p = 0.02). Providing clinicians with electronically-measured antihypertensive adherence reports reduces inertia in the management of uncontrolled hypertension. NCT01257347 ; http://clinicaltrials.gov/show/ NCT01257347.

The relationship between health related quality of life and sensory deficits among patients with diabetes mellitus.

PubMed

Engel-Yeger, Batya; Darawsha Najjar, Sanaa; Darawsha, Mahmud

2017-08-13

(1) To profile sensory deficits examined in the ability to process sensory information from daily environment and discriminate between tactile stimuli among patients with controlled and un-controlled diabetes mellitus. (2) Examine the relationship between the sensory deficits and patients' health-related quality of life. This study included 115 participants aged 33-55 with uncontrolled (n = 22) or controlled (n = 24) glycemic levels together with healthy subjects (n = 69). All participants completed the brief World Health Organization Quality of Life Questionnaire, the Adolescent/Adult Sensory Profile and performed the tactile discrimination test. Sensory deficits were more emphasized among patients with uncontrolled glycemic levels as expressed in difficulties to register sensory input, lower sensation seeking in daily environments and difficulties to discriminate between tactile stimuli. They also reported the lowest physical and social quality of life as compared to the other two groups. Better sensory seeking and registration predicted better quality of life. Disease control and duration contributed to these predictions. Difficulties in processing sensory information from their daily environments are particularly prevalent among patients with uncontrolled glycemic levels, and significantly impacted their quality of life. Clinicians should screen for sensory processing difficulties among patients with diabetes mellitus and understand their impacts on patients' quality of life. Implications for Rehabilitation Patients with diabetes mellitus, and particularly those with uncontrolled glycemic levels, may have difficulties in processing sensory information from daily environment. A multidisciplinary intervention approach is recommended: clinicians should screen for sensory processing deficits among patients with diabetes mellitus and understand their impacts on patients' daily life. By providing the patients with environmental adaptations and coping strategies, clinicians may assist in optimizing sensory experiences in real life context and elevate patients' quality of life. Relating to quality of life and emphasizing a multidisciplinary approach is of major importance in broadening our understanding of health conditions and providing holistic treatment for patients.

Task-specific noise exposure during manual concrete surface grinding in enclosed areas-influence of operation variables and dust control methods.

PubMed

Akbar-Khanzadeh, Farhang; Ames, April L; Milz, Sheryl A; Akbar-Khanzadeh, Mahboubeh

2013-01-01

Noise exposure is a distinct hazard during hand-held concrete grinding activities, and its assessment is challenging because of the many variables involved. Noise dosimeters were used to examine the extent of personal noise exposure while concrete grinding was performed with a variety of grinder sizes, types, accessories, and available dust control methods. Noise monitoring was conducted in an enclosed area covering 52 task-specific grinding sessions lasting from 6 to 72 minutes. Noise levels, either in minute average noise level (Lavg, dBA) or in minute peak (dBC), during concrete grinding were significantly (P < 0.01) correlated with general ventilation (GV: on, off), dust control methods (uncontrolled, wet, Shop-Vac, HEPA, HEPA-Cyclone), grinding cup wheel (blade) sizes of 4-inch (100 mm), 5-inch (125 mm) and 6-inch (150 mm), and surface orientation (horizontal, inclined). Overall, minute Lavg during grinding was 97.0 ± 3.3 (mean ± SD), ranging from 87.9 to 113. The levels of minute Lavg during uncontrolled grinding (98.9 ± 5.2) or wet-grinding (98.5 ± 2.7) were significantly higher than those during local exhaust ventilation (LEV) grinding (96.2 ± 2.8). A 6-inch grinding cup wheel generated significantly higher noise levels (98.7 ± 2.8) than 5-inch (96.3 ± 3.2) or 4-inch (95.3 ± 3.5) cup wheels. The minute peak noise levels (dBC) during grinding was 113 ± 5.2 ranging from 104 to 153. The minute peak noise levels during uncontrolled grinding (119 ± 10.2) were significantly higher than those during wet-grinding (115 ± 4.5) and LEV-grinding (112 ± 3.4). A 6-inch grinding cup wheel generated significantly higher minute peak noise levels (115 ± 5.3) than 5-inch (112 ± 4.5) or 4-inch (111 ± 5.4) cup wheels. Assuming an 8-hour work shift, the results indicated that noise exposure levels during concrete grinding in enclosed areas exceeded the recommended permissible exposure limits and workers should be protected by engineering control methods, safe work practices, and/or personal protective devices.

Multicenter, prospective, comparative cohort study evaluating the efficacy and safety of alfuzosin 10 mg with regard to blood pressure in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia with or without antihypertensive medications.

PubMed

Zhang, Li Tao; Lee, Sung Won; Park, Kwangsung; Chung, Woo Sik; Kim, Sae Woong; Hyun, Jae Seog; Moon, Doo Geon; Yang, Sang-Kuk; Ryu, Ji Kan; Yang, Dae Yul; Moon, Ki Hak; Min, Kweon Sik; Park, Jong Kwan

2015-01-01

The objective of this study was to assess the efficacy and safety of alfuzosin 10 mg monotherapy or combined antihypertensive medication on blood pressure (BP) in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (BPH/LUTS) with or without antihypertensive medication. This was a 3-month, multicenter, randomized, open-label study in 335 patients aged ≥45 years with a clinical diagnosis of BPH/LUTS by medical history and clinical examination, a total International Prostatic Symptom Score (IPSS) ≥8 points, a maximum flow rate >5 mL/sec and ≤15 mL/sec, and a voided volume ≥120 mL. Eligible subjects were randomized to receive alfuzosin 10 mg as monotherapy (group 1) or alfuzosin 10 mg + antihypertensive combination therapy (group 2). Based on baseline BP and hypertensive history with or without antihypertensive medications at first medical examination, group 1 was divided into two subgroups of normotensive and untreated hypertensive patients, and group 2 into two subgroups of controlled hypertensive and uncontrolled hypertensive patients. The primary study outcomes were change in IPSS, BP, and heart rate from baseline. Secondary outcomes were change in IPSS-quality of life score, maximum flow rate, average flow rate, voided volume, and post-voided volume. The overall BP change was not significantly different between groups 1 and 2 (systolic BP, P=0.825; diastolic BP, P>0.999). In patients with uncontrolled or untreated hypertension, alfuzosin 10 mg alone or combined with antihypertensive therapy significantly decreased systolic and diastolic BP. The mean difference in total IPSS and IPSS-quality of life scores from baseline between groups 1 and 2 was 0.45 (95% CI: -1.26, 2.16) and 0.12 (95% CI: -0.21, 0.45), respectively (both P>0.05). Maximum flow rate, average flow rate, voided volume, and post-voided volume at endpoint were numerically, but not significantly, changed from baseline (all P>0.05). This study shows that alfuzosin 10 mg is effective and well tolerated in patients with BPH/LUTS with or without antihypertensive medications. However, in patients with uncontrolled or untreated hypertension, alfuzosin 10 mg alone or in combination with antihypertensive medication appears to decrease systolic and diastolic BP, and these patients should be warned about a decrease in BP on initiation of therapy.

An Investigation of the Causes of the Coronary-Prone (Type A) Behavior Pattern and Coronary Heart Disease.

DTIC Science & Technology

1983-09-01

experiences. Uncontrollable Stress Uncontrollable stress arises when an individual’s outcome is not determined by his/her response to a situation. Seligman ... Linda Hervig, and Ray H. Rosenman. "Heritability of Type A Behavior," Psychosomatic Medicine, 40, No. 6 (1978), pp. 478-486. , Robert T. Rubin, and...Performance, 25 (1980), pp. 184-215. Seligman , M. E. P. Helplessness: On Depression, Develop- ment, and Death. San Francisco: Freeman, 1975. Tamir, I., G

Uncontrolled Hemorrhage Differs From Volume- or Pressure-Matched Controlled Hemorrhage in Swine

DTIC Science & Technology

2007-10-01

differences between these models, we evaluated the relationship between blood volume loss and blood pressure in controlled versus uncontrolled hemorrhage...aortotomy; (2) group P, controlled hemorrhage matched to the blood pressure profile of group U; or (3) group V, controlled hemorrhage matched to the...hemorrhage and received no fluid resuscitation. Group U resulted in a blood loss of 17.6 T 0.7 mL kgj1 and a reduction in blood pressure to 28 T 3 mmHg at

Endo-Perio Lesion and Uncontrolled Diabetes

PubMed Central

Laslami, Kaoutar; Rouggani, Fatimazahraa; El Ouazzani, Amal; Jabri, Mouna

2018-01-01

This work is to discuss the management of an endo-perio lesion, which represents a challenge to clinicians when it comes to diagnosis and prognosis of the involved teeth and especially with an altered general condition. A 50-year-old female patient with uncontrolled diabetes type 2 is suffering from a purulent discharge coming from the upper right canine. Endodontic and periodontal treatments were realized with 36 months radiological and clinical follow-up with the collaboration of her internist doctor. PMID:29888011

General aviation air traffic pattern safety analysis

NASA Technical Reports Server (NTRS)

Parker, L. C.

1973-01-01

A concept is described for evaluating the general aviation mid-air collision hazard in uncontrolled terminal airspace. Three-dimensional traffic pattern measurements were conducted at uncontrolled and controlled airports. Computer programs for data reduction, storage retrieval and statistical analysis have been developed. Initial general aviation air traffic pattern characteristics are presented. These preliminary results indicate that patterns are highly divergent from the expected standard pattern, and that pattern procedures observed can affect the ability of pilots to see and avoid each other.

A Hemoglobin Based Oxygen Carrier, Bovine Polymerized Hemoglobin (HBOC-201) versus Hetastarch (HEX) in an Uncontrolled Liver Injury Hemorrhagic Shock Swine Model with Delayed Evacuation

DTIC Science & Technology

2004-10-01

A Hemoglobin Based Oxygen Carrier, Bovine Polymerized Hemoglobin (HBOC-201) versus Hetastarch (HEX) in an Uncontrolled Liver Injury Hemorrhagic Shock...Transcutaneous tis- sue oxygenation was restored more rap- idly in HBOC-201 pigs, there was a trend to lower lactic acid, and base deficit was less...lactic acidosis and base deficit (BD) abnormalities, indicating on-going hypoperfusion.2–4 As these abnormalities measured upon hospital arrival

Novel Heat Controller for Thermogenerators Working on Uncontrolled Stoves

NASA Astrophysics Data System (ADS)

Juanicó, Luis E.; Rinalde, Fabián; Taglialavore, Eduardo; Molina, Marcelo

2013-07-01

This paper describes the development of a thermogenerator designed for uncontrolled firewood household stoves. It was built on BiTe thermoelectric (TE) modules, and it uses a water pot as a cooling device that also serves as a hot water source. An original heat controller was developed; it has low thermal resistance ( R) during low-power operation, but its R can be continuously increased according to the stove temperature so that the TE never overheats while its power generation is optimized.

The Study of Productivity Measurement and Incentive Methodology (Phase III - Paper Test). Volume 1

DTIC Science & Technology

1986-03-14

possible to measure explicitly, in terms of dollars the profit impacts of these uncontrollable as well as controllable factors and to de - termine and...the rate of engineering changes increases. • Production processes arc be- coming less reliant on direct la - bor as the primary factor in pro...MFPMM makes it •: —.sibie to measure explicitly, in terms of dollars the profit impacts of these uncontrollable as well as controllable factors and to de

Application of adipocyte-derived stem cells in treatment of cutaneous radiation syndrome.

PubMed

Riccobono, Diane; Agay, Diane; Scherthan, Harry; Forcheron, Fabien; Vivier, Mylène; Ballester, Bruno; Meineke, Viktor; Drouet, Michel

2012-08-01

Cutaneous radiation syndrome caused by local high dose irradiation is characterized by delayed outcome and incomplete healing. Recent therapeutic management of accidentally irradiated burn patients has suggested the benefit of local cellular therapy using mesenchymal stem cell grafting. According to the proposed strategy of early treatment, large amounts of stem cells would be necessary in the days following exposure and hospitalization, which would require allogeneic stem cells banking. In this context, the authors compared the benefit of local autologous and allogeneic adipocyte-derived stem cell injection in a large animal model. Minipigs were locally irradiated using a 60Co gamma source at a dose of 50 Gy and divided into three groups. Two groups were grafted with autologous (n = 5) or allogeneic (n = 5) adipocyte-derived stem cells four times after the radiation exposure, whereas the control group received the vehicle without cells (n = 8). A clinical score was elaborated to compare the efficiency of the three treatments. All controls exhibited local inflammatory injuries leading to a persistent painful necrosis, thus mimicking the clinical evolution in human victims. In the autologous adipocyte-derived stem cells group, skin healing without necrosis or uncontrollable pain was observed. In contrast, the clinical outcome was not significantly different in the adipocyte-derived stem cell allogeneic group when compared with controls. This study suggests that autologous adipocyte-derived stem cell grafting improves cutaneous radiation syndrome wound healing, whereas allogeneic adipocyte derived stem cells do not. Further studies will establish whether manipulation of allogeneic stem cells will improve their therapeutic potential.

Open space preservation, property value, and optimal spatial configuration

Treesearch

Yong Jiang; Stephen K. Swallow

2007-01-01

The public has increasingly demonstrated a strong support for open space preservation. How to finance the socially efficient level of open space with the optimal spatial structure is of high policy relevance to local governments. In this study, we developed a spatially explicit open space model to help identify the socially optimal amount and optimal spatial...

Open-ocean boundary conditions from interior data: Local and remote forcing of Massachusetts Bay

USGS Publications Warehouse

Bogden, P.S.; Malanotte-Rizzoli, P.; Signell, R.

1996-01-01

Massachusetts and Cape Cod Bays form a semienclosed coastal basin that opens onto the much larger Gulf of Maine. Subtidal circulation in the bay is driven by local winds and remotely driven flows from the gulf. The local-wind forced flow is estimated with a regional shallow water model driven by wind measurements. The model uses a gravity wave radiation condition along the open-ocean boundary. Results compare reasonably well with observed currents near the coast. In some offshore regions however, modeled flows are an order of magnitude less energetic than the data. Strong flows are observed even during periods of weak local wind forcing. Poor model-data comparisons are attributable, at least in part, to open-ocean boundary conditions that neglect the effects of remote forcing. Velocity measurements from within Massachusetts Bay are used to estimate the remotely forced component of the flow. The data are combined with shallow water dynamics in an inverse-model formulation that follows the theory of Bennett and McIntosh [1982], who considered tides. We extend their analysis to consider the subtidal response to transient forcing. The inverse model adjusts the a priori open-ocean boundary condition, thereby minimizing a combined measure of model-data misfit and boundary condition adjustment. A "consistency criterion" determines the optimal trade-off between the two. The criterion is based on a measure of plausibility for the inverse solution. The "consistent" inverse solution reproduces 56% of the average squared variation in the data. The local-wind-driven flow alone accounts for half of the model skill. The other half is attributable to remotely forced flows from the Gulf of Maine. The unexplained 44% comes from measurement errors and model errors that are not accounted for in the analysis. 

The Effectiveness of Building Permit Regulation for Green Open Space at Housing Estates: Case Study of Kendal Regency, Central Java, Indonesia

NASA Astrophysics Data System (ADS)

Yulianti, Wiwik; Hadi, Sudharto P.

2018-02-01

Increasing demand for settlements steamed by population growth declines the quality of the environment specifically at urban area. The existing spatial planning could not able to prevent the change of land use for settlement and other infrastructures. The Act no. 26 of 2007 on spatial planning stipulates that green open space must reach 30% of the total area, consisting of 20% public open space and 10% private open space. The existing condition of urban area at Kendal Regency reach 245,6 million m2 with 88.145,5 m2 green open space or 0,036% out of total area. An effort to increase green open space in urban areas taken by the Government of Kendal Regency is by promulgating a local regulation stipulating that each housing developer request a building permit is obliged to provide a green open space at least 10 percent of the total housing area. This paper reviews the effectiveness of building permit regulation, the problems encountered and the concept proposed to make the local regulation work. The area of sample taken is three urban districts out of five urban districts, the resource persons chosen are those from relevant offices (Dinas) involved at the implementation of the local regulation. The data collection techniques employed are the Analytical Hierarchy Process (AHP), Geographic Information System (GIS) technology, social observation and informal interview. The data gathered will be analyzed quantitatively and qualitatively.

Retinal complications of gout: a case report and review of the literature.

PubMed

Jiang, Ying; Brenner, Jason E; Foster, William J

2018-01-19

There have been few reported findings of posterior segment complications of gout. While exudative lesions, an increased risk of macular degeneration, and vascular occlusions have been previously reported, to our knowledge, refractile macular lesions have not been reported in a patient with chronic uncontrolled gout. Highly refractile, crystal-like lesions were found in the macula of a 62 year old male patient with chronically uncontrolled gout. The lesions appeared at the termination of retinal arterioles and were located at the level of the retinal pigment epithelium. The lesions did not stain with fluorescein and were associated with larger areas geographic atrophy. Review of the patient's blood tests revealed well-controlled vasculopathic risk factors. Fundus appearance and best-corrected visual acuity remained stable over 12 months of follow-up during which the uric acid levels were well controlled. Retinopathy may be associated with chronically uncontrolled gout and patients with visual complaints should undergo a dilated examination in addition to the typical anterior segment slit-lamp exam.

The medical antigravity suit for management of surgically uncontrollable bleeding associated with abdominal pregnancy.

PubMed

Sandberg, E C; Pelligra, R

1983-07-01

Three patients with abdominal pregnancy have been treated at Stanford University Hospital in recent years. Common to each was surgically uncontrolled hemorrhage for which circumferential pneumatic compression (supplied by a medical antigravity suit) was used to stop the bleeding. In each patient, the hemostatic effect of treatment was dramatic. In published accounts of the use of the garment in other severely hemorrhaging patients, the effects have been similarly dramatic and equally successful. These observations lead to a compelling consideration in regard to optimum management of patients with abdominal pregnancy. If our experience is confirmed by others, optimum management in abdominal pregnancy hereafter should regularly and routinely include removal of the placenta at the primary operation. This approach would anticipate use of the medical antigravity suit to provide hemostasis if surgically uncontrollable bleeding is encountered. Theoretically, the complications and long-term morbidity associated with retention of the placenta would be eliminated by this means while the previous disadvantage of placental removal, the potential for exsanguinating hemorrhage, would be circumvented.

Predictability of uncontrollable multifocal seizures - towards new treatment options

NASA Astrophysics Data System (ADS)

Lehnertz, Klaus; Dickten, Henning; Porz, Stephan; Helmstaedter, Christoph; Elger, Christian E.

2016-04-01

Drug-resistant, multifocal, non-resectable epilepsies are among the most difficult epileptic disorders to manage. An approach to control previously uncontrollable seizures in epilepsy patients would consist of identifying seizure precursors in critical brain areas combined with delivering a counteracting influence to prevent seizure generation. Predictability of seizures with acceptable levels of sensitivity and specificity, even in an ambulatory setting, has been repeatedly shown, however, in patients with a single seizure focus only. We did a study to assess feasibility of state-of-the-art, electroencephalogram-based seizure-prediction techniques in patients with uncontrollable multifocal seizures. We obtained significant predictive information about upcoming seizures in more than two thirds of patients. Unexpectedly, the emergence of seizure precursors was confined to non-affected brain areas. Our findings clearly indicate that epileptic networks, spanning lobes and hemispheres, underlie generation of seizures. Our proof-of-concept study is an important milestone towards new therapeutic strategies based on seizure-prediction techniques for clinical practice.

Physician and patient characteristics associated with clinical inertia in blood pressure control.

PubMed

Harle, Christopher A; Harman, Jeffrey S; Yang, Shuo

2013-11-01

Clinical inertia, the failure to adjust antihypertensive medications during patient visits with uncontrolled hypertension, is thought to be a common problem. This retrospective study used 5 years of electronic medical records from a multispecialty group practice to examine the association between physician and patient characteristics and clinical inertia. Hierarchical linear models (HLMs) were used to examine (1) differences in physician and patient characteristics among patients with and without clinical inertia, and (2) the association between clinical inertia and future uncontrolled hypertension. Overall, 66% of patients experienced clinical inertia. Clinical inertia was associated with one physician characteristic, patient volume (odds ratio [OR]=0.998). However, clinical inertia was associated with multiple patient characteristics, including patient age (OR=1.021), commercial insurance (OR=0.804), and obesity (OR=1.805). Finally, patients with clinical inertia had 2.9 times the odds of uncontrolled hypertension at their final visit in the study period. These findings may aid the design of interventions to reduce clinical inertia. ©2013 Wiley Periodicals, Inc.

[Learned helplessness, generalized self-efficacy, and immune function].

PubMed

Kuno, Mayumi; Yazawa, Hisashi; Ohira, Hideki

2003-02-01

Generalized self-efficacy is considered one of important personality traits that determine psychological and physiological stress responses. The present study examined the interaction effects of generalized self-efficacy and controllability of acute stress on salivary secretory immunoglobulin A (s-IgA), task performance, and psychological stress responses in a typical learned helplessness paradigm. Twenty low and 19 high self-efficacy undergraduate women performed two response selection tasks one after another. In the first task, they were exposed to controllable or uncontrollable aversive noise. The second task was identical for all, but perceived controllability was higher for the high self-efficacy group than the low. Performance under uncontrollable condition was lower than controllable condition. The interaction of self-efficacy and controllability was observed only on the s-IgA variable; increase of secretion of s-IgA secretion under stressor uncontrollability was more prominent in the low self-efficacy group than the high. These results suggested that generalized self-efficacy was a moderator of the stressor controllability effect on secretory immunity.

Coordinated management of combined sewer overflows by means of environmental decision support systems.

PubMed

Murla, Damian; Gutierrez, Oriol; Martinez, Montse; Suñer, David; Malgrat, Pere; Poch, Manel

2016-04-15

During heavy rainfall, the capacity of sewer systems and wastewater treatment plants may be surcharged producing uncontrolled wastewater discharges and a depletion of the environmental quality. Therefore there is a need of advanced management tools to tackle with these complex problems. In this paper an environmental decision support system (EDSS), based on the integration of mathematical modeling and knowledge-based systems, has been developed for the coordinated management of urban wastewater systems (UWS) to control and minimize uncontrolled wastewater spills. Effectiveness of the EDSS has been tested in a specially designed virtual UWS, including two sewers systems, two WWTP and one river subjected to typical Mediterranean rain conditions. Results show that sewer systems, retention tanks and wastewater treatment plants improve their performance under wet weather conditions and that EDSS can be very effective tools to improve the management and prevent the system from possible uncontrolled wastewater discharges. Copyright © 2016 Elsevier B.V. All rights reserved.

Localizer: fast, accurate, open-source, and modular software package for superresolution microscopy

PubMed Central

Duwé, Sam; Neely, Robert K.; Zhang, Jin

2012-01-01

Abstract. We present Localizer, a freely available and open source software package that implements the computational data processing inherent to several types of superresolution fluorescence imaging, such as localization (PALM/STORM/GSDIM) and fluctuation imaging (SOFI/pcSOFI). Localizer delivers high accuracy and performance and comes with a fully featured and easy-to-use graphical user interface but is also designed to be integrated in higher-level analysis environments. Due to its modular design, Localizer can be readily extended with new algorithms as they become available, while maintaining the same interface and performance. We provide front-ends for running Localizer from Igor Pro, Matlab, or as a stand-alone program. We show that Localizer performs favorably when compared with two existing superresolution packages, and to our knowledge is the only freely available implementation of SOFI/pcSOFI microscopy. By dramatically improving the analysis performance and ensuring the easy addition of current and future enhancements, Localizer strongly improves the usability of superresolution imaging in a variety of biomedical studies. PMID:23208219

A realization of sound focused personal audio system using acoustic contrast control.

PubMed

Chang, Ji-Ho; Lee, Chan-Hui; Park, Jin-Young; Kim, Yang-Hann

2009-04-01

A personal audio system that does not use earphone or any wire would have great interest and potential impact on the audio industries. In this study, a line array speaker system is used to localize sound in the listening zone. The contrast control [Choi, J.-W. and Kim, Y.-H. (2002). J. Acoust. Soc. Am. 111, 1695-1700] is applied, which is a method to make acoustically bright zone around the user and acoustically dark zone in other regions by maximizing the ratio of acoustic potential energy density between the bright and the dark zone. This ratio is regarded as acoustic contrast, analogous with what is used for optical devices. For the evaluation of the performance of acoustic contrast control, experiments are performed and the results are compared with those of uncontrolled case and time reversal array.

Complement, a target for therapy in inflammatory and degenerative diseases.

PubMed

Morgan, B Paul; Harris, Claire L

2015-12-01

The complement system is a key innate immune defence against infection and an important driver of inflammation; however, these very properties can also cause harm. Inappropriate or uncontrolled activation of complement can cause local and/or systemic inflammation, tissue damage and disease. Complement provides numerous options for drug development as it is a proteolytic cascade that involves nine specific proteases, unique multimolecular activation and lytic complexes, an arsenal of natural inhibitors, and numerous receptors that bind to activation fragments. Drug design is facilitated by the increasingly detailed structural understanding of the molecules involved in the complement system. Only two anti-complement drugs are currently on the market, but many more are being developed for diseases that include infectious, inflammatory, degenerative, traumatic and neoplastic disorders. In this Review, we describe the history, current landscape and future directions for anti-complement therapies.

Control of transversal instabilities in reaction-diffusion systems

NASA Astrophysics Data System (ADS)

Totz, Sonja; Löber, Jakob; Totz, Jan Frederik; Engel, Harald

2018-05-01

In two-dimensional reaction-diffusion systems, local curvature perturbations on traveling waves are typically damped out and vanish. However, if the inhibitor diffuses much faster than the activator, transversal instabilities can arise, leading from flat to folded, spatio-temporally modulated waves and to spreading spiral turbulence. Here, we propose a scheme to induce or inhibit these instabilities via a spatio-temporal feedback loop. In a piecewise-linear version of the FitzHugh–Nagumo model, transversal instabilities and spiral turbulence in the uncontrolled system are shown to be suppressed in the presence of control, thereby stabilizing plane wave propagation. Conversely, in numerical simulations with the modified Oregonator model for the photosensitive Belousov–Zhabotinsky reaction, which does not exhibit transversal instabilities on its own, we demonstrate the feasibility of inducing transversal instabilities and study the emerging wave patterns in a well-controlled manner.

[Knowledge level of hypertensive patients about hypertension. Relationship between knowledge level and hypertension control].

PubMed

Benítez Camps, M; Egocheaga Cabello, M Isabel; Dalfó Baqué, A; Bajo García, J; Vara González, L; Sanchis Doménech, C; Martín Rioboo, E; Ureña Fernández, T; Domínguez Sardiña, M; Bonet Pla, A

2015-01-01

To assess the knowledge of the hypertensive patients about their hypertension and their relation to its control. Cross-sectional study among 400 hypertensive patients, all over 18 years, selected from 50 primary-care centres, who responded to an hypertension-related survey. Included variables were survey items, age, gender, educational level, professional occupation, blood pressure data and antihypertensive treatment. The obtained differences were analyzed using the chi-square test, Kruskal-Wallis, Wilcoxon, Anova and Bonferroni methods. There were 323 valid surveys. 52.9% of respondents were women, the average age: 65.4 years (SD: 11.2), 54.8% of them had primary education. 39.6% were aware of the objectives of systolic BP control. Only 19.6% having knowledge of those for diastolic BP control, with no differences between controlled and uncontrolled (systolic BP: 39% vs 38.1%, P=.887; diastolic BP: 19.2% vs 21%, P=.721). Over 70% knew about lifestyle changes, without significant differences between controlled and uncontrolled respondents. 82% of controlled respondents, and 79% of those uncontrolled, recognized the chronical nature of the treatment (P=.548), but 15.1% of the controlled respondents and 12.4% of uncontrolled respondents did not see the relation between the treatment and hypertension control (P=.525). 31.1% believed to be well-controlled, but in fact was not. Our patients doesn't know blood pressure targets of control. There isn't relationship between this knowledge and control of hypertension. Copyright © 2014 SEHLELHA. Published by Elsevier Espana. All rights reserved.

BDNF action in the brain attenuates diabetic hyperglycemia via insulin-independent inhibition of hepatic glucose production.

PubMed

Meek, Thomas H; Wisse, Brent E; Thaler, Joshua P; Guyenet, Stephan J; Matsen, Miles E; Fischer, Jonathan D; Taborsky, Gerald J; Schwartz, Michael W; Morton, Gregory J

2013-05-01

Recent evidence suggests that central leptin administration fully normalizes hyperglycemia in a rodent model of uncontrolled insulin-deficient diabetes by reducing hepatic glucose production (HGP) and by increasing glucose uptake. The current studies were undertaken to determine whether brain-derived neurotrophic factor (BDNF) action in the brain lowers blood glucose in uncontrolled insulin-deficient diabetes and to investigate the mechanisms mediating this effect. Adult male rats implanted with cannulas to either the lateral cerebral ventricle or the ventromedial hypothalamic nucleus (VMN) received either vehicle or streptozotocin to induce uncontrolled insulin-deficient diabetes. Three days later, animals received daily intracerebroventricular or intra-VMN injections of either BDNF or its vehicle. We found that repeated daily intracerebroventricular administration of BDNF attenuated diabetic hyperglycemia independent of changes in food intake. Instead, using tracer dilution techniques during a basal clamp, we found that BDNF lowered blood glucose levels by potently suppressing HGP, without affecting tissue glucose uptake, an effect associated with normalization of both plasma glucagon levels and hepatic expression of gluconeogenic genes. Moreover, BDNF microinjection directly into the VMN also lowered fasting blood glucose levels in uncontrolled insulin-deficient diabetes, but this effect was modest compared with intracerebroventricular administration. We conclude that central nervous system BDNF attenuates diabetic hyperglycemia via an insulin-independent mechanism. This action of BDNF likely involves the VMN and is associated with inhibition of glucagon secretion and a decrease in the rate of HGP.

The burden of conscientiousness? Examining brain activation and cortisol response during social evaluative stress.

PubMed

Dahm, Anne-Sophie; Schmierer, Phöbe; Veer, Ilya M; Streit, Fabian; Görgen, Anna; Kruschwitz, Johann; Wüst, Stefan; Kirsch, Peter; Walter, Henrik; Erk, Susanne

2017-04-01

Although conscientiousness has for a long time been considered generally adaptive, there are findings challenging this view, suggesting that conscientiousness might be less advantageous during uncontrollable stress. We here examined the impact of conscientiousness on brain activation during and the cortisol response following an uncontrollable social evaluative stress task in order to test this hypothesis. Brain activation and cortisol levels were measured during an fMRI stress task, where subjects (n=86) performed cognitive tasks containing preprogrammed failure under time pressure, while being monitored by a panel of experts inducing social-evaluative threat. The degree of conscientiousness was measured using the NEO-FFI. We observed a positive correlation between conscientiousness and salivary cortisol levels in response to the stressful task in male subjects only. In male subjects conscientiousness correlated positively with activation in right amygdala and left insula, and, moreover, mediated the influence of amygdala and insula activation on cortisol output. This pattern of brain activation can be interpreted as a disadvantageous response to uncontrollable stress to which highly conscientious individuals might be predisposed. This is the first study showing the effect of conscientiousness on physiology and brain activation to an uncontrollable psychosocial stressor. Our results provide neurobiological evidence for the hypothesis that conscientiousness should not just be seen as beneficial, but rather as a trait associated with either costs or benefits depending on the extent to which one is in control of the situation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effectiveness of a medical education intervention to treat hypertension in primary care.

PubMed

Martínez-Valverde, Silvia; Castro-Ríos, Angélica; Pérez-Cuevas, Ricardo; Klunder-Klunder, Miguel; Salinas-Escudero, Guillermo; Reyes-Morales, Hortensia

2012-04-01

In Mexico, hypertension is among the top five causes for visits to primary care clinics; its complications are among the main causes of emergency and hospital care. The present study reports the effectiveness of a continuing medical education (CME) intervention to improve appropriate care for hypertension, on blood pressure control of hypertensive patients in primary care clinics. A secondary data analysis was carried out using data of hypertensive patients treated by family doctors who participated in the CME intervention. The evaluation was designed as a pre-/post-intervention study with control group in six primary care clinics. The effect of the CME intervention was analysed using multiple logistic regression modelling in which the dependent variable was uncontrolled blood pressure in the post-intervention patient measurement. After the CME intervention, the net reduction of uncontrolled blood pressure between stages in the intervention group was 10.3%. The model results were that being treated by a family doctor who participated in the CME intervention reduced by 53% the probability of lack of control of blood pressure; receiving dietary recommendations reduced 57% the probability of uncontrolled blood pressure. Having uncontrolled blood pressure at the baseline stage increased the probability of lack of control in 166%, and per each unit of increase in body mass index the lack of control increased 7%. CME intervention improved the medical decision-making process to manage hypertension, thus increasing the probability of hypertensive patients to have blood pressure under control. © 2010 Blackwell Publishing Ltd.

Subgingival biodiversity in subjects with uncontrolled type-2 diabetes and chronic periodontitis.

PubMed

Casarin, R C V; Barbagallo, A; Meulman, T; Santos, V R; Sallum, E A; Nociti, F H; Duarte, P M; Casati, M Z; Gonçalves, R B

2013-02-01

There is a bidirectional relationship between periodontal disease and type-2 diabetes mellitus (DM). Inflammatory mediators may negatively affect glycemic control, and increased glucose levels and resultant glycation end-products may alter the host response against bacterial infection. However, no agreement has been reached regarding the effect of DM on periodontal subgingival microbiota. Therefore, the purpose of the present study was to compare the subgingival biodiversity in deep periodontal pockets of subjects with chronic periodontitis and either uncontrolled type-2 diabetes or no diabetes using 16S rRNA gene cloning and sequencing. Twelve subjects with uncontrolled type-2 diabetes (glycated hemoglobin > 8%) and eleven nondiabetic subjects presenting severe and generalized chronic periodontitis were selected. Subgingival biofilm from periodontal pockets > 5 mm were assessed using the 16S rRNA gene cloning and sequencing technique. Significant differences were observed in subgingival microbiota between diabetic and nondiabetic subjects. Diabetic subjects presented higher percentages of total clones of TM7, Aggregatibacter, Neisseria, Gemella, Eikenella, Selenomonas, Actinomyces, Capnocytophaga, Fusobacterium, Veillonella and Streptococcus genera, and lower percentages of Porphyromonas, Filifactor, Eubacterium, Synergistetes, Tannerella and Treponema genera than nondiabetic individuals (p < 0.05). Moreover, some phylotypes, such as Fusobacterium nucleatum, Veillonella parvula, V. dispar and Eikenella corrodens were detected significantly more often in diabetic subjects than in nondiabetic subjects (p < 0.05). Subjects with uncontrolled type-2 diabetes and chronic periodontitis presented significant dissimilarities in subgingival biodiversity compared with nondiabetic subjects. © 2012 John Wiley & Sons A/S.

Health care use and costs for participants in a diabetes disease management program, United States, 2007-2008.

PubMed

Dall, Timothy M; Roary, Mary; Yang, Wenya; Zhang, Shiping; Chen, Yaozhu J; Arday, David R; Gantt, Cynthia J; Zhang, Yiduo

2011-05-01

The Disease Management Association of America identifies diabetes as one of the chronic conditions with the greatest potential for management. TRICARE Management Activity, which administers health care benefits for US military service personnel, retirees, and their dependents, created a disease management program for beneficiaries with diabetes. The objective of this study was to determine whether participation intensity and prior indication of uncontrolled diabetes were associated with health care use and costs for participants enrolled in TRICARE's diabetes management program. This ongoing, opt-out study used a quasi-experimental approach to assess program impact for beneficiaries (n = 37,370) aged 18 to 64 living in the United States. Inclusion criteria were any diabetes-related emergency department visits or hospitalizations, more than 10 diabetes-related ambulatory visits, or more than twenty 30-day prescriptions for diabetes drugs in the previous year. Beginning in June 2007, all participants received educational mailings. Participants who agreed to receive a baseline telephone assessment and telephone counseling once per month in addition to educational mailings were considered active, and those who did not complete at least the baseline telephone assessment were considered passive. We categorized the diabetes status of each participant as "uncontrolled" or "controlled" on the basis of medical claims containing diagnosis codes for uncontrolled diabetes in the year preceding program eligibility. We compared observed outcomes to outcomes predicted in the absence of diabetes management. Prediction equations were based on regression analysis of medical claims for a historical control group (n = 23,818) that in October 2004 met the eligibility criteria for TRICARE's program implemented June 2007. We conducted regression analysis comparing historical control group patient outcomes after October 2004 with these baseline characteristics. Per-person total annual medical savings for program participants, calculated as the difference between observed and predicted outcomes, averaged $783. Active participants had larger reductions in inpatient days and emergency department visits, larger increases in ambulatory visits, and larger increases in receiving retinal examinations, hemoglobin A1c tests, and urine microalbumin tests compared with passive participants. Participants with prior indication of uncontrolled diabetes had higher per-person total annual medical savings, larger reduction in inpatient days, and larger increases in ambulatory visits than did participants with controlled diabetes. Greater intensity of participation in TRICARE's diabetes management program was associated with lower medical costs and improved receipt of recommended testing. That patients who were categorized as having uncontrolled diabetes realized greater program benefits suggests diabetes management programs should consider indication of uncontrolled diabetes in their program candidate identification criteria.

Effect of occlusion, directionality and age on horizontal localization

NASA Astrophysics Data System (ADS)

Alworth, Lynzee Nicole

Localization acuity of a given listener is dependent upon the ability discriminate between interaural time and level disparities. Interaural time differences are encoded by low frequency information whereas interaural level differences are encoded by high frequency information. Much research has examined effects of hearing aid microphone technologies and occlusion separately and prior studies have not evaluated age as a factor in localization acuity. Open-fit hearing instruments provide new earmold technologies and varying microphone capabilities; however, these instruments have yet to be evaluated with regard to horizontal localization acuity. Thus, the purpose of this study is to examine the effects of microphone configuration, type of dome in open-fit hearing instruments, and age on the horizontal localization ability of a given listener. Thirty adults participated in this study and were grouped based upon hearing sensitivity and age (young normal hearing, >50 years normal hearing, >50 hearing impaired). Each normal hearing participant completed one localization experiment (unaided/unamplified) where they listened to the stimulus "Baseball" and selected the point of origin. Hearing impaired listeners were fit with the same two receiver-in-the-ear hearing aids and same dome types, thus controlling for microphone technologies, type of dome, and fitting between trials. Hearing impaired listeners completed a total of 7 localization experiments (unaided/unamplified; open dome: omnidirectional, adaptive directional, fixed directional; micromold: omnidirectional, adaptive directional, fixed directional). Overall, results of this study indicate that age significantly affects horizontal localization ability as younger adult listeners with normal hearing made significantly fewer localization errors than older adult listeners with normal hearing. Also, results revealed a significant difference in performance between dome type; however, upon further examination was not significant. Therefore, results examining type of dome should be viewed with caution. Results examining microphone configuration and microphone configuration by dome type were not significant. Moreover, results evaluating performance relative to unaided (unamplified) were not significant. Taken together, these results suggest open-fit hearing instruments, regardless of microphone or dome type, do not degrade horizontal localization acuity within a given listener relative to their 'older aged' normal hearing counterparts in quiet environments.

Erythrocyte 2,3-diphosphoglycerate depletion associated with hypophosphatemia detected by routine arterial blood gas analysis.

PubMed

Larsen, V H; Waldau, T; Gravesen, H; Siggaard-Andersen, O

1996-01-01

To describe a clinical case where an extremely low erythrocyte 2,3-diphosphoglycerate concentration (2,3-DPG) was discovered by routine blood gas analysis supplemented by computer calculation of derived quantities. The finding of a low 2,3-DPG revealed a severe hypophosphatemia. Open uncontrolled study of a patient case. Intensive care observation during 41 days. A 44 year old woman with an abdominal abscess. Surgical drainage, antibiotics and parenteral nutrition. daily routine blood gas analyses with computer calculation of the hemoglobin oxygen affinity and estimation of the 2,3-DPG. An abrupt decline of 2,3-DPG was observed late in the course coincident with a pronounced hypophosphatemia. The fall in 2,3-DPG was verified by enzymatic analysis. 2,3-DPG may be estimated by computer calculation of routine blood gas data. A low 2,3-DPG which may be associated with hypophosphatemia causes an unfavorable increase in hemoglobin oxygen affinity which reduces the oxygen release to the tissues.

Time series, correlation matrices and random matrix models

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

Vinayak; Seligman, Thomas H.

2014-01-08

In this set of five lectures the authors have presented techniques to analyze open classical and quantum systems using correlation matrices. For diverse reasons we shall see that random matrices play an important role to describe a null hypothesis or a minimum information hypothesis for the description of a quantum system or subsystem. In the former case various forms of correlation matrices of time series associated with the classical observables of some system. The fact that such series are necessarily finite, inevitably introduces noise and this finite time influence lead to a random or stochastic component in these time series.more » By consequence random correlation matrices have a random component, and corresponding ensembles are used. In the latter we use random matrices to describe high temperature environment or uncontrolled perturbations, ensembles of differing chaotic systems etc. The common theme of the lectures is thus the importance of random matrix theory in a wide range of fields in and around physics.« less

Clinical Evaluation of Kshara sutra Therapy in the management of Bhagandara( Fistula- in-Ano)- A prospective study

PubMed Central

Panigrahi, Hemanta Kumar; Rani, Rakesh; Padhi, M.M.; Lavekar, G.S.

2009-01-01

Study design: A prospective study of 50 patients suffering from Bhagandara(Fistula in Ano) (age ranging from 18-54years) treated by Kshara sutra therapy Place: Kshara sutra unit, Central research Unit, Punjabi bagh, New Delhi Duration: January 2007 to July 2008. Objectives: To determine the incidence of low or high anal fistula, recurrence rate following Kshara sutra therapy and effect of Ksharasutra therapy on the Bhagandara. Material and methods: The fifty patients (50) were selected randomly in the Out Patient Department. Study Design: Uncontrolled open level Study. Results: Patients were followed to see the incidence of recurrence, effect of Kshara Sutra Therapy on incontinence. Overall recurrence rate was only 5.88 %. Minor incontinence was observed only following Kshara sutra Therapy for high variety for which no treatment was given. No such complication occurred in low variety. Conclusion: Bhagandara (Fistula in Ano) can be treated by Kshara Sutra Therapy with minimal loss of sphincter muscle and low reoccurrence rate. PMID:22557318

The effect of tranexamic acid on the quality of life of women with heavy menstrual bleeding.

PubMed

Winkler, U H

2001-12-01

To investigate whether medical treatment with tranexamic acid would increase the quality of life of women with heavy menstrual bleeding. This open, uncontrolled usage study included 849 women diagnosed with heavy menstrual bleeding and considered eligible for tranexamic-acid treatment. The condition of the women was investigated at baseline and after the first and the third treated menstruation. Quality of life and subjectively experienced state of health were assessed with the aid of a questionnaire. Satisfaction with the treatment was registered. After the third menstruation, 80% of the women were satisfied with the treatment. Impairment of social activities and impairment at work were greatly reduced by the treatment. Substantial improvements were also recorded with regard to alertness, productivity, cleanliness, spirits, action radius and overall well-being. Adverse reactions to the drug used for the treatment were few and non-serious. Medical treatment with tranexamic acid increases quality of life for women with heavy menstrual bleeding.

Laser Spot Tracking Based on Modified Circular Hough Transform and Motion Pattern Analysis

PubMed Central

Krstinić, Damir; Skelin, Ana Kuzmanić; Milatić, Ivan

2014-01-01

Laser pointers are one of the most widely used interactive and pointing devices in different human-computer interaction systems. Existing approaches to vision-based laser spot tracking are designed for controlled indoor environments with the main assumption that the laser spot is very bright, if not the brightest, spot in images. In this work, we are interested in developing a method for an outdoor, open-space environment, which could be implemented on embedded devices with limited computational resources. Under these circumstances, none of the assumptions of existing methods for laser spot tracking can be applied, yet a novel and fast method with robust performance is required. Throughout the paper, we will propose and evaluate an efficient method based on modified circular Hough transform and Lucas–Kanade motion analysis. Encouraging results on a representative dataset demonstrate the potential of our method in an uncontrolled outdoor environment, while achieving maximal accuracy indoors. Our dataset and ground truth data are made publicly available for further development. PMID:25350502

Anomalies in target-controlled infusion: an analysis after 20 years of clinical use.

PubMed

Engbers, F H M; Dahan, A

2018-05-01

Although target-controlled infusion has been in use for more than two decades, its benefits are being obscured by anomalies in clinical practice caused by a number of important problems. These include: a variety of pharmacokinetic models available in open target-controlled infusion systems, which often confuse the user; the extrapolation of anthropomorphic data which provokes anomalous adjustments of dosing by such systems; and the uncertainty of regulatory requirements for the application of target-controlled infusion which causes uncontrolled exploitation of drugs and pharmacokinetic models in target-controlled infusion devices. Comparison of performance of pharmacokinetic models is complex and mostly inconclusive. However, a specific behaviour of a model in a target-controlled infusion system that is neither intended nor supported by scientific data can be considered an artefact or anomaly. Several of these anomalies can be identified in the current commercially available target-controlled infusion systems and are discussed in this review. © 2018 The Association of Anaesthetists of Great Britain and Ireland.

Monitoring the expansion of built-up areas in Seberang Perai region, Penang State, Malaysia

NASA Astrophysics Data System (ADS)

Samat, N.

2014-02-01

Rapid urbanization has caused land use transformation and encroachment of built environment into arable agriculture land. Uncontrolled expansion could bring negative impacts to society, space and the environment. Therefore, information on expansion and future spatial pattern of built-up areas would be useful for planners and decision makers in formulating policies towards managing and planning for sustainable urban development. This study demonstrates the usage of Geographic Information System in monitoring the expansion of built-up area in Seberang Perai region, Penang State, Malaysia. Built-up area has increased by approximately 20% between 1990 and 2001 and further increased by 12% between 2001 and 2007. New development is expected to continue encroach into existing open space and agriculture area since those are the only available land in this study area. The information on statistics of the expansion of built-up area and future spatial pattern of urban expansion were useful in planning and managing urban spatial growth.

ORF phage display to identify cellular proteins with different functions.

PubMed

Li, Wei

2012-09-01

Open reading frame (ORF) phage display is a new branch of phage display aimed at improving its efficiency to identify cellular proteins with specific binding or functional activities. Despite the success of phage display with antibody libraries and random peptide libraries, phage display with cDNA libraries of cellular proteins identifies a high percentage of non-ORF clones encoding unnatural short peptides with minimal biological implications. This is mainly because of the uncontrollable reading frames of cellular proteins in conventional cDNA libraries. ORF phage display solves this problem by eliminating non-ORF clones to generate ORF cDNA libraries. Here I summarize the procedures of ORF phage display, discuss the factors influencing its efficiency, present examples of its versatile applications, and highlight evidence of its capability of identifying biologically relevant cellular proteins. ORF phage display coupled with different selection strategies is capable of delineating diverse functions of cellular proteins with unique advantages. Copyright © 2012 Elsevier Inc. All rights reserved.

Analysis of delayed TBE-vaccine booster after primary vaccination.

PubMed

Aerssens, Annelies; Cochez, Christel; Niedrig, Matthias; Heyman, Paul; Kühlmann-Rabens, Ilona; Soentjens, Patrick

2016-02-01

An open, uncontrolled single centre study was conducted in the Travel Clinic at the Military Hospital, Brussels. Eighty-eight subjects were recruited who had a primary series of tick-borne encephalitis (TBE) vaccine more than 5 years ago and who never received a booster dose afterwards. Response rate after booster vaccination was very high: 84 out of 88 subjects (95.5%) had neutralizing antibodies on plaque reduction neutralization test and all (100%) had IgG antibodies on ELISA, on Day 21-28 after booster vaccination. This study adds valuable information to the common situation of delayed booster interval. The results of our study indicate that in young healthy travellers (<50 years), one booster vaccination after a primary series of TBE vaccine in the past is sufficient to obtain protective antibodies, even if primary vaccination is much longer than the recommended booster interval of 5 years. © International Society of Travel Medicine, 2016. All rights reserved.For permissions, please e-mail: journals.permissions@oup.com.

Histological biocompatibility of a stainless steel miniature glaucoma drainage device in humans: a case report.

PubMed

De Feo, Fabio; Jacobson, Stewart; Nyska, Abraham; Pagani, Paola; Traverso, Carlo Enrico

2009-06-01

The purpose of this study was to evaluate the histological biocompatibility of a stainless steel miniature glaucoma drainage device. Twenty-four months before death due to heart failure, this seventy-three-year-old female patient underwent filtration surgery for primary open-angle glaucoma uncontrolled in the right eye. The device was implanted at the limbus under a scleral flap. For histopathological evaluation, two corneoscleral specimens were embedded in methacrylate blocks sectioned to a thickness of 50 microns, polished and stained with periodic acid schiff. Some sections included a longitudinal cross-section of the implant. At the interface between the spur and the flange of the device and the cornea, there was a small shoulder of fibrous tissue. A thin, fibrous capsule covered the remainder of the body of the device up to the distal tip. No inflammatory cells occurred within the fibrous capsule. No material or blockage was noted within the lumen. Our results support the biological inertness of the device.

Re-wiring of energy metabolism promotes viability during hyperreplication stress in E. coli

PubMed Central

Campion, Christopher; Weimann, Allan

2017-01-01

Chromosome replication in Escherichia coli is initiated by DnaA. DnaA binds ATP which is essential for formation of a DnaA-oriC nucleoprotein complex that promotes strand opening, helicase loading and replisome assembly. Following initiation, DnaAATP is converted to DnaAADP primarily by the Regulatory Inactivation of DnaA process (RIDA). In RIDA deficient cells, DnaAATP accumulates leading to uncontrolled initiation of replication and cell death by accumulation of DNA strand breaks. Mutations that suppress RIDA deficiency either dampen overinitiation or permit growth despite overinitiation. We characterize mutations of the last group that have in common that distinct metabolic routes are rewired resulting in the redirection of electron flow towards the cytochrome bd-1. We propose a model where cytochrome bd-1 lowers the formation of reactive oxygen species and hence oxidative damage to the DNA in general. This increases the processivity of replication forks generated by overinitiation to a level that sustains viability. PMID:28129339

Laser spot tracking based on modified circular Hough transform and motion pattern analysis.

PubMed

Krstinić, Damir; Skelin, Ana Kuzmanić; Milatić, Ivan

2014-10-27

Laser pointers are one of the most widely used interactive and pointing devices in different human-computer interaction systems. Existing approaches to vision-based laser spot tracking are designed for controlled indoor environments with the main assumption that the laser spot is very bright, if not the brightest, spot in images. In this work, we are interested in developing a method for an outdoor, open-space environment, which could be implemented on embedded devices with limited computational resources. Under these circumstances, none of the assumptions of existing methods for laser spot tracking can be applied, yet a novel and fast method with robust performance is required. Throughout the paper, we will propose and evaluate an efficient method based on modified circular Hough transform and Lucas-Kanade motion analysis. Encouraging results on a representative dataset demonstrate the potential of our method in an uncontrolled outdoor environment, while achieving maximal accuracy indoors. Our dataset and ground truth data are made publicly available for further development.

Mitigating oil spills in the water column

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

Barry, Edward; Libera, Joseph A.; Mane, Anil U.

The scale and scope of uncontrolled oil spills can be devastating. Diverse marine environments and fragile ecologies are some of the most susceptible to the many ill effects, while the economic costs can be crippling. A notoriously difficult challenge with no known technological solution is the successful removal of oil dispersed in the water column. Here, we address this problem through cheap and reusable oil sorbents based on the chemical modification of polymer foams. Interfacial chemistry was optimized and subsequently tested in a simulated marine environment at the National Oil Spill Response Research & Renewable Energy Test Facility, Ohmsett. Wemore » find favorable performance for surface oil mitigation and, for the first time, demonstrate the advanced sorbent's efficiency and efficacy at pilot scale in extraction of crude oil and refined petroleum products dispersed in the water column. As a result, this is a potentially disruptive technology, opening a new field of environmental science focused on sub-surface pollutant sequestration.« less

Mitigating oil spills in the water column

DOE PAGES

Barry, Edward; Libera, Joseph A.; Mane, Anil U.; ...

2017-10-05

The scale and scope of uncontrolled oil spills can be devastating. Diverse marine environments and fragile ecologies are some of the most susceptible to the many ill effects, while the economic costs can be crippling. A notoriously difficult challenge with no known technological solution is the successful removal of oil dispersed in the water column. Here, we address this problem through cheap and reusable oil sorbents based on the chemical modification of polymer foams. Interfacial chemistry was optimized and subsequently tested in a simulated marine environment at the National Oil Spill Response Research & Renewable Energy Test Facility, Ohmsett. Wemore » find favorable performance for surface oil mitigation and, for the first time, demonstrate the advanced sorbent's efficiency and efficacy at pilot scale in extraction of crude oil and refined petroleum products dispersed in the water column. As a result, this is a potentially disruptive technology, opening a new field of environmental science focused on sub-surface pollutant sequestration.« less

Implementation of Phased Array Antenna Technology Providing a Wireless Local Area Network to Enhance Port Security and Maritime Interdiction Operations

DTIC Science & Technology

2009-09-01

boarding team, COTS, WLAN, smart antenna, OpenVPN application, wireless base station, OFDM, latency, point-to-point wireless link. 16. PRICE CODE 17...16 c. SSL/TLS .................................17 2. OpenVPN ......................................17 III. EXPERIMENT METHODOLOGY...network frame at Layer 2 has already been secured by encryption at a higher level. 2. OpenVPN OpenVPN is open source software that provides a VPN

Fatigue crack growth with single overload - Measurement and modeling

NASA Technical Reports Server (NTRS)

Davidson, D. L.; Hudak, S. J., Jr.; Dexter, R. J.

1987-01-01

This paper compares experiments with an analytical model of fatigue crack growth under variable amplitude. The stereoimaging technique was used to measure displacements near the tips of fatigue cracks undergoing simple variations in load amplitude-single overloads and overload/underload combinations. Measured displacements were used to compute strains, and stresses were determined from the strains. Local values of crack driving force (Delta-K effective) were determined using both locally measured opening loads and crack tip opening displacements. Experimental results were compared with simulations made for the same load variation conditions using Newman's FAST-2 model. Residual stresses caused by overloads, crack opening loads, and growth retardation periods were compared.

36 CFR 7.62 - Lake Chelan National Recreation Area.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., and depending on local weather conditions, the superintendent may designate as open to the use of snowmobiles the following locations within the Lake Chelan National Recreation Area: (1) All open areas..., except cross-country ski trails and within the perimeter of the Buckner Orchard. Snowmobile use on open...

Environmental Problems, Causes, and Solutions: An Open Question

ERIC Educational Resources Information Center

Negev, Maya; Garb, Yaakov; Biller, Roni; Sagy, Gonen; Tal, Alon

2010-01-01

In a national evaluation of environmental literacy in Israel, (Negev, Sagy, Garb, Salzberg, & Tal, 2008), the authors included both multiple choice questions and open questions. In this article the authors describe the qualitative analysis of the answers to an open question regarding a local environmental problem. Most participants specified…

Ghana Open Data Initiative | Ghana Open Data Initiative

Science.gov Websites

Information Technology Agency (NITA) 2012-2016 government of Ghana. All right reserved. Agencies Search  Get Involved Finance Health Agriculture Energy Education Environment Local Government City Data Extractive Statistics Business Elections About Us Open Government FAQ Aid Data Sites Data

Self regulating formulations for safe hydrogen gettering

DOEpatents

Shepodd, Timothy Jon

2002-01-01

A method and composition are disclosed for preventing uncontrolled exothermic reaction in the presence of a catalyst. A catalyst deployed as a finely divided powder which is attached to the surface of a low melting point wax or wax-like material which is utilized as a carrier for the catalyst. During operation should the catalyst overheat due to uncontrolled conditions brought about by a run-away reaction the heat of reaction melts the low melting point wax which would itself wet the surface of the catalyst and prevent further catalysis.

Aircraft Accident Report; Uncontrolled Impact with Terrain, Fine Airlines Flight 101, Douglas DC-8-61, N27UA, Miami, Florida, August 7, 1997

DTIC Science & Technology

1998-06-16

Transcolombiana de Carga ATI Air Transport International ATOS Air Transportation Oversight System ATP airline transport pilot CAM cockpit area microphone...495,000 fine against Aero Transcolombiana de Carga (ATC) for operating a DC-8-51 "over the weight limits set forth in its FAA-approved flight manual...PB98-910402 NTSB/AAR-98/02 DCA97MA059 NATIONAL TRANSPORTATION SAFETY BOARD WASHINGTON, D.C. 20594 AIRCRAFT ACCIDENT REPORT c>C== UNCONTROLLED IMPACT

Pediatric intensive care treatment of uncontrolled status epilepticus.

PubMed

Wilkes, Ryan; Tasker, Robert C

2013-04-01

The critically ill mechanically ventilated child with ongoing seizures that are refractory to any treatment presents a distinct challenge in pediatric neurocritical care. The evidence base from randomized controlled trials on which anti-epileptic drug (AED) strategy should be used is inadequate. This review of refractory and super-refractory status epilepticus summarizes recent pediatric case series regarding definitions, the second-tier AED therapies once initial anticonvulsants have failed, and the experience of high-dose midazolam, barbiturate anesthesia, and volatile anesthetics for uncontrolled status epilepticus. Copyright © 2013 Elsevier Inc. All rights reserved.

Satellite recovery - Attitude dynamics of the targets

NASA Technical Reports Server (NTRS)

Cochran, J. E., Jr.; Lahr, B. S.

1986-01-01

The problems of categorizing and modeling the attitude dynamics of uncontrolled artificial earth satellites which may be targets in recovery attempts are addressed. Methods of classification presented are based on satellite rotational kinetic energy, rotational angular momentum and orbit and on the type of control present prior to the benign failure of the control system. The use of approximate analytical solutions and 'exact' numerical solutions to the equations governing satellite attitude motions to predict uncontrolled attitude motion is considered. Analytical and numerical results are presented for the evolution of satellite attitude motions after active control termination.

Molecular machines open cell membranes

NASA Astrophysics Data System (ADS)

García-López, Víctor; Chen, Fang; Nilewski, Lizanne G.; Duret, Guillaume; Aliyan, Amir; Kolomeisky, Anatoly B.; Robinson, Jacob T.; Wang, Gufeng; Pal, Robert; Tour, James M.

2017-08-01

Beyond the more common chemical delivery strategies, several physical techniques are used to open the lipid bilayers of cellular membranes. These include using electric and magnetic fields, temperature, ultrasound or light to introduce compounds into cells, to release molecular species from cells or to selectively induce programmed cell death (apoptosis) or uncontrolled cell death (necrosis). More recently, molecular motors and switches that can change their conformation in a controlled manner in response to external stimuli have been used to produce mechanical actions on tissue for biomedical applications. Here we show that molecular machines can drill through cellular bilayers using their molecular-scale actuation, specifically nanomechanical action. Upon physical adsorption of the molecular motors onto lipid bilayers and subsequent activation of the motors using ultraviolet light, holes are drilled in the cell membranes. We designed molecular motors and complementary experimental protocols that use nanomechanical action to induce the diffusion of chemical species out of synthetic vesicles, to enhance the diffusion of traceable molecular machines into and within live cells, to induce necrosis and to introduce chemical species into live cells. We also show that, by using molecular machines that bear short peptide addends, nanomechanical action can selectively target specific cell-surface recognition sites. Beyond the in vitro applications demonstrated here, we expect that molecular machines could also be used in vivo, especially as their design progresses to allow two-photon, near-infrared and radio-frequency activation.

Group acceptance and commitment therapy (ACT) for bipolar disorder and co-existing anxiety - an open pilot study.

PubMed

Pankowski, Sara; Adler, Mats; Andersson, Gerhard; Lindefors, Nils; Svanborg, Cecilia

2017-03-01

Previous studies have supported acceptance and commitment therapy (ACT) for reducing impairment related to various chronic conditions. ACT may possibly be beneficial for bipolar disorder (BD) with co-existing anxiety, which is associated with a poorer treatment outcome. Efforts are needed to identify suitable psychological interventions for BD and co-existing anxiety. In this open clinical trial, we included 26 patients with BD type 1 or 2 at an outpatient psychiatric unit specializing in affective disorders. The intervention consisted of a 12-session manualized group treatment that included psychoeducation, mindfulness, engaging in values-based behaviour, cognitive defusion, acceptance and relapse prevention modules. Participants completed four self-report questionnaires covering anxiety symptoms (Beck Anxiety Inventory - BAI), depressive symptoms (Beck Depression Inventory - BDI-II), quality of life (Quality of Life Inventory - QOLI) and psychological flexibility (Acceptance and Action Questionnaire - AAQ-2) before, during and after the treatment. At post-treatment, the participants reported significant improvements in all outcome measures, with large effects (Cohen's d between 0.73 and 1.98). The mean reduction in anxiety symptoms was 45%. At post-treatment, 96% of the patients were classified as responders on at least one of the outcome measures. A limitation is that the trial is uncontrolled. The results suggest that ACT has the potential to be an effective treatment for BD patients with co-existing anxiety. Further randomized studies are warranted.

Molecular machines open cell membranes.

PubMed

García-López, Víctor; Chen, Fang; Nilewski, Lizanne G; Duret, Guillaume; Aliyan, Amir; Kolomeisky, Anatoly B; Robinson, Jacob T; Wang, Gufeng; Pal, Robert; Tour, James M

2017-08-30

Beyond the more common chemical delivery strategies, several physical techniques are used to open the lipid bilayers of cellular membranes. These include using electric and magnetic fields, temperature, ultrasound or light to introduce compounds into cells, to release molecular species from cells or to selectively induce programmed cell death (apoptosis) or uncontrolled cell death (necrosis). More recently, molecular motors and switches that can change their conformation in a controlled manner in response to external stimuli have been used to produce mechanical actions on tissue for biomedical applications. Here we show that molecular machines can drill through cellular bilayers using their molecular-scale actuation, specifically nanomechanical action. Upon physical adsorption of the molecular motors onto lipid bilayers and subsequent activation of the motors using ultraviolet light, holes are drilled in the cell membranes. We designed molecular motors and complementary experimental protocols that use nanomechanical action to induce the diffusion of chemical species out of synthetic vesicles, to enhance the diffusion of traceable molecular machines into and within live cells, to induce necrosis and to introduce chemical species into live cells. We also show that, by using molecular machines that bear short peptide addends, nanomechanical action can selectively target specific cell-surface recognition sites. Beyond the in vitro applications demonstrated here, we expect that molecular machines could also be used in vivo, especially as their design progresses to allow two-photon, near-infrared and radio-frequency activation.

Review of past research and proposed action plan for landfill gas-to-energy applications in India.

PubMed

Siddiqui, Faisal Zia; Zaidi, Sadaf; Pandey, Suneel; Khan, Mohd Emran

2013-01-01

Open dumps employed for disposal of municipal solid waste (MSW) are generally referred to as landfills and have been traditionally used as the ultimate disposal method in India. The deposition of MSW in open dumps eventually leads to uncontrolled emission of landfill gas (LFG). This article reviews the MSW disposal practices and LFG emissions from landfills in India during the period 1994 to 2011. The worldwide trend of feasibility of LFG to energy recovery projects and recent studies in India indicate a changed perception of landfills as a source of energy. However, facilitating the implementation of LFG to energy involves a number of challenges in terms of technology, developing a standardized framework and availability of financial incentives. The legislative framework for promotion of LFG to energy projects in India has been reviewed and a comprehensive strategy and action plan for gainful LFG recovery is suggested. It is concluded that the market for LFG to energy projects is not mature in India. There are no on-ground case studies to demonstrate the feasibility of LFG to energy applications. Future research therefore should aim at LFG emission modeling studies at regional level and based on the results, pilot studies may be conducted for the potential sites in the country to establish LFG to energy recovery potential from these landfills.

A simplified open gastrostomy under local anesthesia.

PubMed

Zickler, R W; Barbagiovanni, J T; Swan, K G

2001-08-01

Revision of the standard gastrostomy is often necessary in patients with neuromuscular disorders. These patients pose many anesthetic risks that frequently preclude the use of general anesthesia, intravenous sedation, or endoscopy. Modification of the Stamm gastrostomy enables it to be performed comfortably and readily under local anesthesia. The modification proposed passes the gastrostomy tube through the omentum en route to the abdominal wall. This ensures a seal to the surgical site, eliminates the need for tacking sutures, and allows for a smaller midline incision. These factors greatly reduce the discomfort of the procedure allowing it to be easily accomplished under local anesthesia. This technique of open gastrostomy under local anesthesia has been used in more than 35 patients over the past 10 years with no documented leaks.

Retrospective analysis: Conservative treatment of placenta increta with methotrexate.

PubMed

Zhang, Chunhua; Li, Hongyan; Zuo, Changting; Wang, Xietong

2018-05-01

To evaluate the efficacy of conservative treatment with methotrexate against placenta increta by two different routes of administration through retrospective analysis. A total of 54 women diagnosed with placenta increta after vaginal delivery were enrolled in this retrospective study. The participants accepted conservative management with methotrexate through either intravenous injection or local multi-point injection under ultrasound guidance. The treatment was considered effective if no hysterectomy was mandatory during the follow-up period. Out of the 54 cases, 21 patients were treated with methotrexate intravenously (group 1), and 33 patients received local multi-point injection to the placenta increta under ultrasound guidance (group 2). No maternal death occurred. In group 1, 10 patients expelled the placentas spontaneously, 7 patients underwent uterine curettage and 4 patients underwent hysterectomy for uncontrollable post-partum hemorrhage and infection. In group 2, 25 patients expelled placentas spontaneously and 8 patients underwent uterine curettage with no incidence of hysterectomy. The success rate in group 1 and group 2 was 17/21 and 33/33, respectively. The average time of the spontaneous placenta expulsion was 79.13 ± 29.87 days in group 1 and 42.42 ± 31.83 days in group 2. Local multi-point methotrexate injection under ultrasound guidance is a better alternative for patients with placenta increta, especially for preserving fertility. © 2018 Japan Society of Obstetrics and Gynecology.

Modes of uncontrolled rotational motion of the Progress M-29M spacecraft

NASA Astrophysics Data System (ADS)

Belyaev, M. Yu.; Matveeva, T. V.; Monakhov, M. I.; Rulev, D. N.; Sazonov, V. V.

2018-01-01

We have reconstructed the uncontrolled rotational motion of the Progress M-29M transport cargo spacecraft in the single-axis solar orientation mode (the so-called sunward spin) and in the mode of the gravitational orientation of a rotating satellite. The modes were implemented on April 3-7, 2016 as a part of preparation for experiments with the DAKON convection sensor onboard the Progress spacecraft. The reconstruction was performed by integral statistical techniques using the measurements of the spacecraft's angular velocity and electric current from its solar arrays. The measurement data obtained in a certain time interval have been jointly processed using the least-squares method by integrating the equations of the spacecraft's motion relative to the center of mass. As a result of processing, the initial conditions of motion and parameters of the mathematical model have been estimated. The motion in the sunward spin mode is the rotation of the spacecraft with an angular velocity of 2.2 deg/s about the normal to the plane of solar arrays; the normal is oriented toward the Sun or forms a small angle with this direction. The duration of the mode is several orbit passes. The reconstruction has been performed over time intervals of up to 1 h. As a result, the actual rotational motion of the spacecraft relative to the Earth-Sun direction was obtained. In the gravitational orientation mode, the spacecraft was rotated about its longitudinal axis with an angular velocity of 0.1-0.2 deg/s; the longitudinal axis executed small oscillated relative to the local vertical. The reconstruction of motion relative to the orbital coordinate system was performed in time intervals of up to 7 h using only the angularvelocity measurements. The measurements of the electric current from solar arrays were used for verification.

Blood Pressure Control in Aging Predicts Cerebral Atrophy Related to Small-Vessel White Matter Lesions.

PubMed

Kern, Kyle C; Wright, Clinton B; Bergfield, Kaitlin L; Fitzhugh, Megan C; Chen, Kewei; Moeller, James R; Nabizadeh, Nooshin; Elkind, Mitchell S V; Sacco, Ralph L; Stern, Yaakov; DeCarli, Charles S; Alexander, Gene E

2017-01-01

Cerebral small-vessel damage manifests as white matter hyperintensities and cerebral atrophy on brain MRI and is associated with aging, cognitive decline and dementia. We sought to examine the interrelationship of these imaging biomarkers and the influence of hypertension in older individuals. We used a multivariate spatial covariance neuroimaging technique to localize the effects of white matter lesion load on regional gray matter volume and assessed the role of blood pressure control, age and education on this relationship. Using a case-control design matching for age, gender, and educational attainment we selected 64 participants with normal blood pressure, controlled hypertension or uncontrolled hypertension from the Northern Manhattan Study cohort. We applied gray matter voxel-based morphometry with the scaled subprofile model to (1) identify regional covariance patterns of gray matter volume differences associated with white matter lesion load, (2) compare this relationship across blood pressure groups, and (3) relate it to cognitive performance. In this group of participants aged 60-86 years, we identified a pattern of reduced gray matter volume associated with white matter lesion load in bilateral temporal-parietal regions with relative preservation of volume in the basal forebrain, thalami and cingulate cortex. This pattern was expressed most in the uncontrolled hypertension group and least in the normotensives, but was also more evident in older and more educated individuals. Expression of this pattern was associated with worse performance in executive function and memory. In summary, white matter lesions from small-vessel disease are associated with a regional pattern of gray matter atrophy that is mitigated by blood pressure control, exacerbated by aging, and associated with cognitive performance.

Localized shape abnormalities in the thalamus and pallidum are associated with secondarily generalized seizures in mesial temporal lobe epilepsy.

PubMed

Yang, Linglin; Li, Hong; Zhu, Lujia; Yu, Xinfeng; Jin, Bo; Chen, Cong; Wang, Shan; Ding, Meiping; Zhang, Minming; Chen, Zhong; Wang, Shuang

2017-05-01

Mesial temporal lobe epilepsy (mTLE) is a common type of drug-resistant epilepsy and secondarily generalized tonic-clonic seizures (sGTCS) have devastating consequences for patients' safety and quality of life. To probe the mechanism underlying the genesis of sGTCS, we investigated the structural differences between patients with and without sGTCS in a cohort of mTLE with radiologically defined unilateral hippocampal sclerosis. We performed voxel-based morphometric analysis of cortex and vertex-wise shape analysis of subcortical structures (the basal ganglia and thalamus) on MRI of 39 patients (21 with and 18 without sGTCS). Comparisons were initially made between sGTCS and non-sGTCS groups, and subsequently made between uncontrolled-sGTCS and controlled-sGTCS subgroups. Regional atrophy of the ipsilateral ventral pallidum (cluster size=450 voxels, corrected p=0.047, Max voxel coordinate=107, 120, 65), medial thalamus (cluster size=1128 voxels, corrected p=0.049, Max voxel coordinate=107, 93, 67), middle frontal gyrus (cluster size=60 voxels, corrected p<0.05, Max voxel coordinate=-30, 49.5, 6), and contralateral posterior cingulate cortex (cluster size=130 voxels, corrected p<0.05, Max voxel coordinate=16.5, -57, 27) was found in the sGTCS group relative to the non-sGTCS group. Furthermore, the uncontrolled-sGTCS subgroup showed more pronounced atrophy of the ipsilateral medial thalamus (cluster size=1240 voxels, corrected p=0.014, Max voxel coordinate=107, 93, 67) than the controlled-sGTCS subgroup. These findings indicate a central role of thalamus and pallidum in the pathophysiology of sGTCS in mTLE. Copyright © 2017 Elsevier Inc. All rights reserved.

An arc control and protection system for the JET lower hybrid antenna based on an imaging system.

PubMed

Figueiredo, J; Mailloux, J; Kirov, K; Kinna, D; Stamp, M; Devaux, S; Arnoux, G; Edwards, J S; Stephen, A V; McCullen, P; Hogben, C

2014-11-01

Arcs are the potentially most dangerous events related to Lower Hybrid (LH) antenna operation. If left uncontrolled they can produce damage and cause plasma disruption by impurity influx. To address this issue an arc real time control and protection imaging system for the Joint European Torus (JET) LH antenna has been implemented. The LH system is one of the additional heating systems at JET. It comprises 24 microwave generators (klystrons, operating at 3.7 GHz) providing up to 5 MW of heating and current drive to the JET plasma. This is done through an antenna composed of an array of waveguides facing the plasma. The protection system presented here is based primarily on an imaging arc detection and real time control system. It has adapted the ITER like wall hotspot protection system using an identical CCD camera and real time image processing unit. A filter has been installed to avoid saturation and spurious system triggers caused by ionization light. The antenna is divided in 24 Regions Of Interest (ROIs) each one corresponding to one klystron. If an arc precursor is detected in a ROI, power is reduced locally with subsequent potential damage and plasma disruption avoided. The power is subsequently reinstated if, during a defined interval of time, arcing is confirmed not to be present by image analysis. This system was successfully commissioned during the restart phase and beginning of the 2013 scientific campaign. Since its installation and commissioning, arcs and related phenomena have been prevented. In this contribution we briefly describe the camera, image processing, and real time control systems. Most importantly, we demonstrate that an LH antenna arc protection system based on CCD camera imaging systems works. Examples of both controlled and uncontrolled LH arc events and their consequences are shown.

East African discourses on khat and sex.

PubMed

Beckerleg, Susan

2010-12-01

The study aims to review and analyse the varied East African discourses on the effects of khat use on libido, fertility, transmission of HIV, prostitution and rape. The data were gathered between 2004 and 2009 in Kenya and Uganda. Between 2004 and 2005 across Kenya and Uganda a broad survey approach was adopted, involving identification of and travel to production areas, interviews with producers and consumers in rural and urban settings. In addition, a survey of 300 Ugandan consumers was carried out in late 2004. Between 2007 and 2009, an in-depth study of khat production, trade and consumption was conducted in Uganda. This study also employed a mixture of methods, including key informant interviews participant-observation and a questionnaire survey administered to 210 khat consumers. Khat is associated, by consumers and its detractors alike, with changes in libido and sexual performance. Although there is no evidence to support their claims, detractors of khat use argue that khat causes sexual violence, causes women to enter sex work, and that chewing causes the spread of sexually transmitted diseases, including the HIV virus. In East Africa the discourse on khat and sex has led to consumption of the substances being associated by many people with uncontrolled sexual behaviour. There is no evidence that khat use fuels promiscuity, commercial sex, sexually transmitted diseases or rape. The current discourse on khat and sex touches on all these topics. Local religious and political leaders invoke khat use as a cause of what they argue is a breakdown of morals and social order. In Kenya and Uganda it is women khat consumers who are seen as sexually uncontrolled. In Uganda, the argument is extended even to men: with male khat chewers labelled as prone to commit rape. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

How Do the Location, Size and Budget of Open Space Conservation Affect Land Values?

Treesearch

JunJie Wu; Wenchao Xu; Ralph J. Alig

2016-01-01

In this article we present a model to examine the optimal location, size, and budget of open space conservation and the resulting impact on land values and local fiscal conditions in an urban area. Results indicate that open space conservation can transform the defining features of an urban landscape. A well-designed open space conservation program can improve...

Randomised controlled trial of laparoscopic versus open mesh repair for inguinal hernia: outcome and cost

PubMed Central

Wellwood, James; Sculpher, Mark J; Stoker, David; Nicholls, Graham J; Geddes, Cathy; Whitehead, Anne; Singh, Rameet; Spiegelhalter, David

1998-01-01

Objective: To compare tension-free open mesh hernioplasty under local anaesthetic with transabdominal preperitoneal laparoscopic hernia repair under general anaesthetic. Design: A randomised controlled trial of 403 patients with inguinal hernias. Setting: Two acute general hospitals in London between May 1995 and December 1996. Subjects: 400 patients with a diagnosis of groin hernia, 200 in each group. Main outcome measures: Time until discharge, postoperative pain, and complications; patients’ perceived health (SF-36), duration of convalescence, and patients’ satisfaction with surgery; and health service costs. Results: More patients in the open group (96%) than in the laparoscopic group (89%) were discharged on the same day as the operation (χ2=6.7; 1 df; P=0.01). Although pain scores were lower in the open group while the effect of the local anaesthetic persisted (proportional odds ratio at 2 hours 3.5 (2.3 to 5.1)), scores after open repair were significantly higher for each day of the first week (0.5 (0.3 to 0.7) on day 7) and during the second week (0.7 (0.5 to 0.9)). At 1 month there was a greater improvement (or less deterioration) in mean SF-36 scores over baseline in the laparoscopic group compared with the open group on seven of eight dimensions, reaching significance on five. For every activity considered the median time until return to normal was significantly shorter for the laparoscopic group. Patients randomised to laparoscopic repair were more satisfied with surgery at 1 month and 3 months after surgery. The mean cost per patient of laparoscopic repair was £335 (95% confidence interval £228 to £441) more than the cost of open repair. Conclusion: This study confirms that laparoscopic hernia repair has considerable short term clinical advantages after discharge compared with open mesh hernioplasty, although it was more expensive. Key messages In the 4 hours after surgery laparoscopic hernia repair with general anaesthesia causes more pain than open repair with local anaesthesia (mainly because of the anaesthesia used) and necessitates longer stay in hospital. Laparoscopic hernia repair, however, causes less pain than open hernia repair during the first 2 weeks after discharge Laparoscopic hernia repair results in fewer episodes of wound infection, persistent local pain, genital swelling, numbness, and constipation than open repair. Urinary disturbances are more common after laparoscopic than after open repair Patients’ perception of health 1 month after the operation (assessed with the SF-36) and satisfaction with treatment is superior for laparoscopic patients who also have a shorter period of convalescence after surgery The health service cost of day case laparoscopic repair is £335 more than the cost of open mesh hernioplasty performed on a day case basis PMID:9657784

An open ecosystem engagement strategy through the lens of global food safety

PubMed Central

Stacey, Paul; Fons, Garin; Bernardo, Theresa M

2015-01-01

The Global Food Safety Partnership (GFSP) is a public/private partnership established through the World Bank to improve food safety systems through a globally coordinated and locally-driven approach. This concept paper aims to establish a framework to help GFSP fully leverage the potential of open models. In preparing this paper the authors spoke to many different GFSP stakeholders who asked questions about open models such as: what is it?what’s in it for me?why use an open rather than a proprietary model?how will open models generate equivalent or greater sustainable revenue streams compared to the current “traditional” approaches?  This last question came up many times with assertions that traditional service providers need to see opportunity for equivalent or greater revenue dollars before they will buy-in. This paper identifies open value propositions for GFSP stakeholders and proposes a framework for creating and structuring that value. Open Educational Resources (OER) were the primary open practice GFSP partners spoke to us about, as they provide a logical entry point for collaboration. Going forward, funders should consider requiring that educational resources and concomitant data resulting from their sponsorship should be open, as a public good. There are, however, many other forms of open practice that bring value to the GFSP. Nine different open strategies and tactics (Appendix A) are described, including: open content (including OER and open courseware), open data, open access (research), open government, open source software, open standards, open policy, open licensing and open hardware. It is recommended that all stakeholders proactively pursue "openness" as an operating principle. This paper presents an overall GFSP Open Ecosystem Engagement Strategy within which specific local case examples can be situated. Two different case examples, China and Colombia, are presented to show both project-based and crowd-sourced, direct-to-public paths through this ecosystem. PMID:26213614

Solid waste management in Thailand: an overview and case study (Tha Khon Yang sub-district).

PubMed

Yukalang, Nachalida; Clarke, Beverley Dawn; Ross, Kirstin Elizabeth

2017-09-26

Due to rapid urbanization, solid waste management (SWM) has become a significant issue in several developing countries including Thailand. Policies implemented by the Central Thai Government to manage SWM issues have had only limited success. This article reviews current municipal waste management plans in Thailand and examines municipal waste management at the local level, with focus on the Tha Khon Yang sub-district surrounding Mahasarakham University in Mahasarakham Province. Within two decades this area has been converted from a rural to an urban landscape featuring accommodation for over 45,000 university students and a range of business facilities. This development and influx of people has outpaced the government's ability to manage municipal solid waste (MSW). There are significant opportunities to improve local infrastructure and operational capacity; but there are few mechanisms to provide and distribute information to improve community participation in waste management. Many community-based waste management projects, such as waste recycling banks, the 3Rs (reduce, reuse and recycle), and waste-to-biogas projects have been abandoned. Additionally, waste from Tha Kon Yang and its surrounding areas has been transferred to unsanitary landfills; there is also haphazard dumping and uncontrolled burning of waste, which exacerbate current pollution issues.

Connectivity disruption sparks explosive epidemic spreading.

PubMed

Böttcher, L; Woolley-Meza, O; Goles, E; Helbing, D; Herrmann, H J

2016-04-01

We investigate the spread of an infection or other malfunction of cascading nature when a system component can recover only if it remains reachable from a functioning central component. We consider the susceptible-infected-susceptible model, typical of mathematical epidemiology, on a network. Infection spreads from infected to healthy nodes, with the addition that infected nodes can only recover when they remain connected to a predefined central node, through a path that contains only healthy nodes. In this system, clusters of infected nodes will absorb their noninfected interior because no path exists between the central node and encapsulated nodes. This gives rise to the simultaneous infection of multiple nodes. Interestingly, the system converges to only one of two stationary states: either the whole population is healthy or it becomes completely infected. This simultaneous cluster infection can give rise to discontinuous jumps of different sizes in the number of failed nodes. Larger jumps emerge at lower infection rates. The network topology has an important effect on the nature of the transition: we observed hysteresis for networks with dominating local interactions. Our model shows how local spread can abruptly turn uncontrollable when it disrupts connectivity at a larger spatial scale.

Estimating the potential health impact and costs of implementing a local policy for food procurement to reduce the consumption of sodium in the county of Los Angeles.

PubMed

Gase, Lauren N; Kuo, Tony; Dunet, Diane; Schmidt, Steven M; Simon, Paul A; Fielding, Jonathan E

2011-08-01

We examined approaches to reduce sodium content of food served in settings operated or funded by the government of the County of Los Angeles, California. We adapted health impact assessment methods to mathematically simulate various levels of reduction in the sodium content of food served by the County of Los Angeles and to estimate the reductions' potential impacts on mean systolic blood pressure (SBP) among food-service customers. We used data provided by county government food-service vendors to generate these simulations. Our analysis predicted that if the postulated sodium-reduction strategies were implemented, adults would consume, on average, 233 fewer milligrams of sodium each day. This would correspond to an average decrease of 0.71 millimeters of mercury in SBP among adult hypertensives, 388 fewer cases of uncontrolled hypertension in the study population, and an annual decrease of $629,724 in direct health care costs. Our findings suggest that a food-procurement policy can contribute to positive health and economic effects at the local level. Our approach may serve as an example of sodium-reduction analysis for other jurisdictions to follow.

Staphylococcus aureus-dependent septic arthritis in murine knee joints: local immune response and beneficial effects of vaccination

PubMed Central

Corrado, Alessia; Donato, Paolo; Maccari, Silvia; Cecchi, Raffaella; Spadafina, Tiziana; Arcidiacono, Letizia; Tavarini, Simona; Sammicheli, Chiara; Laera, Donatello; Manetti, Andrea Guido Oreste; Ruggiero, Paolo; Galletti, Bruno; Nuti, Sandra; De Gregorio, Ennio; Bertholet, Sylvie; Seubert, Anja; Bagnoli, Fabio; Bensi, Giuliano; Chiarot, Emiliano

2016-01-01

Staphylococcus aureus is the major cause of human septic arthritis and osteomyelitis, which deserve special attention due to their rapid evolution and resistance to treatment. The progression of the disease depends on both bacterial presence in situ and uncontrolled disruptive immune response, which is responsible for chronic disease. Articular and bone infections are often the result of blood bacteremia, with the knees and hips being the most frequently infected joints showing the worst clinical outcome. We report the development of a hematogenous model of septic arthritis in murine knees, which progresses from an acute to a chronic phase, similarly to what occurs in humans. Characterization of the local and systemic inflammatory and immune responses following bacterial infection brought to light specific signatures of disease. Immunization of mice with the vaccine formulation we have recently described (4C-Staph), induced a strong antibody response and specific CD4+ effector memory T cells, and resulted in reduced bacterial load in the knee joints, a milder general inflammatory state and protection against bacterial-mediated cellular toxicity. Possible correlates of protection are finally proposed, which might contribute to the development of an effective vaccine for human use. PMID:27901071

Open source GIS for HIV/AIDS management

PubMed Central

Vanmeulebrouk, Bas; Rivett, Ulrike; Ricketts, Adam; Loudon, Melissa

2008-01-01

Background Reliable access to basic services can improve a community's resilience to HIV/AIDS. Accordingly, work is being done to upgrade the physical infrastructure in affected areas, often employing a strategy of decentralised service provision. Spatial characteristics are one of the major determinants in implementing services, even in the smaller municipal areas, and good quality spatial information is needed to inform decision making processes. However, limited funds, technical infrastructure and human resource capacity result in little or no access to spatial information for crucial infrastructure development decisions at local level. This research investigated whether it would be possible to develop a GIS for basic infrastructure planning and management at local level. Given the resource constraints of the local government context, particularly in small municipalities, it was decided that open source software should be used for the prototype system. Results The design and development of a prototype system illustrated that it is possible to develop an open source GIS system that can be used within the context of local information management. Usability tests show a high degree of usability for the system, which is important considering the heavy workload and high staff turnover that characterises local government in South Africa. Local infrastructure management stakeholders interviewed in a case study of a South African municipality see the potential for the use of GIS as a communication tool and are generally positive about the use of GIS for these purposes. They note security issues that may arise through the sharing of information, lack of skills and resource constraints as the major barriers to adoption. Conclusion The case study shows that spatial information is an identified need at local level. Open source GIS software can be used to develop a system to provide local-level stakeholders with spatial information. However, the suitability of the technology is only a part of the system – there are wider information and management issues which need to be addressed before the implementation of a local-level GIS for infrastructure management can be successful. PMID:18945338

Presumed consent for organ preservation in uncontrolled donation after cardiac death in the United States: a public policy with serious consequences

PubMed Central

Verheijde, Joseph L; Rady, Mohamed Y; McGregor, Joan

2009-01-01

Organ donation after cessation of circulation and respiration, both controlled and uncontrolled, has been proposed by the Institute of Medicine as a way to increase opportunities for organ procurement. Despite claims to the contrary, both forms of controlled and uncontrolled donation after cardiac death raise significant ethical and legal issues. Identified causes for concern include absence of agreement on criteria for the declaration of death, nonexistence of universal guidelines for duration before stopping resuscitation efforts and techniques, and assumption of presumed intent to donate for the purpose of initiating temporary organ-preservation interventions when no expressed consent to donate is present. From a legal point of view, not having scientifically valid criteria of cessation of circulation and respiration for declaring death could lead to a conclusion that organ procurement itself is the proximate cause of death. Although the revised Uniform Anatomical Gift Act of 2006 provides broad immunity to those involved in organ-procurement activities, courts have yet to provide an opinion on whether persons can be held liable for injuries arising from the determination of death itself. Preserving organs in uncontrolled donation after cardiac death requires the administration of life-support systems such as extracorporeal membrane oxygenation. These life-support systems can lead to return of signs of life that, in turn, have to be deliberately suppressed by the administration of pharmacological agents. Finally, allowing temporary organ-preservation interventions without expressed consent is inherently a violation of the principle of respect for a person's autonomy. Proponents of organ donation from uncontrolled donation after cardiac death, on the other hand, claim that these nonconsensual interventions enhance respect for autonomy by allowing people, through surrogate decision making, to execute their right to donate organs. However, the lack of transparency and the absence of protection of individual autonomy, for the sake of maximizing procurement opportunities, have placed the current organ-donation system of opting-in in great jeopardy. Equally as important, current policies enabling and enhancing organ procurement practices, pose challenges to the constitutional rights of individuals in a pluralistic society as these policies are founded on flawed medical standards for declaring death. PMID:19772617

Presumed consent for organ preservation in uncontrolled donation after cardiac death in the United States: a public policy with serious consequences.

PubMed

Verheijde, Joseph L; Rady, Mohamed Y; McGregor, Joan

2009-09-22

Organ donation after cessation of circulation and respiration, both controlled and uncontrolled, has been proposed by the Institute of Medicine as a way to increase opportunities for organ procurement. Despite claims to the contrary, both forms of controlled and uncontrolled donation after cardiac death raise significant ethical and legal issues. Identified causes for concern include absence of agreement on criteria for the declaration of death, nonexistence of universal guidelines for duration before stopping resuscitation efforts and techniques, and assumption of presumed intent to donate for the purpose of initiating temporary organ-preservation interventions when no expressed consent to donate is present. From a legal point of view, not having scientifically valid criteria of cessation of circulation and respiration for declaring death could lead to a conclusion that organ procurement itself is the proximate cause of death. Although the revised Uniform Anatomical Gift Act of 2006 provides broad immunity to those involved in organ-procurement activities, courts have yet to provide an opinion on whether persons can be held liable for injuries arising from the determination of death itself. Preserving organs in uncontrolled donation after cardiac death requires the administration of life-support systems such as extracorporeal membrane oxygenation. These life-support systems can lead to return of signs of life that, in turn, have to be deliberately suppressed by the administration of pharmacological agents. Finally, allowing temporary organ-preservation interventions without expressed consent is inherently a violation of the principle of respect for a person's autonomy. Proponents of organ donation from uncontrolled donation after cardiac death, on the other hand, claim that these nonconsensual interventions enhance respect for autonomy by allowing people, through surrogate decision making, to execute their right to donate organs. However, the lack of transparency and the absence of protection of individual autonomy, for the sake of maximizing procurement opportunities, have placed the current organ-donation system of opting-in in great jeopardy. Equally as important, current policies enabling and enhancing organ procurement practices, pose challenges to the constitutional rights of individuals in a pluralistic society as these policies are founded on flawed medical standards for declaring death.

78 FR 75376 - State, Local, Tribal, and Private Sector Policy Advisory Committee (SLTP-PAC)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-11

...] State, Local, Tribal, and Private Sector Policy Advisory Committee (SLTP-PAC) AGENCY: National Archives... (NARA) announces a meeting of the State, Local, Tribal, and Private Sector Policy Advisory Committee... Information Program for State, Local, Tribal, and Private Sector Entities. The meeting will be open to the...

Efficacy and Tolerability of Travoprost 0.004%/Timolol 0.5% Fixed-Dose Combination for the Treatment of Primary Open-Angle Glaucoma or Ocular Hypertension Inadequately Controlled with Beta-Blocker Monotherapy.

PubMed

Lerner, Simon Fabian; Park, Ki Ho; Hubatsch, Douglas A; Erichev, Valeriy; Paczka, Jose A; Roberts, Timothy V

2017-01-01

Objective . To evaluate the efficacy and tolerability of travoprost 0.004%/timolol 0.5% fixed-dose combination (TTFC) in patients with open-angle glaucoma (OAG) or ocular hypertension (OHT) inadequately controlled on beta-blocker monotherapy. Methods . In this phase IV, open-label study, 156 patients on beta-blocker monotherapy with mean intraocular pressure (IOP) between 18 and 32 mmHg were randomized (no washout period) to receive TTFC for 8 weeks (TTFC group) or to continue beta-blocker monotherapy for 4 weeks followed by TTFC for the remaining 4 weeks (beta-blocker group). Results . The mean IOP (±standard deviation) at baseline in the TTFC and beta-blocker groups was 22.5 ± 2.5 mmHg and 22.2 ± 2.3 mmHg, respectively, and at weeks 4 and 8, was 16.7 ± 3.1 mmHg and 16.1 ± 3.1 mmHg, respectively, in TTFC group and 21.1 ± 3.1 mmHg and 16.1 ± 2.8 mmHg, respectively, in the beta-blocker group. There was a significant least squares mean difference between TTFC and beta-blocker in 8 a.m. IOP at week 4 (-4.6 mmHg; one-sided 95% confidence interval [-inf, -3.9]; p < 0.0001 [primary endpoint]); the upper bound of the 95% confidence interval was within the prespecified limit (<0). Both treatments were well tolerated. Conclusion . Superior IOP control was achieved with TTFC in patients with OAG or OHT previously uncontrolled with beta-blockers. No new safety findings were identified. This trial is registered with ClinicalTrials.gov NCT02003391.

Manchester iStent study: early results from a prospective UK case series.

PubMed

Patel, Ilesh; de Klerk, Timothy A; Au, Leon

2013-01-01

To evaluate the 6-month efficacy and safety of the iStent microtrabecular bypass stent in patients with open-angle glaucoma. A prospective, uncontrolled, interventional case series. Forty-four eyes with open-angle glaucoma were reported. All subjects underwent ab interno implantation of a single iStent together with (n = 40) or without (n = 4) cataract surgery. Patients were assessed at postoperative week 1, months 1 and 3, and quarterly, thereafter. Data collected included visual acuity, intraocular pressure measurement using Goldmann tonometry, number of glaucoma medications, and number and type of complications. The mean age of the sample was 76.8 years. The mean duration since glaucoma diagnosis was 5.3 years (standard deviation 2.9 years). The mean visual acuity was 0.53 logMAR at baseline that improved to 0.23 at 6 months postoperatively. The mean baseline intraocular pressure was 21.1 mmHg, and this decreased significantly to 16.7 mmHg at 6 months (P < 0.01). The mean number of drops prescribed preoperatively was 2.3, which decreased to 0.6 at 6 months (P < 0.01). Sixty-six per cent of patients were drop-free at 6 months. One patient developed an hyphaema following surgery; no other adverse events were recorded. The iStent proved to be a safe and effective treatment for patients with open-angle glaucoma over our 6-month follow up period. Insertion resulted in a significant decrease in intraocular pressure as well as the number of topical antiglaucoma medications required for adequate intraocular pressure control. © 2013 The Authors. Clinical and Experimental Ophthalmology © 2013 Royal Australian and New Zealand College of Ophthalmologists.

Effects of stressor controllability on psychophysiological, cognitive and behavioural responses in patients with major depression and dysthymia

PubMed Central

Diener, C.; Kuehner, C.; Brusniak, W.; Struve, M.; Flor, H.

2009-01-01

Background The experience of uncontrollability and helplessness in the face of stressful life events is regarded as an important determinant in the development and maintenance of depression. The inability to successfully deal with stressors might be linked to dysfunctional prefrontal functioning. We assessed cognitive, behavioural and physiological effects of stressor uncontrollability in depressed and healthy individuals. In addition, relationships between altered cortical processing and cognitive vulnerability traits of depression were analysed. Method A total of 26 unmedicated depressed patients and 24 matched healthy controls were tested in an expanded forewarned reaction (S1–S2) paradigm. In a factorial design, stressor controllability varied across three consecutive conditions: (a) control, (b) loss of control and (c) restitution of control. Throughout the experiment, error rates, ratings of controllability, arousal, emotional valence and helplessness were assessed together with the post-imperative negative variation (PINV) of the electroencephalogram. Results Depressed participants showed an enhanced frontal PINV as an electrophysiological index of altered information processing during both loss of control and restitution of control. They also felt more helpless than controls. Furthermore, frontal PINV magnitudes were associated with habitual rumination in the depressed subsample. Conclusions These findings indicate that depressed patients are more susceptible to stressor uncontrollability than healthy subjects. Moreover, the experience of uncontrollability seems to bias subsequent information processing in a situation where control is objectively re-established. Alterations in prefrontal functioning appear to contribute to this vulnerability and are also linked to trait markers of depression. PMID:18466665

Stressful life events, social support, attachment security and alexithymia in vitiligo. A case-control study.

PubMed

Picardi, A; Pasquini, P; Cattaruzza, M S; Gaetano, P; Melchi, C F; Baliva, G; Camaioni, D; Tiago, A; Abeni, D; Biondi, M

2003-01-01

It has often been suggested that stress might trigger vitiligo. However, only one study supported this hypothesis, and no study explored the role of other personality or social factors. Out-patients experiencing a recent onset or exacerbation of vitiligo (n = 31) were compared with out-patients with skin conditions in which psychosomatic factors are commonly were regarded as negligible (n = 116). Stressful events during the last 12 months were assessed with Paykel's Interview for Recent Life Events. Attachment style, alexithymia and social support were assessed with the 'Experiences in Close Relationships' questionnaire, the Toronto Alexithymia Scale (TAS-20), and the Multidimensional Scale of Perceived Social Support, respectively. Cases and controls did not differ regarding the total number of events and the number of undesirable, uncontrollable or major events. Three or more uncontrollable events had occurred more frequently among cases than controls. Perceived social support was lower in cases than in controls. Cases scored higher than controls on anxious attachment, tended towards higher scores on avoidant attachment and were classified more often as insecure. Cases scored higher than controls on the TAS-20 and were classified more often as alexithymic or borderline alexithymic. The occurrence of many uncontrollable events, alexithymia and anxious attachment were associated with vitiligo also in multiple logistic regression analysis. These findings suggest that vulnerability to vitiligo is not increased by stressful events, except for many uncontrollable events. Alexithymia, insecure attachment and poor social support appear to increase susceptibility to vitiligo, possibly through deficits in emotion regulation or reduced ability to cope effectively with stress. Copyright 2003 S. Karger AG, Basel

40 CFR 412.46 - New source performance standards (NSPS).

Code of Federal Regulations, 2014 CFR

2014-07-01

... designed open manure storage structure. For those CAFOs where 100 years of local weather data for the CAFO... based upon a site-specific evaluation of the CAFO's open surface manure storage structure. The NPDES... the case of any CAFO using an open surface manure storage structure for which the Director establishes...

40 CFR 412.46 - New source performance standards (NSPS).

Code of Federal Regulations, 2013 CFR

2013-07-01

... designed open manure storage structure. For those CAFOs where 100 years of local weather data for the CAFO... based upon a site-specific evaluation of the CAFO's open surface manure storage structure. The NPDES... the case of any CAFO using an open surface manure storage structure for which the Director establishes...

40 CFR 412.46 - New source performance standards (NSPS).

Code of Federal Regulations, 2012 CFR

2012-07-01

... designed open manure storage structure. For those CAFOs where 100 years of local weather data for the CAFO... based upon a site-specific evaluation of the CAFO's open surface manure storage structure. The NPDES... the case of any CAFO using an open surface manure storage structure for which the Director establishes...

Open Source Communities in Technical Writing: Local Exigence, Global Extensibility

ERIC Educational Resources Information Center

Conner, Trey; Gresham, Morgan; McCracken, Jill

2011-01-01

By offering open-source software (OSS)-based networks as an affordable technology alternative, we partnered with a nonprofit community organization. In this article, we narrate the client-based experiences of this partnership, highlighting the ways in which OSS and open-source culture (OSC) transformed our students' and our own expectations of…

Local anesthetic infusion pump for pain management following open inguinal hernia repair: a meta-analysis.

PubMed

Wu, Chien-Chih; Bai, Chyi-Huey; Huang, Ming-Te; Wu, Chih-Hsiung; Tam, Ka-Wai

2014-01-01

Open inguinal hernia repair is one of the most painful procedures in day surgery. A continuous ambulatory analgesic is thought to reduce postoperative pain when it is applied to the surgical site. The aim of this study is to evaluate the efficacy of local anesthetic infusion pump following open inguinal hernia repair for the reduction of postoperative pain. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) that have investigated the outcomes of using an infusion pump for delivering a local anesthetic contrasted to a control group for open inguinal hernia repair. Pain was assessed from Day 1 to Day 5 following the surgery. The secondary outcomes included analgesia use and postoperative complications. We reviewed 5 trials that totaled 288 patients. The analgesic effects of bupivacaine (4 trials) and ropivacaine (one trial) were compared with a placebo group. The pooled mean difference in the score measuring the degree of pain diminished significantly at Day 1 to Day 4 in the experimental group. Two studies have reported that the number of analgesics required also decreased in the experimental group. No bupivacaine-related complication was reported. Our results revealed that applying a local anesthetic infusion pump following inguinal hernia repairs was more efficacious for reducing postoperative pain than a placebo. However, the findings were based on a small body of evidence in which methodological quality was not high. The potential benefits of applying a local anesthetic infusion pump to hernia repair must still be adequately investigated using further RCTs. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Growing-finishing performance and carcass yield of pigs reared in a climate-controlled and uncontrolled environment

NASA Astrophysics Data System (ADS)

Berton, Mariana Piatto; de Cássia Dourado, Rita; de Lima, Flávia Biondi Fernandes; Rodrigues, Ana Beatriz Bertoncello; Ferrari, Fábio Borba; do Carmo Vieira, Leonardo Dimas; de Souza, Pedro Alves; Borba, Hirasilva

2015-08-01

The objective of this study was to evaluate the effect of temperature on the performance and carcass yield of pigs housed in different environments. Twenty castrated male pigs of the Topigs line were assigned to two treatments: T1, controlled environment, and T2, uncontrolled environment containing a shallow pool. A completely randomized design consisting of two treatments and ten repetitions each was used. The data were submitted to analysis of variance, and means were compared by the Tukey test at a level of significance of 5 % using the SAS 9.2 program (SAS Institute, Inc., NC, USA). The results showed that rearing pigs in an uncontrolled environment during the growing and finishing phases reduced daily feed intake (1.722 and 3.164 kg, respectively) and improved feed conversion (2.15 and 2.70 kg, respectively), but did not influence the carcass yield of the animals. In conclusion, rearing pigs under different environmental conditions during the growing and finishing phases influenced animal performance without interfering with carcass yield.

Immunomodulatory Effects of Soybeans and Processed Soy Food Compounds.

PubMed

Tezuka, Hiroyuki; Imai, Shinjiro

2015-01-01

Inflammation is an immune response against both internal and external antigens in organisms, particularly in mammals, and includes both uncontrolled chronic and low-grade inflammations. Uncontrolled chronic inflammation often leads to severe diseases such as vascular disease, arthritis, cancer, diabete, allergy, and autoimmunity. On the other hand, low-grade inflammation is recognized as a relationship between obesity and risk of metabolic syndrome. Elevated production of pro-inflammatory cytokines and mediators is commonly observed in patients with uncontrolled or low-grade inflammation-associated diseases. Plants have been generated phytochemicals to overcome inflammations and infections through evolution. Phytochemicals belong to alkaloids, polyphenols, flavonoids, coumarins, and terpenoids. The consumption of soybeans plays a role in immune modulation through their components such as isoflavones, saponins, and anthocyanins. Recently, it was reported that the application of phytochemicals into patients with inflammatory diseases improves their symptoms. Therefore, it is important to identify novel phytochemicals with immunomodulatory activities. This review introduces and discusses recent advances and patents regarding soybean or processed soy food compounds which exhibit immunomodulatory activity in immune diseases, particularly allergy, by mediating the suppression of inflammatory pathways.

Robust crop and weed segmentation under uncontrolled outdoor illumination.

PubMed

Jeon, Hong Y; Tian, Lei F; Zhu, Heping

2011-01-01

An image processing algorithm for detecting individual weeds was developed and evaluated. Weed detection processes included were normalized excessive green conversion, statistical threshold value estimation, adaptive image segmentation, median filter, morphological feature calculation and Artificial Neural Network (ANN). The developed algorithm was validated for its ability to identify and detect weeds and crop plants under uncontrolled outdoor illuminations. A machine vision implementing field robot captured field images under outdoor illuminations and the image processing algorithm automatically processed them without manual adjustment. The errors of the algorithm, when processing 666 field images, ranged from 2.1 to 2.9%. The ANN correctly detected 72.6% of crop plants from the identified plants, and considered the rest as weeds. However, the ANN identification rates for crop plants were improved up to 95.1% by addressing the error sources in the algorithm. The developed weed detection and image processing algorithm provides a novel method to identify plants against soil background under the uncontrolled outdoor illuminations, and to differentiate weeds from crop plants. Thus, the proposed new machine vision and processing algorithm may be useful for outdoor applications including plant specific direct applications (PSDA).

Learned helplessness and learned prevalence: exploring the causal relations among perceived controllability, reward prevalence, and exploration.

PubMed

Teodorescu, Kinneret; Erev, Ido

2014-10-01

Exposure to uncontrollable outcomes has been found to trigger learned helplessness, a state in which the agent, because of lack of exploration, fails to take advantage of regained control. Although the implications of this phenomenon have been widely studied, its underlying cause remains undetermined. One can learn not to explore because the environment is uncontrollable, because the average reinforcement for exploring is low, or because rewards for exploring are rare. In the current research, we tested a simple experimental paradigm that contrasts the predictions of these three contributors and offers a unified psychological mechanism that underlies the observed phenomena. Our results demonstrate that learned helplessness is not correlated with either the perceived controllability of one's environment or the average reward, which suggests that reward prevalence is a better predictor of exploratory behavior than the other two factors. A simple computational model in which exploration decisions were based on small samples of past experiences captured the empirical phenomena while also providing a cognitive basis for feelings of uncontrollability. © The Author(s) 2014.

Growing-finishing performance and carcass yield of pigs reared in a climate-controlled and uncontrolled environment.

PubMed

Berton, Mariana Piatto; de Cássia Dourado, Rita; de Lima, Flávia Biondi Fernandes; Rodrigues, Ana Beatriz Bertoncello; Ferrari, Fábio Borba; do Carmo Vieira, Leonardo Dimas; de Souza, Pedro Alves; Borba, Hirasilva

2015-08-01

The objective of this study was to evaluate the effect of temperature on the performance and carcass yield of pigs housed in different environments. Twenty castrated male pigs of the Topigs line were assigned to two treatments: T1, controlled environment, and T2, uncontrolled environment containing a shallow pool. A completely randomized design consisting of two treatments and ten repetitions each was used. The data were submitted to analysis of variance, and means were compared by the Tukey test at a level of significance of 5 % using the SAS 9.2 program (SAS Institute, Inc., NC, USA). The results showed that rearing pigs in an uncontrolled environment during the growing and finishing phases reduced daily feed intake (1.722 and 3.164 kg, respectively) and improved feed conversion (2.15 and 2.70 kg, respectively), but did not influence the carcass yield of the animals. In conclusion, rearing pigs under different environmental conditions during the growing and finishing phases influenced animal performance without interfering with carcass yield.

Effect of prandial treatment timing adjustment, based on continuous glucose monitoring, in patients with type 2 diabetes uncontrolled with once-daily basal insulin: A randomized, phase IV study.

PubMed

Ilany, Jacob; Bhandari, Hamad; Nabriski, Dan; Toledano, Yoel; Konvalina, Noa; Cohen, Ohad

2018-05-01

To evaluate the glycaemic control achieved by prandial once-daily insulin glulisine injection timing adjustment, based on a continuous glucose monitoring sensor, in comparison to once-daily insulin glulisine injection before breakfast in patients with type 2 diabetes who are uncontrolled with once-daily basal insulin glargine. This was a 24-week open-label, randomized, controlled, multicentre trial. At the end of an 8-week period of basal insulin optimization, patients with HbA1c ≥ 7.5% and FPG < 130 mg/dL were randomized (1:1) to either arm A (no sensor) or arm B (sensor) to receive 16-week intensified prandial glulisine treatment. Patients in arm A received pre-breakfast glulisine, and patients in arm B received glulisine before the meal with the highest glucose elevation based on sensor data. The primary outcome was mean HbA1c at week 24 and secondary outcomes included rates of hypoglycaemic events and insulin dosage. A total of 121 patients were randomized to arm A (n = 61) or arm B (n = 60). There was no difference in mean HbA1c at week 24 between arms A and B (8.5% ± 1.2% vs 8.4% ± 1.0%; P = .66). The prandial insulin glulisine dosage for arm A and arm B was 9.3 and 10.1 units, respectively (P = .39). The frequency of hypoglycaemic events did not differ between study arms (36.1% vs 51.7%; P = .08). Using a CGM sensor to identify the meal with the highest glucose excursion and adjusting the timing of prandial insulin treatment did not show any advantage in terms of glycaemic control or safety in our patients. © 2018 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

Comparison of Antidiabetic Regimens in Patients with Type 2 Diabetes Uncontrolled by Combination Therapy of Sulfonylurea and Metformin: Results of the MOHAS Disease Registry in Korea

PubMed Central

Choi, Sung Hee; Oh, Tae Jung

2017-01-01

Background The aim of this study was to investigate the glucose-lowering efficacy of antidiabetic treatments in patients with type 2 diabetes mellitus (T2DM) uncontrolled by sulfonylurea plus metformin. Methods This open-label, multicenter, prospective, observational study was conducted in 144 centers in Korea, from June 2008 to July 2010, and included patients with T2DM who had received sulfonylurea and metformin for at least 3 months and had levels of glycosylated hemoglobin (HbA1c) >7.0% in the last month. Data of clinical and biochemical characteristics were collected at baseline and 6 months after treatment. The treatment option was decided at the physician's discretion. Subjects were classified into the following three groups: intensifying oral hypoglycemic agents (group A), adding basal insulin (group B), or starting intensified insulin therapy (group C). Results Of 2,995 patients enrolled, 2,901 patients were evaluated, and 504 (17.4%), 2,316 (79.8%), and 81 patients (2.8%) were classified into groups A, B, and C, respectively. Subjects in group C showed relatively higher baseline levels of HbA1c and longer duration of diabetes. The mean decrease in HbA1c level was higher in the insulin treated groups (−0.9%±1.3%, −1.6%±1.3%, and −2.4%±2.3% in groups A, B, and C, respectively, P=0.042). The proportion of patients who achieved target HbA1c <7.0% was comparable among the groups; however, intensified insulin therapy seemed to be the most effective in achieving the target HbA1c of 6.5%. Conclusion These findings suggest that insulin-based therapy will be an important option in the improved management of Korean patients with T2DM whose glycemic control is not sufficient with sulfonylurea and metformin. PMID:28537056

Characterization of organic aromatic compounds in soils affected by an uncontrolled tire landfill fire through the use of comprehensive two-dimensional gas chromatography-time-of-flight mass spectrometry.

PubMed

Escobar-Arnanz, J; Mekni, S; Blanco, G; Eljarrat, E; Barceló, D; Ramos, L

2018-02-09

Discarded vehicle tires have become an increasing concern worldwide due to the enormous amount of wastes generated and the increasing evidence of health problems associated to their disposal and accidental combustion. Previous studies conducted involving either simulated or open uncontrolled tire fires have identified aromatics belonging to two main classes, volatile organic compounds and polycyclic aromatic compounds (PAHs), as the most relevant chemicals generated in these burning processes. As a consequence, and due to their recognized toxicity, most studies reported up to now have mainly focused on these two categories of compounds being information concerning the possible occurrence of other aromatic classes rather limited. In this study, the enhanced separation power and structural confirmation capabilities provided by comprehensive two-dimensional gas chromatography-time-of-flight mass spectrometry (GC×GC-ToF MS) has been used, for the first time, for the non-targeted analysis of soils impacted by a tire fire and an ash collected at the scene of the fire. In total, 118 volatile and semi-volatile aromatic compounds have been differentiated. Among them, 104 compounds have been either positively or tentatively identified. PAHs with 3-5 rings and their alkyl-derivatives were the most numerous and relevant classes in the investigated samples. A significant number of sulfur, oxygen- and nitrogen-containing PAHs were also detected in the samples. The application of a script function to the raw GC×GC-ToF MS data allowed the fast filtering and automatic recognition of compounds containing halogens in their structure. This part of the study evidenced that only a limited number of regulated persistent organic pollutants were present in the investigated samples. However, it also revealed the presence of emerging organophosphorous flame retardants, whose levels in tire fire impacted soils are reported for the first time. Copyright © 2017 Elsevier B.V. All rights reserved.

Regulation of Romantic Love Feelings: Preconceptions, Strategies, and Feasibility

PubMed Central

Langeslag, Sandra J. E.; van Strien, Jan W.

2016-01-01

Love feelings can be more intense than desired (e.g., after a break-up) or less intense than desired (e.g., in long-term relationships). If only we could control our love feelings! We present the concept of explicit love regulation, which we define as the use of behavioral and cognitive strategies to change the intensity of current feelings of romantic love. We present the first two studies on preconceptions about, strategies for, and the feasibility of love regulation. Questionnaire responses showed that people perceive love feelings as somewhat uncontrollable. Still, in four open questions people reported to use strategies such as cognitive reappraisal, distraction, avoidance, and undertaking (new) activities to cope with break-ups, to maintain long-term relationships, and to regulate love feelings. Instructed up-regulation of love using reappraisal increased subjective feelings of attachment, while love down-regulation decreased subjective feelings of infatuation and attachment. We used the late positive potential (LPP) amplitude as an objective index of regulation success. Instructed love up-regulation enhanced the LPP between 300–400 ms in participants who were involved in a relationship and in participants who had recently experienced a romantic break-up, while love down-regulation reduced the LPP between 700–3000 ms in participants who were involved in a relationship. These findings corroborate the self-reported feasibility of love regulation, although they are complicated by the finding that love up-regulation also reduced the LPP between 700–3000 ms in participants who were involved in a relationship. To conclude, although people have the preconception that love feelings are uncontrollable, we show for the first time that intentional regulation of love feelings using reappraisal, and perhaps other strategies, is feasible. Love regulation will benefit individuals and society because it could enhance positive effects and reduce negative effects of romantic love. PMID:27529751

Automatic exposure for panoramic systems in uncontrolled lighting conditions: a football stadium case study

NASA Astrophysics Data System (ADS)

Gaddam, Vamsidhar Reddy; Griwodz, Carsten; Halvorsen, Pâl.

2014-02-01

One of the most common ways of capturing wide eld-of-view scenes is by recording panoramic videos. Using an array of cameras with limited overlapping in the corresponding images, one can generate good panorama images. Using the panorama, several immersive display options can be explored. There is a two fold synchronization problem associated to such a system. One is the temporal synchronization, but this challenge can easily be handled by using a common triggering solution to control the shutters of the cameras. The other synchronization challenge is the automatic exposure synchronization which does not have a straight forward solution, especially in a wide area scenario where the light conditions are uncontrolled like in the case of an open, outdoor football stadium. In this paper, we present the challenges and approaches for creating a completely automatic real-time panoramic capture system with a particular focus on the camera settings. One of the main challenges in building such a system is that there is not one common area of the pitch that is visible to all the cameras that can be used for metering the light in order to nd appropriate camera parameters. One approach we tested is to use the green color of the eld grass. Such an approach provided us with acceptable results only in limited light conditions.A second approach was devised where the overlapping areas between adjacent cameras are exploited, thus creating pairs of perfectly matched video streams. However, there still existed some disparity between di erent pairs. We nally developed an approach where the time between two temporal frames is exploited to communicate the exposures among the cameras where we achieve a perfectly synchronized array. An analysis of the system and some experimental results are presented in this paper. In summary, a pilot-camera approach running in auto-exposure mode and then distributing the used exposure values to the other cameras seems to give best visual results.

Intrinsically disordered proteins aggregate at fungal cell-to-cell channels and regulate intercellular connectivity.

PubMed

Lai, Julian; Koh, Chuan Hock; Tjota, Monika; Pieuchot, Laurent; Raman, Vignesh; Chandrababu, Karthik Balakrishna; Yang, Daiwen; Wong, Limsoon; Jedd, Gregory

2012-09-25

Like animals and plants, multicellular fungi possess cell-to-cell channels (septal pores) that allow intercellular communication and transport. Here, using a combination of MS of Woronin body-associated proteins and a bioinformatics approach that identifies related proteins based on composition and character, we identify 17 septal pore-associated (SPA) proteins that localize to the septal pore in rings and pore-centered foci. SPA proteins are not homologous at the primary sequence level but share overall physical properties with intrinsically disordered proteins. Some SPA proteins form aggregates at the septal pore, and in vitro assembly assays suggest aggregation through a nonamyloidal mechanism involving mainly α-helical and disordered structures. SPA loss-of-function phenotypes include excessive septation, septal pore degeneration, and uncontrolled Woronin body activation. Together, our data identify the septal pore as a complex subcellular compartment and focal point for the assembly of unstructured proteins controlling diverse aspects of intercellular connectivity.

ELM suppression in helium plasmas with 3D magnetic fields

DOE PAGES

Evans, T. E.; Loarte, A.; Orlov, D. M.; ...

2017-06-21

Experiments in DIII-D, using non-axisymmetric magnetic perturbation fields in high-purity low toroidal rotation, 4He plasmas have resulted in Type-I edge localized mode (ELM) suppression and mitigation. Suppression is obtained in plasmas with zero net input torque near the L–H power threshold using either electron cyclotron resonant heating (ECRH) or balanced co- and counter-I p neutral beam injection (NBI) resulting in conditions equivalent to those expected in ITER's non-active operating phase. In low-power ECRH H-modes, periods with uncontrolled density and impurity radiation excursions are prevented by applying n = 3 non-axisymmetric magnetic perturbation fields. ELM suppression results from a reduction andmore » an outward shift of the electron pressure gradient peak compared to that in the high-power ELMing phase. Here, the change in the electron pressure gradient peak is primarily due to a drop in the pedestal temperature rather than the pedestal density.« less

USGS capabilities for interdisciplinary investigations in coastal and nearshore ecosystems of the Great Lakes

USGS Publications Warehouse

Myers, Donna N.

2002-01-01

People choose to reside, work, and vacation in coastal areas of the Great Lakes because of the lakes' scenic beauty and their historic and cultural features. Great Lakes nearshore areas also constitute a valuable economic resource. Two million anglers added \\$1 billion to the region's economy in 1996. More than 300 million tons of goods were transported out of major Great Lakes ports at a value of \\$3 billion in 1996. A 1998 survey of Lake Erie beaches estimated contributions of $5 million per year to each local economy with a public beach. More than 70 million people yearly visit national, state and provincial parks in the Great Lakes area. Uncontrolled land development, recreational development, invasive species, climate change, water availability, and water-level changes and fluctuations lead a long list of current and potential issues in coastal and nearshore areas. To be effectively addressed, these complex issues require an interdisciplinary approach.

Variational nonadiabatic dynamics in the moving crude adiabatic representation: Further merging of nuclear dynamics and electronic structure

NASA Astrophysics Data System (ADS)

Joubert-Doriol, Loïc; Izmaylov, Artur F.

2018-03-01

A new methodology of simulating nonadiabatic dynamics using frozen-width Gaussian wavepackets within the moving crude adiabatic representation with the on-the-fly evaluation of electronic structure is presented. The main feature of the new approach is the elimination of any global or local model representation of electronic potential energy surfaces; instead, the electron-nuclear interaction is treated explicitly using the Gaussian integration. As a result, the new scheme does not introduce any uncontrolled approximations. The employed variational principle ensures the energy conservation and leaves the number of electronic and nuclear basis functions as the only parameter determining the accuracy. To assess performance of the approach, a model with two electronic and two nuclear spacial degrees of freedom containing conical intersections between potential energy surfaces has been considered. Dynamical features associated with nonadiabatic transitions and nontrivial geometric (or Berry) phases were successfully reproduced within a limited basis expansion.

ELM suppression in helium plasmas with 3D magnetic fields

NASA Astrophysics Data System (ADS)

Evans, T. E.; Loarte, A.; Orlov, D. M.; Grierson, B. A.; Knölker, M. M.; Lyons, B. C.; Cui, L.; Gohil, P.; Groebner, R. J.; Moyer, R. A.; Nazikian, R.; Osborne, T. H.; Unterberg, E. A.

2017-08-01

Experiments in DIII-D, using non-axisymmetric magnetic perturbation fields in high-purity low toroidal rotation, 4He plasmas have resulted in Type-I edge localized mode (ELM) suppression and mitigation. Suppression is obtained in plasmas with zero net input torque near the L-H power threshold using either electron cyclotron resonant heating (ECRH) or balanced co- and counter-I p neutral beam injection (NBI) resulting in conditions equivalent to those expected in ITER’s non-active operating phase. In low-power ECRH H-modes, periods with uncontrolled density and impurity radiation excursions are prevented by applying n  =  3 non-axisymmetric magnetic perturbation fields. ELM suppression results from a reduction and an outward shift of the electron pressure gradient peak compared to that in the high-power ELMing phase. The change in the electron pressure gradient peak is primarily due to a drop in the pedestal temperature rather than the pedestal density.

The Role of Innate Lymphoid Cells in Immune-Mediated Liver Diseases

PubMed Central

Liu, Meifang; Zhang, Cai

2017-01-01

Innate lymphoid cells (ILCs) are a recently identified group of innate immune cells lacking antigen-specific receptors that can mediate immune responses and regulate tissue homeostasis and inflammation. ILCs comprise group 1 ILCs, group 2 ILCs, and group 3 ILCs. These ILCs usually localize at mucosal surfaces and combat pathogens by the rapid release of certain cytokines. However, the uncontrolled activation of ILCs can also lead to damaging inflammation, especially in the gut, lung, and skin. Although the physiological and pathogenic roles of ILCs in liver diseases have been attracting increasing attention recently, there has been no systematic review regarding the roles of ILCs in immune-mediated liver diseases. Here, we review the relationships between the ILC subsets and their functions in immune-mediated liver diseases, and discuss their therapeutic potential based on current knowledge about the functional roles of these cells in liver diseases. PMID:28659927

Emergency Kausch-Whipple procedure: indications and experiences.

PubMed

Standop, Jens; Glowka, Tim; Schmitz, Volker; Schaefer, Nico; Hirner, Andreas; Kalff, Jörg C

2010-03-01

Pancreaticoduodenectomy is a demanding procedure even in selected patients but becomes formidable when performed in cases of emergency. This study analyzed our experience with urgent pancreatoduodenectomies; special emphases were put on the evaluation of diagnostic means and the validation of existing indications for performance of this procedure. Three hundred one patients who underwent pancreatoduodenectomy between 1989 and 2008 were identified from a pancreatic resection database and reviewed for emergency indications. Six patients (2%) underwent emergency pancreatoduodenectomy. Indications included endoscopy-related perforation, postoperative complications, and uncontrollable intraduodenal tumor bleeding. Length of stay and occurrence of nonsurgical complications were increased in emergency compared with elective pancreatoduodenectomies. Although increased, no significant differences were found regarding mortality and surgery-related complications. Indications for emergency pancreatoduodenectomies were based on clinical decisions rather than on radiologic diagnostics. Urgent pancreatic head resections may be considered as an option in selected patients if handling of local complications by interventional measures or limited surgery seems unsafe.

Comprehensive Routing Security Development and Deployment for the Internet

DTIC Science & Technology

2015-02-01

feature enhancement and bug fixes. • MySQL : MySQL is a widely used and popular open source database package. It was chosen for database support in the...RPSTIR depends on several other open source packages. • MySQL : MySQL is used for the the local RPKI database cache. • OpenSSL: OpenSSL is used for...cryptographic libraries for X.509 certificates. • ODBC mySql Connector: ODBC (Open Database Connectivity) is a standard programming interface (API) for

Open Smart Energy Gateway (OpenSEG)

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

The Open Smart Energy Gateway (OpenSEG) aims to provide near-real time smart meter data to consumers without the delays or latencies associated with it being transported to the utility data center and then back to the consumer's application. To do this, the gateway queries the local Smart Meter to which it is bound to get energy consumption information at pre-defined intervals (minimum interval is 4 seconds). OpenSEG then stores the resulting data internally for retrieval by an external application.

78 FR 60279 - Notice of Open Meeting of the Environmental Financial Advisory Board (EFAB)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-01

... costs; increasing public and private investment; and building state, local, and tribal financial... Infrastructure Investment; and Green Infrastructure. The meeting is open to the public, however, seating is...

Irreversible electroporation of locally advanced pancreatic neck/body adenocarcinoma

PubMed Central

2015-01-01

Objective Irreversible electroporation (IRE) of locally advanced pancreatic adenocarcinoma of the neck has been used to palliate appropriate stage 3 pancreatic cancers without evidence of metastasis and who have undergone appropriate induction therapy. Currently there has not been a standardized reported technique for pancreatic mid-body tumors for patient selection and intra-operative technique. Patients Subjects are patients with locally advanced pancreatic adenocarcinoma of the body/neck who have undergone appropriate induction chemotherapy for a reasonable duration. Main outcome measures Technique of open IRE of locally advanced pancreatic adenocarcinoma of the neck/body is described, with the emphasis on intra-operative ultrasound and intra-operative electroporation management. Results The technique of open IRE of the pancreatic neck/body with bracketing of the celiac axis and superior mesenteric artery with continuous intraoperative ultrasound imaging and consideration of intraoperative navigational system is described. Conclusions IRE of locally advanced pancreatic adenocarcinoma of the body/neck is feasible for appropriate patients with locally advanced unresectable pancreatic cancer. PMID:26029461

Improving mapping for Ebola response through mobilising a local community with self-owned smartphones: Tonkolili District, Sierra Leone, January 2015.

PubMed

Nic Lochlainn, Laura M; Gayton, Ivan; Theocharopoulos, Georgios; Edwards, Robin; Danis, Kostas; Kremer, Ronald; Kleijer, Karline; Tejan, Sumaila M; Sankoh, Mohamed; Jimissa, Augustin; Greig, Jane; Caleo, Grazia

2018-01-01

During the 2014-16 Ebola virus disease (EVD) outbreak, the Magburaka Ebola Management Centre (EMC) operated by Médecins Sans Frontières (MSF) in Tonkolili District, Sierra Leone, identified that available district maps lacked up-to-date village information to facilitate timely implementation of EVD control strategies. In January 2015, we undertook a survey in chiefdoms within the MSF EMC catchment area to collect mapping and village data. We explore the feasibility and cost to mobilise a local community for this survey, describe validation against existing mapping sources and use of the data to prioritise areas for interventions, and lessons learned. We recruited local people with self-owned Android smartphones installed with open-source survey software (OpenDataKit (ODK)) and open-source navigation software (OpenStreetMap Automated Navigation Directions (OsmAnd)). Surveyors were paired with local motorbike drivers to travel to eligible villages. The collected mapping data were validated by checking for duplication and comparing the village names against a pre-existing village name and location list using a geographic distance and text string-matching algorithm. The survey teams gained sufficient familiarity with the ODK and OsmAnd software within 1-2 hours. Nine chiefdoms in Tonkolili District and three in Bombali District were surveyed within two weeks. Following de-duplication, the surveyors collected data from 891 villages with an estimated 127,021 households. The overall survey cost was €3,395; €3.80 per village surveyed. The MSF GIS team (MSF-OCG) created improved maps for the MSF Magburaka EMC team which were used to support surveillance, investigation of suspect EVD cases, hygiene-kit distribution and EVD survivor support. We shared the mapping data with OpenStreetMap, the local Ministry of Health and Sanitation and Sierra Leone District and National Ebola Response Centres. Involving local community and using accessible technology allowed rapid implementation, at moderate cost, of a survey to collect geographic and essential village information, and creation of updated maps. These methods could be used for future emergencies to facilitate response.

Improving mapping for Ebola response through mobilising a local community with self-owned smartphones: Tonkolili District, Sierra Leone, January 2015

PubMed Central

Gayton, Ivan; Theocharopoulos, Georgios; Edwards, Robin; Danis, Kostas; Kremer, Ronald; Kleijer, Karline; Tejan, Sumaila M.; Sankoh, Mohamed; Jimissa, Augustin; Greig, Jane; Caleo, Grazia

2018-01-01

Background During the 2014–16 Ebola virus disease (EVD) outbreak, the Magburaka Ebola Management Centre (EMC) operated by Médecins Sans Frontières (MSF) in Tonkolili District, Sierra Leone, identified that available district maps lacked up-to-date village information to facilitate timely implementation of EVD control strategies. In January 2015, we undertook a survey in chiefdoms within the MSF EMC catchment area to collect mapping and village data. We explore the feasibility and cost to mobilise a local community for this survey, describe validation against existing mapping sources and use of the data to prioritise areas for interventions, and lessons learned. Methods We recruited local people with self-owned Android smartphones installed with open-source survey software (OpenDataKit (ODK)) and open-source navigation software (OpenStreetMap Automated Navigation Directions (OsmAnd)). Surveyors were paired with local motorbike drivers to travel to eligible villages. The collected mapping data were validated by checking for duplication and comparing the village names against a pre-existing village name and location list using a geographic distance and text string-matching algorithm. Results The survey teams gained sufficient familiarity with the ODK and OsmAnd software within 1–2 hours. Nine chiefdoms in Tonkolili District and three in Bombali District were surveyed within two weeks. Following de-duplication, the surveyors collected data from 891 villages with an estimated 127,021 households. The overall survey cost was €3,395; €3.80 per village surveyed. The MSF GIS team (MSF-OCG) created improved maps for the MSF Magburaka EMC team which were used to support surveillance, investigation of suspect EVD cases, hygiene-kit distribution and EVD survivor support. We shared the mapping data with OpenStreetMap, the local Ministry of Health and Sanitation and Sierra Leone District and National Ebola Response Centres. Conclusions Involving local community and using accessible technology allowed rapid implementation, at moderate cost, of a survey to collect geographic and essential village information, and creation of updated maps. These methods could be used for future emergencies to facilitate response. PMID:29298314

Stories from OpenAQ, a Global and Grassroots Open Air Quality Community

NASA Astrophysics Data System (ADS)

Hasenkopf, C. A.; Flasher, J. C.; Veerman, O.; Scalamogna, A.; Silva, D.; Salmon, M.; Buuralda, D.; DeWitt, L. H.

2016-12-01

Air pollution, responsible for more deaths each year than HIV/AIDS and malaria, combined, is a global public health crisis. Yet many scientific questions, including those directly relevant for policy, remain unanswered when it comes to the impact of air pollution on health in highly polluted environments. Often, specific solutions to improving air quality are local and sustained through public engagement, policy and monitoring. Both the overarching science of air quality and health and local solutions rely on access to reliable, timely air quality data. Over the past year, the OpenAQ community has opened up existing disparate air quality data in 24 countries through an open source platform (openaq.org) so that communities around the world can use it to advance science, public engagement, and policy. We will share stories of communities, from Delhi to Ulaanbaatar and from scientists to journalists, using open air quality data from our platform to advance their fight against air inequality. We will share recent research we have conducted on best practices for engaging different communities and building tools that enable the public to fully unleash the power of open air quality data to fight air inequality. The subsequent open-source tools (github.com/openaq) we have developed from this research and our entire data-sharing platform may be of interest to other open data communities.

Beyond the bulk: disclosing the life of single microbial cells

PubMed Central

Rosenthal, Katrin; Oehling, Verena

2017-01-01

Abstract Microbial single cell analysis has led to discoveries that are beyond what can be resolved with population-based studies. It provides a pristine view of the mechanisms that organize cellular physiology, unbiased by population heterogeneity or uncontrollable environmental impacts. A holistic description of cellular functions at the single cell level requires analytical concepts beyond the miniaturization of existing technologies, defined but uncontrolled by the biological system itself. This review provides an overview of the latest advances in single cell technologies and demonstrates their potential. Opportunities and limitations of single cell microbiology are discussed using selected application-related examples. PMID:29029257

[Control of asthma symptoms and cellular markers of inflammation in induced sputum in children and adolescents with chronic asthma].

PubMed

Ciółkowski, Janusz; Stasiowska, Barbara; Mazurek, Henryk

2009-03-01

After the GINA 2006 publication, asthma therapy is based on control of symptoms. However there are suggestions of monitoring of airway inflammation. Aim of the study was to compare clinical criteria of asthma control with cellular markers of lower airway inflammation in induced sputum in a group of young asthmatics. To assess relationship between sputum eosinophilia, asthma severity and spirometry. A group of 154 young patients with chronic asthma (8-21 years) underwent sputum induction by inhalation of 4,5% saline solution. Sputum induction was effective in 121 patients (78%), and in this group control of clinical symptoms was assessed according to GINA 2006 criteria. Asthma was controlled in 82 subjects (67.8%) and uncontrolled in 39 (32.2%). Patients with controlled asthma had higher FEV1/FVC (79.8 +/- 7.1% vs 74.2 +/- 9.9%; p = 0.004) and MMEF (80.7 +/- 23.0% vs 65.3 +/- 21.8%; p < 0.001) than those with uncontrolled disease, but the average FEV1 (as percent predicted) did not differ between the two groups. Patients with controlled asthma had lower sputum eosinophil count than those with uncontrolled asthma (3.5 +/- 6.3% vs 7.2 +/- 8.7%; p = 0.01), but difference in neutrophil count was borderline (27.3 +/- 15.5% vs 34.5 +/- 21.0%; p = 0.05). High sputum eosinophil count (> 3%) was observed in 24.4% of patients with controlled asthma and in 61.5% with uncontrolled asthma (p < 0.001). Increased sputum neutrophil count was more frequent in a group of uncontrolled asthma (2.4 vs 15.4%; p = 0.022). Mean sputum eosinophil count was lower in patients with mild astma than in patients with moderate-severe disease (3.1 +/- 5.7% vs 7.1% +/- 8.8; p = 0.006). Patients with high sputum eosinophil count had lower FEV1 (89.4 +/- 14.9% vs 94.9 +/- 13.9%; p = 0.047), FEV1/FVC (74.5 +/- 10.1% vs 79.2 +/- 9.3%; p = 0.01) and MMEF (68.7 +/- 23.3% vs 81.7 +/- 23.1%; p = 0.004). In this study of young asthmatics, control of asthma symptoms was observed in 67.8% of patients. However, cellular markers of lower airway inflammation were present in 1/4 of patients with controlled asthma and in 3/4 with uncontrolled disease. Sputum eosinophilia was related to asthma severity. FEV1/FVC and MMEF were more important that FEV1 for estimating control of asthma. Improvement of asthma control scoring is needed as well as availability of simple methods of inflammation monitoring.

Abdominal and General Adiposity and Level of Asthma Control in Adults with Uncontrolled Asthma

PubMed Central

Lv, Nan; Xiao, Lan; Camargo, Carlos A.; Wilson, Sandra R.; Buist, A. Sonia; Strub, Peg; Nadeau, Kari C.

2014-01-01

Rationale: Abdominal adiposity may be an important risk factor for uncontrolled asthma in adults, controlling for general obesity. Whether the relationship, if present, is explained by other factors (e.g., asthma onset age, sex, and/or coexisting conditions) is unclear. Objectives: To examine whether clinically applicable anthropometric measures of abdominal adiposity—waist circumference and waist-to-height ratio (WHtR)—are related to poorer asthma control in adults with uncontrolled asthma controlling for body mass index (BMI), and whether the relationship (if present) is explained by gastroesophageal reflux disorder (GERD), sleep quality, or obstructive sleep apnea (OSA) or differs by age of asthma onset or sex. Methods: Patients aged 18 to 70 years with uncontrolled asthma (n = 90) participated in a 6-month randomized clinical trial. Measurements and Main Results: Baseline measures included sociodemographics, standardized anthropometrics, Asthma Control Test (ACT), GERD Symptom Assessment Scale, Pittsburgh Sleep Quality Index, and Berlin Questionnaire for Sleep Apnea. Participants (mean [SD] age, 52 [12] yr) were racially and ethnically diverse, 67% women, and 69% overweight or obese, and 71% reported their age of asthma onset was 12 years or older. Participants had uncontrolled asthma (mean [SD] ACT score, 14.9 [3.7]) and low GERD symptoms score (0.6 [0.4]); 67% reported poor sleep quality, and 42% had a high OSA risk. General linear regression results showed that worse ACT scores were significantly associated with every SD increase in waist circumference (β= −1.03; 95% confidence interval [CI], −1.96 to −0.16; P = 0.02) and waist-to-height ratio (β= −1.16; 95% CI, −2.00 to −0.33; P = 0.008), controlling for sociodemographics. Waist-to-height ratio remained correlated with ACT (β= −2.30; 95% CI, −4.16 to −0.45; P = 0.02) after further adjusting for BMI. The BMI-controlled relationship between WHtR and ACT did not differ by age of asthma onset or sex (P > 0.05 for interactions) and persisted after additional adjustment for GERD, sleep quality, or OSA scores. Poor sleep quality was associated with worse ACT scores (β= −0.87; 95% CI, −1.71 to −0.03; P = 0.045) controlling for waist-to-height ratio, BMI, and sociodemographics. Conclusions: Abdominal adiposity by waist-to-height ratio and poor sleep quality correlated with poorer asthma control in adults with uncontrolled asthma, after controlling for BMI and sociodemographics. These results warrant replication in larger studies of diverse populations. Clinical trial registered with www.clinicaltrials.gov (NCT 01725945). PMID:25343191

Using Campylobacter spp. and Escherichia coli data and Bayesian microbial risk assessment to examine public health risks in agricultural watersheds under tile drainage management.

PubMed

Schmidt, P J; Pintar, K D M; Fazil, A M; Flemming, C A; Lanthier, M; Laprade, N; Sunohara, M D; Simhon, A; Thomas, J L; Topp, E; Wilkes, G; Lapen, D R

2013-06-15

Human campylobacteriosis is the leading bacterial gastrointestinal illness in Canada; environmental transmission has been implicated in addition to transmission via consumption of contaminated food. Information about Campylobacter spp. occurrence at the watershed scale will enhance our understanding of the associated public health risks and the efficacy of source water protection strategies. The overriding purpose of this study is to provide a quantitative framework to assess and compare the relative public health significance of watershed microbial water quality associated with agricultural BMPs. A microbial monitoring program was expanded from fecal indicator analyses and Campylobacter spp. presence/absence tests to the development of a novel, 11-tube most probable number (MPN) method that targeted Campylobacter jejuni, Campylobacter coli, and Campylobacter lari. These three types of data were used to make inferences about theoretical risks in a watershed in which controlled tile drainage is widely practiced, an adjacent watershed with conventional (uncontrolled) tile drainage, and reference sites elsewhere in the same river basin. E. coli concentrations (MPN and plate count) in the controlled tile drainage watershed were statistically higher (2008-11), relative to the uncontrolled tile drainage watershed, but yearly variation was high as well. Escherichia coli loading for years 2008-11 combined were statistically higher in the controlled watershed, relative to the uncontrolled tile drainage watershed, but Campylobacter spp. loads for 2010-11 were generally higher for the uncontrolled tile drainage watershed (but not statistically significant). Using MPN data and a Bayesian modelling approach, higher mean Campylobacter spp. concentrations were found in the controlled tile drainage watershed relative to the uncontrolled tile drainage watershed (2010, 2011). A second-order quantitative microbial risk assessment (QMRA) was used, in a relative way, to identify differences in mean Campylobacter spp. infection risks among monitoring sites for a hypothetical exposure scenario. Greater relative mean risks were obtained for sites in the controlled tile drainage watershed than in the uncontrolled tile drainage watershed in each year of monitoring with pair-wise posterior probabilities exceeding 0.699, and the lowest relative mean risks were found at a downstream drinking water intake reference site. The second-order modelling approach was used to partition sources of uncertainty, which revealed that an adequate representation of the temporal variation in Campylobacter spp. concentrations for risk assessment was achieved with as few as 10 MPN data per site. This study demonstrates for the first time how QMRA can be implemented to evaluate, in a relative sense, the public health implications of controlled tile drainage on watershed-scale water quality. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Emulation of Equal Open Access and Competition Creation in the Wireline Telecommunications Local and Last Mile Market Segments

ERIC Educational Resources Information Center

Van Epps, Daniel L.

2013-01-01

Expanded telecommunications was deemed a serious need for end users. The "Local Market" and "Last Mile" market segments have largely consolidated into "natural utilities". Competition and access problems occur if new providers enter the local market and desire competitive access and service to end users. Local and…

Relationship Between Climate Change Impact, Migration and Socioeconomic Development

NASA Astrophysics Data System (ADS)

Sann Oo, Kyaw

2016-06-01

Geospatial data are available in raster and vector formats and some of them are available in open data form. The technique and tools to handle those data are also available in open source. Though it is free of charge, the knowledge to utilize those data is limited to non-educated in the specific field. The data and technology should be promoted to those levels to utilize in required fields with priceless in developing countries. Before utilize open data, which are required to verify with local knowledge to become usable information for the local people as priceless data resources. Developing country, which economic is based in agriculture, required more information about precise weather data and weather variation by the climate change impact for their socioeconomic development. This study found that rural to urban migration occurs in the developing countries such agriculture based country likes Myanmar when the agriculture economic are affected by unpredictable impact by the climate change. The knowledge sharing using open data resources to non-educated local people is one of the curable solutions for the agriculture economy development in the country. Moreover, the study will find ways to reduce the rural to urban migration.

Convection-Diffusion Layer in an "Open Space" for Local Surface Treatment and Microfabrication using a Four-Aperture Microchemical Pen.

PubMed

Mao, Sifeng; Zhang, Yong; Zhang, Weifei; Zeng, Hulie; Nakajima, Hizuru; Lin, Jin-Ming; Uchiyama, Katsumi

2017-09-06

A four-aperture microchemical pen was used to produce a stable convection-diffusion layer in an "open space" for microreactions and microfabrication. The process represents a new method for microreactions and microfabrication in a convection-diffusion layer. To prove the concept of a convection-diffusion layer in an "open space", bovine serum albumin was labeled with 4-fluoro-7-nitro-2,1,3-benzoxadiazole to confirm that the small convection-diffusion layer was effective for local surface treatment. To demonstrate the potential for microfabrication, silver patterns were fabricated on a glass surface with a convection-diffusion layer by using the silver-mirror reaction. The widths of each silver pattern could be easily controlled from 10 to 60 μm. Patterned silver lines with uniform widths or gradient widths were prepared. This is the first proof of concept study of a convection-diffusion layer in an "open space" used in local surface treatment and microfabrication on a surface. The microchemical pen represents a potential method for the region-selective microtreatment of tissues, cells, and other biological interfaces. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Localization of effective actions in open superstring field theory

NASA Astrophysics Data System (ADS)

Maccaferri, Carlo; Merlano, Alberto

2018-03-01

We consider the construction of the algebraic part of D-branes tree-level effective action from Berkovits open superstring field theory. Applying this construction to the quartic potential of massless fields carrying a specific worldsheet charge, we show that the full contribution to the potential localizes at the boundary of moduli space, reducing to elementary two-point functions. As examples of this general mechanism, we show how the Yang-Mills quartic potential and the instanton effective action of a Dp/D( p - 4) system are reproduced.

Implementing an Open Source Learning Management System: A Critical Analysis of Change Strategies

ERIC Educational Resources Information Center

Uys, Philip M.

2010-01-01

This paper analyses the change and innovation strategies that Charles Sturt University (CSU) used from 2007 to 2009 during the implementation and mainstreaming of an open source learning management system (LMS), Sakai, named locally as "CSU Interact". CSU was in January 2008 the first Australian University to implement an open source…

Weak localization effect in topological insulator micro flakes grown on insulating ferrimagnet BaFe12O19

PubMed Central

Zheng, Guolin; Wang, Ning; Yang, Jiyong; Wang, Weike; Du, Haifeng; Ning, Wei; Yang, Zhaorong; Lu, Hai-Zhou; Zhang, Yuheng; Tian, Mingliang

2016-01-01

Many exotic physics anticipated in topological insulators require a gap to be opened for their topological surface states by breaking time reversal symmetry. The gap opening has been achieved by doping magnetic impurities, which however inevitably create extra carriers and disorder that undermine the electronic transport. In contrast, the proximity to a ferromagnetic/ferrimagnetic insulator may improve the device quality, thus promises a better way to open the gap while minimizing the side-effects. Here, we grow thin single-crystal Sb1.9Bi0.1Te3 micro flakes on insulating ferrimagnet BaFe12O19 by using the van der Waals epitaxy technique. The micro flakes show a negative magnetoresistance in weak perpendicular fields below 50 K, which can be quenched by increasing temperature. The signature implies the weak localization effect as its origin, which is absent in intrinsic topological insulators, unless a surface state gap is opened. The surface state gap is estimated to be 10 meV by using the theory of the gap-induced weak localization effect. These results indicate that the magnetic proximity effect may open the gap for the topological surface attached to BaM insulating ferrimagnet. This heterostructure may pave the way for the realization of new physical effects as well as the potential applications of spintronics devices. PMID:26891682

75 FR 8008 - Revisions to the California State Implementation Plan, Imperial County Air Pollution Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-23

... soils in open and agricultural areas. We are proposing action on local rules that regulate these... prevent vehicular trespass and to stabilize disturbed soil on certain open areas. Agricultural operations...

Large data series: Modeling the usual to identify the unusual

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

Downing, D.J.; Fedorov, V.V.; Lawkins, W.F.

{open_quotes}Standard{close_quotes} approaches such as regression analysis, Fourier analysis, Box-Jenkins procedure, et al., which handle a data series as a whole, are not useful for very large data sets for at least two reasons. First, even with computer hardware available today, including parallel processors and storage devices, there are no effective means for manipulating and analyzing gigabyte, or larger, data files. Second, in general it can not be assumed that a very large data set is {open_quotes}stable{close_quotes} by the usual measures, like homogeneity, stationarity, and ergodicity, that standard analysis techniques require. Both reasons dictate the necessity to use {open_quotes}local{close_quotes} data analysismore » methods whereby the data is segmented and ordered, where order leads to a sense of {open_quotes}neighbor,{close_quotes} and then analyzed segment by segment. The idea of local data analysis is central to the study reported here.« less

Early Warnings for Local Labor Markets

ERIC Educational Resources Information Center

Matland, Marc A.

1976-01-01

This articles summarizes the National Planning Association's (NPA) experience in its initial efforts to develop an early warning system to anticipate job openings generated in local communities by large Federal procurement contracts. (WL)

Daily subcutaneous parecoxib injection for cancer pain: an open label pilot study.

PubMed

Kenner, David J; Bhagat, Sandeep; Fullerton, Sonia L

2015-04-01

Nonsteroidal anti-inflammatory analgesics (NSAIDs) are useful in cancer pain but the specific use of subcutaneous parecoxib has not been previously reported. This pilot study aimed to establish the efficacy and side effect profile of short-term sequential single daily dose subcutaneous parecoxib sodium in patients with severe cancer bone pain. Nineteen hospitalized patients with advanced cancer and uncontrolled malignant bone pain (9 males, 10 females) received 24 courses of one, two, or three days sequential therapy with 'off-label' daily subcutaneous parecoxib. All patients were receiving opioid therapy; the median baseline daily oral equivalent dose (OED) of morphine was 180 mg. Pain was assessed at baseline, 24 hours, 48 hours, and 72 hours. Pain scores as assessed on an 11-point numeric pain rating scale (NPRS), any side effects including subcutaneous site reactions, as well as patient satisfaction rating with analgesia were recorded. A clinically significant decrease in pain scores was defined as a reduction of two or more points on the NPRS. Median pain score of all patient treatments decreased from 7 to 4.5 at 24 hours (p<0.001) and 4.0 at 48 hours. A response was seen in 17 (71%) of the 24 treatments at 24 hours. There was no difference between median negative change in pain scores in 19 (79%) treatments where pain was either strongly movement related, or in 22 (94%) treatments where local bone tenderness was more pronounced. No major side effects were observed during treatment. One patient died from pulmonary embolism after cessation of concurrent prophylactic low molecular weight heparin prior to staging liver biopsy. Subcutaneous site reactions occurred in 2 (8%) treatments and were mild and self limiting. Short-term daily subcutaneous parecoxib injection was effective for malignant bone pain when added to existing analgesic therapy and was well tolerated. Further research is warranted into the short-term use of parecoxib in hospitalized patients with intractable malignant bone pain.

Electroosmotic flow and Joule heating in preparative continuous annular electrochromatography.

PubMed

Laskowski, René; Bart, Hans-Jörg

2015-09-01

An openFOAM "computational fluid dynamic" simulation model was developed for the description of local interaction of hydrodynamics and Joule heating in annular electrochromatography. A local decline of electrical conductivity of the background eluent is caused by an electrokinetic migration of ions resulting in higher Joule heat generation. The model equations consider the Navier-Stokes equation for incompressible fluids, the energy equation for stationary temperature fields, and the mass transfer equation for the electrokinetic flow. The simulations were embedded in commercial ANSYS Fluent software and in open-source environment openFOAM. The annular gap (1 mm width) contained an inorganic C8 reverse-phase monolith as stationary phase prepared by an in situ sol-gel process. The process temperature generated by Joule heating was determined by thermal camera system. The local hydrodynamics in the prototype was detected by a gravimetric contact-free measurement method and experimental and simulated values matched quite well. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Automated Escape Guidance Algorithms for An Escape Vehicle

NASA Technical Reports Server (NTRS)

Flanary, Ronald; Hammen, David; Ito, Daigoro; Rabalais, Bruce; Rishikof, Brian; Siebold, Karl

2002-01-01

An escape vehicle was designed to provide an emergency evacuation for crew members living on a space station. For maximum escape capability, the escape vehicle needs to have the ability to safely evacuate a station in a contingency scenario such as an uncontrolled (e.g., tumbling) station. This emergency escape sequence will typically be divided into three events: The fust separation event (SEP1), the navigation reconstruction event, and the second separation event (SEP2). SEP1 is responsible for taking the spacecraft from its docking port to a distance greater than the maximum radius of the rotating station. The navigation reconstruction event takes place prior to the SEP2 event and establishes the orbital state to within the tolerance limits necessary for SEP2. The SEP2 event calculates and performs an avoidance burn to prevent station recontact during the next several orbits. This paper presents the tools and results for the whole separation sequence with an emphasis on the two separation events. The fust challenge includes collision avoidance during the escape sequence while the station is in an uncontrolled rotational state, with rotation rates of up to 2 degrees per second. The task of avoiding a collision may require the use of the Vehicle's de-orbit propulsion system for maximum thrust and minimum dwell time within the vicinity of the station vicinity. The thrust of the propulsion system is in a single direction, and can be controlled only by the attitude of the spacecraft. Escape algorithms based on a look-up table or analytical guidance can be implemented since the rotation rate and the angular momentum vector can be sensed onboard and a-priori knowledge of the position and relative orientation are available. In addition, crew intervention has been provided for in the event of unforeseen obstacles in the escape path. The purpose of the SEP2 burn is to avoid re-contact with the station over an extended period of time. Performing this maneuver properly requires knowledge of the orbital state, which is obtained during the navigation state reconstruction event. Since the direction of the delta-v of the SEPI maneuver is a random variable with respect to the Local Vertical Local Horizontal (LVLH) coordinate system, calculating the required SEP2 burn is a challenge. This problem was solved using a neural network as a model-free function approximation technique.

Local delivery of molecules from a nanopipette for quantitative receptor mapping on live cells.

PubMed

Babakinejad, Babak; Jönsson, Peter; López Córdoba, Ainara; Actis, Paolo; Novak, Pavel; Takahashi, Yasufumi; Shevchuk, Andrew; Anand, Uma; Anand, Praveen; Drews, Anna; Ferrer-Montiel, Antonio; Klenerman, David; Korchev, Yuri E

2013-10-01

Using nanopipettes to locally deliver molecules to the surface of living cells could potentially open up studies of biological processes down to the level of single molecules. However, in order to achieve precise and quantitative local delivery it is essential to be able to determine the amount and distribution of the molecules being delivered. In this work, we investigate how the size of the nanopipette, the magnitude of the applied pressure or voltage, which drives the delivery, and the distance to the underlying surface influences the number and spatial distribution of the delivered molecules. Analytical expressions describing the delivery are derived and compared with the results from finite element simulations and experiments on delivery from a 100 nm nanopipette in bulk solution and to the surface of sensory neurons. We then developed a setup for rapid and quantitative delivery to multiple subcellular areas, delivering the molecule capsaicin to stimulate opening of Transient Receptor Potential Vanilloid subfamily member 1 (TRPV1) channels, membrane receptors involved in pain sensation. Overall, precise and quantitative delivery of molecules from nanopipettes has been demonstrated, opening up many applications in biology such as locally stimulating and mapping receptors on the surface of live cells.

Impact of a history of maternal depression and anxiety on asthma control during pregnancy.

PubMed

Grzeskowiak, Luke E; Smith, Brian; Roy, Anil; Schubert, K Oliver; Baune, Bernhard T; Dekker, Gustaaf A; Clifton, Vicki L

2017-09-01

To determine the impact of self-reported maternal depression/anxiety on asthma control during pregnancy. Pregnant women with a doctor diagnosis of asthma (n = 189) were prospectively recruited at their antenatal booking visit, and the presence of maternal depression and anxiety was identified using self-report and routine questionnaire assessments. Data on exacerbations and asthma control were collected during gestation. Asthma control was assessed using the Juniper Asthma Control Questionnaire (ACQ) and women were classified as having recurrent uncontrolled asthma if their ACQ score was >1.5 during two or more consecutive study visits. Exacerbations were defined as events that led to increased treatment requirements, and doctor or hospital visits. There were 85 women with self-reported depression/anxiety and 104 women without self-reported depression/anxiety. The presence of depression/anxiety was associated with an increased likelihood (adjusted hazard ratio (HR) 1.67: 95% confidence interval (CI) 1.03-2.72) and incidence (adjusted incidence rate ratio (IRR) 1.71: 95% CI 1.13-2.58) of uncontrolled asthma during pregnancy, as well as an increased risk of recurrent uncontrolled asthma during 2 or more study visits (adjusted relative risk (RR) 1.98: 95% CI 1.00-3.91). No impact of depression/anxiety was observed with respect to the likelihood (adjusted HR 0.70: 95% CI 0.35-1.41) or incidence of exacerbations during pregnancy (adjusted IRR 0.66: 95% CI 0.35-1.26). This study provides evidence that the presence of maternal depression/anxiety is associated with an increased likelihood and incidence of uncontrolled asthma during pregnancy. Given the high prevalence of co-morbid depression/anxiety among asthmatics, further research investigating such associations is urgently required.

Lack of control of hypertension in primary cardiovascular disease prevention in Europe: Results from the EURIKA study.

PubMed

Borghi, Claudio; Tubach, Florence; De Backer, Guy; Dallongeville, Jean; Guallar, Eliseo; Medina, Jesús; Perk, Joep; Roy, Carine; Banegas, José R; Rodriguez-Artalejo, Fernando; Halcox, Julian P

2016-09-01

The prevalence of and factors associated with uncontrolled hypertension and apparent resistant hypertension were assessed in the European Study on Cardiovascular Risk Prevention and Management in Usual Daily Practice (EURIKA; NCT00882336). EURIKA was a cross-sectional observational study including patients being treated for the primary prevention of cardiovascular disease in 12 European countries. Patients were assessed if they were being treated for hypertension (N=5220). Blood pressure control was defined according to European guidelines, with sensitivity analysis taking account of patients' age and diabetes status. Associated factors were assessed using multivariate analysis. In the primary analysis, a total of 2691 patients (51.6%) had uncontrolled hypertension. Factors significantly associated with an increased risk of having uncontrolled hypertension included female sex (odds ratio [OR]: 2.29; 95% confidence interval [CI]: 1.93-2.73), body mass index (BMI; OR per kg/m(2): 1.03; 95% CI: 1.01-1.04), and geographic location. A total of 749 patients (14.3%) had apparent resistant hypertension. Factors significantly associated with an increased risk of having apparent resistant hypertension included BMI (OR per kg/m(2): 1.06; 95% CI: 1.04-1.08), diabetes (OR: 1.28; 95% CI: 1.06-1.53), use of statins (OR: 1.36; 95% CI: 1.15-1.62), serum uric acid levels (OR: 1.16; 95% CI: 1.09-1.23), and geographic location. Similar results were seen in sensitivity analyses. Over 50% of patients treated for hypertension continued to have uncontrolled blood pressure and 14.3% had apparent resistant hypertension. Positive associations were seen with other cardiovascular risk factors. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Role of pressure in angiotensin II-induced renal injury: chronic servo-control of renal perfusion pressure in rats.

PubMed

Mori, Takefumi; Cowley, Allen W

2004-04-01

Renal perfusion pressure was servo-controlled chronically in rats to quantify the relative contribution of elevated arterial pressure versus angiotensin II (Ang II) on the induction of renal injury in Ang II-induced hypertension. Sprague-Dawley rats fed a 4% salt diet were administered Ang II for 14 days (25 ng/kg per minute IV; saline only for sham rats), and the renal perfusion pressure to the left kidney was continuously servo-controlled to maintain a normal pressure in that kidney throughout the period of hypertension. An aortic occluder was implanted around the aorta between the two renal arteries and carotid and femoral arterial pressure were measured continuously throughout the experiment to determine uncontrolled and controlled renal perfusion pressure, respectively. Renal perfusion pressure of uncontrolled, controlled, and sham kidneys over the period of Ang II or saline infusion averaged 152.6+/-7.0, 117.4+/-3.5, and 110.7+/-2.2 mm Hg, respectively. The high-pressure uncontrolled kidneys exhibited tubular necrosis and interstitial fibrosis, especially prominent in the outer medullary region. Regional glomerular sclerosis and interlobular artery injury were also pronounced. Controlled kidneys were significantly protected from interlobular artery injury, juxtamedullary glomeruli injury, tubular necrosis, and interstitial fibrosis as determined by comparing the level of injury. Glomerular injury was not prevented in the outer cortex. Transforming growth factor (TGF)-beta and active NF-kappaB proteins determined by immunohistochemistry were colocalized in the uncontrolled kidney in regions of interstitial fibrosis. We conclude that the preferential juxtamedullary injury found in Ang II hypertension is largely induced by pressure and is probably mediated through the TGF-beta and NF-kappaB pathway.

Resuscitation with lactated ringer's does not increase inflammatory response in a Swine model of uncontrolled hemorrhagic shock.

PubMed

Watters, Jennifer M; Brundage, Susan I; Todd, S Rob; Zautke, Nathan A; Stefater, J A; Lam, J C; Muller, Patrick J; Malinoski, Darren; Schreiber, Martin A

2004-09-01

Lactated Ringer's (LR) and normal saline (NS) are widely and interchangeably used for resuscitation of trauma victims. Studies show LR to be superior to NS in the physiologic response to resuscitation. Recent in vitro studies demonstrate equivalent effects of LR and NS on leukocytes. We aimed to determine whether LR resuscitation would produce an equivalent inflammatory response compared with normal saline (NS) resuscitation in a clinically relevant swine model of uncontrolled hemorrhagic shock. Thirty-two swine were randomized. Control animals (n = 6) were sacrificed following induction of anesthesia for baseline data. Sham animals (n = 6) underwent laparotomy and 2 h of anesthesia. Uncontrolled hemorrhagic shock animals (n = 10/group) underwent laparotomy, grade V liver injury, and blinded resuscitation with LR or NS to maintain baseline blood pressure for 1.5 h before sacrifice. Lung was harvested, and tissue mRNA levels of interleukin-6 (IL-6), granulocyte colony-stimulating factor (G-CSF), and tumor necrosis factor-alpha (TNF-alpha) were determined using quantitative reverse transcriptase polymerase chain reaction (Q-RT-PCR). Sections of lung were processed and examined for neutrophils sequestered within the alveolar walls. Cytokine analysis showed no difference in IL-6 gene transcription in any group (P = 0.99). Resuscitated swine had elevated G-CSF and TNF-alpha gene transcription, but LR and NS groups were not different from each other (P= 0.96 and 0.10, respectively). Both resuscitation groups had significantly more alveolar neutrophils present than controls (P < 0.01) and shams (P < 0.05) but were not different from one another (P= 0.83). LR and NS resuscitation have equivalent effects on indices of inflammation in the lungs in our model of uncontrolled hemorrhagic shock.

MyAirCoach: the use of home-monitoring and mHealth systems to predict deterioration in asthma control and the occurrence of asthma exacerbations; study protocol of an observational study

PubMed Central

Honkoop, Persijn J; Simpson, Andrew; Bonini, Matteo; Snoeck-Stroband, Jiska B; Meah, Sally; Fan Chung, Kian; Usmani, Omar S; Fowler, Stephen; Sont, Jacob K

2017-01-01

Introduction Asthma is a variable lung condition whereby patients experience periods of controlled and uncontrolled asthma symptoms. Patients who experience prolonged periods of uncontrolled asthma have a higher incidence of exacerbations and increased morbidity and mortality rates. The ability to determine and to predict levels of asthma control and the occurrence of exacerbations is crucial in asthma management. Therefore, we aimed to determine to what extent physiological, behavioural and environmental data, obtained by mobile healthcare (mHealth) and home-monitoring sensors, as well as patient characteristics, can be used to predict episodes of uncontrolled asthma and the onset of asthma exacerbations. Methods and analysis In an 1-year observational study, patients will be provided with mHealth and home-monitoring systems to record daily measurements for the first-month (phase I) and weekly measurements during a follow-up period of 11 months (phase II). Our study population consists of 150 patients, aged ≥18 years, with a clinician's diagnosis of asthma, currently on controller medication, with uncontrolled asthma and/or minimally one exacerbation in the past 12 months. They will be enrolled over three participating centres, including Leiden, London and Manchester. Our main outcomes are the association between physiological, behavioural and environmental data and (1) the loss of asthma control and (2) the occurrence of asthma exacerbations. Ethics This study was approved by the Medical Ethics Committee of the Leiden University Medical Center in the Netherlands and by the NHS ethics service in the UK. Trial registration number NCT02774772. PMID:28119390

A Systematic Review: Family Support Integrated with Diabetes Self-Management among Uncontrolled Type II Diabetes Mellitus Patients.

PubMed

Pamungkas, Rian Adi; Chamroonsawasdi, Kanittha; Vatanasomboon, Paranee

2017-09-15

The rate of type-2 diabetes mellitus (T2D) is dramatically increasing worldwide. Continuing diabetes mellitus (DM) care needs effective self-management education and support for both patients and family members. This study aimed to review and describe the impacts of diabetes mellitus self-management education (DSME) that involve family members on patient outcomes related to patient health behaviors and perceived self-efficacy on self-management such as medication adherence, blood glucose monitoring, diet and exercise changes, health outcomes including psychological well-being and self-efficacy, and physiological markers including body mass index, level of blood pressure, cholesterol level and glycemic control. Three databases, PubMed, CINAHL, and Scopus were reviewed for relevant articles. The search terms were "type 2 diabetes," "self-management," "diabetes self-management education (DSME)," "family support," "social support," and "uncontrolled glycaemia." Joanna Briggs Institute (JBI) guidelines were used to determine which studies to include in the review. Details of the family support components of DSME intervention and the impacts of these interventions had on improving the health outcomes patients with uncontrolled glycaemia patients. A total of 22 intervention studies were identified. These studies involved different DSME strategies, different components of family support provided, and different health outcomes to be measured among T2D patients. Overall, family support had a positive impact on healthy diet, increased perceived support, higher self-efficacy, improved psychological well-being and better glycemic control. This systematic review found evidence that DSME with family support improved self-management behaviors and health outcomes among uncontrolled glycaemia T2D patients. The findings suggest DSME models that include family engagement can be a useful direction for improving diabetes care.

Surgical Outcomes of Ahmed or Baerveldt Tube Shunt Implantation for medically Uncontrolled Traumatic Glaucoma.

PubMed

Yadgarov, Arkadiy; Liu, Dan; Crane, Elliot S; Khouri, Albert S

2017-01-01

To describe postoperative surgical success of either Ahmed or Baerveldt tube shunt implantation for eyes with medically uncontrolled traumatic glaucoma. A review was carried out to identify patients with traumatic glaucoma that required tube shunt implantation between 2009 and 2015 at Rutgers University in Newark, New Jersey, USA. Seventeen eyes from 17 patients met inclusion criteria, including at least 3-month postoperative follow-up. The main outcome measure was surgical success at 1-year follow-up after tube implantation. Mean preoperative intraocular pressure (IOP) was 34.1 ± 8.2 mm Hg on 3.1 ± 1.6 ocular hypotensive medications. Nine eyes (53%) sustained closed globe injury. Ten eyes (59%) received an Ahmed valve shunt and seven eyes (41%) received a Baerveldt tube shunt. Surgical success rate at 1 year postoperatively was 83%. Compared to preoperative, the mean postoperative IOP was significantly lower (16.1 ± 3.5 mm Hg, p < 0.001) on significantly fewer ocular hypertensive medications (1.3 ± 1.6, p = 0.001) at a mean follow-up of 10 months. Mean IOP reduction at last follow-up was 49%. There were three cases of surgical failures: One case of hypotony, one case of tube extrusion with subsequent explan-tation, and one case requiring second tube insertion for IOP control. Implantation of an Ahmed or Baerveldt tube shunt provided successful control of IOP in patients with medically uncontrollable traumatic glaucoma. Yadgarov A, Liu D, Crane ES, Khouri AS. Surgical Outcomes of Ahmed or Baerveldt Tube Shunt Implantation for medically Uncontrolled Traumatic Glaucoma. J Curr Glaucoma Pract 2017;11(1):16-21.

Consequences of uncontrolled cooling during sterlet (Acipenser ruthenus) sperm cryopreservation on post-thaw motility and fertilizing ability.

PubMed

Horokhovatskyi, Yevhen; Rodina, Marek; Asyabar, Hadiseh Dadras; Boryshpolets, Sergii; Dzyuba, Borys

2017-06-01

The significant influence of the number and position of fish sperm sample straws in uncontrolled cooling devices on post-thaw spermatozoa parameters, such as motility and fertilizing ability, is presented in this study. The two most popular uncontrolled cooling devices were used in this study: a Styrofoam box setup with a polystyrene floating raft on liquid nitrogen and the dry shipper setup with a straw holder. We tested the effect of different quantities of straws (6 or 60) placed on the polystyrene floating raft and the position of the straws in the holder (on the periphery or in the centre). Using these cooling methods, sperm of 10 male sterlets diluted with methanol containing cryoprotective medium was frozen. All temperature changes were recorded by a thermocouple inside the straw, and the thermogram intervals were analysed. Spermatozoa motility was evaluated by video microscopy with integrated computer-assisted sperm analysis software. Fertilization trials were conducted at a 10 5 spermatozoa/egg ratio. Post-thaw spermatozoa parameters, including the percent of motile spermatozoa, curvilinear velocity, velocity according to the smoothed path, linearity of track, beat-cross frequency and fertilization rate, were significantly decreased in the 60-straw floating raft setup in comparison to all of the other cooling methods. The freezing rate between -10 °C and -30 °C was significantly decreased by up to 18.6 ± 0.61 °C/min for the 60-straw floating raft setup in comparison to the other freezing conditions. Considering the above results, efforts to standardize cryopreservation protocols using uncontrolled cooling devices should take into account the amount of straws subjected to freezing. Copyright © 2017. Published by Elsevier Inc.

Clinical lung transplantation from uncontrolled non-heart-beating donors revisited.

PubMed

Gomez-de-Antonio, David; Campo-Cañaveral, Jose Luis; Crowley, Silvana; Valdivia, Daniel; Cordoba, Mar; Moradiellos, Javier; Naranjo, Jose Manual; Ussetti, Piedad; Varela, Andrés

2012-04-01

The aim of our study is to review and update the long-term results from our previously published series of lung transplantation in uncontrolled non-heart-beating donors (NHBDs). A prospective collection of data was undertaken from all lung transplants performed among uncontrolled NHBDs between 2002 and December 2009. The statistical analysis was performed using SPSS software and survival was estimated using the Kaplan-Meier method. Twenty-nine lung transplants were performed. Mean total ischemic times for the first and second lung were 575 minutes (SD 115.6) and 701 minutes (SD 111.3), respectively. Primary graft dysfunction (PGD) G1, G2 and G3 occurred in 5 cases (17%), 5 cases (17%) and 11 cases (38%), respectively. Overall hospital mortality rate was 17% (5 patients). Statistical analysis revealed a statistically significant association of mortality with ischemic times and with PGD. In terms of overall survival, 3-month, 1-year, 2-year and 5-year survival rates were 78%, 68%, 57% and 51%, respectively, and the conditional survival rates in those who survived the first 3 months were 86%, 72% and 65%, respectively. The cumulative incidence of bronchiolitis obliterans syndrome (BOS) was 11%, 35% and 45% at 1, 3 and 5 years, respectively. Lung transplantation from uncontrolled non-heart-beating donors shows acceptable results for both mid- and long-term survival and BOS; however, the higher rates of PGD and its impact on early mortality must make us more demanding with respect to the acceptance criteria and methods of evaluation used with these donors. Copyright © 2012 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Association between control to target blood pressures and healthy lifestyle factors among Japanese hypertensive patients: longitudinal data analysis from Fukushima Research of Hypertension (FRESH).

PubMed

Yokokawa, Hirohide; Goto, Aya; Sanada, Hironobu; Watanabe, Tsuyoshi; Felder, Robin A; Jose, Pedro A; Yasumura, Seiji

2014-01-01

To determine success rates in controlling target blood pressures longitudinally by measuring several factors, including lifestyle characteristics associated with uncontrolled blood pressures for target treatment goals. This prospective observational cohort study (September 2008-September 2010) collected information on blood pressure control status and healthy lifestyle factors listed in Breslow's seven health practices through medical records and self-administered questionnaires from 884 of the 1264 Japanese hypertensive patients initially registered in the FRESH study. Multivariate analysis adjusted for associated factors was performed to estimate the association between lifestyle change and "uncontrolled blood pressures" at the final follow-up survey. Median age and proportion of men were 73 years and 39.1%, respectively. All survey failure rates were 37.6% among non-elderly patients (<65 years of age) without diabetes mellitus or chronic kidney disease, and 35.0% among patients with these diseases or myocardial infarction. Maintaining a healthy lifestyle was a protective factor against uncontrolled blood pressures in multivariate analysis. Obesity and smoking status were associated with uncontrolled blood pressures, and exercise frequency was borderline significance. The number of participants with healthy responses for these factors remained relatively low during follow up. Our study revealed low rates of controlled blood pressures, especially in non-elderly patients without diabetes mellitus or chronic kidney disease, and patients with these diseases or myocardial infarction. Our data indicate the need to maintain a healthy lifestyle, in particular, ideal body weight and adequate exercise frequency, for better hypertension management according to treatment guidelines. Copyright © 2013 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

Glycemic control, cognitive function, and family support among middle-aged and older Hispanics with diabetes: The Hispanic Community Health Study/Study of Latinos.

PubMed

Strizich, Garrett; Kaplan, Robert C; González, Hector M; Daviglus, Martha L; Giachello, Aida L; Teng, Yanping; Lipton, Richard B; Grober, Ellen

2016-07-01

To examine among Hispanics in the U.S., a population with increased reliance on informal healthcare support structures, (1) the association between cognitive function and control of diabetes; and (2) whether this association is modified by family support. The Digit Symbol Substitution Test (DSST), word fluency, and learning and delayed recall components of the Spanish English Verbal Learning Test were administered to 1794 Hispanic adults aged 45-76years with diagnosed diabetes. An executive function index and global cognitive function index (GCFI) were derived. Uncontrolled diabetes (HbA1c⩾7% [53mmol/mol]) was compared across quartiles of cognitive function using multivariable logit models with interaction terms for cognitive function and family support. After adjustment, lower DSST scores were associated with uncontrolled diabetes (P=0.03). Family support modified the relationship between other measures of cognition and diabetes control (Pinteraction: 0.002, 0.09). Among individuals with low family support, as cognitive function declined, the odds of uncontrolled diabetes increased (P-trend across quartiles of the GCFI, 0.015). Among those with low family support, persons in the lowest quartile of global cognitive function were more than twice as likely to have uncontrolled diabetes as those in the highest performing quartile (OR=2.31; 95% CI: 1.17, 4.55). There was no similar effect among those with high family support. Family support may buffer the negative association between low cognitive functioning and diabetes control in US Hispanics/Latinos. Educational programs targeted at family members of middle-age and older persons with diabetes regardless of neurocognitive status may help improve population-level glycemic control. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Prevalence of Recommendations Made Within Dental Research Articles Using Uncontrolled Intervention or Observational Study Designs.

PubMed

Wilson, M K; Chestnutt, I G

2016-03-01

Evidence to inform clinical practice is reliant on research carried out using appropriate study design. The objectives of this work were to (i) identify the prevalence of articles reporting on human studies using uncontrolled intervention or observational research designs published in peer-reviewed dental journals and (ii) determine the nature of recommendations made by these articles. Six peer-reviewed dental journals were selected. Issues published in January to June 2013 were examined and the types of articles published categorized. Following pre-defined inclusion/exclusion criteria, human studies classified as using uncontrolled intervention or observational research designs were subject to detailed review by two independent investigators, to examine if they presented clinical, policy or research recommendations and if these recommendations were supported by the data presented. 52.9% (n = 156) of studies published during the time period met the inclusion criteria. Studies with uncontrolled intervention or observational research designs comprised a larger proportion of the primary research studies published in the journals with lower impact factors (73.3%; n = 107) compared to the high impact journals (38.9%; n = 49). Analysis showed that 60.9% (n = 95) of the included studies made recommendations for clinical practice/dental policy. In 28.2% (n = 44) of studies, the clinical/policy recommendations made were judged to not be fully supported by the data presented. Many studies published in the current dental literature, which are not considered to produce strong evidence, make recommendations for clinical practice or policy. There were some cases when the recommendations were not fully supported by the data presented. Copyright © 2016 Elsevier Inc. All rights reserved.

Anesthesia Preoperative Clinic Referral for Elevated Hba1c Reduces Complication Rate in Diabetic Patients Undergoing Total Joint Arthroplasty.

PubMed

Kallio, Peter J; Nolan, Jenea; Olsen, Amy C; Breakwell, Susan; Topp, Richard; Pagel, Paul S

2015-06-01

Diabetes mellitus (DM) is risk factor for complications after orthopedic surgery. We tested the hypothesis that anesthesia preoperative clinic (APC) referral for elevated glycosylated hemoglobin (HbA1c) reduces complication rate after total joint arthroplasty (TJA). Patients (n = 203) with and without DM were chosen from 1,237 patients undergoing TJA during 2006 - 12. Patients evaluated in the APC had surgery in 2006 - 8 regardless of HbA1c (uncontrolled). Those evaluated between in subsequent two-year intervals were referred to primary care for HbA1c ≥ 10% and ≥ 8%, respectively, to improve DM control before surgery. Complications and mortality were quantified postoperatively and at three, six, and twelve months. Length of stay (LOS) and patients requiring a prolonged LOS (> 5 days) were recorded. Patients (197 men, 6 women) underwent 71, 131, and 1 total hip, knee, and shoulder replacements, respectively. Patients undergoing TJA with uncontrolled HbA1c and those with HbA1c < 10%, but not those with HbA1c < 8%, had a higher incidence of coronary disease and hypercholesterolemia than patients without DM. An increase in complication rate was observed in DM patients with uncontrolled HbA1c versus patients without DM (P < 0.001); the complication rate progressively decreased with tighter HbA1c control. More DM patients with preoperative HbA1c that was uncontrolled or ≥ 10% required prolonged LOS versus those without DM (P < 0.001 and P = 0.0404, respectively). APC referral for elevated HbA1c reduces complication rate and the incidence of prolonged hospitalization during the first year after surgery in diabetics undergoing TJA.

A Systematic Review: Family Support Integrated with Diabetes Self-Management among Uncontrolled Type II Diabetes Mellitus Patients

PubMed Central

Pamungkas, Rian Adi; Chamroonsawasdi, Kanittha; Vatanasomboon, Paranee

2017-01-01

The rate of type-2 diabetes mellitus (T2D) is dramatically increasing worldwide. Continuing diabetes mellitus (DM) care needs effective self-management education and support for both patients and family members. This study aimed to review and describe the impacts of diabetes mellitus self-management education (DSME) that involve family members on patient outcomes related to patient health behaviors and perceived self-efficacy on self-management such as medication adherence, blood glucose monitoring, diet and exercise changes, health outcomes including psychological well-being and self-efficacy, and physiological markers including body mass index, level of blood pressure, cholesterol level and glycemic control. Three databases, PubMed, CINAHL, and Scopus were reviewed for relevant articles. The search terms were “type 2 diabetes,” “self-management,” “diabetes self-management education (DSME),” “family support,” “social support,” and “uncontrolled glycaemia.” Joanna Briggs Institute (JBI) guidelines were used to determine which studies to include in the review. Details of the family support components of DSME intervention and the impacts of these interventions had on improving the health outcomes patients with uncontrolled glycaemia patients. A total of 22 intervention studies were identified. These studies involved different DSME strategies, different components of family support provided, and different health outcomes to be measured among T2D patients. Overall, family support had a positive impact on healthy diet, increased perceived support, higher self-efficacy, improved psychological well-being and better glycemic control. This systematic review found evidence that DSME with family support improved self-management behaviors and health outcomes among uncontrolled glycaemia T2D patients. The findings suggest DSME models that include family engagement can be a useful direction for improving diabetes care. PMID:28914815

Influence of pH control in the formation of inclusion bodies during production of recombinant sphingomyelinase-D in Escherichia coli.

PubMed

Castellanos-Mendoza, Andrea; Castro-Acosta, Ricardo M; Olvera, Alejandro; Zavala, Guadalupe; Mendoza-Vera, Miguel; García-Hernández, Enrique; Alagón, Alejandro; Trujillo-Roldán, Mauricio A; Valdez-Cruz, Norma A

2014-09-12

Inclusion bodies (IBs) are aggregated proteins that form clusters when protein is overexpressed in heterologous expression systems. IBs have been considered as non-usable proteins, but recently they are being used as functional materials, catalytic particles, drug delivery agents, immunogenic structures, and as a raw material in recombinant therapeutic protein purification. However, few studies have been made to understand how culture conditions affect the protein aggregation and the physicochemical characteristics that lead them to cluster. The objective of our research was to understand how pH affects the physicochemical properties of IBs formed by the recombinant sphingomyelinase-D of tick expressed in E. coli BL21-Gold (DE3) by evaluating two pH culture strategies. Uncontrolled pH culture conditions favored recombinant sphingomyelinase-D aggregation and IB formation. The IBs of sphingomyelinase-D produced under controlled pH at 7.5 and after 24 h were smaller (<500 nm) than those produced under uncontrolled pH conditions (>500 nm). Furthermore, the composition, conformation and β-structure formation of the aggregates were different. Under controlled pH conditions in comparison to uncontrolled conditions, the produced IBs presented higher resistance to denaturants and proteinase-K degradation, presented β-structure, but apparently as time passes the IBs become compacted and less sensitive to amyloid dye binding. The manipulation of the pH has an impact on IB formation and their physicochemical characteristics. Particularly, uncontrolled pH conditions favored the protein aggregation and sphingomyelinase-D IB formation. The evidence may lead to find methodologies for bioprocesses to obtain biomaterials with particular characteristics, extending the application possibilities of the inclusion bodies.

Inhaled corticosteroids and asthma control in adult-onset asthma: 12-year follow-up study.

PubMed

Vähätalo, Iida; Ilmarinen, Pinja; Tuomisto, Leena E; Niemelä, Onni; Kankaanranta, Hannu

2018-04-01

Prescribed inhaled corticosteroid (ICS) doses in asthma have been studied in cross-sectional settings whereas long-term follow-up studies have not been carried out. To evaluate prescribed medication longitudinally by calculating cumulative ICS doses and dose changes in a cohort of new-onset adult asthma during 12 years and in different groups of asthma control. A total of 203 patients were followed for 12 years as part of Seinäjoki Adult Asthma Study (SAAS). All asthma-related visits and prescribed medication over the study period were collected from medical records. Total cumulative ICS dose for the 12-year follow-up period was 3.4g (±SEM 0.1) per patient. Both respiratory specialists and GPs prescribed step-ups and step-downs in ICS treatment and in total 649 dose changes were noted during the follow-up (median 3(1-5) per patient). Patients with uncontrolled asthma received higher ICS doses throughout the follow-up period, and therefore, cumulative 12-year ICS dose (3.8g ± SEM 0.2) in this group was higher than that in those with partially controlled (3.4g ± SEM 0.2) or controlled disease (2.9g ± SEM 0.2) (p = 0.0001). Patients with uncontrolled asthma were also prescribed a higher number of ICS dose changes than patients with controlled disease. Despite frequent dose changes and high ICS doses during the 12-year follow-up, the level of asthma control remained poor in patients with uncontrolled asthma. This suggests that high ICS doses may not be effective enough for management of disease in patients with uncontrolled adult-onset asthma and novel targeted treatments are required. Copyright © 2018 Elsevier Ltd. All rights reserved.

Is There a Clinically Meaningful Change in the Blood Pressure of Osteoarthritis Patients with Comorbid Hypertension During the Course of Balneotherapy?

PubMed Central

Hayta, Emrullah; Yılmaz, Mehmet Birhan; Yayıkçı, İlker; Özer, Zafer; Şahin, Özlem

2015-01-01

Background: Balneotherapy (BT) is a treatment modality that uses the physical and chemical effects of water, including thermomineral, acratothermal, and acratopegal waters. It has many effects on cardiovascular system. Aim: The aim of the study is to investigate the effects of 3-week BT on blood pressure of osteoarthritis (OA) patients with no hypertension (HT), and controlled or uncontrolled HT. Materials and Methods: The OA patients (n = 270) were divided into three groups: No HT, controlled HT, and uncontrolled HT. All the groups received BT in the facilities of our university hospital at the same time every day (10:00-11:30 AM) for 10 min per day, 5 days per week, for a total duration of 15 days in a 3-week period. Systolic and diastolic blood pressures and pulse rates were measured before and after BT on daily basis. Results: Overall, (1) the pulse rates of study groups measured after BT were significantly increased compared to before BT; (2) the systolic blood pressures of study groups measured before and after BT were found as comparable; and (3) the diastolic blood pressures of no HT and controlled HT groups measured before and after BT were not statistically significant (P > 0.05); however, in the uncontrolled HT group, the diastolic blood pressure showed a decreasing trend after BT (P < 0.05). Conclusions: In patients with OA, BT can be safely used without resulting in any meaningful changes in systolic and diastolic blood pressures in patients with normal and controlled HT but a decrease in diastolic blood pressure of patients with uncontrolled HT. This may be an advantage in OA patients having HT as comorbid disease. PMID:26713300

Differences in Paracingulate Connectivity Associated with Epileptiform Discharges and Uncontrolled Seizures in Genetic Generalized Epilepsy

PubMed Central

Kay, Benjamin P; Holland, Scott K; Privitera, Michael D; Szaflarski, Jerzy P

2014-01-01

Summary Objective Patients with genetic generalized epilepsy (GGE) frequently continue to suffer from seizures despite appropriate clinical management. GGE is associated with changes in the resting-state networks modulated by clinical factors such as duration of disease and response to treatment. However, the effect of GSWDs and/or seizures on resting-state functional connectivity (RSFC) is not well understood. Methods We investigated the effects of GSWD frequency (in GGE patients), GGE (patients vs. healthy controls), and seizures (uncontrolled vs. controlled) on RSFC using seed-based voxel correlation in simultaneous EEG and resting-state fMRI (EEG/fMRI) data from 72 GGE patients (23 w/uncontrolled seizures) and 38 healthy controls. We used seeds in paracingulate cortex, thalamus, cerebellum, and posterior cingulate cortex to examine changes in cortical-subcortical resting-state networks and the default mode network (DMN). We excluded from analyses time points surrounding GSWDs to avoid possible contamination of the resting state. Results (1) Higher frequency of GSWDs was associated with an increase in seed-based voxel correlation with cortical and subcortical brain regions associated with executive function, attention, and the DMN, (2) RSFC in patients with GGE, when compared to healthy controls, was increased between paracingulate cortex and anterior, but not posterior, thalamus, and (3) GGE patients with uncontrolled seizures exhibited decreased cereballar RSFC. Significance Our findings in this large sample of patients with GGE (1) demonstrate an effect of interictal GSWDs on resting-state networks, (2) provide evidence that different thalamic nuclei may be affected differently by GGE, and (3) suggest that cerebellum is a modulator of ictogenic circuits. PMID:24447031