Alteration of the Cortical Actin Cytoskeleton Deregulates Ca2+ Signaling, Monospermic Fertilization, and Sperm Entry

PubMed Central

Puppo, A.; Chun, Jong T.; Gragnaniello, Giovanni; Garante, Ezio; Santella, Luigia

2008-01-01

Background When preparing for fertilization, oocytes undergo meiotic maturation during which structural changes occur in the endoplasmic reticulum (ER) that lead to a more efficient calcium response. During meiotic maturation and subsequent fertilization, the actin cytoskeleton also undergoes dramatic restructuring. We have recently observed that rearrangements of the actin cytoskeleton induced by actin-depolymerizing agents, or by actin-binding proteins, strongly modulate intracellular calcium (Ca2+) signals during the maturation process. However, the significance of the dynamic changes in F-actin within the fertilized egg has been largely unclear. Methodology/Principal Findings We have measured changes in intracellular Ca2+ signals and F-actin structures during fertilization. We also report the unexpected observation that the conventional antagonist of the InsP3 receptor, heparin, hyperpolymerizes the cortical actin cytoskeleton in postmeiotic eggs. Using heparin and other pharmacological agents that either hypo- or hyperpolymerize the cortical actin, we demonstrate that nearly all aspects of the fertilization process are profoundly affected by the dynamic restructuring of the egg cortical actin cytoskeleton. Conclusions/Significance Our findings identify important roles for subplasmalemmal actin fibers in the process of sperm-egg interaction and in the subsequent events related to fertilization: the generation of Ca2+ signals, sperm penetration, cortical granule exocytosis, and the block to polyspermy. PMID:18974786

Observations of Isotope Fractionation in Prestellar Cores: Interstellar Origin of Meteoritic Hot Spot?

NASA Technical Reports Server (NTRS)

Milam, S. N.; Charnley, S. B.

2011-01-01

Isotopically fractionated material is found in many solar system objects, including meteorites and comets. It is thought, in some cases, to trace interstellar material that was incorporated into the solar system without undergoing significant processing. Here, we show the results of models and observations of the nitrogen and carbon fractionation in proto-stellar cores.

CCTC and the Process for Reauthorization of Bilingual Teacher Preparation Standards: A Critical-Historical Perspective

ERIC Educational Resources Information Center

Cadiero-Kaplan, Karen; Berta-Avila, Margarita; Flores, Juan

2007-01-01

California and the rest of the United Sates are undergoing significant challenges in providing educational opportunities for an increasingly diverse population. These challenges include inadequate literacy and numeracy skills among large segments of the student and adult populations; an ongoing shift in the demographic profile of the population,…

Practices of Conformity and Resistance in the Marketisation of the Academy: Bourdieu, Professionalism and Academic Capitalism

ERIC Educational Resources Information Center

Collyer, Fran M.

2015-01-01

The paper reports on an empirical study based on qualitative interviews with staff from four Australian universities. These universities are shown to be undergoing significant social change as processes of marketisation impact on the everyday practices of academic workers. The universities are analysed as sites of contestation between the new…

Patient expectations for surgery: are they being met?

PubMed

Jones, K R; Burney, R E; Christy, B

2000-06-01

The purpose of the study was to determine patient expectations for the outcomes of three elective surgical procedures, the extent to which patient expectations for surgery were met, the reasons for unmet expectations, and the factors that might predict unmet expectations. Better understanding of these questions might help identify targeted interventions to better prepare patients for specific health care experiences. In a longitudinal, prospective design, a convenience sample of 445 patients (age range, 18 to 86 years) at a general surgery clinic at a major academic medical center was included--177 patients undergoing inguinal hernia repair, 146 undergoing parathyroidectomy, and 122 undergoing cholecystectomy. Patients completed both standardized and newly developed condition-specific health survey instruments. Preoperative interviews were administered, followed by mailed surveys 2 months after surgery. Between 9% and 27% of the respondents reported unmet expectations, with significant variation by condition; reasons included perceived lack of symptom relief, surgical complications, and process of care issues. Patients undergoing parathyroidectomy had a greater probability of unmet expectations. Both feeling prepared for surgery and improved postoperative symptom relief and role functioning reduced the probability of unmet expectations. To reduce the level of unmet expectations, patients need to be prepared both for the surgical experience and for what to expect in the recovery phase. This is especially true for complex illnesses such as primary hyperparathyroidism. Innovative educational strategies to ensure adequate preparation for surgery will be needed, and attention will need to be paid to latent, unstated process measures, if unmet expectations are to be reduced.

Acrylamide formation in food: a mechanistic perspective.

PubMed

Yaylayan, Varoujan A; Stadler, Richard H

2005-01-01

Earliest reports on the origin of acrylamide in food have confirmed asparagine as the main amino acid responsible for its formation. Available evidence suggests that sugars and other carbonyl compounds play a specific role in the decarboxylation process of asparagine, a necessary step in the generation of acrylamide. It has been proposed that Schiff base intermediate formed between asparagine and the sugar provides a low energy alternative to the decarboxylation from the intact Amadori product through generation and decomposition of oxazolidin-5-one intermediate, leading to the formation of a relatively stable azomethine ylide. Literature data indicate the propensity of such protonated ylides to undergo irreversible 1,2-prototropic shift and produce, in this case, decarboxylated Schiff bases which can easily rearrange into corresponding Amadori products. Decarboxylated Amadori products can either undergo the well known beta-elimination process initiated by the sugar moiety to produce 3-aminopropanamide and 1-deoxyglucosone or undergo 1,2-elimination initiated by the amino acid moiety to directly generate acrylamide. On the other hand, the Schiff intermediate can either hydrolyze and release 3-aminopropanamide or similarly undergo amino acid initiated 1,2-elimination to directly form acrylamide. Other thermolytic pathways to acrylamide--considered marginal at this stage--via the Strecker aldehyde, acrolein, and acrylic acid, are also addressed. Despite significant progress in the understanding of the mechanistic aspects of acrylamide formation, concrete evidence for the role of the different proposed intermediates in foods is still lacking.

LORS. Learning Oriented Reality Structure...Or How to Keep Your Sanity and Have Fun Besides in All Those Crazy Meetings!

ERIC Educational Resources Information Center

Hollis, Joseph W.; And Others

The LORS technique is a combination of several techniques such as role projection, simulation, psychodrama, feedback, value clarification, role reversal, dramatization, decision making, process analysis, and others. The significant difference is that, when the techniques are used together, each often undergoes changes to the point that the effect…

Oxidative aging and secondary organic aerosol formation from simulated wildfire emissions

Treesearch

C. J. Hennigan; M. A. Miracolo; G. J. Engelhart; A. A. May; Cyle Wold; WeiMin Hao; T. Lee; A. P. Sullivan; J. B. Gilman; W. C. Kuster; J. A. de Gouw; J. L. Collett; S. M. Kreidenweis; A. L. Robinson

2010-01-01

Wildfires are a significant fraction of global biomass burning and a major source of trace gas and particle emissions in the atmosphere. Understanding the air quality and climate implications of wildfires is difficult since the emissions undergo complex transformations due to aging processes during transport away from the source. As part of the third Fire Lab at...

Mythorealistic Concept of "Beautiful Lady" in the Structure of the Author's Identity (Based on the Diaries of Alexander Blok)

ERIC Educational Resources Information Center

Minets, Diana

2016-01-01

The present paper deals with the diaries of Alexander Blok dated 1901-1921 reflecting the process of the writer's self-identification. During 20 years under the influence of various social and cultural situations Blok's "Self-Conception" is undergoing significant changes. The vector of these changes shows the complicated evolution of the…

78 FR 76280 - Polyethylene Retail Carrier Bags From the People's Republic of China: Affirmative Preliminary...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-17

... length, and which appears ready to undergo the final step in the production process, i.e., to use a die... March 3, 2014. Notification of the International Trade Commission Pursuant to section 781(e) of the Act... Components Produced in the Foreign Country Is a Significant Portion of the Total Value of the Merchandise E...

Hispanic parents' experiences of the process of caring for a child undergoing routine surgery: a focus on pain and pain management.

PubMed

Olshansky, Ellen; Zender, Robynn; Kain, Zeev N; Rosales, Alvina; Guadarrama, Josue; Fortier, Michelle A

2015-07-01

The purpose was to understand the processes Hispanic parents undergo in managing postoperative care of children after routine surgical procedures. Sixty parents of children undergoing outpatient surgery were interviewed. Data were analyzed using grounded theory methodology. Parents experienced five subprocesses that comprised the overall process of caring for a child after routine surgery: (a) becoming informed; (b) preparing; (c) seeking reassurance; (d) communicating with one's child; and (e) making pain management decisions. Addressing cultural factors related to pain management in underserved families may instill greater confidence in managing pain. © 2015, Wiley Periodicals, Inc.

40 CFR 261.39 - Conditional Exclusion for Used, Broken Cathode Ray Tubes (CRTs) and Processed CRT Glass...

Code of Federal Regulations, 2013 CFR

2013-07-01

... Cathode Ray Tubes (CRTs) and Processed CRT Glass Undergoing Recycling. 261.39 Section 261.39 Protection of... (CRTs) and Processed CRT Glass Undergoing Recycling. Used, broken CRTs are not solid wastes if they meet... destined for recycling and if they meet the following requirements: (1) Storage. The broken CRTs must be...

40 CFR 261.39 - Conditional Exclusion for Used, Broken Cathode Ray Tubes (CRTs) and Processed CRT Glass...

Code of Federal Regulations, 2010 CFR

2010-07-01

... Cathode Ray Tubes (CRTs) and Processed CRT Glass Undergoing Recycling. 261.39 Section 261.39 Protection of... (CRTs) and Processed CRT Glass Undergoing Recycling. Used, broken CRTs are not solid wastes if they meet... destined for recycling and if they meet the following requirements: (1) Storage. The broken CRTs must be...

40 CFR 261.39 - Conditional Exclusion for Used, Broken Cathode Ray Tubes (CRTs) and Processed CRT Glass...

Code of Federal Regulations, 2014 CFR

2014-07-01

... Cathode Ray Tubes (CRTs) and Processed CRT Glass Undergoing Recycling. 261.39 Section 261.39 Protection of... (CRTs) and Processed CRT Glass Undergoing Recycling. Used, broken CRTs are not solid wastes if they meet... destined for recycling and if they meet the following requirements: (1) Storage. The broken CRTs must be...

40 CFR 261.39 - Conditional Exclusion for Used, Broken Cathode Ray Tubes (CRTs) and Processed CRT Glass...

Code of Federal Regulations, 2011 CFR

2011-07-01

... Cathode Ray Tubes (CRTs) and Processed CRT Glass Undergoing Recycling. 261.39 Section 261.39 Protection of... (CRTs) and Processed CRT Glass Undergoing Recycling. Used, broken CRTs are not solid wastes if they meet... destined for recycling and if they meet the following requirements: (1) Storage. The broken CRTs must be...

40 CFR 261.39 - Conditional Exclusion for Used, Broken Cathode Ray Tubes (CRTs) and Processed CRT Glass...

Code of Federal Regulations, 2012 CFR

2012-07-01

... Cathode Ray Tubes (CRTs) and Processed CRT Glass Undergoing Recycling. 261.39 Section 261.39 Protection of... (CRTs) and Processed CRT Glass Undergoing Recycling. Used, broken CRTs are not solid wastes if they meet... destined for recycling and if they meet the following requirements: (1) Storage. The broken CRTs must be...

What Constitutes the Pre-School Curricula? Discourses of "Core Curricula for Pre-School Education in Finland in 1972-2000"

ERIC Educational Resources Information Center

Turunen, Tuija A.; Maatta, Kaarina

2012-01-01

The focus of this article is on Finnish pre-school curricula from the early pioneering years to the start of the new millennium (1972-2000). Pre-school has been part of the Finnish education system for nearly 40 years. It has been undergoing a challenging reconstruction process and changes influenced significantly by the increasing call for…

Granisetron plus dexamethasone for prevention of postoperative nausea and vomiting in patients undergoing laparoscopic surgery: A meta-analysis

PubMed Central

Zhu, Min; Zhou, Chengmao; Huang, Bing; Ruan, Lin; Liang, Rui

2017-01-01

Objective This study was designed to compare the effectiveness of granisetron plus dexamethasone for preventing postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic surgery. Methods We searched the literature in the Cochrane Library, PubMed, EMBASE, and CNKI. Results In total, 11 randomized controlled trials were enrolled in this analysis. The meta-analysis showed that granisetron in combination with dexamethasone was significantly more effective than granisetron alone in preventing PONV in patients undergoing laparoscopy surgery. No significant differences in adverse reactions (dizziness and headache) were found in association with dexamethasone. Conclusion Granisetron in combination with dexamethasone was significantly more effective than granisetron alone in preventing PONV in patients undergoing laparoscopic surgery, with no difference in adverse reactions between the two groups. Granisetron alone or granisetron plus dexamethasone can be used to prevent PONV in patients undergoing laparoscopic surgery. PMID:28436248

Granisetron plus dexamethasone for prevention of postoperative nausea and vomiting in patients undergoing laparoscopic surgery: A meta-analysis.

PubMed

Zhu, Min; Zhou, Chengmao; Huang, Bing; Ruan, Lin; Liang, Rui

2017-06-01

Objective This study was designed to compare the effectiveness of granisetron plus dexamethasone for preventing postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic surgery. Methods We searched the literature in the Cochrane Library, PubMed, EMBASE, and CNKI. Results In total, 11 randomized controlled trials were enrolled in this analysis. The meta-analysis showed that granisetron in combination with dexamethasone was significantly more effective than granisetron alone in preventing PONV in patients undergoing laparoscopy surgery. No significant differences in adverse reactions (dizziness and headache) were found in association with dexamethasone. Conclusion Granisetron in combination with dexamethasone was significantly more effective than granisetron alone in preventing PONV in patients undergoing laparoscopic surgery, with no difference in adverse reactions between the two groups. Granisetron alone or granisetron plus dexamethasone can be used to prevent PONV in patients undergoing laparoscopic surgery.

[Change in Perioperative Hemostatic Function in Patients Undergoing Hepatic Resection for Primary and Metastatic Liver Cancer].

PubMed

Komasawa, Nobuyasu; Ueki, Ryusuke; Atagi, Kazuaki; Nishi, Shinichi

2015-08-01

Patients undergoing primary hepatic resection often develop hemostatic dysfunction associated with cirrhosis. We retrospectively surveyed pre- and postoperative prothrombin time (PT) and the PT expressed as international normalized ratio (PT-INR) in 39 patients undergoing primary liver resection. We also compared PT changes between primary and metastatic cancer cases (8 cases). Postoperative PT-INR was 1.40 ± 0.38, which was significantly prolonged compared to preoperative PT-INR of 1.08 ± 0.07. Preoperative PT was over 70% in all 39 patients undergoing primary liver resection, whereas postoperative PT was less than 60% in 13 of 39 patients. No significant difference was found in preoperative PT-INR between primary and metastatic cancer cases, but postoperative PT-INR was significantly prolonged in primary cancer cases. Patients undergoing primary liver resection are susceptible to hemostatic dysfunction, even with preoperative PT levels within normal limits.

Influence of mechanical cell salvage on red blood cell aggregation, deformability, and 2,3-diphosphoglycerate in patients undergoing cardiac surgery with cardiopulmonary bypass.

PubMed

Gu, Y John; Vermeijden, Wytze J; de Vries, Adrianus J; Hagenaars, J Ans M; Graaff, Reindert; van Oeveren, Willem

2008-11-01

Mechanical cell salvage is increasingly used during cardiac surgery. Although this procedure is considered safe, it is unknown whether it affects the red blood cell (RBC) function, especially the RBC aggregation, deformability, and the contents of 2,3-diphosphoglycerate (2,3-DPG). This study examines the following: (1) whether the cell salvage procedure influences RBC function; and (2) whether retransfusion of the salvaged blood affects RBC function in patients. Forty patients undergoing cardiac surgery with cardiopulmonary bypass were randomly allocated to a cell saver group (n = 20) or a control group (n = 20). In the cell saver group, the blood aspirated from the wound area and the residual blood from the heart-lung machine were processed with a continuous-flow cell saver before retransfusion. In the control group this blood was retransfused without processing. The RBC aggregation and deformability were measured with a laser-assisted optical rotational cell analyzer and 2,3,-DPG by conventional laboratory test. The cell saver procedure did not influence the RBC aggregation but significantly reduced the RBC deformability (p = 0.007) and the content of RBC 2,3-DPG (p = 0.032). However, in patients receiving the processed blood, their intraoperative and postoperative RBC aggregation, deformability, and 2,3-DPG content did not differ from those of the control patients. Both groups of patients had a postoperative drop of RBC function as a result of hemodilution. The mechanical cell salvage procedure reduces the RBC deformability and the cell 2,3-DPG content. Retransfusion of the processed blood by cell saver does not further compromise the RBC function in patients undergoing cardiac surgery with cardiopulmonary bypass.

Acute phase protein haptoglobin as inflammatory marker in serum and synovial fluid in an equine model of arthritis.

PubMed

Barrachina, Laura; Remacha, Ana Rosa; Soler, Lourdes; García, Natalia; Romero, Antonio; Vázquez, Francisco José; Vitoria, Arantza; Álava, María Ángeles; Lamprave, Fermín; Rodellar, Clementina

2016-12-01

Acute phase proteins are useful inflammatory markers in horses. Haptoglobin (Hp) serum level is increased in horses undergoing different inflammatory processes, including arthritis. However, Hp concentration has not been assessed in inflammatory synovial fluid (SF). The aim of the present study was to investigate the Hp response in serum and SF in horses undergoing experimentally induced arthritis. For this purpose, serum and SF samples were collected from 12 animals before amphotericin B-induced arthritis was created (T0, healthy) and 15days after the lesion induction (T1, joint inflammation) and Hp was determined by single radial immunodiffusion. The Hp increase between T0 and T1 was significant in both serum and SF, and serum Hp concentration at T0 was significantly higher than in SF, but significant differences were not found at T1, indicating a higher Hp increase in SF. A significant positive correlation for Hp concentration between serum and SF samples was found. These results highlight the potential usefulness of Hp as inflammatory marker in horses, showing for the first time the increase of Hp in SF from joint inflammation in the horse. Copyright © 2016 Elsevier B.V. All rights reserved.

Chlorination processing of local planetary ores for oxygen and metallurgically important metals

NASA Technical Reports Server (NTRS)

Lynch, D. C.

1989-01-01

The use of chlorine to extract, reclaim, and purify metals has attractive possibilities for extraterrestrial processing of local planetary resources. While a complete cyclic process has been proposed for the recovery of metallurgically significant metals and oxygen, herein the chlorination step of the cycle is examined. An experimental apparatus for reacting refractory materials, such as ilmenite, in a microwave induced plasma is being built. Complex equilibria calculations reveal that stable refractory materials can, under the influence of a plasma, undergo chlorination and yield oxygen as a by-product. These issues and the potential advantages for plasma processing in space are reviewed. Also presented is a discussion of the complex equilibria program used in the analysis.

The development of a stable, coated pellet formulation of a water-sensitive drug, a case study: development of a stable core formulation.

PubMed

Fitzpatrick, Shaun; Taylor, Scott; Booth, Steven W; Newton, Michael J

2006-01-01

A development program has been carried out to provide a stable extrusion/spheronisation pellet formulation for a highly water-soluble drug, sitagliptin, which undergoes a change in physical form on processing and is subject to hydrolytic decomposition. A conventional extrusion/spheronization formulation resulted in significant degradation of the drug. The inclusion of glyceryl monostearate into the formulation was found to reduce the water levels required to such a level that there was no significant degradation of the drug during processing to form pellets. The use of a ram extruder to screen formulations with small quantities minimizes the need for the drug in the formulation-screening process, and the results from this method of extrusion were found to be translatable to the use of a screen extruder, which allowed scale-up of the process.

Probing the structural dependency of photoinduced properties of colloidal quantum dots using metal-oxide photo-active substrates.

PubMed

Patty, Kira; Sadeghi, Seyed M; Campbell, Quinn; Hamilton, Nathan; West, Robert G; Mao, Chuanbin

2014-09-21

We used photoactive substrates consisting of about 1 nm coating of a metal oxide on glass substrates to investigate the impact of the structures of colloidal quantum dots on their photophysical and photochemical properties. We showed during irradiation these substrates can interact uniquely with such quantum dots, inducing distinct forms of photo-induced processes when they have different cores, shells, or ligands. In particular, our results showed that for certain types of core-shell quantum dot structures an ultrathin layer of a metal oxide can reduce suppression of quantum efficiency of the quantum dots happening when they undergo extensive photo-oxidation. This suggests the possibility of shrinking the sizes of quantum dots without significant enhancement of their non-radiative decay rates. We show that such quantum dots are not influenced significantly by Coulomb blockade or photoionization, while those without a shell can undergo a large amount of photo-induced fluorescence enhancement via such blockade when they are in touch with the metal oxide.

Probing the structural dependency of photoinduced properties of colloidal quantum dots using metal-oxide photo-active substrates

PubMed Central

Patty, Kira; Sadeghi, Seyed M.; Campbell, Quinn; Hamilton, Nathan; West, Robert G.; Mao, Chuanbin

2014-01-01

We used photoactive substrates consisting of about 1 nm coating of a metal oxide on glass substrates to investigate the impact of the structures of colloidal quantum dots on their photophysical and photochemical properties. We showed during irradiation these substrates can interact uniquely with such quantum dots, inducing distinct forms of photo-induced processes when they have different cores, shells, or ligands. In particular, our results showed that for certain types of core-shell quantum dot structures an ultrathin layer of a metal oxide can reduce suppression of quantum efficiency of the quantum dots happening when they undergo extensive photo-oxidation. This suggests the possibility of shrinking the sizes of quantum dots without significant enhancement of their non-radiative decay rates. We show that such quantum dots are not influenced significantly by Coulomb blockade or photoionization, while those without a shell can undergo a large amount of photo-induced fluorescence enhancement via such blockade when they are in touch with the metal oxide. PMID:25316953

Influence of Sous Vide and water immersion processing on polyacetylene content and instrumental color of parsnip (Pastinaca sativa) disks.

PubMed

Rawson, Ashish; Koidis, Anastasios; Rai, Dilip K; Tuohy, Maria; Brunton, Nigel

2010-07-14

The effect of blanching (95 +/- 3 degrees C) followed by sous vide (SV) processing (90 degrees C for 10 min) on levels of two polyacetylenes in parsnip disks immediately after processing and during chill storage was studied and compared with the effect of water immersion (WI) processing (70 degrees C for 2 min.). Blanching had the greatest influence on the retention of polyacetylenes in sous vide processed parsnip disks resulting in significant decreases of 24.5 and 24% of falcarinol (1) and falcarindiol (2) respectively (p < 0.05). Subsequent SV processing did not result in additional significant losses in polyacetylenes compared to blanched samples. Subsequent anaerobic storage of SV processed samples resulted in a significant decrease in 1 levels (p < 0.05) although no change in 2 levels was observed (p > 0.05). 1 levels in WI processed samples were significantly higher than in SV samples (p

Symposium on Turbulence (13th) Held at Rolla, Missouri on September 21- 23, 1992

DTIC Science & Technology

1992-09-01

this article Is part of a project aimed at Increasing the role of computational fluid dynamics ( CFD ) in the process of developing more efficient gas...techniques in and fluid physics of high speed compressible or reacting flows undergoing significant changes of indices of refraction. Possible Topics...in experimental fluid mechanics; homogeneous turbulence, including closures and statistical properties; turbulence in compressible fluids ; fine scale

Parametric Excitation of Electrostatic Dust-Modes by Ion-Cyclotron Waves in a Dusty Plasma

NASA Astrophysics Data System (ADS)

Islam, M. K.; Salahuddin, M.; Ferdous, T.; Salimullah, M.

A large amplitude electrostatic ion-cyclotron wave propagating through a magnetized and collisional dusty plasma undergoes strong parametric instability off the low-frequency dust-modes. The presence of the dust-component has effect on the nonlinear coupling via the dust-modes. The ion-neutral collisions are seen to have significant effect on the damping and consequent overall growth of the parametric excitation process.

Redistribution Mechanisms and Quantification of Homogeneity in Friction Stir Welding and Processing of an Aluminum Silicon Alloy

DTIC Science & Technology

2012-09-01

have been extensively studied in regard to the mechanical effects of the Si particle distribution. Micro- mechanisms of fracture are significantly...ratio particles, and that global fracture occurs by linkage of these locally fractured areas. Their overall conclusion was that the mechanical ...interface, which is undergoing deformation in either tension or compression. Particle fracture was found to occur by two mechanisms : interface

UV-damaged DNA binding protein-1 and de-etiolated-1 regulate golden 2-like transcription factor by assembling a cullin 4-based ubiquitin ligase in tomato

USDA-ARS?s Scientific Manuscript database

Fleshy fruit undergo a novel developmental program that ends in the irreversible process of ripening and eventual tissue senescence. During these maturation processes, fruit undergo numerous physiological, biochemical and structural alterations, making them more attractive to seed dispersal organism...

The influence of physician recommendation on prostate-specific antigen screening.

PubMed

Pucheril, Daniel; Dalela, Deepansh; Sammon, Jesse; Sood, Akshay; Sun, Maxine; Trinh, Quoc-Dien; Menon, Mani; Abdollah, Firas

2015-10-01

Prostate-specific antigen (PSA) screening is controversial, and little is known regarding a physician's effect on a patient's decision to undergo screening. This study's objective was to evaluate the effect of a patient's understanding of the risks and benefits of screening compared to the final recommendation of the provider on the patient's decision to undergo PSA screening. Using the 2012 Behavioral Risk Factor Surveillance System, men older than 55 years who did not have a history of prostate cancer/prostate "problem" and who reported a PSA test within the preceding year were considered to have undergone screening. The percentages of men informed and not informed of the risks and benefits of screening and the percentage men receiving recommendations for PSA screening from their provider were reported. Multivariable complex-sample logistic regression calculated the odds of undergoing screening. In all, 75% of men were informed of screening benefits; however, 32% were informed of screening risks. After being informed of both, 56% of men opted for PSA screening if the provider recommended it, compared with only 21% when not recommended. Men receiving a recommendation to undergo PSA testing had higher odds of undergoing screening (odds ratio [OR] = 4.98, 95% CI: 4.53-5.48) compared with those who were only informed about screening benefits (OR = 2.40, 95% CI: 2.18-2.65) or risks (OR = 0.92, 95% CI: 0.86-0.98). Significant limitations include recall and nonresponse bias. Patients' decision to undergo or forgo PSA screening is heavily influenced by the recommendation of their physician; it is imperative that physicians are cognizant of their biases and facilitate a shared decision-making process. Copyright © 2015 Elsevier Inc. All rights reserved.

A multicomponent theory-based intervention improves uptake of pelvic floor muscle training before radical prostatectomy: a 'before and after' cohort study.

PubMed

Hirschhorn, Andrew D; Kolt, Gregory S; Brooks, Andrew J

2014-03-01

To assess the effect of a multicomponent theory-based intervention, incorporating patient information guides, an evidence summary, audit and feedback processes and a provider directory, in the provision/receipt of preoperative pelvic floor muscle training (PFMT) among patients undergoing radical prostatectomy. Over an 18-month period (9 months before and 9 months after the intervention), we measured the provision/receipt of preoperative PFMT using surveys of patients undergoing radical prostatectomy at one public hospital (n = 32) and two private hospitals (n = 107) in Western Sydney, Australia, as well as practice audits of associated public sector (n = 4) and private sector (n = 2) providers of PFMT. Self-report urinary incontinence was assessed 3 months after radical prostatectomy using the International Consultation on Incontinence Questionnaire - Urinary Incontinence Form (ICIQ-UI Short Form). There was a significant increase in the proportion of survey respondents receiving preoperative PFMT post-intervention (post-intervention: 42/58 respondents, 72% vs pre-intervention: 37/81 respondents, 46%, P = 0.002). There was a corresponding significant increase in provision of preoperative PFMT by private sector providers (mean [sd] post-intervention: 16.7 [3.7] patients/month vs pre-intervention: 12.1 [3.6] patients/month, P = 0.018). Respondents receiving preoperative PFMT had significantly better self-report urinary incontinence at 3 months after radical prostatectomy than those who did not receive preoperative PFMT (mean [sd] ICIQ-UI Short Form sum-scores: 6.2 [5.0] vs 9.2 [5.8], P = 0.002). The intervention increased the provision/receipt of preoperative PFMT among patients undergoing radical prostatectomy. Additional component strategies aimed at increasing the use of public sector providers may be necessary to further improve PFMT receipt among patients undergoing radical prostatectomy in the public hospital system. © 2013 The Authors. BJU International published by John Wiley & Sons Ltd on behalf of BJU International.

[Expertise and biodiversity: the environmental impact assessment in the context of Natura 2000 network].

PubMed

Makowiak, Jessica

2014-03-01

Natura 2000 network, established by the Habitats directive, states that "any plan or project likely to have a significant effect on a Natura 2000 site, shall undergo an appropriate assessment to determine its implications for the site". The safeguards set out in this article are triggered not by a certainty but by a likelihood of significant effects. The paradox clearly appears: the significant implications of a project can be assessed only through an impact assessment process. So the administration and the judge are asked, inevitably, to participate to the building of the definition of practical aspect of expertise.

Haemodynamic results of replacement of mitral and aortic valves with autologous fascia lata prostheses

PubMed Central

Talavlikar, P. H.; Walbaum, P. R.; Kitchin, A. H.

1973-01-01

Twelve patients undergoing aortic and 28 undergoing mitral valve replacement with autologous fascia lata valves were studied before and six months after surgery. One aortic and 10 mitral valves were found to be significantly incompetent. Of the incompetent mitral valves, two appeared to have perivalvular leaks. Six of the remainder were associated with abnormal ventricular filling patterns. Valve failure was much less common when the design was modified to provide a loose cusp structure; out of 12 such valves none was incompetent. Transvalvular gradients persist with fascial valves though they are lower than with most mechanical prostheses. Ventricular function was greatly improved in successful aortic replacement but remained impaired in the case of mitral replacement. Valve failure appeared to be associated with, or accelerated by, haemodynamic stress rather than due to inevitable degenerative pathological processes. PMID:4731108

Molecular Dynamics Studies of Structure and Functions of Water-Membrane Interfaces

NASA Technical Reports Server (NTRS)

Pohorille, Andrew; Wilson, Michael A.; DeVincenzi, Donald L. (Technical Monitor)

2001-01-01

A large number of essential cellular processes occur at the interfaces between water and membranes. The selectivity and dynamics of these processes are largely determined by the structural and electrical properties of the water-membrane interface. We investigate these properties by the molecular dynamics method. Over the time scales of the simulations, the membrane undergoes fluctuations described by the capillary wave model. These fluctuations produce occasional thinning defects in the membrane which provide effective pathways for passive transport of ions and small molecules across the membrane. Ions moving through the membrane markedly disrupt its structure and allow for significant water penetration into the membrane interior. Selectivity of transport, with respect to ionic charge, is determined by the interfacial electrostatic potential. Many small molecules. of potential significance in catalysis, bioenergetics and pharmacology, are shown to bind to the interface. The energetics and dynamics of this process will be discussed.

Production of C-14 and neutrons in red giants

NASA Technical Reports Server (NTRS)

Cowan, J. J.; Rose, W. K.

1977-01-01

We have examined the effects of mixing various amounts of hydrogen-rich material into the intershell convective region of red giants undergoing helium shell flashes. We find that significant amounts of C-14 can be produced via the N-14(n, p)C-14 reaction. If substantial portions of this intershell region are mixed out into the envelopes of red giants, then C-14 may be detectable in evolved stars. We find a neutron flux many orders of magnitude above the flux required for the classical s-process, and thus an intermediate neutron process (i-process) may operate in evolved red giants. In all cases studied we find substantial enhancements of O-17. These mixing models offer a plausible explanation of the observations of enhanced O-17 in the carbon star IRC 10216. For certain physical conditions we find significant enhancements of N-15 in the intershell region.

A nonlinear dynamical system for combustion instability in a pulse model combustor

NASA Astrophysics Data System (ADS)

Takagi, Kazushi; Gotoda, Hiroshi

2016-11-01

We theoretically and numerically study the bifurcation phenomena of nonlinear dynamical system describing combustion instability in a pulse model combustor on the basis of dynamical system theory and complex network theory. The dynamical behavior of pressure fluctuations undergoes a significant transition from steady-state to deterministic chaos via the period-doubling cascade process known as Feigenbaum scenario with decreasing the characteristic flow time. Recurrence plots and recurrence networks analysis we adopted in this study can quantify the significant changes in dynamic behavior of combustion instability that cannot be captured in the bifurcation diagram.

The effect of upper gastrointestinal system endoscopy process on serum oxidative stress levels.

PubMed

Turan, Mehmet Nuri; Aslan, Mehmet; Bolukbas, Filiz Fusun; Bolukbas, Cengiz; Selek, Sahbettin; Sabuncu, Tevfik

2016-12-01

Some authors have investigated the effects of oxidative stress in some process such as undergoing laparoscopic. However, the effect of upper gastrointestinal system endoscopy process on oxidative stress is unclear. We evaluated the short-term effect of upper gastrointestinal system endoscopy process on oxidative stress. Thirty patients who underwent endoscopy process and 20 healthy controls were enrolled in the prospective study. Serum total antioxidant capacity and total oxidant status measurements were measured before and after endoscopy process. The ratio percentage of total oxidant status to total antioxidant capacity was regarded as oxidative stress index. Before endoscopy process, serum total antioxidant capacity levels were higher, while serum total oxidant status levels and oxidative stress index values were lower in patients than controls, but this difference was not statistically significant (all, p > 0.05). After endoscopy process, serum total antioxidant capacity and total oxidant status levels were significantly higher in patients than before endoscopy process (both, p < 0.05). However, oxidative stress index values were slight higher in patients but this difference was not statistically significant (p > 0.05). We observed that serum TAC and TOS levels were increased in patients who underwent endoscopy process after endoscopy process. However, short-time upper gastrointestinal system endoscopy process did not cause an important change in the oxidative stress index. Further studies enrolling a larger number of patients are required to clarify the results obtained here.

A dynamic population model to investigate effects of climate and climate-independent factors on the lifecycle of the tick Amblyomma americanum (Acari: Ixodidae)

USGS Publications Warehouse

Ludwig, Antoinette; Ginsberg, Howard; Hickling, Graham J.; Ogden, Nicholas H.

2016-01-01

The lone star tick, Amblyomma americanum, is a disease vector of significance for human and animal health throughout much of the eastern United States. To model the potential effects of climate change on this tick, a better understanding is needed of the relative roles of temperature-dependent and temperature-independent (day-length-dependent behavioral or morphogenetic diapause) processes acting on the tick lifecycle. In this study, we explored the roles of these processes by simulating seasonal activity patterns using models with site-specific temperature and day-length-dependent processes. We first modeled the transitions from engorged larvae to feeding nymphs, engorged nymphs to feeding adults, and engorged adult females to feeding larvae. The simulated seasonal patterns were compared against field observations at three locations in United States. Simulations suggested that 1) during the larva-to-nymph transition, some larvae undergo no diapause while others undergo morphogenetic diapause of engorged larvae; 2) molted adults undergo behavioral diapause during the transition from nymph-to-adult; and 3) there is no diapause during the adult-to-larva transition. A model constructed to simulate the full lifecycle of A. americanum successfully predicted observed tick activity at the three U.S. study locations. Some differences between observed and simulated seasonality patterns were observed, however, identifying the need for research to refine some model parameters. In simulations run using temperature data for Montreal, deterministic die-out of A. americanum populations did not occur, suggesting the possibility that current climate in parts of southern Canada is suitable for survival and reproduction of this tick.

A Dynamic Population Model to Investigate Effects of Climate and Climate-Independent Factors on the Lifecycle of Amblyomma americanum (Acari: Ixodidae).

PubMed

Ludwig, Antoinette; Ginsberg, Howard S; Hickling, Graham J; Ogden, Nicholas H

2016-01-01

The lone star tick, Amblyomma americanum, is a disease vector of significance for human and animal health throughout much of the eastern United States. To model the potential effects of climate change on this tick, a better understanding is needed of the relative roles of temperature-dependent and temperature-independent (day-length-dependent behavioral or morphogenetic diapause) processes acting on the tick lifecycle. In this study, we explored the roles of these processes by simulating seasonal activity patterns using models with site-specific temperature and day-length-dependent processes. We first modeled the transitions from engorged larvae to feeding nymphs, engorged nymphs to feeding adults, and engorged adult females to feeding larvae. The simulated seasonal patterns were compared against field observations at three locations in United States. Simulations suggested that 1) during the larva-to-nymph transition, some larvae undergo no diapause while others undergo morphogenetic diapause of engorged larvae; 2) molted adults undergo behavioral diapause during the transition from nymph-to-adult; and 3) there is no diapause during the adult-to-larva transition. A model constructed to simulate the full lifecycle of A. americanum successfully predicted observed tick activity at the three U.S. study locations. Some differences between observed and simulated seasonality patterns were observed, however, identifying the need for research to refine some model parameters. In simulations run using temperature data for Montreal, deterministic die-out of A. americanum populations did not occur, suggesting the possibility that current climate in parts of southern Canada is suitable for survival and reproduction of this tick. © Crown copyright 2015.

The Influence of decision aids on prostate cancer screening preferences: A randomized survey study.

PubMed

Weiner, Adam B; Tsai, Kyle P; Keeter, Mary-Kate; Victorson, David E; Schaeffer, Edward M; Catalona, William J; Kundu, Shilajit D

2018-05-28

Shared decision making is recommended regarding prostate cancer screening. Decision aids may facilitate this process; however, the impact of decision aids on screening preferences is poorly understood. In an online survey, a national sample of adults were randomized to one of six different professional societies' online decision aids. We compared pre- and post-decision aid responses. The primary outcome was change in participant likelihood to undergo or recommend prostate cancer screening on a scale of 1 (unlikely) to 100 (extremely likely). Secondary outcomes included change in participant comfort with prostate cancer screening based on the average of six, five-point Likert-scale questions. Median age was 53 years for the 1,336 participants, and 50% were men. Randomized groups did not differ significantly by race, age, gender, income, marital status, or education level. Likelihood to undergo or recommend prostate cancer screening decreased from 83 to 78 following decision aid exposure (p<0.001; Figure). Reviewing the decision aid from the Centers for Disease Control or American Academy of Family Physicians did not alter likelihood (both p>0.2), while the decision aid from the United States Preventive Services Task Force was associated with the largest decrease in screening preference (-16.0, p<0.001). Participants reported increased comfort with the decision-making process for prostate cancer screening from 3.5 to 4.1 (out of 5, p<0.001) following exposure to a decision aid. Exposure to a decision aid decreased participant likelihood to undergo or recommend prostate cancer screening and increased comfort with the screening process. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Nursing care of the patient undergoing coronary artery bypass grafting.

PubMed

Martin, Caron G; Turkelson, Sandra L

2006-01-01

The role of the professional nurse in the perioperative care of the patient undergoing open heart surgery is beneficial for obtaining a positive outcome for the patient. This article focuses on the preoperative and postoperative nursing care of patients undergoing coronary artery bypass graft surgery. Risk assessment, preoperative preparation, current operative techniques, application of the nursing process immediately after surgery, and common postoperative complications will be explored.

Probing the structural dependency of photoinduced properties of colloidal quantum dots using metal-oxide photo-active substrates

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

Patty, Kira; Campbell, Quinn; Hamilton, Nathan

We used photoactive substrates consisting of about 1 nm coating of a metal oxide on glass substrates to investigate the impact of the structures of colloidal quantum dots on their photophysical and photochemical properties. We showed during irradiation these substrates can interact uniquely with such quantum dots, inducing distinct forms of photo-induced processes when they have different cores, shells, or ligands. In particular, our results showed that for certain types of core-shell quantum dot structures an ultrathin layer of a metal oxide can reduce suppression of quantum efficiency of the quantum dots happening when they undergo extensive photo-oxidation. This suggestsmore » the possibility of shrinking the sizes of quantum dots without significant enhancement of their non-radiative decay rates. We show that such quantum dots are not influenced significantly by Coulomb blockade or photoionization, while those without a shell can undergo a large amount of photo-induced fluorescence enhancement via such blockade when they are in touch with the metal oxide.« less

Assessing disease-modifying effects of norepinephrine in Down syndrome and Alzheimer's disease.

PubMed

Ponnusamy, Ravikumar; McNerney, M Windy; Moghadam, Shahrzad; Salehi, Ahmad

2017-11-08

Building upon the knowledge that a number of important brain circuits undergo significant degeneration in Alzheimer's disease, numerous recent studies suggest that the norepinephrine-ergic system in the brainstem undergoes significant alterations early in the course of both Alzheimer's disease and Down syndrome. Massive projections from locus coeruleus neurons to almost the entire brain, extensive innervation of brain capillaries, and widespread distribution of noradrenergic receptors enable the norepinephrine-ergic system to play a crucial role in neural processes, including cognitive function. These anatomical and functional characteristics support the role of the norepinephrine-ergic system as an important target for developing new therapies for cognitive dysfunction. Careful neuropathological examinations using postmortem samples from individuals with Alzheimer's disease have implicated the role of the norepinephrine-ergic system in the etiopathogenesis of Alzheimer's disease. Furthermore, numerous studies have supported the existence of a strong interaction between norepinephrine-ergic and neuroimmune systems. We explore the interaction between the two systems that could play a role in the disease-modifying effects of norepinephrine in Alzheimer's disease and Down syndrome. Copyright © 2017. Published by Elsevier B.V.

The pediatric mandible: I. A primer on growth and development.

PubMed

Smartt, James M; Low, David W; Bartlett, Scott P

2005-07-01

After studying this article, the participant should be able to: 1. Describe embryonic and fetal mandibular development. 2. Summarize the aggregate changes in mandibular form from birth to puberty. 3. Describe the eruption and maturation of the deciduous and permanent mandibular dentition. In this, the first of two articles addressing the surgical management of pediatric mandibular fractures, the authors provide a detailed discussion of mandibular development and anatomy during the fetal period, infancy, and childhood. A review of the pertinent literature was performed. The changing structure of the developing mandible is discussed, with particular attention to surgically relevant anatomical structures. Throughout development, key anatomical structures with relevance to surgical therapy change markedly in position. The mandible undergoes significant change in its bony structure and the composition of its surrounding soft tissues. The mandible's bony structure becomes more robust, with an increasingly acute gonial angle and enlargement of the ramus and body. Furthermore, the mandible provides the bony structure from which tooth buds erupt as the deciduous and permanent dentition--a process that generates significant growth of the alveolar process. As a consequence, the distance between the developing dentition and the inferior mandibular border increases. While the canal of the inferior alveolar nerve undergoes significant superior displacement, the mental foramen becomes positioned more posteriorly over time. In addition, the ligamentous and muscular attachments that surround the temporomandibular joint become increasingly robust. Throughout childhood and adolescence, the blood supply of the mandibular body changes little, with the buccal periosteal plexus and inferior dental artery making significant contributions. Mandibular growth provides the basis for normal occlusal relations and the generation of increasingly large masticatory force. Although the exact mechanisms of bone remodeling during mandibular development remain unclear, the process likely receives contributions from primary growth centers and the response to local alterations in biomechanical force produced by surrounding soft-tissue structures. A working knowledge of the changing mandibular anatomy is a prerequisite for effective clinical management of traumatic injury.

Tough, Microcracking-Resistant, High-Temperature Polymer

NASA Technical Reports Server (NTRS)

Pater, Ruth H.; Razon, Pert; Smith, Ricky; Working, Dennis; Chang, Alice; Gerber, Margaret

1990-01-01

Simultaneous synthesis from thermosetting and thermoplastic components yields polyimide with outstanding properties. Involves process in which one polymer cross-linked in immediate presence of other, undergoing simultaneous linear chain extension. New material, LaRC-RP40 synthesized from high-temperature thermosetting imide prepolymer and from thermoplastic monomer. Three significantly improved properties: toughness, resistance to microcracking, and glass-transition temperature. Shows promise as high-temperature matrix resin for variety of components of aircraft engines and for use in other aerospace structures.

[Protective effects of micro-encapsulated Bifidobacteria on gut barrier after hemorrhagic shock and resuscitation: experiment with rats].

PubMed

Ruan, Xiang-cai; Wang, Shen-ming; Shi, Han-ping; Li, Xiao-xi; Xia, Feng-geng; Ming, Fei-ping

2009-03-10

To investigate the effects of micro-encapsulated bifidobacteria on gut barrier and bacterial translocation after hemorrhagic shock and resuscitation. Sprague-Dawley rats were divided into 6 groups: PBS+sham shock group fed with PBS for 7 days and then undergoing sham shock, bifidobacteria+sham shock group fed with bifidobacteria (10(9) cfu/d) for 7 days and then undergoing sham shock, micro-encapsulated bifidobacteria+sham shock group, fed with micro-encapsulated bifidobacteria (10(9) cfu/d) for 7 days and then undergoing sham shock, PBS+hemorrhagic shock group fed with PBS for 7 days and then undergoing hemorrhagic shock, bifidobacteria+shock group fed with bifidobacteria for 7 days and then undergoing hemorrhagic shock, and micro-encapsulated bifidobacteria+shock group, fed with micro-encapsulated bifidobacteria for 7 days and then undergoing hemorrhagic shock. Three hours after resuscitation laparotomy was performed, distal cecum was resected to undergo bacteriological analysis of the cecal content, mesenteric lymph nodes (MLNs), a liver lobe, and the middle part of spleen were resected to undergo bacterial culture for bacterial translocation, and the terminal ileum was resected to observe the villous damage. There was no significant difference in the amount of blood loss among the 3 hemorrhagic shock groups. The amounts of aerobes in cecum of the bifidobacteria+shock and micro-encapsulated bifidobacteria+shock groups, especially that of the latter group, were significantly lower than that of the PBS+shock group. The amounts of anaerobes and the amounts of bifidobacteria in cecum of the bifidobacteria+shock group and micro-encapsulated bifidobacteria+shock group, especially those of the latter group, were significantly higher than those of the PBS+shock group. No bacterial translocation to liver was observed in all groups. The magnitudes of total aerobes translocation in spleen of the bifidobacteria+shock and encapsulated bifidobacteria+shock groups were significantly lower than that of the PBS+shock group, however, there were not significant differences in the translocation in the MLN of total aerobes ad bifidobacteria among different groups. The percentage of ileal villous damage of the bifidobacteria+shock and encapsulated bifidobacteria+shock groups were significantly lower than that of the PBS+shock group. Bifidobacteria effectively protects the gut barrier, reduces bacterial translocation from the gut after hemorrhagic shock and resuscitation. And micro-encapsulated Bifidobacteria can enhance those effects further.

Meta-Analysis of Postoperative Outcome Parameters Comparing Descemet Membrane Endothelial Keratoplasty Versus Descemet Stripping Automated Endothelial Keratoplasty.

PubMed

Pavlovic, Ivana; Shajari, Mehdi; Herrmann, Eva; Schmack, Ingo; Lencova, Anna; Kohnen, Thomas

2017-12-01

This meta-analysis compares Descemet membrane endothelial keratoplasty (DMEK) with Descemet stripping automated endothelial keratoplasty (DSAEK) to evaluate their strength and weakness profiles. Meta-analysis. We performed a meta-analysis and searched the peer-reviewed literature in PubMed, Cochrane Library, Web of Science, and Embase following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Prospective and retrospective trials performing and comparing DMEK and DSAEK were included. Effects were calculated as odds ratios or standardized mean differences. A total of 11 studies with a total of 723 eyes (350 DMEK and 373 DSAEK) were included. No significant difference was found regarding the total detachment rate, graft failure, and rejection. One of 340 eyes undergoing DMEK showed total detachment and 5 of 363 eyes undergoing DSAEK showed total detachment (P = 0.28). Six of 280 eyes undergoing DMEK showed graft failure; 1 of 313 eyes undergoing DSAEK developed this complication (P = 0.18). No rejection was observed in 158 eyes undergoing DMEK; 4 cases of rejection occurred in 196 eyes undergoing DSAEK (P = 0.37). No significant difference was found regarding endothelial cell loss (P = 0.48). There was a significantly higher partial detachment rate with DMEK: 88 of 340 eyes undergoing DMEK showed partial detachment; 16 of 363 eyes undergoing DSAEK showed this complication (P < 0.00001). DMEK was superior in best-corrected visual acuity after 6 months (P < 0.001), subjective evaluation of visual acuity (P = 0.001), patient satisfaction (P < 0.001), and was the method preferred by patients (P = 0.001). DMEK and DSAEK have a similar complication profile. However, the superiority in the visual outcome and patient satisfaction makes DMEK the preferred option for most patients.

Women's perceptions, expectations and satisfaction with induced labour--a questionnaire-based study.

PubMed

Shetty, Ashalatha; Burt, Rhona; Rice, Pat; Templeton, Allan

2005-11-01

To evaluate the understanding and expectations of women undergoing labour induction, to assess their actual experience of the process and to compare their satisfaction with labour to those labouring spontaneously. Four hundred and fifty women at term undergoing induction of labour and cervical ripening with prostaglandinE2 vaginal tablets and 450 women labouring spontaneously were recruited into the study. The induction group were requested to complete a questionnaire prior to the start of their induction process and another questionnaire post-delivery. The post-delivery questionnaire contained two sections, one pertaining to issues to do with the induction and the second with the actual labour process. The spontaneously labouring group was requested to complete a questionnaire post-delivery, which only contained the section pertaining to the actual labour process. The main outcome measures were satisfaction with labour, perception of pain and length of labour between the induced and spontaneous labour groups, and issues that the women might wish changed about their induction. In the induction group, 34.7% were not satisfied with the information they received about the induction prior to the procedure and 27.2% expected to deliver within 12h of the administration of the inducing agent. Post-induction, 40% of the women felt the most important aspect they would like to change about their induction were they to have another one, would be the speed of the induction, 13.6% felt they might wish to take the inducing agent orally, 7% to have fewer vaginal examinations and 9% to have fewer complications. Among the women who returned questionnaires, 26.3% had a caesarean delivery in the induction group and 21.4% in the spontaneous labour group. Significantly more women were satisfied with their labour in the spontaneous labour group 79.5% versus 70.4%, RR 0.89, 95% CI 0.8-0.96, P=0.006). Labour that is artificially induced does result in lower satisfaction rates as compared to that following spontaneous onset. The longer time delay between the start of the induction and the delivery plays a significant part in this, with the mode of administration of the inducing agent, more vaginal examinations and the increase in caesarean deliveries being perceived as secondary issues. There is a need to improve the information provided to women undergoing labour induction, to counter unrealistic expectations and thereby improve satisfaction.

Assessment of hydrochemical processes and groundwater hydrodynamics in a multilayer aquifer system under long-term irrigation condition: A case study of Nefzaoua basin, southern Tunisia.

PubMed

Tarki, M; Ben Hammadi, M; El Mejri, H; Dassi, L

2016-04-01

The hydrochemical and isotopic investigation of the Nefzaoua aquifer system demonstrates that groundwater mineralization in is controlled by natural and anthropogenic processes including water-rock interaction and irrigation return flow. It identifies all of the water bodies that flow within the aquifer system and their circulation patterns. The isotopically depleted paleowaters, identified within the deep and intermediate aquifers, undergo significant enrichment by evaporation during irrigation and recharged the shallow aquifer by return flow. Subsequently, they infiltrate to the intermediate aquifer which receives also rainfall modern recharge. Copyright © 2016 Elsevier Ltd. All rights reserved.

Gene Expression Profiling Identifies FKBP39 as an Inhibitor of Autophagy in Larval Drosophila Fat Body

PubMed Central

Juhász, Gábor; Puskás, László G.; Komonyi, Orbán; Érdi, Balázs; Maróy, Péter; Neufeld, Thomas P.; Sass, Miklós

2007-01-01

In Drosophila, the fat body undergoes a massive burst of autophagy at the end of larval development in preparation for the pupal transition. To identify genes involved in this process, we carried out a microarray analysis. We found that mRNA levels of the homologs of Atg8, the coat protein of early autophagic structures, and lysosomal hydrolases were upregulated, consistent with previous results. Genes encoding mitochondrial proteins and many chaperones were downregulated, including the inhibitor of eIF2alpha kinases and the peptidyl-prolyl cis-trans isomerase (PPiase) FKBP39. Genetic manipulation of FKBP39 expression had a significant effect on autophagy, potentially through modulation of the transcription factor Foxo. Accordingly, we found that Foxo mutants can not properly undergo autophagy in response to starvation, and that overexpression of Foxo induces autophagy. PMID:17363962

Taste aversion memory reconsolidation is independent of its retrieval.

PubMed

Rodriguez-Ortiz, Carlos J; Balderas, Israela; Garcia-DeLaTorre, Paola; Bermudez-Rattoni, Federico

2012-10-01

Reconsolidation refers to the destabilization/re-stabilization memory process upon its activation. However, the conditions needed to undergo reconsolidation, as well as its functional significance is quite unclear and a matter of intense investigation. Even so, memory retrieval is held as requisite to initiate reconsolidation. Therefore, in the present work we examined whether transient pharmacological disruption of memory retrieval impedes reconsolidation of stored memory in the widely used associative conditioning task, taste aversion. We found that AMPA receptors inhibition in the amygdala impaired retrieval of taste aversion memory. Furthermore, AMPA receptors blockade impeded retrieval regardless of memory strength. However, inhibition of retrieval did not affect anisomycin-mediated disruption of reconsolidation. These results indicate that retrieval is a dispensable condition to undergo reconsolidation and provide evidence of molecular dissociation between retrieval and activation of memory in the non-declarative memory model taste aversion. Copyright © 2012 Elsevier Inc. All rights reserved.

Temperature- and composition-dependent hydrogen diffusivity in palladium from statistically-averaged molecular dynamics

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

Zhou, Xiaowang; Heo, Tae Wook; Wood, Brandon C.

Solid-state hydrogen storage materials undergo complex phase transformations whose kinetics is often limited by hydrogen diffusion. Among metal hydrides, palladium hydride undergoes a diffusional phase transformation upon hydrogen uptake, during which the hydrogen diffusivity varies with hydrogen composition and temperature. Here we perform robust statistically-averaged molecular dynamics simulations to obtain a well-converged analytical expression for hydrogen diffusivity in bulk palladium that is valid throughout all stages of the reaction. Our studies confirm significant dependence of the diffusivity on composition and temperature that elucidate key trends in the available experimental measurements. Whereas at low hydrogen compositions, a single process dominates, atmore » high hydrogen compositions, diffusion is found to exhibit behavior consistent with multiple hopping barriers. Further analysis, supported by nudged elastic band computations, suggests that the multi-barrier diffusion can be interpreted as two distinct mechanisms corresponding to hydrogen-rich and hydrogen-poor local environments.« less

Temperature- and composition-dependent hydrogen diffusivity in palladium from statistically-averaged molecular dynamics

DOE PAGES

Zhou, Xiaowang; Heo, Tae Wook; Wood, Brandon C.; ...

2018-03-09

Solid-state hydrogen storage materials undergo complex phase transformations whose kinetics is often limited by hydrogen diffusion. Among metal hydrides, palladium hydride undergoes a diffusional phase transformation upon hydrogen uptake, during which the hydrogen diffusivity varies with hydrogen composition and temperature. Here we perform robust statistically-averaged molecular dynamics simulations to obtain a well-converged analytical expression for hydrogen diffusivity in bulk palladium that is valid throughout all stages of the reaction. Our studies confirm significant dependence of the diffusivity on composition and temperature that elucidate key trends in the available experimental measurements. Whereas at low hydrogen compositions, a single process dominates, atmore » high hydrogen compositions, diffusion is found to exhibit behavior consistent with multiple hopping barriers. Further analysis, supported by nudged elastic band computations, suggests that the multi-barrier diffusion can be interpreted as two distinct mechanisms corresponding to hydrogen-rich and hydrogen-poor local environments.« less

Politicas y Gobierno de la Educacion Superior En American Latina. (Policies and Governance of Higher Education in Latin America). Texas Papers on Latin America. Paper No. 99-02.

ERIC Educational Resources Information Center

Cardiel, Hugo Casanova

Higher education is undergoing a complex process of transformation at the international level. This transformation is based especially in the fields of policies and governance of higher education institutions. In Latin America this trend has been growing since the 1980s, and higher education is undergoing a strong modification in its processes and…

An updated meta-analysis on the effectiveness of preoperative prophylactic antibiotics in patients undergoing breast surgical procedures.

PubMed

Sajid, Muhammad S; Hutson, Kristian; Akhter, Naved; Kalra, Lorain; Rapisarda, Ignacio F; Bonomi, Ricardo

2012-01-01

To systematically analyze published randomized trials on the effectiveness of preoperative prophylactic antibiotics in patients undergoing breast surgical procedures. Trials on the effectiveness of preoperative prophylactic antibiotics in patients undergoing breast surgery were selected and analyzed to generate summated data (expressed as risk ratio [RR]) by using RevMan 5.0. Nine randomized controlled trials encompassing 3720 patients undergoing breast surgery were retrieved from the electronic databases. The antibiotics group comprised a total of 1857 patients and non-antibiotics group, 1863 patients. There was no heterogeneity [χ(2) = 7.61, d.f. = 7, p < 0.37; I(2) = 8%] amongst trials. Therefore, in the fixed-effects model (RR, 0.64; 95% CI, 0.50-0.83; z = 3.48; p < 0.0005), the use of preoperative prophylactic antibiotics in patients undergoing breast surgical procedures was statistically significant in reducing the incidence of surgical site infection (SSI). Furthermore, in the fixed-effects model (RR, 1.30; 95% CI, 0.89-1.90; z = 1.37; p < 0.17), adverse reactions secondary to the use of prophylactic antibiotics was not statistically significant between the two groups. Preoperative prophylactic antibiotics significantly reduce the risk of SSI after breast surgical procedures. The risk of adverse reactions from prophylactic antibiotic administration is not significant in these patients. Therefore, preoperative prophylactic antibiotics in breast surgery patients may be routinely administered. Further research is required, however, on risk stratification for SSI, timing and duration of prophylaxis, and the need for prophylaxis in patients undergoing breast reconstruction versus no reconstruction. © 2012 Wiley Periodicals, Inc.

Surgery-Independent Language Function Decline in Patients Undergoing Awake Craniotomy.

PubMed

Gonen, Tal; Sela, Gal; Yanakee, Ranin; Ram, Zvi; Grossman, Rachel

2017-03-01

Despite selection process before awake-craniotomy, some patients experience an unexpected decline in language functions in the operating room (OR), compared with their baseline evaluation, which may impair their functional monitoring. To investigate this phenomenon we prospectively compared language function the day before surgery and on entrance to the OR. Data were collected prospectively from consecutive patients undergoing awake-craniotomy with intraoperative cortical mapping for resection of gliomas affecting language areas. Language functions of 79 patients were evaluated and compared 1-2 days before surgery and after entering the OR. Changes in functional linguistic performance were analyzed with respect to demographic, clinical, and pathologic characteristics. There was a significant decline in language function, beyond sedation effect, after entering the OR, (from median/interquartile range: 0.94/0.72-0.98 to median/interquartile range: 0.86/0.51-0.94; Z = -7.19, P < 0.001). Univariate analyses revealed that this decline was related to age, preoperative Karnofsky Performance Scale, tumor location, tumor pathology, and preexisting language deficits. Multivariate stepwise regression identified tumor pathology and the presence of preoperative language deficit as significant independent predictors for this functional decline. Patients undergoing awake-craniotomy may experience a substantial decline in language functioning after entering the OR. Tumor grade and the presence of preoperative language deficits were significant risk factors for this phenomenon, suggesting a possible relation between cognitive reserve, psychobehavioral coping abilities and histologic features of a tumor involving language areas. Capturing and identifying this unique population of patients who are prone to experience such language decline may improve our ability in the future to select patients eligible for awake-craniotomy. Copyright © 2016 Elsevier Inc. All rights reserved.

Knowledge and expectations of women undergoing cancer genetic risk assessment: a qualitative analysis of free-text questionnaire comments.

PubMed

Phelps, C; Wood, F; Bennett, P; Brain, K; Gray, J

2007-08-01

Individuals undergoing cancer genetic risk assessment have been found to have a poor understanding of the process, which may affect how well they cope with learning their risk. This paper reports free-text data from questionnaires completed by women undergoing a randomised controlled trial of a psychological intervention. Of the 268 women undergoing genetic assessment for familial breast/ovarian cancer risk who were invited to take part in the trial, 157 women returned research questionnaires. Of these, 97 women provided free-text comments upon referral to a cancer genetics clinic, 62 provided comments whilst waiting for risk information (average, moderate or high), and 36 women provided comments following notification of risk. This paper reports a thematic analysis of the free-text data. Themes reflected individuals' poor knowledge and uncertainty about genetic risk assessment. How well individuals responded to learning their risk depended upon whether expectations had been met. Regardless of risk, individuals undergoing cancer genetic risk assessment are likely to benefit from increased information about its process and timescales, and access to increased psychological support. Free-text comments can provide valuable data about individuals' expectations and knowledge of genetics services.

Environmental effects on composite airframes: A study conducted for the ARM UAV Program (Atmospheric Radiation Measurement Unmanned Aerospace Vehicle)

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

Noguchi, R.A.

1994-06-01

Composite materials are affected by environments differently than conventional airframe structural materials are. This study identifies the environmental conditions which the composite-airframe ARM UAV may encounter, and discusses the potential degradation processes composite materials may undergo when subjected to those environments. This information is intended to be useful in a follow-on program to develop equipment and procedures to prevent, detect, or otherwise mitigate significant degradation with the ultimate goal of preventing catastrophic aircraft failure.

Visible-light sensitization of vinyl azides by transition-metal photocatalysis.

PubMed

Farney, Elliot P; Yoon, Tehshik P

2014-01-13

Irradiation of vinyl and aryl azides with visible light in the presence of Ru photocatalysts results in the formation of reactive nitrenes, which can undergo a variety of C-N bond-forming reactions. The ability to use low-energy visible light instead of UV in the photochemical activation of azides avoids competitive photodecomposition processes that have long been a significant limitation on the synthetic use of these reactions. Copyright © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Factors predictive of critical value of hypocalcemia after total parathyroidectomy without autotransplantation in patients with secondary hyperparathyroidism.

PubMed

Yang, Meng; Zhang, Ling; Huang, Linping; Sun, Xiaoliang; Ji, Haoyang; Lu, Yao

2016-09-01

Severe hypocalcemia is the most dangerous complication occurring after total parathyroidectomy without autotransplantation (TPTX) for secondary hyperparathyroidism (SHPT). We aim to identify the prevalence and potential risk factors of very severe hypocalcemia in patients with SHPT undergoing TPTX. From April 2012 to August 2015, 157 patients with SHPT undergoing TPTX were reviewed. The critical value of hypocalcemia (CVH) was postoperative serum Ca(2+) levels of ≤1.5 mmol/L. Univariate analysis showed that patients in the CVH group were significantly younger than those in the non-CVH group. Sex ratio was significantly different between the two groups. The CVH group had significantly higher levels of preoperative PTH and ALP. Male sex and preoperative levels of PTH and ALP were significant independent risk factors by logistic regression analysis. Male sex, preoperative PTH and ALP were significantly associated with CVH in patients with SHPT undergoing TPTX.

Experiences of Spanish women undergoing hysterosalpingography as part of the infertility process: a phenomenological study.

PubMed

Fernández-Sola, Cayetano; Martínez-Caba, María Isabel; Hernández-Padilla, José Manuel; Carmona-Samper, Esther; Granero-Molina, José

2016-02-01

To describe and understand the experiences and perceptions of women who undergo hysterosalpingography as part of the infertility process. Nurses and midwives should conduct research into the emotional aspects of caring for patients undergoing infertility treatment. The hysterosalpingography is considered to be the most feared test in the infertility process and the one about which very little is known. A phenomenological qualitative study. Ten Spanish women who had undergone hysterosalpingography participated in this study. In-depth interviews were carried out between October 2012-May 2013. Data analysis was performed with the help of atlas.ti software to identify emerging themes. The experience of the participants who underwent hysterosalpingography during the infertility process is represented by the following three themes: (1) becoming a mother to feel complete as a person and as a woman, with the subthemes 'maternity as a life objective' and 'maternity in terms of gender identity'; (2) infertility--an intimate experience which provokes negative feelings, with the subthemes 'negative feelings regarding own infertility' and 'infertility as an experience that is little shared with others'; (3) Undergoing hysterosalpingography, with the subthemes 'feelings regarding hysterosalpingography', 'treatment by medical providers' and 'areas for improvement regarding the service given by the providers'. For women who undergo hysterosalpingography, maternity may be seen as a life objective that could identify them as women. Results suggest that although infertility is experienced with negative feelings such as anxiety, frustration and sadness, hysterosalpingography seems to be related with both hope and fear when facing the test. Knowing the experiences of these women could help nurses, midwives and physicians to provide better patient-centred care. © 2016 John Wiley & Sons Ltd.

The role of colonic mast cells and myenteric plexitis in patients with diverticular disease.

PubMed

Bassotti, Gabrio; Villanacci, Vincenzo; Nascimbeni, Riccardo; Antonelli, Elisabetta; Cadei, Moris; Manenti, Stefania; Lorenzi, Luisa; Titi, Amin; Salerni, Bruno

2013-02-01

Gut mast cells represent an important cell population involved in intestinal homeostasis and inflammatory processes. However, their possible role has not to date been investigated in colonic diverticular disease. This study aims to evaluate colonic mast cells in patients undergoing surgery for diverticular disease. Surgical resection samples from 27 patients undergoing surgery for diverticular disease (12 emergency procedures for severe disease and 15 elective procedures) were evaluated. The number of mast cells was assessed in the various layers by means of a specific antibody (tryptase) and compared with those evaluated in ten controls. In patients with mast cells degranulation, double immunohistochemistry, also assessing nerve fibres, was carried out. In addition, the presence of myenteric plexitis was sought. Compared with controls, the number of mast cells in diverticular patients was significantly increased, both as an overall figure and in the various layers of the large bowel. In patients in whom mast cells degranulation was present, these were always closed to nerve fibres. No differences were found between the two subgroups of patients with respect to the number and distribution of mast cells; however, all patients undergoing emergency surgery (but none of those undergoing elective procedures) had myenteric plexitis, represented by lymphocytic infiltration in 67 % and eosinophilic infiltration in 33 % of cases. Patients with diverticular disease display an increase of mast cells in the large bowel. The presence of myenteric plexitis in those with complicated, severe disease, suggest that this could represent a histopathologic marker of more aggressive disease.

The R2R3 MYB Transcription Factors FOUR LIPS and MYB88 Regulate Female Reproductive Development

PubMed Central

Lamb, Rebecca S.

2012-01-01

Gamete formation is an important step in the life cycle of sexually reproducing organisms. In flowering plants, haploid spores are formed after the meiotic division of spore mother cells. These spores develop into male and female gametophytes containing gametes after undergoing mitotic divisions. In the female, the megaspore mother cell undergoes meiosis forming four megaspores, of which one is functional and three degenerate. The megaspore then undergoes three mitotic cycles thus generating an embryo sac with eight nuclei. The embryo sac undergoes cellularization to form the mature seven-celled female gametophyte. Entry into and progression through meiosis is essential for megasporogenesis and subsequent megagametogenesis, but control of this process is not well understood. FOUR LIPS (FLP) and its paralogue MYB88, encoding R2R3 MYB transcription factors, have been extensively studied for their role in limiting the terminal division in stomatal development by direct regulation of the expression of cell cycle genes. Here it is demonstrated that FLP and MYB88 also regulate female reproduction. Both FLP and MYB88 are expressed during ovule development and their loss significantly increases the number of ovules produced by the placenta. Despite the presence of excess ovules, single and double mutants exhibit reduced seed set due to reduced female fertility. The sterility results at least in part from defective meiotic entry and progression. Therefore, FLP and MYB88 are important regulators of entry into megasporogenesis, and probably act via the regulation of cell cycle genes. PMID:22915737

Energy Delivery Systems for Treatment of Benign Prostatic Hyperplasia

PubMed Central

2006-01-01

Executive Summary Objective The Ontario Health Technology Advisory Committee asked the Medical Advisory Secretariat (MAS) to conduct a health technology assessment on energy delivery systems for the treatment of benign prostatic hyperplasia (BPH). Clinical Need: Target Population and Condition BPH is a noncancerous enlargement of the prostate gland and the most common benign tumour in aging men. (1) It is the most common cause of lower urinary tract symptoms (LUTS) and bladder outlet obstruction (BOO) and is an important cause of diminished quality of life among aging men. (2) The primary goal in the management of BPH for most patients is a subjective improvement in urinary symptoms and quality of life. Until the 1930s, open prostatectomy, though invasive, was the most effective form of surgical treatment for BPH. Today, the benchmark surgical treatment for BPH is transurethral resection of the prostate (TURP), which produces significant changes of all subjective and objective outcome parameters. Complications after TURP include hemorrhage during or after the procedure, which often necessitates blood transfusion; transurethral resection (TUR) syndrome; urinary incontinence; bladder neck stricture; and sexual dysfunction. A retrospective review of 4,031 TURP procedures performed by one surgeon between 1979 and 2003 showed that the incidence of complications was 2.4% for blood transfusion, 0.3% for TUR syndrome, 1.5% for hemostatic procedures, 2.8% for bladder neck contracture, and 1% for urinary stricture. However, the incidence of blood transfusion and TUR syndrome decreased as the surgeon’s skills improved. During the 1990s, a variety of endoscopic techniques using a range of energy sources have been developed as alternative treatments for BPH. These techniques include the use of light amplification by stimulated emission of radiation (laser), radiofrequency, microwave, and ultrasound, to heat prostate tissue and cause coagulation or vaporization. In addition, new electrosurgical techniques that use higher amounts of energy to cut, coagulate, and vaporize prostatic tissue have entered the market as competitors to TURP. The driving force behind these new treatment modalities is the potential of producing good hemostasis, thereby reducing catheterization time and length of hospital stay. Some have the potential to be used in an office environment and performed under local anesthesia. Therefore, these new procedures have the potential to rival TURP if their effectiveness is proven over the long term. The Technology Being Reviewed The following energy-based techniques were considered for assessment: transurethral electrovaporization of the prostate (TUVP) transurethral electrovapor resection of the prostate (TUVRP) transurethral electrovaporization of the prostate using bipolar energy (plasmakinetic vaporization of the prostate [PKVP]) visual laser ablation of the prostate (VLAP) transurethral ultrasound guided laser incision prostatectomy (TULIP) contact laser vaporization of the prostate (CLV) interstitial laser coagulation (ILC) holmium laser resection of the prostate (HoLRP) holmium laser enucleation of the prostate (HoLEP) holmium laser ablation of the prostate (HoLAP) potassium titanyl phosphate (KTP) laser transurethral microwave thermotherapy (TUMT) transurethral needle ablation (TUNA) Review Strategy A search of electronic databases (OVID MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, EMBASE, The Cochrane Library, and the International Agency for Health Technology Assessment [INAHTA] database) was undertaken to identify evidence published from January 1, 2000 to June 21, 2006. The search was limited to English-language articles and human studies. The literature search identified 284 citations, of which 38 randomized controlled trials (RCTs) met the inclusion criteria. Since the application of high-power (80 W) KTP laser (photoselective vaporization of the prostate [PVP]) has been supported in the United States and has resulted in a rapid diffusion of this technology in the absence of any RCTs, the MAS decided that any comparative studies on PVP should be identified and evaluated. Hence, the literature was searched and one prospective cohort study (3) was identified but evaluated separately. Findings of Literature Review and Analysis Meta-analysis of the results of RCTs shows that monopolar electrovaporization is as clinically effective as TURP for the relief of urinary symptoms caused by BPH (based on 5-year follow-up data). Meta-analysis of the results of RCTs shows that bipolar electrovaporization (PKVP) is clinically as effective as TURP for the relief of urinary symptoms caused by BPH (based on 1-year follow-up data). Two of the three RCTs on VLAP have shown that patients undergoing VLAP had a significantly lesser improvement in urinary symptom scores compared with patients undergoing TURP. RCTs showed that the time to catheter removal was significantly longer in patients undergoing VLAP compared with patients undergoing TURP. Meta-analysis of the rate of reoperation showed that patients undergoing VLAP had a significantly higher rate of reoperation compared with patients undergoing TURP. Meta-analysis showed that patients undergoing CLV had a significantly lesser improvement in urinary symptom scores compared with TURP at 2 years and at 3 or more years of follow-up. Two RCTs with 6-month and 2-year follow-up showed similar improvement in symptom scores for ILC and TURP. Time to catheter removal was significantly longer in patients undergoing ILC compared with patients undergoing TURP. The results of RCTs on HoLEP with 1-year follow-up showed excellent clinical outcomes with regard to the urinary symptom score and peak urinary flow. Meta-analysis showed that at 1-year follow-up, patients undergoing HoLEP had a significantly greater improvement in urinary symptom scores and peak flow rate compared with patients undergoing TURP. Procedural time is significantly longer in HoLEP compared with TURP. The results of one RCT with 4-year follow-up showed that HoLRP and TURP provided equivalent improvement in urinary symptom scores. The results of one RCT with 1-year follow-up showed that patients undergoing KTP had a lesser improvement in urinary symptom scores than did patients undergoing TURP. However, the results were not significant at longer-term follow-up periods. Two RCTs that provided 3-year follow-up data reported that patients undergoing TUMT had a significantly lesser improvement in symptom score compared with patients undergoing TURP. RCTs reported a longer duration of catheterization for TUMT compared with TURP (P values are not reported). The results of a large RCT with 5-year follow-up showed a significantly lesser improvement in symptom scores in patients undergoing TUNA compared with patients undergoing TURP. Meta-analysis of the rate of reoperation showed that patients undergoing TUNA had a significantly higher rate of reoperation compared with patients undergoing TURP. Based on the results of RCTs, TURP is associated with a 0.5% risk of TUR syndrome, while no cases of TUR syndrome have been reported in patients undergoing monopolar or bipolar electrovaporization, laser-based procedures, TUMT, or TUNA. Based on the results of RCTs, the rate of blood transfusion ranges from 0% to 8.3% in patients undergoing TURP. The rate is about 1.7% in monopolar electrovaporization, 1.4% in bipolar electrovaporization, and 0.4% in the VLAP procedure. No patients undergoing CLV, ILC, HoLEP, HoLRP, KTP, TUMT, and TUNA required blood transfusion. The mean length of hospital stay is between 2 and 5 days for patients undergoing TURP, about 3 days for electrovaporization, about 2 to 4 days for Nd:YAG laser procedures, and about 1 to 2 days for holmium laser procedures. TUMT and TUNA can each be performed as a day procedure in an outpatient setting (0.5 and 1 day respectively). Based on a prospective cohort study, PVP is clinically as effective as TURP for the relief of urinary symptoms caused by BPH (based on 6-month follow-up data). Time to catheter removal was significantly shorter in patients undergoing PVP than in those undergoing TURP. Operating room time was significantly longer in PVP than in TURP. PVP has the potential to reduce health care expenses due to shorter hospital stays. Economic Analysis In the three most recent fiscal years (FY) reported, an average of approximately 5,000 TURP procedures per year were performed in Ontario. From FY 2002 to FY 2004, the total number of surgical interventions decreased by approximately 500 procedures. During this time, the increase in costs of drugs to the government was estimated at approximately $10 million (Cdn); however, there was a concurrent decrease in costs due to a decline in the total number of surgical procedures, estimated at approximately $1.9 million (Cdn). From FY 2002 to FY 2004, the increase in costs associated with the increase in utilization of drugs for the treatment of BPH translates into $353 (Cdn) per patient while the cost savings associated with a decrease in the total number of surgical procedures translates into a savings of $3,906 (Cdn) per patient. The following table summarizes the change in the current budget, depending on various estimates of the total percentage of the 5,000 TURP procedures that might be replaced by other energy-based interventions for the treatment of BPH in the future. Executive Summary Table 1: Budget Impact With Various Estimates of the Percentage of TURP Procedures Captured by Energy-based Interventions for the Treatment of BPH Technology Cost perprocedure, $ Budget Impact of 25% diffusion, $M Budget Impact of 50% diffusion, $M Budget Impact of 75% diffusion, $M Budget Impact of 100% diffusion, $M Incremental Budget Impact, $M TURP 3,887 19.4 Bipolar Electrovaporization 4,011 19.6 19.7 19.9 20.0 0.6 Monopolar Electrovaporization 4,130 19.7 20.0 20.3 20.6 1.2 TUMT 1,529 16.5 13.5 10.6 7.6 (11.8)  TUNA 4,804 20.6 21.7 22.9 24.0 4.6 PVP 1,184 16.0 12.7 9.3 5.9 (13.5)   Holmium Laser 3,892 19.4 19.4 19.4 19.4 0.02 VLAP Nd:YAG 4,663 20.4 21.4 22.3 23.3 3.9 CLAP Nd:YAG 4,615 20.3 21.2 22.4 23.0 3.6 * All costs are in Canadian currency. Parentheses indicative of cost reduction. PMID:23074487

A registry-based randomized trial comparing radial and femoral approaches in women undergoing percutaneous coronary intervention: the SAFE-PCI for Women (Study of Access Site for Enhancement of PCI for Women) trial.

PubMed

Rao, Sunil V; Hess, Connie N; Barham, Britt; Aberle, Laura H; Anstrom, Kevin J; Patel, Tejan B; Jorgensen, Jesse P; Mazzaferri, Ernest L; Jolly, Sanjit S; Jacobs, Alice; Newby, L Kristin; Gibson, C Michael; Kong, David F; Mehran, Roxana; Waksman, Ron; Gilchrist, Ian C; McCourt, Brian J; Messenger, John C; Peterson, Eric D; Harrington, Robert A; Krucoff, Mitchell W

2014-08-01

This study sought to determine the effect of radial access on outcomes in women undergoing percutaneous coronary intervention (PCI) using a registry-based randomized trial. Women are at increased risk of bleeding and vascular complications after PCI. The role of radial access in women is unclear. Women undergoing cardiac catheterization or PCI were randomized to radial or femoral arterial access. Data from the CathPCI Registry and trial-specific data were merged into a final study database. The primary efficacy endpoint was Bleeding Academic Research Consortium type 2, 3, or 5 bleeding or vascular complications requiring intervention. The primary feasibility endpoint was access site crossover. The primary analysis cohort was the subgroup undergoing PCI; sensitivity analyses were conducted in the total randomized population. The trial was stopped early for a lower than expected event rate. A total of 1,787 women (691 undergoing PCI) were randomized at 60 sites. There was no significant difference in the primary efficacy endpoint between radial or femoral access among women undergoing PCI (radial 1.2% vs. 2.9% femoral, odds ratio [OR]: 0.39; 95% confidence interval [CI]: 0.12 to 1.27); among women undergoing cardiac catheterization or PCI, radial access significantly reduced bleeding and vascular complications (0.6% vs. 1.7%; OR: 0.32; 95% CI: 0.12 to 0.90). Access site crossover was significantly higher among women assigned to radial access (PCI cohort: 6.1% vs. 1.7%; OR: 3.65; 95% CI: 1.45 to 9.17); total randomized cohort: (6.7% vs. 1.9%; OR: 3.70; 95% CI: 2.14 to 6.40). More women preferred radial access. In this pragmatic trial, which was terminated early, the radial approach did not significantly reduce bleeding or vascular complications in women undergoing PCI. Access site crossover occurred more often in women assigned to radial access. (SAFE-PCI for Women; NCT01406236). Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

The effects of aromatherapy on pruritus in patients undergoing hemodialysis.

PubMed

Ro, You-Ja; Ha, Hyae-Chung; Kim, Chun-Gill; Yeom, Hye-A

2002-08-01

This study was designed to investigate the effects of aromatherapy on pruritus in patients with chronic renal failure undergoing hemodialysis. The participants were 29 adult patients living in Seoul, Korea. Thirteen patients were assigned to the experimental group and received the aromatherapy massage on the arm 3 times a week for 4 weeks. Pruritus score, skin pH, stratum corneum hydration, and pruritus-related biochemical markers were measured before and after the treatment. The results showed that pruritus score was significantly decreased after aromatherapy. Skin pH showed no significant changes in either group while stratum corneum hydration increased significantly in the experimental group after aromatherapy. The results support the use aromatherapy as a useful and effective method of managing pruritus in patients undergoing hemodialysis.

Bio-Derived, Binderless, Hierarchically Porous Carbon Anodes for Li-ion Batteries

NASA Astrophysics Data System (ADS)

Campbell, Brennan; Ionescu, Robert; Favors, Zachary; Ozkan, Cengiz S.; Ozkan, Mihrimah

2015-09-01

Here we explore the electrochemical performance of pyrolyzed skins from the species A. bisporus, also known as the Portobello mushroom, as free-standing, binder-free, and current collector-free Li-ion battery anodes. At temperatures above 900 °C, the biomass-derived carbon nanoribbon-like architectures undergo unique processes to become hierarchically porous. During heat-treatment, the oxygen and heteroatom-rich organics and potassium compounds naturally present in the mushroom skins play a mutual role in creating inner void spaces throughout the resulting carbon nanoribbons, which is a process analogous to KOH-activation of carbon materials seen in literature. The pores formed in the pyrolytic carbon nanoribbons range in size from sub-nanometer to tens of nanometers, making the nanoribbons micro, meso, and macroporous. Detailed studies were conducted on the carbon nanoribbons using SEM and TEM to study morphology, as well as XRD and EDS to study composition. The self-supporting nanoribbon anodes demonstrate significant capacity increase as they undergo additional charge/discharge cycles. After a pyrolysis temperature of 1100 °C, the pristine anodes achieve over 260 mAh/g after 700 cycles and a Coulombic efficiency of 101.1%, without the use of harmful solvents or chemical activation agents.

Bio-Derived, Binderless, Hierarchically Porous Carbon Anodes for Li-ion Batteries.

PubMed

Campbell, Brennan; Ionescu, Robert; Favors, Zachary; Ozkan, Cengiz S; Ozkan, Mihrimah

2015-09-29

Here we explore the electrochemical performance of pyrolyzed skins from the species A. bisporus, also known as the Portobello mushroom, as free-standing, binder-free, and current collector-free Li-ion battery anodes. At temperatures above 900 °C, the biomass-derived carbon nanoribbon-like architectures undergo unique processes to become hierarchically porous. During heat-treatment, the oxygen and heteroatom-rich organics and potassium compounds naturally present in the mushroom skins play a mutual role in creating inner void spaces throughout the resulting carbon nanoribbons, which is a process analogous to KOH-activation of carbon materials seen in literature. The pores formed in the pyrolytic carbon nanoribbons range in size from sub-nanometer to tens of nanometers, making the nanoribbons micro, meso, and macroporous. Detailed studies were conducted on the carbon nanoribbons using SEM and TEM to study morphology, as well as XRD and EDS to study composition. The self-supporting nanoribbon anodes demonstrate significant capacity increase as they undergo additional charge/discharge cycles. After a pyrolysis temperature of 1100 °C, the pristine anodes achieve over 260 mAh/g after 700 cycles and a Coulombic efficiency of 101.1%, without the use of harmful solvents or chemical activation agents.

The role of electrostatics and temperature on morphological transitions of hydrogel nanostructures self-assembled by peptide amphiphiles via molecular dynamics simulations.

PubMed

Fu, Iris W; Markegard, Cade B; Chu, Brian K; Nguyen, Hung D

2013-10-01

Smart biomaterials that are self-assembled from peptide amphiphiles (PA) are known to undergo morphological transitions in response to specific physiological stimuli. The design of such customizable hydrogels is of significant interest due to their potential applications in tissue engineering, biomedical imaging, and drug delivery. Using a novel coarse-grained peptide/polymer model, which has been validated by comparison of equilibrium conformations from atomistic simulations, large-scale molecular dynamics simulations are performed to examine the spontaneous self-assembly process. Starting from initial random configurations, these simulations result in the formation of nanostructures of various sizes and shapes as a function of the electrostatics and temperature. At optimal conditions, the self-assembly mechanism for the formation of cylindrical nanofibers is deciphered involving a series of steps: (1) PA molecules quickly undergo micellization whose driving force is the hydrophobic interactions between alkyl tails; (2) neighboring peptide residues within a micelle engage in a slow ordering process that leads to the formation of β-sheets exposing the hydrophobic core; (3) spherical micelles merge together through an end-to-end mechanism to form cylindrical nanofibers that exhibit high structural fidelity to the proposed structure based on experimental data. As the temperature and electrostatics vary, PA molecules undergo alternative kinetic mechanisms, resulting in the formation of a wide spectrum of nanostructures. A phase diagram in the electrostatics-temperature plane is constructed delineating regions of morphological transitions in response to external stimuli. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

The impact of atosiban on pregnancy outcomes in women undergoing in vitro fertilization-embryo transfer: A meta-analysis

PubMed Central

Huang, Qian-Yi; Rong, Min-Hua; Lan, Ai-Hua; Lin, Xiao-Miao; Lin, Xing-Gu; He, Rong-Quan; Chen, Gang; Li, Mu-Jun

2017-01-01

Background Atosiban is administered to women undergoing in vitro fertilization-embryo transfer (IVF-ET) to improve pregnancy outcomes. However, the results of this treatment were controversial. We conducted this meta-analysis to investigate whether atosiban improves pregnancy outcomes in the women undergoing in vitro fertilization (IVF). Methods Databases of PubMed, EMBASE, Web of Science, China BioMedicine, and Google Scholar were systematically searched. Meta-analyses were performed to investigate whether atosiban improves pregnancy outcomes in the women undergoing IVF. Results Our results showed that atosiban was associated with higher implantation (OR = 1.63, 95% CI: 1.17–2.27; P = 0.004) and clinical pregnancy (OR = 1.84, 95% CI: 1.31–2.57; P < 0.001) rates. However, atosiban showed no significant association with the miscarriage, live birth, multiple pregnancy or ectopic pregnancy rates. When a further subgroup analysis was performed in the women undergoing repeated implantation failure (RIF), implantation (OR = 1.93, 95% CI: 1.45–2.57; P < 0.001), clinical pregnancy (OR = 2.48, 95% CI: 1.70–3.64; P <0.001) and the live birth (OR = 2.89, 95% CI: 1.78–4.67; P < 0.001) rates were significantly higher in the case group. Nevertheless, no significant difference was detected in the miscarriage and multiple pregnancy rates between the case and control groups. Conclusion Atosiban may be more appropriate for women undergoing RIF and play only a limited role in improving pregnancy outcomes in the general population of women undergoing IVF. These conclusions should be verified in large and well-designed studies. PMID:28422984

Impact of prior permanent pacemaker on long-term clinical outcomes of patients undergoing percutaneous coronary intervention.

PubMed

Li, Yan-Jie; Zhang, Wei-Wei; Yang, Xiao-Xiao; Li, Ning; Qiu, Xing-Biao; Qu, Xin-Kai; Fang, Wei-Yi; Yang, Yi-Qing; Li, Ruo-Gu

2017-04-01

The impact of permanent pacemaker (PPM) on long-term clinical outcomes of patients undergoing percutaneous coronary intervention (PCI) has not been studied. PPM may increase heart failure (HF) burden on patients undergoing PCI. We recruited consecutive patients undergoing PCI and carried out a nested case-control study. Patients with confirmed PPM undergoing first PCI were identified and matched by age and sex in 1:1 fashion to patients without PPM undergoing first PCI. Clinical data were collected and analyzed. The primary endpoint outcomes were all-cause mortality and hospitalization for HF. The final analysis included 156 patients. The mean follow-up period was 4.6 ± 2.9 years. The overall all-cause mortality was 21.15%, without significant difference between the 2 groups (21.79% vs 20.51%; P = 0.85). However, the rate of HF-related hospitalization was significantly higher in patients with PPM than in controls (26.92% vs 10.26%; P = 0.008). After adjustment for hypertension, type 2 diabetes mellitus, hyperlipidemia, chronic kidney disease, stroke, left ventricular ejection fraction, brain natriuretic peptide, and acute coronary syndrome (ACS), PCI patients with PPM were still associated with a greater hospitalization rate for HF (odds ratio: 4.31, 95% confidence interval: 0.94-19.80, P = 0.061). Further analysis in the ACS subgroup showed VVI-mode pacing enhanced the risk for HF-associated hospitalization (adjusted odds ratio: 8.27, 95% confidence interval: 1.37-49.75, P = 0.02). PPM has no effect on all-cause mortality in patients undergoing first PCI but significantly increases the HF-associated hospitalization rate, especially in ACS patients. © 2016 Wiley Periodicals, Inc.

A preliminary study of the relationship between the long arm of the Y chromosome (Yqh+) and reproductive outcomes in IVF/ICSI-ET.

PubMed

Xiao, Zhuoni; Zhou, Xin; Xu, Wangming; Yang, Jing

2012-11-01

To compare the reproductive outcomes of Yqh+-carrying and control couples undergoing IVF/ICSI treatments. Retrospective analysis of 72 Yqh+ carriers and 986 Yqh+ non-carriers undergoing their first cycle of ART in a single centre between August 2005 and May 2011. Yqh+ carrying couples had significantly worse reproductive outcomes compared with control couples undergoing IVF treatment. There were a significantly higher cancellation rate (20.69% vs 7.9%; P<0.05; OR, 3.03; CI, 1.18-7.79) and a significant lower fertilisation rate (50.05% vs 66.01%; P<0.05; OR, 0.61; CI, 0.49-0.57), implantation rate (8.33% vs 20.87%; P<0.05; OR, 0.35; CI, 0.14-0.87), good quality embryo ratio (44.70% vs 57.89%; P<0.05; OR, 0.59; CI, 0.43-0.80) and clinical pregnancy rate (17.39% vs 39.59%; P<0.05; OR, 0.32; CI, 0.11-0.96) in Yqh+ group compared with control group undergoing IVF treatment. Yqh+ carrying couples had similar reproductive outcomes compared with control couples undergoing ICSI treatment. The Y chromosome polymorphic variant Yqh+ most likely plays a role in infertility. Yqh+ couples with poor reproductive outcomes in IVF treatment can be advised to undergo ICSI to improve their reproductive results in the next cycle. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

[Evaluation of psychological fear in children undergoing head-up tilt test].

PubMed

Chu, Wei-Hong; Wu, Li-Jia; Wang, Cheng; Lin, Ping; Li, Fang; Zhu, Li-Ping; Ran, Jing; Zou, Run-Mei; Liu, De-Yu

2014-03-01

To investigate the effects of different tilt angles of head-up tilt test (HUTT) and different responses to HUTT on the psychological fear in children undergoing the test. HUTT was performed on children with unexplained syncope or pre-syncope (107 cases: 52 males and 55 females), aged 5.5-17.8 years (mean 12.0±2.8 years). All subjects were randomly assigned to undergo HUTT at an angle of 60°, 70° or 80°; the negative cases underwent sublingual nitroglycerin-provocation HUTT at the same tilt angle. The Wong-Baker Faces Pain Rating Scale was used for self-assessment of psychological fear in subjects during HUTT at the end point of the test. The positive rate, hemodynamic changes and distribution of response types showed no significant differences between children at tilt angles of 60°, 70° and 80° (P>0.05). The greater the tilt angle, the higher the degree of psychological fear in children undergoing the test, but there were no significant differences between them (P>0.05). The degree of psychological fear in children who showed a positive response to HUTT (n=76) was significantly higher than that in children who showed a negative response (n=31) (P<0.01). HUTT can cause psychological fear in children undergoing the test, and the degree of psychological fear increases in children tested at tilt angles from 60° to 80°, but the differences have no statistical significance. A positive response to HUTT can significantly increase the psychological fear in children.

Structural and chemical evolution of the CdS:O window layer during individual CdTe solar cell processing steps

DOE PAGES

Abbas, A.; Meysing, D. M.; Reese, M. O.; ...

2017-12-01

Oxygenated cadmium sulfide (CdS:O) is often used as the n-type window layer in high-performance CdTe heterojunction solar cells. The as-deposited layer prepared by reactive sputtering is XRD amorphous, with a bulk composition of CdS0.8O1.2. Recently it was shown that this layer undergoes significant transformation during device fabrication, but the roles of the individual high temperature processing steps was unclear. In this work high resolution transmission electron microscopy coupled to elemental analysis was used to understand the evolution of the heterojunction region through the individual high temperature fabrication steps of CdTe deposition, CdCl2 activation, and back contact activation. It is foundmore » that during CdTe deposition by close spaced sublimation at 600 degrees C the CdS:O film undergoes recrystallization, accompanied by a significant (~30%) reduction in thickness. It is observed that oxygen segregates during this step, forming a bi-layer morphology consisting of nanocrystalline CdS adjacent to the tin oxide contact and an oxygen-rich layer adjacent to the CdTe absorber. This bilayer structure is then lost during the 400 degrees C CdCl2 treatment where the film transforms into a heterogeneous structure with cadmium sulfate clusters distributed randomly throughout the window layer. The thickness of window layer remains essentially unchanged after CdCl2 treatment, but a ~25 nm graded interfacial layer between CdTe and the window region is formed. Finally, the rapid thermal processing step used to activate the back contact was found to have a negligible impact on the structure or composition of the heterojunction region.« less

Structural and chemical evolution of the CdS:O window layer during individual CdTe solar cell processing steps

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

Abbas, A.; Meysing, D. M.; Reese, M. O.

Oxygenated cadmium sulfide (CdS:O) is often used as the n-type window layer in high-performance CdTe heterojunction solar cells. The as-deposited layer prepared by reactive sputtering is XRD amorphous, with a bulk composition of CdS0.8O1.2. Recently it was shown that this layer undergoes significant transformation during device fabrication, but the roles of the individual high temperature processing steps was unclear. In this work high resolution transmission electron microscopy coupled to elemental analysis was used to understand the evolution of the heterojunction region through the individual high temperature fabrication steps of CdTe deposition, CdCl2 activation, and back contact activation. It is foundmore » that during CdTe deposition by close spaced sublimation at 600 degrees C the CdS:O film undergoes recrystallization, accompanied by a significant (~30%) reduction in thickness. It is observed that oxygen segregates during this step, forming a bi-layer morphology consisting of nanocrystalline CdS adjacent to the tin oxide contact and an oxygen-rich layer adjacent to the CdTe absorber. This bilayer structure is then lost during the 400 degrees C CdCl2 treatment where the film transforms into a heterogeneous structure with cadmium sulfate clusters distributed randomly throughout the window layer. The thickness of window layer remains essentially unchanged after CdCl2 treatment, but a ~25 nm graded interfacial layer between CdTe and the window region is formed. Finally, the rapid thermal processing step used to activate the back contact was found to have a negligible impact on the structure or composition of the heterojunction region.« less

[The health of adults undergoing an eviction process].

PubMed

Bolívar Muñoz, Julia; Bernal Solano, Mariola; Mateo Rodríguez, Inmaculada; Daponte Codina, Antonio; Escudero Espinosa, Cecilia; Sánchez Cantalejo, Carmen; González Usera, Isis; Robles Ortega, Humbelina; Mata Martín, José Luis; Fernández Santaella, M Carmen; Vila Castellar, Jaime

2016-01-01

To analyze perceived health status and other health-related indicators in the adult population in Granada (Spain) undergoing an eviction process from their homes, whether rented or owned, in comparison with health indicators in the general adult population in Andalusia. A cross-sectional survey was administered by trained staff. The survey included instruments from the Andalusian Health Survey 2011 for measuring variables related to physical and mental health, as well as health-related habits. We compared the results with those obtained from the Andalusian general population through the Andalusian Health Survey. A bivariate analysis using the χ2 test and a multivariate logistic regression analysis were conducted. We obtained a total sample of 205 people in the process of eviction. A total of 59.5% (n=122) were women, and 40.5% (n=83) were men. Participants were more likely to have poor health (odds ratio [OR]: 12.63, 95% confidence interval [95%CI]: 8.74-18.27), have cardiovascular diseases (OR: 3.08; 95%CI: 1.54- 6.16), or to smoke (OR: 1.68; 95% CI: 1.21-2.33) compared with the Andalusian general population. Most of the health indicators analyzed showed a worse outcome for women undergoing an eviction process. Our results suggest that, in the current context of economic crisis, people undergoing a process of eviction in Granada and its metropolitan area show poorer health than the Andalusian general population. Further research is needed on health and evictions from different methodological approaches, for a better understanding of the topic. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

Emotional resistance building: how family members of loved ones undergoing chemotherapy treatment process their fear of emotional collapse.

PubMed

McCarthy, Bridie; Andrews, Tom; Hegarty, Josephine

2015-04-01

To explore family members' experiences when their loved one is undergoing chemotherapy treatment as an outpatient for newly diagnosed colorectal cancer and to develop an explanatory theory of how they process their main concern. Most individuals with cancer are now treated as outpatients and cared for by family members. International research highlights the many side effects of chemotherapy, which in the absence of specific information and/or experience can be difficult for family members to deal with. Unmet needs can have an impact on the health of both patients and family members. Classic grounded theory methodology was used for this study. Using classic grounded theory methodology, family members (n = 35) of patients undergoing chemotherapy treatment for cancer were interviewed (June 2010-July 2011). Data were analysed using the concurrent processes of constant comparative analysis, data collection, theoretical sampling and memo writing. The main concern that emerged for participants was fear of emotional collapse. This fear was dealt with through a process conceptualized as 'Emotional Resistance Building'. This is a basic social process with three phases: 'Figuring out', 'Getting on with it' and 'Uncertainty adjustment'. The phases are not linear, but interrelated as participants can be in any one or more of the phases at any one time. This theory has the potential to be used by healthcare professionals working in oncology to support family members of patients undergoing chemotherapy. New ways of supporting family members through this most difficult and challenging period are articulated within this theory. © 2014 John Wiley & Sons Ltd.

Factors Related to Intention to Undergo Female Sterilization Among Married Women in Rural Kathmandu, Nepal

PubMed Central

Nanthamongkolchai, Sutham; Pitikultang, Supachai

2016-01-01

Background: Sterilization is most widely used fertility regulation method in Nepal. However, prevalence of uptake of female sterilization in central hilly region is less than the national average. The objective of the study was to explore the number and factors related to intention of married women to undergo female sterilization in rural Kathmandu which lies within central hilly region. Materials and Methods: This is a community based cross-sectional survey research conducted in rural area of Kathmandu valley. Two hundred and forty currently married women with at least one child of any age were interviewed using a structured pre-tested questionnaire. Results: More than four-fifth of the respondents intended to undergo sterilization. Almost two-third of them wanted to limit their family size by taking this option. More than one-third of women not-intending to undergo sterilization feared weakness after sterilization. Age of the respondents, duration of marriage, and number of living children were significantly associated with intention to undergo sterilization. 15-24 years age group were six times more likely to have the intention for sterilization (OR 6.79, CI 2.28-20.19) compared to age 35 years and above group. Mothers with less than 3 living children are about three times more likely to have the intention to undergo sterilization (OR 2.87, CI 1.3-6.33) compared to women with more than 2 living children. Women married for 6 to 10 years were three times more likely to have the intention (OR 3.0, CI 1.09-8.27). However, gender of the living children was not associated with intention to undergo sterilization. Conclusion: There were significant numbers of women intending to undergo sterilization. Age of the mother, number of living children and the duration of marriage were found to be significantly influencing the intention to undergo sterilization. However, as intention refers to future plan, the respondents’ intention may change over time. The national family planning program also needs to identify the key factors in accepting the sterilization and target these women to increase utilization. PMID:27152235

Intratumoral bidirectional transitions between epithelial and mesenchymal cells in triple-negative breast cancer.

PubMed

Yamamoto, Mizuki; Sakane, Kota; Tominaga, Kana; Gotoh, Noriko; Niwa, Takayoshi; Kikuchi, Yasuko; Tada, Keiichiro; Goshima, Naoki; Semba, Kentaro; Inoue, Jun-Ichiro

2017-06-01

Epithelial-mesenchymal transition (EMT) and its reverse process, mesenchymal-epithelial transition MET, are crucial in several stages of cancer metastasis. Epithelial-mesenchymal transition allows cancer cells to move to proximal blood vessels for intravasation. However, because EMT and MET processes are dynamic, mesenchymal cancer cells are likely to undergo MET transiently and subsequently re-undergo EMT to restart the metastatic process. Therefore, spatiotemporally coordinated mutual regulation between EMT and MET could occur during metastasis. To elucidate such regulation, we chose HCC38, a human triple-negative breast cancer cell line, because HCC38 is composed of epithelial and mesenchymal populations at a fixed ratio even though mesenchymal cells proliferate significantly more slowly than epithelial cells. We purified epithelial and mesenchymal cells from Venus-labeled and unlabeled HCC38 cells and mixed them at various ratios to follow EMT and MET. Using this system, we found that the efficiency of EMT is approximately an order of magnitude higher than that of MET and that the two populations significantly enhance the transition of cells from the other population to their own. In addition, knockdown of Zinc finger E-box-binding homeobox 1 (ZEB1) or Zinc finger protein SNAI2 (SLUG) significantly suppressed EMT but promoted partial MET, indicating that ZEB1 and SLUG are crucial to EMT and MET. We also show that primary breast cancer cells underwent EMT that correlated with changes in expression profiles of genes determining EMT status and breast cancer subtype. These changes were very similar to those observed in EMT in HCC38 cells. Consequently, we propose HCC38 as a suitable model to analyze EMT-MET dynamics that could affect the development of triple-negative breast cancer. © 2017 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.

Design and Manufacture of Conical Shell Structures Using Prepreg Laminates

NASA Astrophysics Data System (ADS)

Khakimova, Regina; Burau, Florian; Degenhardt, Richard; Siebert, Mark; Castro, Saullo G. P.

2016-06-01

The design and manufacture of unstiffened composite conical structures is very challenging, as the variation of the fiber orientations, lay-up and the geometry of the ply pieces have a significant influence on the thickness imperfections and ply angle deviations imprinted to the final part. This paper deals with the manufacture of laminated composite cones through the prepeg/autoclave process. The cones are designed to undergo repetitive buckling tests without accumulating permanent damage. The aim is to define a process that allows the control of fiber angle deviations and the removal of thickness imperfections generated from gaps and overlaps between ply pieces. Ultrasonic scan measurements are used to proof the effectiveness of the proposed method.

Repair of the threatened feminine identity: experience of women with cervical cancer undergoing fertility preservation surgery.

PubMed

Komatsu, Hiroko; Yagasaki, Kaori; Shoda, Rie; Chung, Younghui; Iwata, Takashi; Sugiyama, Juri; Fujii, Takuma

2014-01-01

Fertility preservation is important for women of reproductive age with cervical cancer. The underlying reasons behind suboptimal reproductive results after successful fertility-preserving surgery have not yet been fully revealed. The objective of this study was to explore the experience of fertility preservation with radical trachelectomy from the perspective of women with cervical cancer. We conducted interviews with women with cervical cancer who underwent radical trachelectomy using a Grounded Theory methodology with a theoretical framework of symbolic interactionism. Our findings articulate a process in which feminine identity is first threatened by a diagnosis of cancer, then repaired by fertility preservation with radical trachelectomy, and finally reconstructed after the surgery, through interactions with self, others, and external events in women with cervical cancer. Feeling incomplete as a woman because of the loss of the uterus was a critical factor in the women's feeling that their feminine identity was threatened. Thus, fertility preservation was significant for these women. The meaning of fertility preservation varied among the women, and their life perspectives were therefore distinct after the surgery. Women with cervical cancer who undergo radical trachelectomy experience an identity transformation process, and child bearing is not the only expected outcome of fertility preservation. Nurses should coordinate care through the cancer trajectory. Understanding the identity transformation process helps nurses to assess patients' needs and provide appropriate individual care.

Protective Effects of Trehalose on the Corneal Epithelial Cells

PubMed Central

Aragona, Pasquale; Colosi, Pietro; Colosi, Francesca; Pisani, Antonina; Puzzolo, Domenico; Micali, Antonio

2014-01-01

Purpose. Aim of the present work was to evaluate the effects of the trehalose on the corneal epithelium undergoing alcohol delamination. Methods. Twelve patients undergoing laser subepithelial keratomileusis (LASEK) were consecutively included in the study. The right eyes were pretreated with 3% trehalose eye drops, whilst left eyes were used as control. Epithelial specimens were processed for cells vitality assessment, apoptosis, and light and transmission electron microscopy; a morphometric analysis was performed in both groups. Results. In both trehalose-untreated eyes (TUE) and trehalose-treated eyes (TTE), the percentage of vital cells was similar and no apoptotic cells were observed. In TUE, the corneal epithelium showed superficial cells with reduced microfolds, wing cells with vesicles and dilated intercellular spaces, and dark basal cells with vesicles and wide clefts. In TTE, superficial and wing cells were better preserved, and basal cells were generally clear with intracytoplasmatic vesicles. The morphometric analysis showed statistically significant differences between the two groups: the TTE epithelial height was higher, the basal cells showed larger area and clearer cytoplasm. The distribution of desmosomes and hemidesmosomes was significantly different between the groups. Conclusions. Trehalose administration better preserved morphological and morphometric features of alcohol-treated corneal epithelium, when compared to controls. PMID:25045743

Protective effects of trehalose on the corneal epithelial cells.

PubMed

Aragona, Pasquale; Colosi, Pietro; Rania, Laura; Colosi, Francesca; Pisani, Antonina; Puzzolo, Domenico; Micali, Antonio

2014-01-01

Aim of the present work was to evaluate the effects of the trehalose on the corneal epithelium undergoing alcohol delamination. Twelve patients undergoing laser subepithelial keratomileusis (LASEK) were consecutively included in the study. The right eyes were pretreated with 3% trehalose eye drops, whilst left eyes were used as control. Epithelial specimens were processed for cells vitality assessment, apoptosis, and light and transmission electron microscopy; a morphometric analysis was performed in both groups. In both trehalose-untreated eyes (TUE) and trehalose-treated eyes (TTE), the percentage of vital cells was similar and no apoptotic cells were observed. In TUE, the corneal epithelium showed superficial cells with reduced microfolds, wing cells with vesicles and dilated intercellular spaces, and dark basal cells with vesicles and wide clefts. In TTE, superficial and wing cells were better preserved, and basal cells were generally clear with intracytoplasmatic vesicles. The morphometric analysis showed statistically significant differences between the two groups: the TTE epithelial height was higher, the basal cells showed larger area and clearer cytoplasm. The distribution of desmosomes and hemidesmosomes was significantly different between the groups. Trehalose administration better preserved morphological and morphometric features of alcohol-treated corneal epithelium, when compared to controls.

Cognitive ability is heritable and predicts the success of an alternative mating tactic

PubMed Central

Smith, Carl; Philips, André; Reichard, Martin

2015-01-01

The ability to attract mates, acquire resources for reproduction, and successfully outcompete rivals for fertilizations may make demands on cognitive traits—the mechanisms by which an animal acquires, processes, stores and acts upon information from its environment. Consequently, cognitive traits potentially undergo sexual selection in some mating systems. We investigated the role of cognitive traits on the reproductive performance of male rose bitterling (Rhodeus ocellatus), a freshwater fish with a complex mating system and alternative mating tactics. We quantified the learning accuracy of males and females in a spatial learning task and scored them for learning accuracy. Males were subsequently allowed to play the roles of a guarder and a sneaker in competitive mating trials, with reproductive success measured using paternity analysis. We detected a significant interaction between male mating role and learning accuracy on reproductive success, with the best-performing males in maze trials showing greater reproductive success in a sneaker role than as a guarder. Using a cross-classified breeding design, learning accuracy was demonstrated to be heritable, with significant additive maternal and paternal effects. Our results imply that male cognitive traits may undergo intra-sexual selection. PMID:26041347

Cognitive ability is heritable and predicts the success of an alternative mating tactic.

PubMed

Smith, Carl; Philips, André; Reichard, Martin

2015-06-22

The ability to attract mates, acquire resources for reproduction, and successfully outcompete rivals for fertilizations may make demands on cognitive traits--the mechanisms by which an animal acquires, processes, stores and acts upon information from its environment. Consequently, cognitive traits potentially undergo sexual selection in some mating systems. We investigated the role of cognitive traits on the reproductive performance of male rose bitterling (Rhodeus ocellatus), a freshwater fish with a complex mating system and alternative mating tactics. We quantified the learning accuracy of males and females in a spatial learning task and scored them for learning accuracy. Males were subsequently allowed to play the roles of a guarder and a sneaker in competitive mating trials, with reproductive success measured using paternity analysis. We detected a significant interaction between male mating role and learning accuracy on reproductive success, with the best-performing males in maze trials showing greater reproductive success in a sneaker role than as a guarder. Using a cross-classified breeding design, learning accuracy was demonstrated to be heritable, with significant additive maternal and paternal effects. Our results imply that male cognitive traits may undergo intra-sexual selection. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

Establishment of reference values for various coagulation tests in healthy Florida manatees (Trichechus manatus latirostris) and evaluation of coagulation in debilitated manatees during rehabilitation.

PubMed

Gerlach, Trevor J; Bandt, Carsten; Conner, Bobbi; Ball, Ray L

2015-11-01

To establish reference ranges for coagulation parameters in healthy Florida manatees (Trichechus manatus latirostris) and compare results with those for debilitated manatees undergoing treatment at a rehabilitation facility. Prospective study. 29 healthy manatees and 45 debilitated manatees with various diseases. Manatees considered healthy on the basis of results of physical examination, CBC, and serum biochemical analysis underwent coagulation testing including measurement of prothrombin time, partial thromboplastin time, D-dimer concentration, platelet count, and fibrinogen concentration to establish reference ranges. For comparison, a group of manatees undergoing rehabilitation was also tested, and the results were compared. Thromboelastography was also performed on some animals. Values for D-dimer concentration were significantly higher in debilitated versus healthy animals. There was no significant difference for prothrombin time, partial thromboplastin time, platelet count, or fibrinogen concentration between groups. Thromboelastography was performed on 8 healthy animals. Reference ranges were established for various tests of coagulation that may assist clinicians during the initial evaluation and rehabilitation of Florida manatees. Future research to evaluate the effect of specific disease processes on the coagulation cascade is recommended.

The trait of sensory processing sensitivity and neural responses to changes in visual scenes

PubMed Central

Xu, Xiaomeng; Aron, Arthur; Aron, Elaine; Cao, Guikang; Feng, Tingyong; Weng, Xuchu

2011-01-01

This exploratory study examined the extent to which individual differences in sensory processing sensitivity (SPS), a temperament/personality trait characterized by social, emotional and physical sensitivity, are associated with neural response in visual areas in response to subtle changes in visual scenes. Sixteen participants completed the Highly Sensitive Person questionnaire, a standard measure of SPS. Subsequently, they were tested on a change detection task while undergoing functional magnetic resonance imaging (fMRI). SPS was associated with significantly greater activation in brain areas involved in high-order visual processing (i.e. right claustrum, left occipitotemporal, bilateral temporal and medial and posterior parietal regions) as well as in the right cerebellum, when detecting minor (vs major) changes in stimuli. These findings remained strong and significant after controlling for neuroticism and introversion, traits that are often correlated with SPS. These results provide the first evidence of neural differences associated with SPS, the first direct support for the sensory aspect of this trait that has been studied primarily for its social and affective implications, and preliminary evidence for heightened sensory processing in individuals high in SPS. PMID:20203139

Streamed video clips to reduce anxiety in children during inhaled induction of anesthesia.

PubMed

Mifflin, Katherine A; Hackmann, Thomas; Chorney, Jill Maclaren

2012-11-01

Anesthesia induction in children is frequently achieved by inhalation of nitrous oxide and sevoflurane. Pediatric anesthesiologists commonly use distraction techniques such as humor or nonprocedural talk to reduce anxiety and facilitate a smooth transition at this critical phase. There is a large body of successful distraction research that explores the use of video and television distraction methods for minor medical and dental procedures, but little research on the use of this method for ambulatory surgery. In this randomized control trial study we examined whether video distraction is effective in reducing the anxiety of children undergoing inhaled induction before ambulatory surgery. Children (control = 47, video = 42) between 2 and 10 years old undergoing ambulatory surgery were randomly assigned to a video distraction or control group. In the video distraction group a video clip of the child's preference was played during induction, and the control group received traditional distraction methods during induction. The modified Yale Preoperative Anxiety Scale was used to assess the children's anxiety before and during the process of receiving inhalation anesthetics. All subjects were similar in their age and anxiety scores before entering the operating rooms. Children in the video distraction group were significantly less anxious at induction and showed a significantly smaller change in anxiety from holding to induction than did children in the control group. Playing video clips during the inhaled induction of children undergoing ambulatory surgery is an effective method of reducing anxiety. Therefore, pediatric anesthesiologists may consider using video distraction as a useful, valid, alternative strategy for achieving a smooth transition to the anesthetized state.

The appropriateness of use of percutaneous transluminal coronary angioplasty in Spain.

PubMed

Aguilar, M D; Fitch, K; Lázaro, P; Bernstein, S J

2001-05-01

The rapid increase in the number of percutaneous transluminal coronary angioplasty (PTCA) procedures performed in Spain in recent years raises questions about how appropriately this procedure is being used. To examine this issue, we studied the appropriateness of use of PTCA in Spanish patients and factors associated with inappropriate use. We applied criteria for the appropriate use of PTCA developed by an expert panel of Spanish cardiologists and cardiovascular surgeons to a random sample of 1913 patients undergoing PTCA in Spain in 1997. The patients were selected through a two-step sampling process, stratifying by hospital type (public/private) and volume of procedures (low/medium/high). We examined the association between inappropriate use of PTCA and different clinical and sociodemographic factors. Overall, 46% of the PTCA procedures were appropriate, 31% were uncertain and 22% were inappropriate. Two factors contributing to inappropriate use were patients' receipt of less than optimal medical therapy and their failure to undergo stress testing. Institutional type and volume of procedures were not significantly related with inappropriate use. One of every five PTCA procedures in Spain is done for inappropriate reasons. Assuring that patients receive optimal medical therapy and undergo stress testing when indicated could contribute to more appropriate use of PTCA.

CaMKII prevents spontaneous acrosomal exocytosis in sperm through induction of actin polymerization.

PubMed

Shabtay, Ortal; Breitbart, Haim

2016-07-01

In order to interact with the egg and undergo acrosomal exocytosis or the acrosome reaction (AR), mammalian spermatozoa must undergo a series of biochemical changes in the female reproductive tract, collectively called capacitation. We showed that F-actin is formed during sperm capacitation and fast depolymerization occurs prior to the AR. We hypothesized that F-actin protects the sperm from undergoing spontaneous-AR (sAR) which decreases fertilization rate. We show that activation of the actin-severing protein gelsolin induces a significant increase in sAR. Moreover, inhibition of CaMKII or PLD during sperm capacitation, caused an increase in sAR and inhibition of F-actin formation. Spermine, which leads to PLD activation, was able to reverse the effects of CaMKII inhibition on sAR-increase and F-actin-decrease. Furthermore, the increase in sAR and the decrease in F-actin caused by the inactivation of the PLD-pathway, were reversed by activation of CaMKII using H2O2 or by inhibiting protein phosphatase 1 which enhance the phosphorylation and oxidation states of CaMKII. These results indicate that two distinct pathways lead to F-actin formation in the sperm capacitation process which prevents the occurrence of sAR. Copyright © 2016 Elsevier Inc. All rights reserved.

KSC-98pc1166

NASA Image and Video Library

1998-09-28

The orbiter Atlantis, being towed from the Shuttle Landing Facility toward the Vehicle Assembly Building (VAB) , intersects the morning sun's rays. In the background, to the right of the VAB, are the Orbiter Processing Facility 1 and 2. Atlantis spent 10 months in Palmdale, CA, undergoing extensive inspections and modifications in the orbiter processing facility there. The modifications included several upgrades enabling it to support International Space Station missions, such as adding an external airlock for ISS docking missions and installing thinner, lighter thermal protection blankets for weight reduction which will allow it to haul heavier cargo. Atlantis will undergo preparations at KSC in Orbiter Processing Facility 2 for its planned flight in June 1999

Circadian rhythm and menopause.

PubMed

Pines, A

2016-12-01

Circadian rhythm is an internal biological clock which initiates and monitors various physiological processes with a fixed time-related schedule. The master circadian pacemaker is located in the suprachiasmatic nucleus in the hypothalamus. The circadian clock undergoes significant changes throughout the life span, at both the physiological and molecular levels. This cyclical physiological process, which is very complex and multifactorial, may be associated with metabolic alterations, atherosclerosis, impaired cognition, mood disturbances and even development of cancer. Sex differences do exist, and the well-known sleep disturbances associated with menopause are a good example. Circadian rhythm was detected in the daily pattern of hot flushes, with a peak in the afternoons. Endogenous secretion of melatonin decreases with aging across genders, and, among women, menopause is associated with a significant reduction of melatonin levels, affecting sleep. Although it might seem that hot flushes and melatonin secretion are likely related, there are not enough data to support such a hypothesis.

Prevalence and predictors of renal artery stenosis in patients undergoing peripheral and coronary angiography.

PubMed

Shukla, Anand N; Madan, Tarun H; Jayaram, Ashwal A; Kute, Vivek B; Rawal, Jayesh R; Manjunath, A P; Udhreja, Satyam

2013-12-01

Renal artery stenosis is a potential cause of secondary hypertension, ischemic nephropathy and end-stage renal disease. Atherosclerosis is by far the most common etiology of renal artery stenosis in elderly. We investigated whether the presence of significant atherosclerotic renal artery stenosis (ARAS) with luminal diameter narrowing ≥50 % could be predicted in patients undergoing peripheral and coronary angiography. The records of 3,500 consecutive patients undergoing simultaneous renal angiography along with peripheral and coronary angiography were reviewed. The patients with known renal artery disease were excluded. Prevalence of ARAS was 5.7 %. Significant ARAS (luminal diameter narrowing ≥50 %) was present in 139 patients (3.9 %). Hypertension with altered serum creatinine and triple-vessel CAD were associated with significant renal artery stenosis in multivariate analysis. No significant relationship between the involved coronary arteries like left anterior descending, left circumflex, right coronary artery and ARAS was found. Only hypertension and altered serum creatinine were associated with bilateral ARAS. Extent of CAD or risk factors like diabetes, hyperlipidemia or smoking did not predict the unilateral or bilateral ARAS. Prevalence of ARAS among the patients in routine cardiac catheterization was 5.7 %. Hypertension is closely associated with significant ARAS. Significant CAD in the form of triple-vessel disease and altered renal function tests are closely associated with ARAS. They predict the presence of significant renal artery stenosis in patients undergoing routine peripheral and coronary angiography. Moreover, hypertension and altered renal functions predict bilateral ARAS.

The Development of Gyrification in Childhood and Adolescence

ERIC Educational Resources Information Center

White, Tonya; Su, Shu; Schmidt, Marcus; Kao, Chiu-Yen; Sapiro, Guillermo

2010-01-01

Gyrification is the process by which the brain undergoes changes in surface morphology to create sulcal and gyral regions. The period of greatest development of brain gyrification is during the third trimester of pregnancy, a period of time in which the brain undergoes considerable growth. Little is known about changes in gyrification during…

KENNEDY SPACE CENTER, FLA. - An engine pulls the container enclosing a segment of a solid rocket booster from the Rotation Processing and Surge Facility. The container will join others on the main track for a trip to Utah where the segments will undergo firing. The segments were part of the STS-114 stack. It is the first time actual flight segments that had been stacked for flight in the VAB are being returned for testing. They will undergo firing, which will enable inspectors to check the viability of the solid and verify the life expectancy for stacked segments.

NASA Image and Video Library

2004-01-30

KENNEDY SPACE CENTER, FLA. - An engine pulls the container enclosing a segment of a solid rocket booster from the Rotation Processing and Surge Facility. The container will join others on the main track for a trip to Utah where the segments will undergo firing. The segments were part of the STS-114 stack. It is the first time actual flight segments that had been stacked for flight in the VAB are being returned for testing. They will undergo firing, which will enable inspectors to check the viability of the solid and verify the life expectancy for stacked segments.

Comparison of neurocognitive results after coronary artery bypass grafting and thoracic aortic surgery using retrograde cerebral perfusion.

PubMed

Miyairi, Takeshi; Takamoto, Shinichi; Kotsuka, Yutaka; Takeuchi, Atsuko; Yamanaka, Katsuo; Sato, Hajime

2005-07-01

Retrograde cerebral perfusion (RCP) is used as an adjunctive method to hypothermic circulatory arrest to enhance cerebral protection in patients undergoing thoracic aortic surgery. It remains unclear whether RCP provides improved neurological and neuropsychological outcome. Forty-six patients undergoing thoracic aortic surgery using RCP, and 28 undergoing coronary artery bypass grafting (CABG; n = 28) with CPB, were enrolled in the study. Patients receiving RCP were subdivided into two groups, those with less than 60 min of RCP (S-RCP; n = 27) and with 60 min or more (L-RCP; n = 19). The patients' neurocognitive state was assessed by the revised Wechsler Adult Intelligence Scale a few days before operation, at 2-3 weeks and 4-6 months after operation. There were no stroke, seizure, and hospital mortality in either group. Significant decline between baseline and early scores were seen in three subtests (digit span, arithmetic, and picture completion) for S-RCP and four (digit span, arithmetic, picture completion, and picture arrangement) for L-RCP. Significant decline between baseline and late scores were seen in one subtest (arithmetic) for S-RCP, four (digit span, arithmetic, picture completion, and picture arrangement) for L-RCP, and one (object assembly) for CABG. The mean change of scores for one late test (digit symbol) was significantly lower in S-RCP than in CABG. The mean change of scores for three early tests (digit span, vocabulary, and picture arrangement) and four late tests (information, digit span, picture completion, and picture arrangement) were significantly lower in L-RCP than in CABG. Stepwise logistic regression analysis disclosed that, after considering the other variables, significant difference in test score changes were observed between CABG and L-RCP for two early tests (picture completion and digit symbol) as well as for three late tests (digit span, similarities, and picture completion). None of test score changes showed significant difference between CABG and S-RCP. The neurocognitive outcome in patients undergoing RCP less than 60 min were comparable with patients undergoing CABG without circulatory arrest. Prolonged RCP of 60 min or more in patients undergoing surgery of the thoracic aorta was associated with postoperative neurocognitive impairment.

Racing performance of Standardbred trotting horses undergoing surgery of the carpal flexor sheath and age- and sex-matched control horses.

PubMed

Carmalt, James L; Johansson, Bengt C; Zetterström, Sandra M; McOnie, Rebecca C

2017-07-01

OBJECTIVE To determine factors affecting race speed in Swedish Standardbred horses undergoing surgery of the carpal flexor sheath (CFS), to investigate whether preoperative racing speed was associated with specific intraoperative findings and whether horses returned to racing, and to compare the performance of horses undergoing surgery of the CFS with that of age- and sex-matched control horses. ANIMALS 149 Swedish Standardbred trotters undergoing surgery of the CFS and 274 age- and sex-matched control horses. PROCEDURES Medical records of CFS horses were examined. Racing data for CFS and control horses were retrieved from official online records. Generalizing estimating equations were used to examine overall and presurgery racing speeds and the association of preoperative clinical and intraoperative findings with preoperative and postoperative speeds. Multivariable regression analysis was used to examine career earnings and number of career races. Kaplan-Meier survival analysis was used to compare career longevity between CFS and control horses. RESULTS CFS horses were significantly faster than control horses. The CFS horses that raced before surgery were slower as they approached the surgery date, but race speed increased after surgery. There were 124 of 137 (90.5%) CFS horses that raced after surgery. No intrathecal pathological findings were significantly associated with preoperative racing speed. Career longevity did not differ between CFS and control horses. CONCLUSIONS AND CLINICAL RELEVANCE Horses undergoing surgery of the CFS had a good prognosis to return to racing after surgery. Racing careers of horses undergoing surgery of the CFS were not significantly different from racing careers of control horses.

Predicting Likelihood of Surgery Prior to First Visit in Patients with Back and Lower Extremity Symptoms: A simple mathematical model based on over 8000 patients.

PubMed

Boden, Lauren M; Boden, Stephanie A; Premkumar, Ajay; Gottschalk, Michael B; Boden, Scott D

2018-02-09

Retrospective analysis of prospectively collected data. To create a data-driven triage system stratifying patients by likelihood of undergoing spinal surgery within one year of presentation. Low back pain (LBP) and radicular lower extremity (LE) symptoms are common musculoskeletal problems. There is currently no standard data-derived triage process based on information that can be obtained prior to the initial physician-patient encounter to direct patients to the optimal physician type. We analyzed patient-reported data from 8006 patients with a chief complaint of LBP and/or LE radicular symptoms who presented to surgeons at a large multidisciplinary spine center between September 1, 2005 and June 30, 2016. Univariate and multivariate analysis identified independent risk factors for undergoing spinal surgery within one year of initial visit. A model incorporating these risk factors was created using a random sample of 80% of the total patients in our cohort, and validated on the remaining 20%. The baseline one-year surgery rate within our cohort was 39% for all patients and 42% for patients with LE symptoms. Those identified as high likelihood by the center's existing triage process had a surgery rate of 45%. The new triage scoring system proposed in this study was able to identify a high likelihood group in which 58% underwent surgery, which is a 46% higher surgery rate than in non-triaged patients and a 29% improvement from our institution's existing triage system. The data-driven triage model and scoring system derived and validated in this study (Spine Surgery Likelihood model [SSL-11]), significantly improved existing processes in predicting the likelihood of undergoing spinal surgery within one year of initial presentation. This triage system will allow centers to more selectively screen for surgical candidates and more effectively direct patients to surgeons or non-operative spine specialists. 4.

Steepest entropy ascent for two-state systems with slowly varying Hamiltonians

NASA Astrophysics Data System (ADS)

Militello, Benedetto

2018-05-01

The steepest entropy ascent approach is considered and applied to two-state systems. When the Hamiltonian of the system is time-dependent, the principle of maximum entropy production can still be exploited; arguments to support this fact are given. In the limit of slowly varying Hamiltonians, which allows for the adiabatic approximation for the unitary part of the dynamics, the system exhibits significant robustness to the thermalization process. Specific examples such as a spin in a rotating field and a generic two-state system undergoing an avoided crossing are considered.

KSC-98pc1164

NASA Image and Video Library

1998-09-28

The orbiter Atlantis is towed away from the Shuttle Landing Facility after returning home from California atop its Shuttle Carrier Aircraft. The orbiter spent 10 months in Palmdale undergoing extensive inspections and modifications in the orbiter processing facility there. The modifications included several upgrades enabling it to support International Space Station missions, such as adding an external airlock for ISS docking missions and installing thinner, lighter thermal protection blankets for weight reduction which will allow it to haul heavier cargo. Atlantis will undergo preparations in the Orbiter Processing Facility at KSC for its planned flight in June 1999

Density of Spray-Formed Materials

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

Kevin M. McHugh; Volker Uhlenwinkel; Nils Ellendr

2008-06-01

Spray Forming is an advanced materials processing technology that transforms molten metal into a near-net-shape solid by depositing atomized droplets onto a substrate. Depending on the application, the spray-formed material may be used in the as-deposited condition or it may undergo post-deposition processing. Regardless, the density of the as-deposited material is an important issue. Porosity is detrimental because it can significantly reduce strength, toughness, hardness and other properties. While it is not feasible to achieve fully-dense material in the as-deposited state, density greater than 99% of theoretical density is possible if the atomization and impact conditions are optimized. Thermal conditionsmore » at the deposit surface and droplet impact angle are key processing parameters that influence the density of the material. This paper examines the factors that contribute to porosity formation during spray forming and illustrates that very high as-deposited density is achieved by optimizing processing parameters.« less

Listening to Another Sense: Somatosensory Integration in the Auditory System

PubMed Central

Wu, Calvin; Stefanescu, Roxana A.; Martel, David T.

2014-01-01

Conventionally, sensory systems are viewed as separate entities, each with its own physiological process serving a different purpose. However, many functions require integrative inputs from multiple sensory systems, and sensory intersection and convergence occur throughout the central nervous system. The neural processes for hearing perception undergo significant modulation by the two other major sensory systems, vision and somatosensation. This synthesis occurs at every level of the ascending auditory pathway: the cochlear nucleus, inferior colliculus, medial geniculate body, and the auditory cortex. In this review, we explore the process of multisensory integration from 1) anatomical (inputs and connections), 2) physiological (cellular responses), 3) functional, and 4) pathological aspects. We focus on the convergence between auditory and somatosensory inputs in each ascending auditory station. This review highlights the intricacy of sensory processing, and offers a multisensory perspective regarding the understanding of sensory disorders. PMID:25526698

Nucleation, Growth, Annealing, and Coagulation of Refractory Oxides and Metals: Recent Experimental Progress and Applications to Astrophysical Systems

NASA Technical Reports Server (NTRS)

Nuth, J. A.; Rietmeijer, F. J. M.; Hallenbeck, S. L.; Withey, P. A.

1999-01-01

Starting with cooling, refractory vapors diluted in significant quantities of H and He there are four processes that most natural systems will undergo: nucleation, growth, annealing, and coagulation. Nucleation is the processes by which the first stable refractory nuclei form in the vapor. These are the seeds onto which the remaining vapors will condense during the growth stage. Solids of any composition will try to arrange themselves into the least energetic configuration, provided that there is sufficient energy available to support such processes as diffusion and the breaking of chemical bonds. There is a significant activation energy associated with the annealing process in refractory solids due to the relatively high energy of the chemical bonds in solids. The grains formed in most cosmochemical systems are extremely small and often tightly coupled to the gas. Because of their small physical cross sections coagulation may be a very slow process unless there is another driving force involved in addition to normal Brownian motion. In what follows we will briefly cover each of these four stages for refractory oxide and metal grains, although in inverse order.

Genetic and epigenetic profiling of CLL disease progression reveals limited somatic evolution and suggests a relationship to memory-cell development.

PubMed

Smith, E N; Ghia, E M; DeBoever, C M; Rassenti, L Z; Jepsen, K; Yoon, K-A; Matsui, H; Rozenzhak, S; Alakus, H; Shepard, P J; Dai, Y; Khosroheidari, M; Bina, M; Gunderson, K L; Messer, K; Muthuswamy, L; Hudson, T J; Harismendy, O; Barrett, C L; Jamieson, C H M; Carson, D A; Kipps, T J; Frazer, K A

2015-04-10

We examined genetic and epigenetic changes that occur during disease progression from indolent to aggressive forms of chronic lymphocytic leukemia (CLL) using serial samples from 27 patients. Analysis of DNA mutations grouped the leukemia cases into three categories: evolving (26%), expanding (26%) and static (47%). Thus, approximately three-quarters of the CLL cases had little to no genetic subclonal evolution. However, we identified significant recurrent DNA methylation changes during progression at 4752 CpGs enriched for regions near Polycomb 2 repressive complex (PRC2) targets. Progression-associated CpGs near the PRC2 targets undergo methylation changes in the same direction during disease progression as during normal development from naive to memory B cells. Our study shows that CLL progression does not typically occur via subclonal evolution, but that certain CpG sites undergo recurrent methylation changes. Our results suggest CLL progression may involve developmental processes shared in common with the generation of normal memory B cells.

Factors That Influence the Decision to Undergo Labiaplasty: Media, Relationships, and Psychological Well-Being.

PubMed

Sharp, Gemma; Tiggemann, Marika; Mattiske, Julie

2016-04-01

An increasing number of women are undergoing labiaplasty procedures; however, very little is known about the psychological factors that motivate women to seek out this procedure. To investigate the factors that influence women's decisions to undergo labiaplasty. Women seeking to undergo labiaplasty (n = 35) were compared with women who were not (n = 30). Standardized measures were employed to assess the patients' media exposure (television, the Internet, advertising, pornography), relationship quality, and psychological well-being. Women's motivations for deciding to undergo a labiaplasty procedure were characterized as "appearance," "functional," "sexual," or "psychological" motivations, with concerns about the labia's appearance being the most commonly reported motivation. Correspondingly, women seeking labiaplasty were significantly less satisfied with the appearance of their genitals than the comparison group (P < .001). These women had also experienced greater exposure to images of female genitalia on the Internet (P = .004) and in advertisements (P = .021), and had internalized these images to a greater extent (P = .010). There were no differences between the two groups on the measures of relationship quality. However, significantly fewer of the women seeking to undergo a labiaplasty procedure were involved in a romantic relationship at the time of the study (P = .039). There were also no differences between the two groups on the measures of psychological well-being, except that women seeking to undergo labiaplasty were less satisfied with their lives overall (P = .027). The findings identified media exposure and relationship status as important factors that influence women's decisions to undergo labiaplasty. 3 Risk. © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

THE MURINE LOCAL LYMPH NODE ASSAY: AN ALTERNATIVE TEST METHOD FOR THE EVALUATION OF THE POTENTIAL FOR CHEMICALS TO ELICIT ALLERGIC CONTACT DERMATITIS

EPA Science Inventory

ABSTRACT
The process that a new toxicology test method must undergo to attain acceptance and regulatory implementation may seem daunting. As the first test method to undergo Interagency Coordinating Committee on the Validation of Alternative Methods (ICCVAM) review, the local...

Prophylactic antibiotics to prevent surgical site infection after breast cancer surgery.

PubMed

Jones, Daniel J; Bunn, Frances; Bell-Syer, Sophie V

2014-03-09

Surgery has been used as part of breast cancer treatment for centuries; however any surgical procedure has the potential risk of infection. Infection rates for surgical treatment of breast cancer are documented at between 3% and 15%, higher than average for a clean surgical procedure. Pre- and perioperative antibiotics have been found to be useful in lowering infection rates in other surgical groups, yet there is no consensus on the use of prophylactic antibiotics for breast cancer surgery. To determine the effects of prophylactic (pre- or perioperative) antibiotics on the incidence of surgical site infection (SSI) after breast cancer surgery. For this third update we searched the Cochrane Wounds Group Specialised Register (5 December 2013); the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); the Database of Abstracts of Reviews of Effects (DARE) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; and EBSCO CINAHL. We applied no language or date restrictions. Randomised controlled trials of pre- and perioperative antibiotics for patients undergoing surgery for breast cancer were included. Primary outcomes were rates of surgical site infection (SSI) and adverse reactions. Two review authors independently examined the title and abstracts of all studies identified by the search strategy, then assessed study quality and extracted data from those that met the inclusion criteria. A total of eleven studies (2867 participants) were included in the review. Ten studies evaluated preoperative antibiotic compared with no antibiotic or placebo. One study evaluated perioperative antibiotic compared with no antibiotic. Pooling of the results demonstrated that prophylactic antibiotics administered preoperatively significantly reduce the incidence of SSI for patients undergoing breast cancer surgery without reconstruction (pooled risk ratio (RR) 0.67, 95% confidence interval (CI) 0.53 to 0.85). Analysis of the single study comparing perioperative antibiotic with no antibiotic found no statistically significant effect of antibiotics on the incidence of SSI (RR 0.11, 95% CI 0.01 to 1.95). No studies presented separate data for patients who underwent reconstructive surgery at the time of removal of the breast tumour. Prophylactic antibiotics administered preoperatively reduce the risk of SSI in patients undergoing surgery for breast cancer. Further studies involving patients undergoing immediate breast reconstruction are needed as studies have identified this group as being at higher risk of infection than those who do not undergo immediate breast reconstruction.

Iliac artery stenting in patients with poor distal runoff: Influence of concomitant infrainguinal arterial reconstruction.

PubMed

Timaran, Carlos H; Ohki, Takao; Gargiulo, Nicholas J; Veith, Frank J; Stevens, Scott L; Freeman, Michael B; Goldman, Mitchell H

2003-09-01

Inadequate infrainguinal runoff is considered an important risk factor for iliac stent failure. However, the influence of concomitant infrainguinal arterial reconstruction (CIAR) on iliac stent patency is unknown. This study evaluated the influence of CIAR on outcome of iliac angioplasty and stenting (IAS) in patients with poor distal runoff. Over 5 years (1996 to 2001), 68 IAS procedures (78 stents) were performed in 62 patients with poor distal runoff (angiographic runoff score >or=5). The SVS/AAVS reporting standards were followed to define outcome variables and risk factors. Data were analyzed with both univariate analysis (Kaplan-Meier method [K-M]) and regression analysis (Cox proportional hazards model). Indications for iliac artery stenting were disabling claudication (59%) and limb salvage (41%). Of the 68 procedures, IAS with CIAR was performed in 31 patients (46%), and IAS alone was performed in 37 patients (54%). Patients undergoing IAS with CIAR were older (P =.03) and had more extensive and multifocal iliac artery occlusive disease, with more TASC (TransAtlantic Inter-Society Consensus) type C lesions (P =.03), compared with patients undergoing IAS alone. No other significant differences in risk factors were noted. Runoff scores between patients undergoing IAS with CIAR and those undergoing IAS alone were not significantly different (median runoff scores, 6 [range, 5-8] and 7 [range, 5-9], respectively; P =.77). Primary stent patency rate at 1, 3, and 5 years was 87%, 54%, and 42%, respectively, for patients undergoing IAS with CIAR, and was 76%, 66%, and 55%, respectively, for patients undergoing IAS. Univariate analysis revealed that primary stent patency rate was not significantly different between the 2 groups (K-M, log-rank test, P =.81). Primary graft patency rate for CIAR was 81%, 52%, and 46% at 1, 3, and 5 years, respectively. Performing CIAR did not affect primary iliac stent patency (relative risk, 1.1; 95% confidence interval, 0.49-2.47; P =.81). Overall, there was a trend toward improved limb salvage in patients undergoing IAS with CIAR, compared with those undergoing IAS alone (K-M, log rank test, P =.07). In patients undergoing IAS with poor distal runoff, CIAR does not improve iliac artery stent patency. Infrainguinal bypass procedures should therefore be reserved for patients who do not demonstrate clinical improvement and possibly for those with limb-threatening ischemia.

Electromechanical fatigue in IPMC under dynamic energy harvesting conditions

NASA Astrophysics Data System (ADS)

Krishnaswamy, Arvind; Roy Mahapatra, D.

2011-04-01

Ionic polymer-metal composites (IPMCs) are an interesting subset of smart, multi-functional materials that have shown promises in energy conversion technologies. Being electromechanically coupled, IPMCs can function as dynamic actuators and sensors, transducers for energy conversion and harvesting, as well as artificial muscles for medical and industrial applications. Like all natural materials, even IPMCs undergo fatigue under dynamic load conditions. Here, we investigate the electromechanical fatigue induced in the IPMCs due to the application of cyclic mechanical bending deformation under hydrodynamic energy harvesting condition. Considering the viscoelastic nature of the IPMC, we employ an analytical approach to modeling electromechanical fatigue primarily under the cyclic stresses induced in the membrane. The polymer-metal composite undergoes cyclic softening throughout the fatigue life without attaining a saturated state of charge migration. However, it results in (1) degradation of electromechanical performance; (2) nucleation and growth of microscopic cracks in the metal electrodes; (3) delamination of metal electrodes at the polymer-electrode interface. To understand these processes, we employ a phenomenological approach based on experimentally measured relaxation properties of the IPMC membrane. Electromechanical performance improves significantly with self-healing like properties for a certain range of relaxation time. This is due to reorientation of the backbone polymer chains which eventually leads to a regenerative process with increased charge transport.

Bio-Derived, Binderless, Hierarchically Porous Carbon Anodes for Li-ion Batteries

PubMed Central

Campbell, Brennan; Ionescu, Robert; Favors, Zachary; Ozkan, Cengiz S.; Ozkan, Mihrimah

2015-01-01

Here we explore the electrochemical performance of pyrolyzed skins from the species A. bisporus, also known as the Portobello mushroom, as free-standing, binder-free, and current collector-free Li-ion battery anodes. At temperatures above 900 °C, the biomass-derived carbon nanoribbon-like architectures undergo unique processes to become hierarchically porous. During heat-treatment, the oxygen and heteroatom-rich organics and potassium compounds naturally present in the mushroom skins play a mutual role in creating inner void spaces throughout the resulting carbon nanoribbons, which is a process analogous to KOH-activation of carbon materials seen in literature. The pores formed in the pyrolytic carbon nanoribbons range in size from sub-nanometer to tens of nanometers, making the nanoribbons micro, meso, and macroporous. Detailed studies were conducted on the carbon nanoribbons using SEM and TEM to study morphology, as well as XRD and EDS to study composition. The self-supporting nanoribbon anodes demonstrate significant capacity increase as they undergo additional charge/discharge cycles. After a pyrolysis temperature of 1100 °C, the pristine anodes achieve over 260 mAh/g after 700 cycles and a Coulombic efficiency of 101.1%, without the use of harmful solvents or chemical activation agents. PMID:26415917

[Effect of Supportan on nutritional status and immune function of late-staged gastric cancer patients undergoing chemotherapy].

PubMed

Zhong, Hai-jun; Ying, Jie-er; Ma, Sheng-lin

2006-09-01

To evaluate the effect of Supportan, an enteral nutrition (EN) specific for tumor patients, on the nutritional status and immune function of late-staged gastric cancer patients undergoing chemotherapy. Sixty-six late-staged gastric cancer patients undergoing chemotherapy were randomly divided into EN group (n=33) and control group (n=33). During chemotherapy, the patients in EN group received Supportan and the patients in the control group received basic diet. On the 14th day before chemotherapy and after chemotherapy, nutritional status and cell immune indicators were evaluated. As for nutrition indicators, there were no significant differences in EN group before and after chemotherapy (P > 0.05). Total protein, hemoglobin, prealbumin and transferrin significantly decreased after chemotherapy compared with those before chemotherapy in the control group (P< 0.01). The levels of CD4(+), CD8(+) T cells and CD4/CD8 were significantly increased, and NK cells, serum levels of IL-1, IL-6 were significantly decreased after chemotherapy in EN group (P< 0.01). The levels of IL-6 and TNF-alpha were significantly higher after chemotherapy than those before chemotherapy in the control group(P< 0.01). Curative effects of immune nutrition in EN group were superior to that in the control group, however, the differences were not statistically significant. The incidences of nausea, vomiting and marrow inhibition in Supportan group was lower compared with those in the control group, but with no significant difference. Supportan can prevent malnutrition of the late-staged gastric cancer patients undergoing chemotherapy, and improve immune function and alleviate adverse effects of chemotherapy.

Global regulatory developments for clinical stem cell research: diversification and challenges to collaborations.

PubMed

Rosemann, Achim; Bortz, Gabriela; Vasen, Federico; Sleeboom-Faulkner, Margaret

2016-10-01

In this article, we explore regulatory developments in stem cell medicine in seven jurisdictions: Japan, China, India, Argentina, Brazil, the USA and the EU. We will show that the research methods, ethical standards and approval procedures for the market use of clinical stem cell interventions are undergoing an important process of global diversification. We will discuss the implications of this process for international harmonization and the conduct of multicountry clinical research collaborations. It will become clear that the increasing heterogeneity of research standards and regulations in the stem cell field presents a significant challenge to international clinical trial partnerships, especially with countries that diverge from the regulatory models that have been developed in the USA and the EU.

KSC-01pp0244

NASA Image and Video Library

2001-02-03

The lid is off the shipping container with the Multi-Purpose Logistics Module Donatello inside. It sits on a transporter inside the Space Station Processing Facility. In the SSPF, Donatello will undergo processing by the payload test team, including integrated electrical tests with other Station elements in the SSPF, leak tests, electrical and software compatibility tests with the Space Shuttle (using the Cargo Integrated Test equipment) and an Interface Verification Test once the module is installed in the Space Shuttle’s payload bay at the launch pad. The most significant mechanical task to be performed on Donatello in the SSPF is the installation and outfitting of the racks for carrying the various experiments and cargo. Donatello will be launched on mission STS-130, currently planned for September 2004

KSC-01pp0245

NASA Image and Video Library

2001-02-03

Workers in the Space Station Processing Facility attach an overhead crane to the Multi-Purpose Logistics Module Donatello to lift it out of the shipping container. In the SSPF, Donatello will undergo processing by the payload test team, including integrated electrical tests with other Station elements in the SSPF, leak tests, electrical and software compatibility tests with the Space Shuttle (using the Cargo Integrated Test equipment) and an Interface Verification Test once the module is installed in the Space Shuttle’s payload bay at the launch pad. The most significant mechanical task to be performed on Donatello in the SSPF is the installation and outfitting of the racks for carrying the various experiments and cargo. Donatello will be launched on mission STS-130, currently planned for September 2004

KSC-01pp0246

NASA Image and Video Library

2001-02-03

In the Space Station Processing Facility, workers help guide the overhead crane as it lifts the Multi-Purpose Logistics Module Donatello out of the shipping container. In the SSPF, Donatello will undergo processing by the payload test team, including integrated electrical tests with other Station elements in the SSPF, leak tests, electrical and software compatibility tests with the Space Shuttle (using the Cargo Integrated Test equipment) and an Interface Verification Test once the module is installed in the Space Shuttle’s payload bay at the launch pad. The most significant mechanical task to be performed on Donatello in the SSPF is the installation and outfitting of the racks for carrying the various experiments and cargo. Donatello will be launched on mission STS-130, currently planned for September 2004

KSC-01pp0247

NASA Image and Video Library

2001-02-03

In the Space Station Processing Facility, workers help guide the Multi-Purpose Logistics Module Donatello as it moves the length of the SSPF toward a workstand. In the SSPF, Donatello will undergo processing by the payload test team, including integrated electrical tests with other Station elements in the SSPF, leak tests, electrical and software compatibility tests with the Space Shuttle (using the Cargo Integrated Test equipment) and an Interface Verification Test once the module is installed in the Space Shuttle’s payload bay at the launch pad. The most significant mechanical task to be performed on Donatello in the SSPF is the installation and outfitting of the racks for carrying the various experiments and cargo. Donatello will be launched on mission STS-130, currently planned for September 2004

KSC-01pp0248

NASA Image and Video Library

2001-02-03

In the Space Station Processing Facility, workers wait for the Multi-Purpose Logistics Module Donatello, suspended by an overhead crane, to move onto a workstand. In the SSPF, Donatello will undergo processing by the payload test team, including integrated electrical tests with other Station elements in the SSPF, leak tests, electrical and software compatibility tests with the Space Shuttle (using the Cargo Integrated Test equipment) and an Interface Verification Test once the module is installed in the Space Shuttle’s payload bay at the launch pad. The most significant mechanical task to be performed on Donatello in the SSPF is the installation and outfitting of the racks for carrying the various experiments and cargo. Donatello will be launched on mission STS-130, currently planned for September 2004

The Influence of Oral Carbohydrate Solution Intake on Stress Response before Total Hip Replacement Surgery during Epidural and General Anaesthesia.

PubMed

Çeliksular, M Cem; Saraçoğlu, Ayten; Yentür, Ercüment

2016-06-01

The effects of oral carbohydrate solutions, ingested 2 h prior to operation, on stress response were studied in patients undergoing general or epidural anaesthesia. The study was performed on 80 ASA I-II adult patients undergoing elective total hip replacement, which were randomized to four groups (n=20). Group G patients undergoing general anaesthesia fasted for 8 h preoperatively; Group GN patients undergoing general anaesthesia drank oral carbohydrate solutions preoperatively; Group E patients undergoing epidural anaesthesia fasted for 8 h and Group EN patients undergoing epidural anaesthesia drank oral carbohydrate solutions preoperatively. Groups GN and EN drank 800 mL of 12.5% oral carbohydrate solution at 24:00 preoperatively and 400 mL 2 h before the operation. Blood samples were taken for measurements of glucose, insulin, cortisol and IL-6 levels. The effect of preoperative oral carbohydrate ingestion on blood glucose levels was not significant. Insulin levels 24 h prior to surgery were similar; however, insulin levels measured just before surgery were 2-3 times higher in groups GN and EN than in groups G and E. Insulin levels at the 24(th) postoperative hour in epidural groups were increased compared to those at basal levels, although general anaesthesia groups showed a decrease. From these measurements, only the change in Group EN was statistically significant (p<0.05). Plasma cortisol levels at the 2(nd) peroperative hour were higher in epidural groups than in general anaesthesia groups. Both anaesthesia techniques did not have an effect on IL-6 levels. We concluded that epidural anaesthesia suppressed stress response, although preoperative oral carbohydrate nutrition did not reveal a significant effect on surgical stress response.

The Application of an Evidence-Based Clinical Nursing Path for Improving the Preoperative and Postoperative Quality of Care of Pediatric Retroperitoneal Neuroblastoma Patients: A Randomized Controlled Trial at a Tertiary Medical Institution.

PubMed

Liu, Yang; Mo, Lin; Tang, Yan; Wang, Qiuhong; Huang, Xiaoyan

A clinical nursing path (CNP) that encourages patients and their families to become actively involved in healthcare decision-making processes may improve outcomes of pediatric retroperitoneal neuroblastoma (NB) patients. The aim of this study was to evaluate the utility and value of an evidence-based CNP provided to pediatric retroperitoneal NB patients undergoing resection surgery. One hundred twenty NB cases were assigned to a control group or a CNP group. The control group was provided with standard nursing care. The CNP group was provided with nursing care in accordance with an evidence-based CNP. The utility and value of the CNP were compared with standard nursing care. Outcome measures included rates of postoperative complications, lengths of hospital stay, and cost of hospitalization, as well as preoperative and postoperative quality of care and patient satisfaction with care. The rates of postoperative complications, length of preoperative hospitalization, total length of hospital stay, and costs of hospitalization were significantly lower for patients receiving the CNP compared with the control group. Preoperative and postoperative quality of care and patient satisfaction with care were significantly higher in patients receiving the CNP compared with the control group. Adoption of a CNP for preoperative and postoperative care of pediatric retroperitoneal NB patients undergoing resection surgery improves clinical outcomes and patient satisfaction with care. A CNP can increase families' participation in a patient's recovery process, enhance nurses' understanding of the services they are providing, and improve the quality of healthcare received by patients.

Factors influencing behavioral intention to undergo Papanicolaou testing in early adulthood: Comparison of Japanese and Korean women.

PubMed

Kang, Kyung-Ah; Kim, Shin-Jeong; Kaneko, Noriyo

2017-12-01

In this study, we identified the factors influencing behavioral intention to undergo Papanicolaou testing among Japanese and Korean women in early adulthood. Their behavioral intentions were compared in this cross-sectional descriptive study. In total, 887 women (Japanese = 498, Korean = 389) aged 20-39 years participated in this study. Using a self-report questionnaire, knowledge, attitudes, subjective norm, perceived behavioral control, and behavioral intention were surveyed. There were significant differences between Japanese and Korean women's scores on all main variables. For Japanese women, all the variables moderately correlated with behavioral intention. In comparison, for Korean women, all independent variables, except for knowledge, moderately correlated with behavioral intention. Through a multiple regression analysis, age, undergoing Papanicolaou testing, attitudes, subjective norm, and perceived behavioral control were identified as significant predictors of behavioral intention among Japanese women. Among Korean women, job status, undergoing a Papanicolaou test, attitudes, subjective norm, and perceived behavioral control were demonstrated as significant predictors of behavioral intention. Health professionals should consider these factors to encourage Papanicolaou testing in women in early adulthood. © 2017 John Wiley & Sons Australia, Ltd.

Beach erosion and nest site selection by the leatherback sea turtle Dermochelys coriacea (Testudines: Dermochelyidae) and implications for management practices at Playa Gandoca, Costa Rica.

PubMed

Spanier, Matthew J

2010-12-01

Leatherback sea turtles (Dermochelys coriacea) nest on dynamic, erosion-prone beaches. Erosive processes and resulting nest loss have long been presumed to be a hindrance to clutch survival. In order to better understand how leatherbacks cope with unstable nesting beaches, I investigated the role of beach erosion in leatherback nest site selection at Playa Gandoca, Costa Rica. I also examined the potential effect of nest relocation, a conservation strategy in place at Playa Gandoca to prevent nest loss to erosion, on the temperature of incubating clutches. I monitored changes in beach structure as a result of erosion at natural nest sites during the time the nest was laid, as well as in subsequent weeks. To investigate slope as a cue for nest site selection, I measured the slope of the beach where turtles ascended from the sea to nest, as well as the slopes at other random locations on the beach for comparison. I examined temperature differences between natural and relocated nest sites with thermocouples placed in the sand at depths typical of leatherback nests. Nests were distributed non-randomly in a clumped distribution along the length of the beach and laid at locations that were not undergoing erosion. The slope at nest sites was significantly different than at randomly chosen locations on the beach. The sand temperature at nest depths was significantly warmer at natural nest sites than at locations of relocated nests. The findings of this study suggest leatherbacks actively select nest sites that are not undergoing erosive processes, with slope potentially being used as a cue for site selection. The relocation of nests appears to be inadvertently cooling the nest environment. Due to the fact that leatherback clutches undergo temperature-dependent sex determination, the relocation of nests may be producing an unnatural male biasing of hatchlings. The results of this study suggest that the necessity of relocation practices, largely in place to protect nests from erosion, should be reevaluated to ensure the proper conservation of this critically endangered species.

Effects of alexithymia and empathy on the neural processing of social and monetary rewards.

PubMed

Goerlich, Katharina Sophia; Votinov, Mikhail; Lammertz, Sarah E; Winkler, Lina; Spreckelmeyer, Katja N; Habel, Ute; Gründer, Gerhard; Gossen, Anna

2017-07-01

Empathy has been found to affect the neural processing of social and monetary rewards. Alexithymia, a subclinical condition showing a close inverse relationship with empathy is linked to dysfunctions of socio-emotional processing in the brain. Whether alexithymia alters the neural processing of rewards, which is currently unknown. Here, we investigated the influence of both alexithymia and empathy on reward processing using a social incentive delay (SID) task and a monetary incentive delay (MID) task in 45 healthy men undergoing functional magnetic resonance imaging. Controlling for temperament-character dimensions and rejection sensitivity, the relationship of alexithymia and empathy with neural activity in several a priori regions of interest (ROIs) was examined by means of partial correlations, while participants anticipated and received social and monetary rewards. Results were considered significant if they survived Holm-Bonferroni correction for multiple comparisons. Alexithymia modulated neural activity in several ROIs of the emotion and reward network, both during the anticipation of social and monetary rewards and in response to the receipt of monetary rewards. In contrast, empathy did not affect reward anticipation and modulated ROI activity only in response to the receipt of social rewards. These results indicate a significant influence of alexithymia on the processing of social and monetary rewards in the healthy brain.

Emotional Processes in Patients Undergoing Coronary Artery Bypass Graft Surgeries with Extracorporeal Circulation in View of Selected Indicators of the Inflammatory Condition

PubMed Central

Płotek, Włodzimierz; Pielok, Joanna; Cybulski, Marcin; Samborska, Regina

2015-01-01

Background The aim of this study was to describe positive and negative emotions in patients undergoing coronary artery bypass graft (CABG) surgeries with extracorporeal circulation and the correlations between emotions and basic indicators of the inflammatory condition: C-reactive protein (CRP) concentration, body temperature, and leukocyte count. Material/Methods Standardized tools were used to select 52 patients (aged 47–63 years, 6 women – 11.5% and 46 men – 88.5%) without dementia or depression. The Positive and Negative Affect Schedule (PANAS) was used to examine positive affect (PA) and negative affect (NA) and the State-Trait Anxiety Inventory (STAI X1 and X2) was used to examine the anxiety level. The patients underwent CABG surgery according to a common anesthesia protocol and for 5 consecutive days they were observed in the ward, where selected indicators of the inflammatory condition were monitored. Results A detailed description of the results of examinations of emotions was presented. The patients with low PA-trait level, high NA-trait level, and high anxiety-trait level (STAI X2) exhibited statistically significantly higher body temperatures than the other patients in the postoperative period. The patients with high NA-trait and anxiety-state levels (STAI X1) had statistically significantly lower CRP levels in the postoperative period than the patients with low NA-trait and anxiety-state levels (STAI X1). Conclusions Patients undergoing CABG operations express both positive and negative affects. The changes in the inflammatory markers are expressed mostly by CRP concentration. There exist relationships between the result of tests assessing emotions and the markers of the inflammatory condition. PMID:25573296

Association of Patient Age at Gastric Bypass Surgery With Long-term All-Cause and Cause-Specific Mortality.

PubMed

Davidson, Lance E; Adams, Ted D; Kim, Jaewhan; Jones, Jessica L; Hashibe, Mia; Taylor, David; Mehta, Tapan; McKinlay, Rodrick; Simper, Steven C; Smith, Sherman C; Hunt, Steven C

2016-07-01

Bariatric surgery is effective in reducing all-cause and cause-specific long-term mortality. Whether the long-term mortality benefit of surgery applies to all ages at which surgery is performed is not known. To examine whether gastric bypass surgery is equally effective in reducing mortality in groups undergoing surgery at different ages. All-cause and cause-specific mortality rates and hazard ratios (HRs) were estimated from a retrospective cohort within 4 categories defined by age at surgery: younger than 35 years, 35 through 44 years, 45 through 54 years, and 55 through 74 years. Mean follow-up was 7.2 years. Patients undergoing gastric bypass surgery seen at a private surgical practice from January 1, 1984, through December 31, 2002, were studied. Data analysis was performed from June 12, 2013, to September 6, 2015. A cohort of 7925 patients undergoing gastric bypass surgery and 7925 group-matched, severely obese individuals who did not undergo surgery were identified through driver license records. Matching criteria included year of surgery to year of driver license application, sex, 5-year age groups, and 3 body mass index categories. Roux-en-Y gastric bypass surgery. All-cause and cause-specific mortality compared between those undergoing and not undergoing gastric bypass surgery using HRs. Among the 7925 patients who underwent gastric bypass surgery, the mean (SD) age at surgery was 39.5 (10.5) years, and the mean (SD) presurgical body mass index was 45.3 (7.4). Compared with 7925 matched individuals not undergoing surgery, adjusted all-cause mortality after gastric bypass surgery was significantly lower for patients 35 through 44 years old (HR, 0.54; 95% CI, 0.38-0.77), 45 through 54 years old (HR, 0.43; 95% CI, 0.30-0.62), and 55 through 74 years old (HR, 0.50; 95% CI, 0.31-0.79; P < .003 for all) but was not lower for those younger than 35 years (HR, 1.22; 95% CI, 0.82-1.81; P = .34). The lack of mortality benefit in those undergoing gastric bypass surgery at ages younger than 35 years primarily derived from a significantly higher number of externally caused deaths (HR, 2.53; 95% CI, 1.27-5.07; P = .009), particularly among women (HR, 3.08; 95% CI, 1.4-6.7; P = .005). Patients undergoing gastric bypass surgery had a significantly lower age-related increase in mortality than severely obese individuals not undergoing surgery (P = .001). Gastric bypass surgery was associated with improved long-term survival for all patients undergoing surgery at ages older than 35 years, with externally caused deaths only elevated in younger women. Gastric bypass surgery is protective against mortality even for older patients and also reduces the age-related increase in mortality observed in severely obese individuals not undergoing surgery.

Women undergoing aortic surgery are at higher risk for unplanned readmissions compared with men especially when discharged home.

PubMed

Flink, Benjamin J; Long, Chandler A; Duwayri, Yazan; Brewster, Luke P; Veeraswamy, Ravi; Gallagher, Katherine; Arya, Shipra

2016-06-01

Women undergoing vascular surgery have higher morbidity and mortality. Our study explores gender-based differences in patient-centered outcomes such as readmission, length of stay (LOS), and discharge destination (home vs nonhome facility) in aortic aneurysm surgery. Patients were identified from the American College of Surgeons National Surgical Quality Improvement Project database (2011-2013) undergoing abdominal, thoracic, and thoracoabdominal aortic aneurysms (N = 17,763), who were discharged and survived their index hospitalization. The primary outcome was unplanned readmission, and secondary outcomes were discharge to a nonhome facility, LOS, and reasons for unplanned readmission. Univariate, multivariate, and stratified analyses based on gender and discharge destination were used. Overall, 1541 patients (8.7%) experienced an unplanned readmission, with a significantly higher risk in women vs men (10.8% vs 8%; P < .001) overall (Procedure subtypes: abdominal aortic aneurysm [10.1% vs 7.7%; P < .001], thoracic aortic aneurysm [14.1% vs 13.5%; P = .8], and thoracoabdominal aortic aneurysm [14.8% vs 10%; P = .051]). The higher odds of readmission in women compared with men persisted in multivariate analysis after controlling for covariates (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.05-1.4). Similarly, the rate of discharge to a nonhome facility was nearly double in women compared with men (20.6% vs 10.7%; P < .001), but discharge to a nonhome facility was not a significant predictor of unplanned readmission. Upon stratification by discharge destination, the higher odds of readmissions in women compared with men occurred in patients who were discharged home (OR, 1.2; 95% CI, 1.02-1.4) but not in those who were discharged to a nonhome facility (OR, 1.06; 95% CI, 0.8-1.4). Significant differences in LOS were seen in patients who were discharged home. No gender differences were found in reasons for readmission with the three most common reasons being thromboembolic events, wound infections, and pneumonia. Gender disparity exists in the risk of unplanned readmission among aortic aneurysm surgery patients. Women who were discharged home have a higher likelihood of unplanned readmission despite longer LOS than men. These data suggest that further study into the discharge planning processes, social factors, and use of rehabilitation services is needed for women undergoing aortic procedures to decrease readmissions. Published by Elsevier Inc.

Identification of variant-specific surface proteins in Giardia muris trophozoites.

PubMed

Ropolo, Andrea S; Saura, Alicia; Carranza, Pedro G; Lujan, Hugo D

2005-08-01

Giardia lamblia undergoes antigenic variation, a process that might allow the parasite to evade the host's immune response and adapt to different environments. Here we show that Giardia muris, a related species that naturally infects rodents, possesses multiple variant-specific surface proteins (VSPs) and expresses VSPs on its surface, suggesting that it undergoes antigenic variation similar to that of G. lamblia.

KSC-98pc1165

NASA Image and Video Library

1998-09-28

The orbiter Atlantis, being towed from the Shuttle Landing Facility, is reflected in waters from the Banana Creek next to the towway. The orbiter spent 10 months in Palmdale, CA, undergoing extensive inspections and modifications in the orbiter processing facility there. The modifications included several upgrades enabling it to support International Space Station missions, such as adding an external airlock for ISS docking missions and installing thinner, lighter thermal protection blankets for weight reduction which will allow it to haul heavier cargo. Atlantis will undergo preparations in the Orbiter Processing Facility at KSC for its planned flight in June 1999

Dermatological Manifestations in Patients Undergoing In Vitro Fertilisation: A Prospective Study.

PubMed

Sood, Aradhana; Sahu, Suvash; Karunakaran, Sandeep; Joshi, Rajneesh K; Raman, Deep Kumar

Changing sociodemographic patterns with an increase in the age of childbirth have affected fertility rates worldwide. With advancing reproductive medicine, assisted reproductive techniques (ARTs) are becoming common. While dermatological manifestations in normal pregnancies have been well documented, there is a paucity of data regarding cutaneous manifestations in patients undergoing ART. The objectives of our study were to estimate the incidence and types of dermatological manifestations in patients undergoing in vitro fertilisation (IVF) and to study their associations with age, type of infertility, and outcome of the procedure. A prospective cohort of 200 patients undergoing IVF in a tertiary care centre was observed for occurrence of any dermatological manifestations from initiation of the IVF protocol to the outcome of the procedure at 3 weeks after embryo transfer. Dermatological manifestations were seen in 27% of the study group, with urticaria being the most common cutaneous finding seen in 13.5%, followed by acneform eruptions (3%). Twenty-six (96.3%) of patients who manifested with urticaria were on progesterone. No statistically significant association was found between the occurrence of dermatological manifestations and the outcome of IVF, type of infertility, history of ART, and ovum donation in our study. Association between the age of the patient and the outcome of IVF cycle was statistically significant. Dermatological manifestations are seen in almost one-quarter of patients undergoing IVF, with progesterone-induced urticaria being the most common. Occurrence of cutaneous manifestations has no significant association with the outcome of IVF.

Management patterns of medicare patients undergoing treatment for upper urinary tract calculi.

PubMed

Matlaga, Brian R; Meckley, Lisa M; Kim, Micheline; Byrne, Thomas W

2014-06-01

We conducted this study to identify differences in the re-treatment rates and ancillary procedures for the two most commonly utilized stone treatment procedures in the Medicare population: ureteroscopy (URS) and shock wave lithotripsy (SWL). A retrospective claims analysis of the Medicare standard analytical file 5% sample was conducted to identify patients with a new diagnosis of urolithiasis undergoing treatment with URS or SWL from 2009-2010. Outcomes evaluated: (1) repeat stone removal procedures within 120 days post index procedure, (2) stent placement procedures on the index date, 30 days prior to and 120 days post index date, and (3) use of general anesthesia. We identified 3885 eligible patients, of which 2165 (56%) underwent SWL and 1720 (44%) underwent URS. Overall, SWL patients were 1.73 times more likely to undergo at least one repeat procedure than URS patients, and twice as likely to require multiple re-treatments compared to URS. Among those with ureteral stones, SWL patients were 2.27 times more likely to undergo repeat procedures. The difference was not statistically significant in renal stone patients. Overall, SWL patients were 1.41 times more likely than URS patients to have a stent placed prior to index procedure, and 1.33 times more likely to have a stent placed subsequent to the index procedure. The majority of URS patients (77.8%) had a stent placed at the time of index procedure. There was no significant difference in anesthetic approaches between SWL and URS. Patients undergoing SWL are significantly more likely to require re-treatments than URS patients. SWL patients are also significantly more likely to require ureteral stent placement as a separate event. SWL and URS patients have similar rates of general anesthesia.

The economic implications of a multimodal analgesic regimen for patients undergoing major orthopedic surgery: a comparative study of direct costs.

PubMed

Duncan, Christopher M; Hall Long, Kirsten; Warner, David O; Hebl, James R

2009-01-01

Total knee and total hip arthoplasty (THA) are 2 of the most common surgical procedures performed in the United States and represent the greatest single Medicare procedural expenditure. This study was designed to evaluate the economic impact of implementing a multimodal analgesic regimen (Total Joint Regional Anesthesia [TJRA] Clinical Pathway) on the estimated direct medical costs of patients undergoing lower extremity joint replacement surgery. An economic cost comparison was performed on Mayo Clinic patients (n = 100) undergoing traditional total knee or total hip arthroplasty using the TJRA Clinical Pathway. Study patients were matched 1:1 with historical controls undergoing similar procedures using traditional anesthetic (non-TJRA) techniques. Matching criteria included age, sex, surgeon, type of procedure, and American Society of Anesthesiologists (ASA) physical status (PS) classification. Hospital-based direct costs were collected for each patient and analyzed in standardized inflation-adjusted constant dollars using cost-to-charge ratios, wage indexes, and physician services valued using Medicare reimbursement rates. The estimated mean direct hospital costs were compared between groups, and a subgroup analysis was performed based on ASA PS classification. The estimated mean direct hospital costs were significantly reduced among TJRA patients when compared with controls (cost difference, 1999 dollars; 95% confidence interval, 584-3231 dollars; P = 0.0004). A significant reduction in hospital-based (Medicare Part A) costs accounted for the majority of the total cost savings. Use of a comprehensive, multimodal analgesic regimen (TJRA Clinical Pathway) in patients undergoing lower extremity joint replacement surgery provides a significant reduction in the estimated total direct medical costs. The reduction in mean cost is primarily associated with lower hospital-based (Medicare Part A) costs, with the greatest overall cost difference appearing among patients with significant comorbidities (ASA PS III-IV patients).

Transection Speed and Impact on Perioperative Inflammatory Response - A Randomized Controlled Trial Comparing Stapler Hepatectomy and CUSA Resection.

PubMed

Schwarz, Christoph; Klaus, Daniel A; Tudor, Bianca; Fleischmann, Edith; Wekerle, Thomas; Roth, Georg; Bodingbauer, Martin; Kaczirek, Klaus

2015-01-01

Parenchymal transection represents a crucial step during liver surgery and many different techniques have been described so far. Stapler resection is supposed to be faster than CUSA resection. However, whether speed impacts on the inflammatory response in patients undergoing liver resection (LR) remains unclear. This is a randomized controlled trial including 40 patients undergoing anatomical LR. Primary endpoint was transection speed (cm2/min). Secondary endpoints included the perioperative change of pro- and anti-inflammatory cytokines, overall surgery duration, length of hospital stay, morbidity and mortality. Mean transection speed was significantly higher in patients undergoing stapler hepatectomy compared to CUSA resection (CUSA: 1 (0.4) cm2/min vs. Stapler: 10.8 (6.1) cm2/min; p<0.0001). Analyzing the impact of surgery duration on inflammatory response revealed a significant correlation between IL-6 levels measured at the end of surgery and the overall length of surgery (p<0.0001, r = 0.6188). Patients undergoing CUSA LR had significantly higher increase of interleukin-6 (IL-6) after parenchymal transection compared to patients with stapler hepatectomy in the portal and hepatic veins, respectively (p = 0.028; p = 0.044). C-reactive protein levels on the first post-operative day were significantly lower in the stapler cohort (p = 0.010). There was a trend towards a reduced overall surgery time in patients with stapler LR, especially in the subgroup of patients undergoing minor hepatectomies (p = 0.020). Liver resection using staplers is fast, safe and suggests a diminished inflammatory response probably due to a decreased parenchymal transection time. ClinicalTrials.gov NCT01785212.

Transection Speed and Impact on Perioperative Inflammatory Response – A Randomized Controlled Trial Comparing Stapler Hepatectomy and CUSA Resection

PubMed Central

Schwarz, Christoph; Klaus, Daniel A.; Tudor, Bianca; Fleischmann, Edith; Wekerle, Thomas; Roth, Georg; Bodingbauer, Martin; Kaczirek, Klaus

2015-01-01

Background Parenchymal transection represents a crucial step during liver surgery and many different techniques have been described so far. Stapler resection is supposed to be faster than CUSA resection. However, whether speed impacts on the inflammatory response in patients undergoing liver resection (LR) remains unclear. Materials and Methods This is a randomized controlled trial including 40 patients undergoing anatomical LR. Primary endpoint was transection speed (cm2/min). Secondary endpoints included the perioperative change of pro- and anti-inflammatory cytokines, overall surgery duration, length of hospital stay, morbidity and mortality. Results Mean transection speed was significantly higher in patients undergoing stapler hepatectomy compared to CUSA resection (CUSA: 1 (0.4) cm2/min vs. Stapler: 10.8 (6.1) cm2/min; p<0.0001). Analyzing the impact of surgery duration on inflammatory response revealed a significant correlation between IL-6 levels measured at the end of surgery and the overall length of surgery (p<0.0001, r = 0.6188). Patients undergoing CUSA LR had significantly higher increase of interleukin-6 (IL-6) after parenchymal transection compared to patients with stapler hepatectomy in the portal and hepatic veins, respectively (p = 0.028; p = 0.044). C-reactive protein levels on the first post-operative day were significantly lower in the stapler cohort (p = 0.010). There was a trend towards a reduced overall surgery time in patients with stapler LR, especially in the subgroup of patients undergoing minor hepatectomies (p = 0.020). Conclusions Liver resection using staplers is fast, safe and suggests a diminished inflammatory response probably due to a decreased parenchymal transection time. Trial Registration ClinicalTrials.gov NCT01785212 PMID:26452162

[Clinical outcomes and economic analysis of two ovulation induction protocols in patients undergoing repeated IVF/ICSI cycles].

PubMed

Chen, Xiao; Geng, Ling; Li, Hong

2014-04-01

To compare the clinical outcomes and cost-effectiveness of luteal phase down-regulation with gonadotrophin-releasing hormone (GnRH) agonist protocol and GnRH antagonist protocol in patients undergoing repeated in vitro fertilization and intracytoplasmic sperm injection (IVF-ICSI) cycles. A retrospective analysis of clinical outcomes and costs was conducted among 198 patients undergoing repeated IVF-ICSI cycles, including 109 receiving luteal phase down-regulation with GnRH agonist protocol (group A) and 89 receiving GnRH antagonist protocol (group B). The numbers of oocytes retrieved and good embryos, clinical pregnancy rate, abortion rate, the live birth rate, mean total cost, and the cost-effective ratio were compared between the two groups. In patients undergoing repeated IVF-ICSI cycles, the two protocols produced no significant differences in the number of good embryos, clinical pregnancy rate, abortion rate, or twin pregnancy rate. Compared with group B, group A had better clinical outcomes though this difference was not statistically significant. The number of retrieved oocytes was significantly greater and live birth rate significantly higher in group A than in group B (9.13=4.98 vs 7.11=4.74, and 20.2% vs 9.0%, respectively). Compared with group B, group A had higher mean total cost per cycle but lower costs for each oocyte retrieved (2729.11 vs 3038.60 RMB yuan), each good embryo (8867.19 vs 9644.85 RMB yuan), each clinical pregnancy (77598.06 vs 96139.85 RMB yuan). For patients undergoing repeated IVF/ICSI cycle, luteal phase down-regulation with GnRH agonist protocol produces good clinical outcomes with also good cost-effectiveness in spite an unsatisfactory ovarian reserve.

The Meaning of Disease and Spiritual Responses to Stressors in Adults With Acute Leukemia Undergoing Hematopoietic Stem Cell Transplantation.

PubMed

Farsi, Zahra

2015-12-01

Some studies have shown that patients with cancer may experience significant spiritual distress as well as spiritual growth, that there is a positive association between spirituality and coping, and that positive religious coping predicts enhanced health outcomes. This study was designed to help explain how the meaning of disease and spiritual responses to threatening stressors influence the final experiential outcomes of adults with leukemia undergoing hematopoietic stem cell transplantation in Iran. This grounded theory study conducted in-depth interviews between 2009 and 2011 on 10 adults in Iran with leukemia undergoing hematopoietic stem cell transplantation. Recorded audio interviews were transcribed verbatim in Persian and coded and analyzed using Corbin and Strauss (2008)'s approach. Main categories that emerged from data included "experiencing the meaning of cancer"; "changing perceptions of death, life and health"; and "moving toward perfection and sublimity." "Finding meaning" was the main concept that defined the final outcome of the experience of participants. Understanding the meaning to patients of disease and treatments may help healthcare providers better appreciate the patients' perspective and improve the physician-patient relationship. Nurses are well positioned to play a decisive role in helping patients cope effectively with their treatment process and in helping ensure positive outcomes for treatments through their helping patients find the unique meaning of their experience.

The effect of preoperative magnesium supplementation on blood catecholamine concentrations in patients undergoing CABG.

PubMed

Pasternak, K; Dabrowski, W; Dobija, J; Wrońskal, J; Rzecki, Z; Biernacka, J

2006-06-01

It is well known that magnesium (Mg) plays an important role in many physiological processes such as regulation of blood catecholamine concentrations, particularly epinephrine (E) and norepinephrine (NE). The complex character of extracorporeal circulation (ECC) with intraoperative normovolemic haemodilution (NH) may alter blood Mg levels, which is likely to result in disorders of E and NE. The aim of this study was to analyze the influence of preoperative Mg supplementation on E and NE in patients undergoing CABG. Forty male patients undergoing CABG under general anaesthesia were included. Patients were randomly divided into two groups: A--the patients receiving pre-operative magnesium supplementation and B--patients without pre-operative magnesium supplementation. The Mg, E and NE blood concentrations were measured in five stages: 1) before anesthesia after the radial artery cannulation, 2) during NH and ECC, 3) immediately after surgery, 4) in the morning of the 1st postoperative day, 5) in the morning of the 2nd postoperative day. The Mg levels were determined by spectrophotometric methods, E and NE were measured by radioimmunoassay methods. The CABG caused a decrease of Mg and an increase of E and NE in both groups, but the changes were significantly higher in group B. 1) CABG causes a decrease of Mg and an increase of E and NE; 2) Preoperative, oral supplementation of Mg substantially reduces intra- and postoperative disorders.

Adopted Individuals' Views on the Utility and Value of Expanded Carrier Screening.

PubMed

Spencer, Sara; Ewing, Sarah; Calcagno, Kathryn; O'Neill, Suzanne

2018-03-30

Adoptees may not have family medical history and ethnicity information. Carrier screening assesses reproductive risk. Expanded carrier screening (ECS) screens for many genetic conditions regardless of a patient's knowledge of family history and ethnicity. This study aimed to better understand the opinions and attitudes of adopted individuals on the use of ECS in determining a patient's reproductive genetic risks. Specifically, the study assessed how adopted individuals feel that results of ECS may be useful to them and whether adoptees feel that meeting with a genetics professional in the process of undergoing ECS would be useful. Adult adoptees (N = 124) were recruited online. Their opinions on ECS were explored. The majority reported they had never been offered carrier screening (92%). The majority of adoptees wanted ECS (76%). Neither the amount of contact with biological relatives nor having medical knowledge about biological relatives was significantly associated with adoptees' desire to pursue ECS. There was a significant positive correlation between adoptees of higher education levels and the amount they would pay for ECS (p = 0.004). The majority of participants (95%) indicated a genetics professional would be helpful when undergoing ECS. The findings suggest this population may want ECS and support from genetics healthcare professionals. Advocacy for genetic counseling and testing for adoptees appears justifiable.

The impact of semen processing on sperm parameters and pregnancy rates after intrauterine insemination.

PubMed

Ruiter-Ligeti, Jacob; Agbo, Chioma; Dahan, Michael

2017-06-01

The objective of this retrospective study was to evaluate the effect of semen processing on computer analyzed semen parameters and pregnancy rates after intrauterine insemination (IUI). Over a two-year period, a total of 981 couples undergoing 2231 IUI cycles were evaluated and the freshly collected non-donor semen was analyzed before and after density gradient centrifugation (DGC). DGC led to significant increases in sperm concentration by 66±74 ×106/mL (P=0.0001), percentage of motile sperm by 24±22% (P=0.0001), concentration motile by 27±58 ×106/mL (P=0.0001), and forward sperm progression by 18±14 µ/s (P=0.0001). In 95% of cases, there was a decrease in the total motile sperm count (TMSC), with an average decrease of 50±124% compared to pre-processed samples (P=0.0001). Importantly, the decrease in TMSC did not negatively affect pregnancy rates (P=0.45). This study proves that DGC leads to significant increases in most sperm parameters, with the exception of TMSC. Remarkably, the decrease in TMSC did not affect the pregnancy rate. This should reassure clinicians when the TMSC is negatively affected by processing.

Patella Fractures Prior to Total Knee Arthroplasty: Worse Outcomes but Equivalent Survivorship.

PubMed

Houdek, Matthew T; Shannon, Steven F; Watts, Chad D; Wagner, Eric R; Sems, Stephen A; Sierra, Rafael J

2015-12-01

Distal femur and/or tibial plateau fractures adversely affect outcomes of TKA; however it is unknown if a previous patella fracture affects outcome. We reviewed 113 patients undergoing TKA with a previous patella fracture from 1990 to 2012. Component survival was compared to 19,641 patients undergoing TKA for osteoarthritis during the same period. The 15-year implant survivals following a previous patella fracture was 86%. There was no difference in implant survival compared to patients undergoing TKA for OA (P=0.31). Knee society scores significantly improved following TKA; however patients with a fracture had complications related to knee flexion. Patients undergoing primary TKA following a patella fracture have similar overall revision free survival compared to those undergoing TKA for OA at 15-years. Copyright © 2015 Elsevier Inc. All rights reserved.

[The Application of Grief Theories to Bereaved Family Members].

PubMed

Wu, Lee-Jen Suen; Chou, Chuan-Chiang; Lin, Yen-Chun

2017-12-01

Loss is an inevitable experience for humans for which grief is a natural response. Nurses must have an adequate understanding of grief and bereavement in order to be more sensitive to these painful emotions and to provide appropriate care to families who have lost someone they love deeply. This article introduces four important grief theories: Freud's grief theory, Bowlby's attachment theory, Stroebe and Schuts' dual process model, and Neiyemer's meaning reconstruction model. Freud's grief theory holds that the process of grief adaptation involves a bereaved family adopting alternative ways to connect with the death of a loved one and to restore their self-ego. Attachment theory holds that individuals who undergo grieving that is caused by separation from significant others and that triggers the process of grief adaptation will fail to adapt if they resist change. The dual process model holds that bereaved families undergo grief adaptation not only as a way to face their loss but also to restore normality in their lives. Finally, the meaning reconstruction model holds that the grief-adaptation strength of bereaved families comes from their meaning reconstruction in response to encountered events. It is hoped that these theories offer nurses different perspectives on the grieving process and provide a practical framework for grief assessment and interventions. Additionally, specific interventions that are based on these four grief theories are recommended. Furthermore, theories of grief may help nurses gain insight into their own practice-related reactions and healing processes, which is an important part of caring for the grieving. Although the grieving process is time consuming, nurses who better understand grief will be better able to help family members prepare in advance for the death of a loved one and, in doing so, help facilitate their healing, with a view to the future and to finally returning to normal daily life.

Access to breast reconstruction after mastectomy and patient perspectives on reconstruction decision making.

PubMed

Morrow, Monica; Li, Yun; Alderman, Amy K; Jagsi, Reshma; Hamilton, Ann S; Graff, John J; Hawley, Sarah T; Katz, Steven J

2014-10-01

Most women undergoing mastectomy for breast cancer do not undergo breast reconstruction. To examine correlates of breast reconstruction after mastectomy and to determine if a significant unmet need for reconstruction exists. We used Surveillance, Epidemiology, and End Results registries from Los Angeles, California, and Detroit, Michigan, for rapid case ascertainment to identify a sample of women aged 20 to 79 years diagnosed as having ductal carcinoma in situ or stages I to III invasive breast cancer. Black and Latina women were oversampled to ensure adequate representation of racial/ethnic minorities. Eligible participants were able to complete a survey in English or Spanish. Of 3252 women sent the initial survey a median of 9 months after diagnosis, 2290 completed it. Those who remained disease free were surveyed 4 years later to determine the frequency of immediate and delayed reconstruction and patient attitudes toward the procedure; 1536 completed the follow-up survey. The 485 who remained disease free at follow-up underwent analysis. Disease-free survival of breast cancer. Breast reconstruction at any time after mastectomy and patient satisfaction with different aspects of the reconstruction decision-making process. Response rates in the initial and follow-up surveys were 73.1% and 67.7%, respectively (overall, 49.4%). Of 485 patients reporting mastectomy at the initial survey and remaining disease free, 24.8% underwent immediate and 16.8% underwent delayed reconstruction (total, 41.6%). Factors significantly associated with not undergoing reconstruction were black race (adjusted odds ratio [AOR], 2.16 [95% CI, 1.11-4.20]; P = .004), lower educational level (AOR, 4.49 [95% CI, 2.31-8.72]; P < .001), increased age (AOR in 10-year increments, 2.53 [95% CI, 1.77-3.61]; P < .001), major comorbidity (AOR, 2.27 [95% CI, 1.01-5.11]; P = .048), and chemotherapy (AOR, 1.82 [95% CI, 0.99-3.31]; P = .05). Only 13.3% of women were dissatisfied with the reconstruction decision-making process, but dissatisfaction was higher among nonwhite patients in the sample (AOR, 2.87 [95% CI, 1.27-6.51]; P = .03). The most common patient-reported reasons for not having reconstruction were the desire to avoid additional surgery (48.5%) and the belief that it was not important (33.8%), but 36.3% expressed fear of implants. Reasons for avoiding reconstruction and systems barriers to care varied by race; barriers were more common among nonwhite participants. Residual demand for reconstruction at 4 years was low, with only 30 of 263 who did not undergo reconstruction still considering the procedure. Reconstruction rates largely reflect patient demand; most patients are satisfied with the decision-making process about reconstruction. Specific approaches are needed to address lingering patient-level and system factors with a negative effect on reconstruction among minority women.

Effects of ionizing radiations on a pharmaceutical compound, chloramphenicol

NASA Astrophysics Data System (ADS)

Varshney, L.; Patel, K. M.

1994-05-01

Chloramphenicol, a broad spectrum antibiotic, has been irradiated using Cobalt-60 γ radiation and electron beam at graded radiation doses upto 100 kGy. Several degradation products and free radicals are formed on irradiation. Purity, degradation products, free radicals, discolouration, crystallinity, solubility and entropy of radiation processing have been investigated. Aqueous solutions undergo extensive radiolysis even at low doses. Physico-chemical, microbiological and toxicological tests do not show significant degradation at sterilization dose. High performance liquid chromatography (HPLC), differential scanning calorimetry (DSC), UV-spectrophotometry, diffuse reflectance spectroscopy (DRS) and electron spin resonance spectroscopy (ESR) techniques were employed for the investigations.

Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis.

PubMed

Manheimer, Eric; Zhang, Grant; Udoff, Laurence; Haramati, Aviad; Langenberg, Patricia; Berman, Brian M; Bouter, Lex M

2008-03-08

To evaluate whether acupuncture improves rates of pregnancy and live birth when used as an adjuvant treatment to embryo transfer in women undergoing in vitro fertilisation. Systematic review and meta-analysis. Medline, Cochrane Central, Embase, Chinese Biomedical Database, hand searched abstracts, and reference lists. Review methods Eligible studies were randomised controlled trials that compared needle acupuncture administered within one day of embryo transfer with sham acupuncture or no adjuvant treatment, with reported outcomes of at least one of clinical pregnancy, ongoing pregnancy, or live birth. Two reviewers independently agreed on eligibility; assessed methodological quality; and extracted outcome data. For all trials, investigators contributed additional data not included in the original publication (such as live births). Meta-analyses included all randomised patients. Seven trials with 1366 women undergoing in vitro fertilisation were included in the meta-analyses. There was little clinical heterogeneity. Trials with sham acupuncture and no adjuvant treatment as controls were pooled for the primary analysis. Complementing the embryo transfer process with acupuncture was associated with significant and clinically relevant improvements in clinical pregnancy (odds ratio 1.65, 95% confidence interval 1.27 to 2.14; number needed to treat (NNT) 10 (7 to 17); seven trials), ongoing pregnancy (1.87, 1.40 to 2.49; NNT 9 (6 to 15); five trials), and live birth (1.91, 1.39 to 2.64; NNT 9 (6 to 17); four trials). Because we were unable to obtain outcome data on live births for three of the included trials, the pooled odds ratio for clinical pregnancy more accurately represents the true combined effect from these trials rather than the odds ratio for live birth. The results were robust to sensitivity analyses on study validity variables. A prespecified subgroup analysis restricted to the three trials with the higher rates of clinical pregnancy in the control group, however, suggested a smaller non-significant benefit of acupuncture (odds ratio 1.24, 0.86 to 1.77). Current preliminary evidence suggests that acupuncture given with embryo transfer improves rates of pregnancy and live birth among women undergoing in vitro fertilisation.

Identification of Variant-Specific Surface Proteins in Giardia muris Trophozoites

PubMed Central

Ropolo, Andrea S.; Saura, Alicia; Carranza, Pedro G.; Lujan, Hugo D.

2005-01-01

Giardia lamblia undergoes antigenic variation, a process that might allow the parasite to evade the host's immune response and adapt to different environments. Here we show that Giardia muris, a related species that naturally infects rodents, possesses multiple variant-specific surface proteins (VSPs) and expresses VSPs on its surface, suggesting that it undergoes antigenic variation similar to that of G. lamblia. PMID:16041041

Surgical Site Infection Reduction Bundle: Implementation and Challenges at Ventura County Medical Center.

PubMed

Losh, Joseph M; Gough, Amy; Rutherford, Richard; Romero, Javier; Diaz, Graal; Schweitzer, Jeremy

2017-10-01

Surgical Site Infections (SSIs) are a significant cause of morbidity and increased cost in the postoperative patient occurring in 2-5 per cent of those undergoing inpatient surgery. Ventura County Medical Center (VCMC) initiated an SSI reduction bundle in 2013, to try to reduce the incidence of SSI. The bundle is a series of best practices including preoperative, perioperative, intraoperative, and postoperative components, as well as items focused on the staff and electronic medical record. VCMC started with a 6.1 per cent SSI rate in 2013. A consistent reduction in SSI rate followed each quarter after that for a rate of less than 2.0 per cent in early 2016. The most critical aspect of this process was the necessary collaboration between disparate departments and the ongoing investment of the staff to this challenging process; the people at the heart of the collaborative process were the key to its success.

Achievement of European standards by CROB-IRCCS.

PubMed

Gallicchio, Rosj; Scapicchio, Daniele; Musto, Pellegrino; Storto, Giovanni

2015-01-01

The Organisation of European Cancer Institutes (OECI) has recently endorsed a program for the accreditation of Italian cancer institutes. Any cancer center that aims to provide research, education, and care services to cancer patients should undergo an evaluation process in order to become OECI accredited. On a center basis, the task turned out to be challenging, and required commitment and increased workload. The timing is an adjunctive constraint, especially when dealing with bureaucracy. Once undertaken, the accreditation process goes through preparation and completion of the self-evaluation, peer review, report, and final designation. This process constitutes an unrepeatable opportunity for improvement. It is required to implement the necessary changes in order to improve policies, procedures, and employee training. Sharing the highlighted general remarks, strengths, and opportunities provided by the different audit teams (on a cancer center basis) will constitute a significant instrument to enhance cancer care.

Neural correlates of active controlled retrieval development: An exploratory ERP study.

PubMed

Simard, France; Cadoret, Geneviève

2018-07-01

Working memory is composed of different processes and encompasses not only the temporary storage of information but also its manipulation in order to perform complex cognitive activities. During childhood, one of these manipulation processes, namely active controlled retrieval, improves significantly between the age of 6 to 10, suggesting that the neuronal network supporting this function undergoes substantial maturational changes. The present study examined the neural activity of 14 healthy children and 14 adults while performing an active controlled retrieval task. Results showed differences in brain activity according to active controlled retrieval in a 300-500 ms window corresponding to the retrieval period. Active controlled retrieval was associated with a P3b-like potential in parietal sites for both children and adults. In fronto-central sites, children demonstrated a "N400 like" potential associated with active retrieval processing. These results are discussed in terms of maturational development. Copyright © 2018 Elsevier Inc. All rights reserved.

Effect of heat treatment On Microstructure of steel AISI 01 Tools

NASA Astrophysics Data System (ADS)

Dyanasari Sebayang, Melya; Yudo, Sesmaro Max; Silitonga, Charlie

2018-03-01

This study discusses the influence of quenching, normalizing, and annealing to changes in hardness, tensile, and microstructure of materials tool steel AISI 01 after the material undergo heat treatment process. This heat treatment process includes an initial warming of 600° C and a 5-minute detention time, followed by heating to an austenisation temperature of 850°C. After that a different cooling process, including annealing process, normalizing and quenching oil SAE 40. Tests performed include tensile, hard, and microstructure with shooting using SEM (Scanning Electron Microscope). This is done to see the effect of different heat treatment and cooling process. The result of this research is difference of tensile test value, hard, and micro structure from influence of difference of each process. The quenching process obtains the highest tensile and hard values followed by the normalizing process, annealing, and the lowest is in the starting material, this is because the initial material does not undergo heat treatment process. The resulting microstructure is pearlit and cementite, the difference seen from the shape and size of the grains. The larger the grain size, the greater the hardness.

Cell-free DNA and telomere length among women undergoing in vitro fertilization treatment.

PubMed

Czamanski-Cohen, J; Sarid, O; Cwikel, J; Douvdevani, A; Levitas, E; Lunenfeld, E; Har-Vardi, I

2015-11-01

The current research is aimed at finding potential non-invasive bio-markers that will help us learn more about the mechanisms at play in failed assisted reproduction treatment. This exploratory pilot study examined the relationship between cell-free DNA (CFD) in plasma and telomere length in lymphocytes among women undergoing in vitro fertilization (IVF) and compared telomere length and CFD levels to a healthy control group. Blood of 20 women undergoing IVF was collected at three time points during the IVF cycle. We assessed the relationship between CFD and telomere length as well as controlling for morning cortisol levels. We also collected blood of 10 healthy controls at two time points (luteal and follicular phases of the menstrual cycle) and compared mean telomere length, CFD, and cortisol levels between the IVF patients and healthy controls. The results revealed an inverse relationship between CFD levels and telomere lengths at several time points that remained significant even after controlling for cortisol levels. Women undergoing IVF had statistically significant higher levels of CFD and shorter telomeres compared to healthy controls. The relationship between telomere length and CFD should be further explored in larger studies in order to uncover potential mechanisms that cause both shortened telomere length and elevated CFD in women undergoing IVF.

Improving women's knowledge of prostaglandin induction of labour through the use of information brochures: a quasi-experimental study.

PubMed

Cooper, Megan; Warland, Jane

2011-12-01

To gain a better understanding of women's baseline level of knowledge of induction of labour (IOL) and determine whether giving written information at the time IOL is decided, results in significant differences in knowledge and understanding of the process. Fifty pregnant women undergoing antenatal care at a small maternity hospital were recruited. A quasi experimental trial was conducted with non random selection of participants, 25 selected to act as the control group and 25 selected as the intervention group. The study was conducted to determine women's knowledge of IOL both before (non-intervention) and after (intervention) the introduction of a written information brochure. Statistically significant increases in knowledge were evident in the intervention group for knowledge about action (p=0.002) and timing of prostaglandins (p=0.03), the number of side effects known (p<0.0001) as well as time to birth (p=0.001) indicating an increased understanding of the process as a result of reading an information brochure. These results suggest that those in the non-intervention group lacked knowledge pertinent to IOL, even though they have consented to and actually arrived at the hospital prepared to undergo the IOL procedure. The most significant disparity noted between the intervention and non-intervention groups was women's knowledge of side effects of prostaglandin. Further to this, many women in the non-intervention group had unrealistic expectations of both the time for drug action and likely time from prostaglandin administration to birth. In contrast women in the intervention group knew about the common side effects of prostaglandin and possessed a more realistic understanding of the likely time to birth following this procedure. The results indicate that a specifically designed information brochure explaining the process of IOL in plain language has the effect of enhancing women's knowledge. This area of study warrants further investigation, especially research into the role of written information to improve women's understanding across other areas of maternity care education provision. Copyright © 2010 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Application of electrokinetic soil flushing to four herbicides: A comparison.

PubMed

dos Santos, E Vieira; Souza, F; Saez, C; Cañizares, P; Lanza, M R V; Martinez-Huitle, C A; Rodrigo, M A

2016-06-01

In this work, four bench-scale plants containing soil spiked with four herbicides (2,4-Dichlorophenoxyacetic acid (2,4-D), oxyfluorfen, chlorsulfuron and atrazine) undergo treatment consisting of an electrokinetic soil flushing (EKSF). Results clearly demonstrate that efficiency of EKSF depends on the chemical characteristic of the pesticide used. The amount of pesticide collected in the anode well is more significant than that collected in the cathode wells, indicating that the electromigration is much more important than drainage by electro-osmotic flux for this application. After 15 d of treatment, the 2,4-D is the pesticide most efficiently removed (95% of removal), while chlorsulfuron is the pesticide more resilient to the treatment. Additionally, volatilization was found to be a process of the major significance in the application of electrokinetic techniques to soil polluted with herbicides and because of that it should always be taken into account in the future design of full-scale processes. Copyright © 2016 Elsevier Ltd. All rights reserved.

Embryo yield after in vitro fertilization in women undergoing embryo banking for fertility preservation before chemotherapy.

PubMed

Robertson, Audra D; Missmer, Stacey A; Ginsburg, Elizabeth S

2011-02-01

To evaluate embryo yield after IVF in patients undergoing embryo banking before chemotherapy. A retrospective cohort study. Hospital-based academic medical center. Thirty-eight women diagnosed with cancer or autoimmune disease presenting for IVF cycles, with or without intracytoplasmic sperm injection (ICSI), for embryo cryopreservation before any therapy were compared with 921 presumably fertile women undergoing IVF for male factor infertility from January 2001 through October 2007. Standard IVF or ICSI protocol, embryo freezing, and ET. The number of 2 pronuclear (2PN) embryos created and suitable for cryopreservation or transfer. No statistically significant differences were observed between preservation and male factor groups for number of embryos, number of oocytes, or amount of gonadotropin needed to stimulate follicular development. Peak serum E(2) levels were significantly lower for women with disease-seeking fertility preservation. Women facing chemotherapy as treatment for cancer or systemic autoimmune disease infrequently undergo fertility preservation. If offered this potentially fertility-preserving option, these data suggest equivalent embryo yield compared with women with infertile male partners. Our data report no significant complications in subsequent births in those who sought fertility preservation, which is informative and encouraging for these women and their providers. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Solvent-induced controllable synthesis, single-crystal to single-crystal transformation and encapsulation of Alq3 for modulated luminescence in (4,8)-connected metal-organic frameworks.

PubMed

Lan, Ya-Qian; Jiang, Hai-Long; Li, Shun-Li; Xu, Qiang

2012-07-16

In this work, for the first time, we have systematically demonstrated that solvent plays crucial roles in both controllable synthesis of metal-organic frameworks (MOFs) and their structural transformation process. With solvent as the only variable, five new MOFs with different structures have been constructed, in which one MOF undergoes solvent-induced single-crystal to single-crystal (SCSC) transformation that involves not only solvent exchange but also the cleavage and formation of coordination bonds. Particularly, a significant crystallographic change has been realized through an unprecedented three-step SCSC transformation process. Furthermore, we have demonstrated that the obtained MOF could be an excellent host for chromophores such as Alq3 for modulated luminescent properties.

Financing biotechnology projects: lender due diligence requirements and the role of independent technical consultants.

PubMed

Keller, J B; Plath, P B

1999-01-01

An increasing number of biotechnology projects are being brought to commercialization using conventional structured finance sources, which have traditionally only been available to proven technologies and primary industries. Attracting and securing competitive cost financing from mainstream lenders, however, will require the sponsor of a new technology or process to undergo a greater level of due diligence. The specific areas and intensity of investigation, which are typically required by lenders in order to secure long-term financing for biotechnology-based manufacturing systems, is reviewed. The processes for evaluating the adequacy of prior laboratory testing and pilot plant demonstrations is discussed. Particular emphasis is given to scale-up considerations and the ability of the proposed facility design to accommodate significant modifications, in the event that scale-up problems are encountered.

On the Origin of Banded Structure in Dusty Protoplanetary Discs: HL Tau and TW Hya

NASA Astrophysics Data System (ADS)

Boley, Aaron C.

2017-10-01

We present simulations of planet-planetesimal interactions that can reproduce major and minor banded structure in the HL Tau and TW Hya discs provided that small grains trace the dynamically cold planetesimal population. The consequences of the model and its limitations will be discussed. In particular, the model requires that planetesimals form throughout the disc at early times, that planetesimal-planetesimal collisions are predominately among the cold population, and that pebble accretion leads to mass redistribution of the small grains onto planetesimals before the grains can undergo significant radial drift. The meteortic record may suggest that a similar process occurred in the Solar System. The model implies that grain size distributions inferred from submm/mm studies may reflect early debris processes rather than grain growth.

Blood Infusion and the Risk of Haemorrhage in Patients Undergoing Cardiac Surgery with Extracorporeal Circulation.

PubMed

Luque-Oliveros, Manuel; Garcia-Carpintero, Maria Angeles; Cauli, Omar

2017-01-01

Patients undergoing cardiac surgery with extracorporeal circulation (ECC) frequently present haemorrhages as a complication associated with high morbidity and mortality. One of the factors that influences this risk is the volume of blood infused during surgery. The objective of this study was to determine the optimal volume of autologous blood that can be processed during cardiac surgery with ECC. We also determined the number of salvaged red blood cells to be reinfused into the patient in order to minimize the risk of haemorrhage in the postoperative period. This was an observational retrospective cross-sectional study performed in 162 ECC cardiac surgery patients. Data regarding the sociodemographic profiles of the patients, their pathologies and surgical treatments, and the blood volume recovered, processed, and reinfused after cell salvage were collected. We also evaluated the occurrence of postoperative haemorrhage. The volume of blood infused after cell salvage had a statistically significant effect (p < 0.01) on the risk of post-operative haemorrhage; the receiver operating characteristic sensitivity was 0.813 and the optimal blood volume cut-off was 1800 ml. The best clinical outcome (16.7% of patients presenting haemorrhages) was in patients that had received less than 1800 ml of recovered and processed autologous blood, which represented a volume of up to 580 ml reinfused red blood cells. The optimum thresholds for autologous processed blood and red blood cells reinfused into the patient were 1800 and 580 ml, respectively. Increasing these thresholds augmented the risk of haemorrhage as an immediate postoperative period complication. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Closeup view of an External Tank (ET) Attach Ring undergoing ...

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

Close-up view of an External Tank (ET) Attach Ring undergoing preparations in the Processing Building of the Rotation Processing and Surge Facility at Kennedy Space Center. After preparations are complete the ET Attach Ring will be mated to the top of the Aft Motor Segment. The most prominent features in this view are the ET/Solid Rocket Booster Struts in the center and left in the view and the Aft Integrated Electronics Assembly located on the right side if the ring in this view. - Space Transportation System, Solid Rocket Boosters, Lyndon B. Johnson Space Center, 2101 NASA Parkway, Houston, Harris County, TX

KENNEDY SPACE CENTER, FLA. - In the Orbiter Processing Facility, workers remove the overhead crane from the nose cap that was removed from Atlantis. The reinforced carbon-carbon (RCC) nose cap is being sent to the original manufacturing company, Vought in Ft. Worth, Texas, a subsidiary of Lockheed Martin, to undergo non-destructive testing such as CAT scan and thermography.

NASA Image and Video Library

2003-10-29

KENNEDY SPACE CENTER, FLA. - In the Orbiter Processing Facility, workers remove the overhead crane from the nose cap that was removed from Atlantis. The reinforced carbon-carbon (RCC) nose cap is being sent to the original manufacturing company, Vought in Ft. Worth, Texas, a subsidiary of Lockheed Martin, to undergo non-destructive testing such as CAT scan and thermography.

KENNEDY SPACE CENTER, FLA. - In the Orbiter Processing Facility, the nose cap from Atlantis is secured on a shipping pallet. The reinforced carbon-carbon (RCC) nose cap is being sent to the original manufacturing company, Vought in Ft. Worth, Texas, a subsidiary of Lockheed Martin, to undergo non-destructive testing such as CAT scan and thermography.

NASA Image and Video Library

2003-10-29

KENNEDY SPACE CENTER, FLA. - In the Orbiter Processing Facility, the nose cap from Atlantis is secured on a shipping pallet. The reinforced carbon-carbon (RCC) nose cap is being sent to the original manufacturing company, Vought in Ft. Worth, Texas, a subsidiary of Lockheed Martin, to undergo non-destructive testing such as CAT scan and thermography.

KENNEDY SPACE CENTER, FLA. - In the Orbiter Processing Facility, packing material is placed over the nose cap that was removed from Atlantis. The reinforced carbon-carbon (RCC) nose cap is being sent to the original manufacturing company, Vought in Ft. Worth, Texas, a subsidiary of Lockheed Martin, to undergo non-destructive testing such as CAT scan and thermography.

NASA Image and Video Library

2003-10-29

KENNEDY SPACE CENTER, FLA. - In the Orbiter Processing Facility, packing material is placed over the nose cap that was removed from Atlantis. The reinforced carbon-carbon (RCC) nose cap is being sent to the original manufacturing company, Vought in Ft. Worth, Texas, a subsidiary of Lockheed Martin, to undergo non-destructive testing such as CAT scan and thermography.

KENNEDY SPACE CENTER, FLA. - In the Orbiter Processing Facility, the nose cap from Atlantis is lowered toward a shipping pallet. The reinforced carbon-carbon (RCC) nose cap is being sent to the original manufacturing company, Vought in Ft. Worth, Texas, a subsidiary of Lockheed Martin, to undergo non-destructive testing such as CAT scan and thermography.

NASA Image and Video Library

2003-10-29

KENNEDY SPACE CENTER, FLA. - In the Orbiter Processing Facility, the nose cap from Atlantis is lowered toward a shipping pallet. The reinforced carbon-carbon (RCC) nose cap is being sent to the original manufacturing company, Vought in Ft. Worth, Texas, a subsidiary of Lockheed Martin, to undergo non-destructive testing such as CAT scan and thermography.

KENNEDY SPACE CENTER, FLA. - The Japanese Experiment Module (JEM) is moved on its workstand in the Space Station Processing Facility. The JEM will undergo pre-assembly measurements. Developed by the Japan Aerospace Exploration Agency (JAXA), the JEM will enhance the unique research capabilities of the orbiting complex by providing an additional environment for astronauts to conduct science experiments.

NASA Image and Video Library

2003-11-05

KENNEDY SPACE CENTER, FLA. - The Japanese Experiment Module (JEM) is moved on its workstand in the Space Station Processing Facility. The JEM will undergo pre-assembly measurements. Developed by the Japan Aerospace Exploration Agency (JAXA), the JEM will enhance the unique research capabilities of the orbiting complex by providing an additional environment for astronauts to conduct science experiments.

Configurational and constitutional information storage: multiple dynamics in systems based on pyridyl and acyl hydrazones.

PubMed

Chaur, Manuel N; Collado, Daniel; Lehn, Jean-Marie

2011-01-03

The C=N group of hydrazones can undergo E/Z isomerization both photochemically and thermally, allowing the generation of a closed process that can be tuned by either of these two physical stimuli. On the other hand, hydrazine-exchange reactions enable a constitutional change in a given hydrazone. The two classes of processes: 1) configurational (physically stimulated) and 2) constitutional (chemically stimulated) give access to short-term and long-term information storage, respectively. Such transformations are reported herein for two hydrazones (bis-pyridyl hydrazone and 2-pyridinecarboxaldehyde phenylhydrazone) that undergo a closed, chemically or physically driven process, and, in addition, can be locked or unlocked at will by metal-ion coordination or removal. These features also extend to acyl hydrazones derived from 2-pyridinecarboxaldehyde. Similarly to the terpydine-like hydrazones, such acyl hydrazones can undergo both constitutional and configurational changes, as well as metal-ion coordination. All these types of hydrazones represent dynamic systems capable of acting as multiple state molecular devices, in which the presence of coordination sites furthermore allows the metal ion-controlled locking and unlocking of the interconversion of the different states. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Importance of tissue perfusion in ST segment elevation myocardial infarction patients undergoing reperfusion strategies: role of adenosine.

PubMed

Forman, Mervyn B; Jackson, Edwin K

2007-11-01

High risk ST segment elevation myocardial infarction (STEMI) patients undergoing reperfusion therapy continue to exhibit significant morbidity and mortality due in part to myocardial reperfusion injury. Importantly, preclinical studies demonstrate that progressive microcirculatory failure (the "no-reflow" phenomenon) contributes significantly to myocardial reperfusion injury. Diagnostic techniques to measure tissue perfusion have validated this concept in humans, and it is now clear that abnormal tissue perfusion occurs frequently in STEMI patients undergoing reperfusion therapy. Moreover, because tissue perfusion correlates poorly with epicardial blood flow (TIMI flow grade), clinical studies show that tissue perfusion is an independent predictor of early and late mortality in STEMI patients and is associated with infarct size, ventricular function, CHF and ventricular arrhythmias. The mechanisms responsible for abnormal tissue perfusion are multifactorial and include both mechanical obstruction and vasoconstrictor humoral factors. Adenosine, an endogenous nucleoside, maintains microcirculatory flow following reperfusion by activating four well-characterized extracellular receptors. Because activation of adenosine receptors attenuates the mechanical and functional mechanisms leading to the "no reflow" phenomenon and activates other cardioprotective pathways as well, it is not surprising that both experimental and clinical studies show striking myocardial salvage with intravenous infusions of adenosine administered in the peri-reperfusion period. For example, a post hoc analysis of the AMISTAD II trial indicates a significant reduction in 1 and 6-month mortality in STEMI patients undergoing reperfusion therapy who are treated with adenosine within 3 hours of symptoms. In conclusion, adenosine's numerous cardioprotective effects, including attenuation of the "no-reflow" phenomenon, support its use in high risk STEMI undergoing reperfusion.

Factors associated with disposition of cryopreserved reproductive tissue.

PubMed

Styer, Aaron K; Cekleniak, Natalie A; Legedza, Anna; Mutter, George L; Hornstein, Mark D

2003-09-01

To study patient characteristics associated with the preferences for the disposition of cryopreserved semen and embryos in the event of death or divorce. Retrospective exploratory study. Tertiary care academic medical center. One hundred twelve men banking sperm, 54 female patients (partners of men banking sperm) undergoing in vitro fertilization (IVF), and 112 women undergoing IVF who were not partners of men banking sperm. Male patients banking sperm and couples undergoing IVF completed a standard consent form detailing their desired dispositions (disposal or release to a surviving party) of cryopreserved sperm and embryos in the event of death or divorce. Effect of marital status, age, reason for sperm banking, infertility diagnosis, partner status (single or significant-other partner) on sperm, and embryo disposition choice. In the event of death, married men were 5.5 times more likely to release banked sperm to a surviving party than were single men. The estimated odds of giving sperm to a survivor were 1.07 times greater with every 1-year increase in age. The choice of sperm disposal was significantly related to the banking reason for the case of banking prior to chemotherapy and/or radiation for malignancy. In the case of male death, the decisions of couples undergoing IVF for embryo disposition agreed with choices of male patients for sperm disposition approximately 33% of the time more often than by chance alone. Decisions surrounding disposition of cryopreserved sperm are significantly associated with marital status, age, and reason for banking sperm. Respective choices of sperm and embryo disposition in couples undergoing IVF were similar in the situation of male death.

Predictive factors for complications in children with esophageal atresia and tracheoesophageal fistula.

PubMed

Shah, R; Varjavandi, V; Krishnan, U

2015-04-01

The objective of this study was to describe the incidence of complications in children with esophageal atresia (EA) with or without tracheoesophageal fistula (TEF) at a tertiary pediatric hospital and to identify predictive factors for their occurrence. A retrospective chart review of 110 patients born in or transferred to Sydney Children's Hospital with EA/TEF between January 1999 and December 2010 was done. Univariate and multivariate regression analyses were performed to identify predictive factors for the occurrence of complications in these children. From univariate analysis, early esophageal stricture formation was more likely in children with 'long-gap' EA (odds ratio [OR] = 16.32). Patients with early strictures were more likely to develop chest infections (OR = 3.33). Patients with severe tracheomalacia were more likely to experience 'cyanotic/dying' (OR = 180) and undergo aortopexy (OR = 549). Patients who had gastroesophageal reflux disease were significantly more likely to require fundoplication (OR = 10.83) and undergo aortopexy (OR = 6.417). From multivariate analysis, 'long-gap' EA was a significant predictive factor for late esophageal stricture formation (P = 0.007) and for gastrostomy insertion (P = 0.001). Reflux was a significant predictive factor for requiring fundoplication (P = 0.007) and gastrostomy (P = 0.002). Gastrostomy insertion (P = 0.000) was a significant predictive factor for undergoing fundoplication. Having a prior fundoplication (P = 0.001) was a significant predictive factor for undergoing a subsequent aortopexy. Predictive factors for the occurrence of complications post EA/TEF repair were identified in this large single centre pediatric study. © 2014 International Society for Diseases of the Esophagus.

Evaluating the efficacy of lavender aromatherapy on peripheral venous cannulation pain and anxiety: A prospective, randomized study.

PubMed

Karaman, Tugba; Karaman, Serkan; Dogru, Serkan; Tapar, Hakan; Sahin, Aynur; Suren, Mustafa; Arici, Semih; Kaya, Ziya

2016-05-01

This study was designed to evaluate the effectiveness of lavender aromatherapy on pain, anxiety, and level of satisfaction associated with the peripheral venous cannulation (PVC) in patients undergoing surgery. One hundred and six patients undergoing surgery were randomized to receive aromatherapy with lavender essential oil (the lavender group) or a placebo (the control group) during PVC. The patients' pain, anxiety, and satisfaction scores were measured. There was no statistically significantly difference between the groups in terms of demographic data. After cannulation, the pain and anxiety scores (anxiety 2) of the patients in the lavender group were significantly lower than the control group (for p = 0.01 for pain scores; p < 0.001 for anxiety 2 scores). In addition, patient satisfaction was significantly higher in the lavender group than in the control group (p = 0.003). Lavender aromatherapy had beneficial effects on PVC pain, anxiety, and satisfaction level of patients undergoing surgery. Copyright © 2016 Elsevier Ltd. All rights reserved.

FLASH protects ZEB1 from degradation and supports cancer cells' epithelial-to-mesenchymal transition

PubMed Central

Abshire, C F; Carroll, J L; Dragoi, A-M

2016-01-01

Cancer metastasis remains a significant challenge and the leading cause of cancer-associated deaths. It is postulated that during metastasis cells undergo epithelial-to-mesenchymal transition (EMT), a process characterized by loss of cell–cell contacts and increased migratory and invasive potential. ZEB1 is one the most prominent transcriptional repressors of genes associated with EMT. We identified caspase-8-associated protein 2 (CASP8AP2 or FLASH) as a novel posttranscriptional regulator of ZEB1. Here we demonstrate that FLASH protects ZEB1 from proteasomal degradation brought by the action of the ubiquitin ligases SIAH1 and F-box protein FBXO45. As a result, loss of FLASH rapidly destabilized ZEB1 and reversed EMT cellular characteristics. Importantly, loss of FLASH blocked transforming growth factor-β-induced EMT and enhanced sensitivity to chemotherapy. Thus, we propose that FLASH–ZEB1 interplay may be a protective mechanism against ZEB1 degradation in cells undergoing EMT and may be an efficacious target for therapies aimed to block EMT progression. PMID:27526108

Mouse embryonic stem cells undergo Charontosis, a novel programmed cell death pathway dependent upon cathepsins, p53, and EndoG, in response to etoposide treatment

PubMed Central

Tichy, Elisia D.; Stephan, Zachary A.; Osterburg, Andrew; Noel, Greg; Stambrook, Peter J.

2013-01-01

Embryonic stem cells (ESCs) are hypersensitive to many DNA damaging agents and can rapidly undergo cell death or cell differentiation following exposure. Treatment of mouse ESCs (mESCs) with etoposide (ETO), a topoisomerase II poison, followed by a recovery period resulted in massive cell death with characteristics of a programmed cell death pathway (PCD). While cell death was both caspase- and necroptosis-independent, it was partially dependent on the activity of lysosomal proteases. A role for autophagy in the cell death process was eliminated, suggesting that ETO induces a novel PCD pathway in mESCs. Inhibition of p53 either as a transcription factor by pifithrin α or in its mitochondrial role by pifithrin μ significantly reduced ESC death levels. Finally, EndoG was newly identified as a protease participating in the DNA fragmentation observed during ETO-induced PCD. We coined the term Charontosis after Charon, the ferryman of the dead in Greek mythology, to refer to the PCD signaling events induced by ETO in mESCs. PMID:23500643

Synaptic genes are extensively downregulated across multiple brain regions in normal human aging and Alzheimer’s disease

PubMed Central

Berchtold, Nicole C.; Coleman, Paul D.; Cribbs, David H.; Rogers, Joseph; Gillen, Daniel L.; Cotman, Carl W.

2014-01-01

Synapses are essential for transmitting, processing, and storing information, all of which decline in aging and Alzheimer’s disease (AD). Because synapse loss only partially accounts for the cognitive declines seen in aging and AD, we hypothesized that existing synapses might undergo molecular changes that reduce their functional capacity. Microarrays were used to evaluate expression profiles of 340 synaptic genes in aging (20–99 years) and AD across 4 brain regions from 81 cases. The analysis revealed an unexpectedly large number of significant expression changes in synapse-related genes in aging, with many undergoing progressive downregulation across aging and AD. Functional classification of the genes showing altered expression revealed that multiple aspects of synaptic function are affected, notably synaptic vesicle trafficking and release, neurotransmitter receptors and receptor trafficking, postsynaptic density scaffolding, cell adhesion regulating synaptic stability, and neuromodulatory systems. The widespread declines in synaptic gene expression in normal aging suggests that function of existing synapses might be impaired, and that a common set of synaptic genes are vulnerable to change in aging and AD. PMID:23273601

Thermal stability, antioxidant, and anti-inflammatory activity of curcumin and its degradation product 4-vinyl guaiacol.

PubMed

Esatbeyoglu, Tuba; Ulbrich, Katrin; Rehberg, Clemens; Rohn, Sascha; Rimbach, Gerald

2015-03-01

Curcumin is a secondary plant metabolite present in Curcuma longa L. Since curcumin is widely used as a food colorant in thermally processed food it may undergo substantial chemical changes which in turn could affect its biological activity. In the current study, curcumin was roasted at 180 °C up to 70 minutes and its kinetic of degradation was analyzed by means of HPLC-PDA and LC-MS, respectively. Roasting of curcumin resulted in the formation of the degradation products vanillin, ferulic acid, and 4-vinyl guaiacol. In cultured hepatocytes roasted curcumin as well as 4-vinyl guaiacol enhanced the transactivation of the redox-regulated transcription factor Nrf2, known to be centrally involved in cellular stress response and antioxidant defense mechanisms. The antioxidant enzyme paraoxonase 1 was induced by roasted curcumin and 4-vinyl guaiacol. Furthermore, roasted curcumin and 4-vinyl guaiacol decreased interleukin-6 gene expression in lipopolysaccharide stimulated murine macrophages. Current data suggest that curcumin undergoes degradation due to roasting and its degradation product exhibit significant biological activity in cultured cells.

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

Rudraswami, N. G.; Prasad, M. Shyam; Dey, S.

Most dust-sized cosmic particles undergo ablation and chemical alteration during atmospheric entry, which alters their original properties. A comprehensive understanding of this process is essential in order to decipher their pre-entry characteristics. The purpose of the study is to illustrate the process of vaporization of different elements for various entry parameters. The numerical results for particles of various sizes and various zenith angles are treated in order to understand the changes in chemical composition that the particles undergo as they enter the atmosphere. Particles with large sizes (> few hundred μ m) and high entry velocities (>16 km s{sup −1})more » experience less time at peak temperatures compared to those that have lower velocities. Model calculations suggest that particles can survive with an entry velocity of 11 km s{sup −1} and zenith angles (ZA) of 30°–90°, which accounts for ∼66% of the region where particles retain their identities. Our results suggest that the changes in chemical composition of MgO, SiO{sub 2}, and FeO are not significant for an entry velocity of 11 km s{sup −1} and sizes <300 μ m, but the changes in these compositions become significant beyond this size, where FeO is lost to a major extent. However, at 16 km s{sup −1} the changes in MgO, SiO{sub 2}, and FeO are very intense, which is also reflected in Mg/Si, Fe/Si, Ca/Si, and Al/Si ratios, even for particles with a size of 100 μ m. Beyond 400 μ m particle sizes at 16 km s{sup −1}, most of the major elements are vaporized, leaving the refractory elements, Al and Ca, suspended in the troposphere.« less

Using a multimedia presentation to improve patient understanding and satisfaction with informed consent for minimally invasive vascular procedures.

PubMed

Bowers, N; Eisenberg, E; Montbriand, J; Jaskolka, J; Roche-Nagle, G

2017-02-01

As vascular procedures become more complex, patient understanding of their treatment(s) can become more difficult. We wished to evaluate the utility of multimedia presentations (MPs) to improve patient understanding of their vascular interventions. Patients undergoing endovascular aneurysm repair (EVAR), peripheral angioplasty, Hickman catheter and peripherally inserted central catheter (PICC) insertion were randomized into a control group receiving traditional verbal consent, and a MP group that were shown a two minute simplified video of their procedure on an iPad™ computer in addition to the traditional verbal consent. After obtaining consent, all patients completed a questionnaire assessing their comprehension of the procedure, and satisfaction with the consent process. Satisfaction was rated on a 5 point Likert scale with 5 being 'very helpful' in understanding the procedure. Ninety-three patients were recruited for this study, 62% of which were male. The intervention significantly increased total comprehension in all procedure types controlling for procedure type (multimedia vs. control; F = 9.14, P = .003). A second ANOVA showed there was a significant main effect by intervention (F = 44.06, p < .000) with those in the intervention group showing higher overall satisfaction scores after controlling for surgery type. This study suggests that patients find the use of MP during the consent process to be helpful in patient understanding and that there is improved satisfaction. Given the rapid rate of innovation in vascular interventions, increased regular use of MPs to help patients understand their procedures would be beneficial in the care of patients undergoing vascular interventions. Copyright © 2015 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Ablation and Chemical Alteration of Cosmic Dust Particles during Entry into the Earth’s Atmosphere

NASA Astrophysics Data System (ADS)

Rudraswami, N. G.; Shyam Prasad, M.; Dey, S.; Plane, J. M. C.; Feng, W.; Carrillo-Sánchez, J. D.; Fernandes, D.

2016-12-01

Most dust-sized cosmic particles undergo ablation and chemical alteration during atmospheric entry, which alters their original properties. A comprehensive understanding of this process is essential in order to decipher their pre-entry characteristics. The purpose of the study is to illustrate the process of vaporization of different elements for various entry parameters. The numerical results for particles of various sizes and various zenith angles are treated in order to understand the changes in chemical composition that the particles undergo as they enter the atmosphere. Particles with large sizes (> few hundred μm) and high entry velocities (>16 km s‑1) experience less time at peak temperatures compared to those that have lower velocities. Model calculations suggest that particles can survive with an entry velocity of 11 km s‑1 and zenith angles (ZA) of 30°–90°, which accounts for ∼66% of the region where particles retain their identities. Our results suggest that the changes in chemical composition of MgO, SiO2, and FeO are not significant for an entry velocity of 11 km s‑1 and sizes <300 μm, but the changes in these compositions become significant beyond this size, where FeO is lost to a major extent. However, at 16 km s‑1 the changes in MgO, SiO2, and FeO are very intense, which is also reflected in Mg/Si, Fe/Si, Ca/Si, and Al/Si ratios, even for particles with a size of 100 μm. Beyond 400 μm particle sizes at 16 km s‑1, most of the major elements are vaporized, leaving the refractory elements, Al and Ca, suspended in the troposphere.

Children with chronic renal disease undergoing dialysis or conservative treatment--differences in structural and functional echocardiographic parameters.

PubMed

Scavarda, Valeska Tavares; Pinheiro, Aurelio Carvalho; Costa, Symône Damasceno; de Andrade, Zélia Maria; Carvalhaes, João Tomás de Abreu; Campos, Orlando; Carvalho, Antonio Carlos; Moises, Valdir Ambrosio

2014-10-01

Cardiac disease frequently occurs in children with chronic kidney disease (CKD) undergoing dialysis (DI), but it is not well studied in patients undergoing conservative treatment (CT). The aim of our study was to use echocardiography to analyze and compare the cardiac involvement of children with CKD undergoing DI or CT. Seventy-one children with CKD were included; 41 undergoing DI and 30 undergoing CT. There were 33 controls. Measurements of arterial pressure and structural and functional echocardiographic variables were obtained; the children were followed up for 18 months. Tests of comparison and multiple regression were used; significant if P < 0.05. Arterial hypertension (AH) was present in 37 of 71 (52%) children with CKD: 27 (65.8%) in DI and 10 (33.3%) in CT (X2 = 8.7; P = 0.003). An abnormal left ventricular geometric pattern was present in 37/41 (90.3%) undergoing DI, 33 had left ventricular hypertrophy (LVH), and in 14/30 (46.7%) undergoing CT, 5 had LVH. Ejection fraction was normal in all groups; diastolic function alteration (DFA) occurred in 28/41 (68.3%) children on DI and in 10/30 (33.3%) on CT (X2 = 9.2; P = 0.002). For children with CKD, DI (P = 0.002) and hypertension (P = 0.04) were associated with LVH; among those on DI, only AH was associated with LVH (P = 0.02). During the follow-up, 18 (43.9%) children undergoing DI had at least one cardiovascular event. Children with CKD undergoing CT had less cardiac involvement than those undergoing DI. LVH was associated with DI and AH in all children with CKD and with AH in those on DI.

HEMATOPOIETIC PROGENITOR CELL CONTENT OF VERTEBRAL BODY MARROW USED FOR COMBINED SOLID ORGAN AND BONE MARROW TRANSPLANTATION

PubMed Central

Rybka, Witold B.; Fontes, Paulo A.; Rao, Abdul S.; Winkelstein, Alan; Ricordi, Camillo; Ball, Edward D.; Starzl, Thomas E.

2010-01-01

While cadaveric vertebral bodies (VB) have long been proposed as a suitable source of bone marrow (BM) for transplantation (BMT), they have rarely been used for this purpose. We have infused VB BM immediately following whole organ (WO) transplantation to augment donor cell chimerism. We quantified the hematopoietic progenitor cell (HPC) content of VB BM as well as BM obtained from the iliac crests (IC) of normal allogeneic donors (ALLO) and from patients with malignancy undergoing autologous marrow harvest (AUTO). Patients undergoing WOIBM transplantation also had AUTO BM harvested in the event that subsequent lymphohematopoietic reconstitution was required. Twenty-four VB BM, 24 IC BM-ALLO, 31 IC AUTO, and 24 IC WO-AUTO were harvested. VB BM was tested 12 to 72 hr after procurement and infused after completion ofWO grafting. IC BM was tested and then used or cryopreserved immediately. HPC were quantified by clonal assay measuring CFU-GM, BFU-E, and CFU-GEMM, and by flow cytometry for CD34+ progenitor cells. On an average, 9 VB were processed during each harvest, and despite an extended processing time the number of viable nucleated cells obtained was significantly higher than that from IC. Furthermore, by HPC content, VB BM was equivalent to IC BM, which is routinely used for BMT. We conclude that VB BM is a clinically valuable source of BM for allogeneic transplantation. PMID:7701582

Photochemical Cycling of Humic-Like Substances in Atmospheric Aerosols

NASA Astrophysics Data System (ADS)

Rincon, A. G.; Guzman, M. I.; Hoffmann, M. R.; Colussi, A. J.

2007-12-01

Colored, humic-like substances (HULIS) arising from the biodegradation of organic detritus are widespread in natural surface waters, where they ultimately undergo solar photolysis into small alpha-dicarbonylic species, such as glyoxal, glyoxylic and pyruvic acids. Diversely generated and chemically dissimilar HULIS are also found in the atmospheric aerosol. How are significant levels of colored HULIS produced and sustained in the concentrated aerosol phase under intense solar irradiation? Here, this issue is tackled by investigating the solar photolysis of aqueous pyruvic acid (PA) solutions at concentrations representative of the atmospheric aerosol using UV-absorption, high resolution electrospray mass, and nuclear magnetic resonance spectrometries. Under such conditions, PA is not photodegraded but yields polyfunctional polymers, whose mass and UV-absorption spectra remain unaffected after 3, 8 and 22 h photolysis. Unless diluted, these polymers undergo condensation/polymerization in the post-photolysis period into mass < 700 Da species that absorb in the visible, and are bleached upon resuming irradiation. The re- photolyzed solutions recover the mass and UV-absorption spectra of first photolyzed solutions. Whereas initial pH has no effect on the mechanism of reaction, ammonium bisulfate, a major component of the aerosol, markedly influences these processes. These findings suggest that the chemical identity and concentration levels of complex organic substances in the aerosol are the result of dynamic photochemical processing in the condensed phase.

Expression profile of senescence-associated beta-galactosidase and activation of telomerase in human ovarian surface epithelial cells undergoing immortalization.

PubMed

Litaker, J R; Pan, J; Cheung, Y; Zhang, D K; Liu, Y; Wong, S C; Wan, T S; Tsao, S W

1998-11-01

Senescence is a specific physiological stage of cells characterized by long population doubling time. It accounts for the inability of normal somatic cells to undergo indefinite cell division. As the number of population doublings increase, cell cycle regulatory mechanisms come into play and signal cells to exit the cell cycle and become senescent. Senescence has been implicated in the aging process and may function as a tumor suppressor mechanism in human cells. The ability to measure the degree of cellular senescence is important in understanding the biological processes regulating cell aging and immortalization. Senescent cells exhibit an enzyme termed senescence-associated histochemical staining. Cells immortalized by viral oncogenes often enter a stage of crisis at the early phase of immortalization. The cells at crisis have a long population doubling time. Cells at the crisis stage resemble senescent cells and the expression of SA- beta-Gal may be used to monitor the process of immortalization. In this study the expression profile of SA-beta-Gal was examined in human ovarian surface epithelial cells (HOSE 6-3) undergoing immortalization by the human papilloma viral oncogene E6 and E7 (HPV E6 and E7). Our results showed a low percentage (12.0%) of HOSE 6-3 cells expressing SA-beta-Gal activity at the pre-crisis stage. The percentage of HOSE 6-3 cells expressing SA-beta-Gal activity was highest (39.2%) at the crisis stage. When HOSE 6-3 cells achieved immortalized status there was a sharp decrease in cells (1. 3%) expressing SA-beta-Gal activity. In addition, an inverse relationship between the expression of SA-beta-Gal activity and telomerase activity was noted in cells undergoing immortalization. The results confirm that the SA-beta-Gal enzyme is a good marker for monitoring the population of cells undergoing senescence at different stages of immortalization and that telomerase activation is a characteristic feature of post-crisis cells.

Effectiveness of group cognitive behavioral therapy with mindfulness in end-stage renal disease hemodialysis patients.

PubMed

Sohn, Bo Kyung; Oh, Yun Kyu; Choi, Jung-Seok; Song, Jiyoun; Lim, Ahyoung; Lee, Jung Pyo; An, Jung Nam; Choi, Hee-Jeong; Hwang, Jae Yeon; Jung, Hee-Yeon; Lee, Jun-Young; Lim, Chun Soo

2018-03-01

Many patients with end-stage renal disease (ESRD) undergoing hemodialysis (HD) experience depression. Depression influences patient quality of life (QOL), dialysis compliance, and medical comorbidity. We developed and applied a group cognitive behavioral therapy (CBT) program including mindfulness meditation for ESRD patients undergoing HD, and measured changes in QOL, mood, anxiety, perceived stress, and biochemical markers. We conducted group CBT over a 12-week period with seven ESRD patients undergoing HD and suffering from depression. QOL, mood, anxiety, and perceived stress were measured at baseline and at weeks 8 and 12 using the World Health Organization Quality of Life scale, abbreviated version (WHOQOL-BREF), the Beck Depression Inventory II (BDI-II), the Hamilton Rating Scale for Depression (HAM-D), the Beck Anxiety Inventory (BAI), and the Perceived Stress Scale (PSS). Biochemical markers were measured at baseline and after 12 weeks. The Temperament and Character Inventory was performed to assess patient characteristics before starting group CBT. The seven patients showed significant improvement in QOL, mood, anxiety, and perceived stress after 12 weeks of group CBT. WHOQOL-BREF and the self-rating scales, BDI-II and BAI, showed continuous improvement across the 12-week period. HAM-D scores showed significant improvement by week 8; PSS showed significant improvement after week 8. Serum creatinine levels also improved significantly following the 12 week period. In this pilot study, a CBT program which included mindfulness meditation enhanced overall mental health and biochemical marker levels in ESRD patients undergoing HD.

Effects of carprofen and meloxicam on C-reactive protein, ceruloplasmin, and fibrinogen concentrations in dogs undergoing ovariohysterectomy.

PubMed

Kum, Cavit; Voyvoda, Huseyin; Sekkin, Selim; Karademir, Umit; Tarimcilar, Tugrul

2013-10-01

To evaluate the effects of perioperative oral administration of carprofen and meloxicam on concentrations of 3 acute-phase proteins in dogs undergoing elective ovariohysterectomy (OVH). 18 healthy adult anestrous female dogs undergoing elective OVH. Dogs were allocated to 3 groups (6 dogs/group). A placebo treatment, carprofen (2.0 mg/kg), or meloxicam (0.2 mg/kg) was orally administered to the dogs of the respective groups. The initial doses were administered 30 minutes before premedication prior to OVH; additional doses were administered once daily for 4 days after surgery. Blood samples were collected 45 minutes before premedication and 4, 8, 12, 24, 36, 48, 72, 96, and 120 hours after the end of OVH; samples were used for measurement of total WBC and neutrophil counts and concentrations of C-reactive protein (CRP), ceruloplasmin, and fibrinogen. Values did not differ significantly among groups for WBC and neutrophil counts, serum concentrations of CRP and ceruloplasmin, and plasma concentrations of fibrinogen. Concentrations of all inflammatory markers, except serum ceruloplasmin, increased significantly following OVH, but in a similar manner for each group. No significant changes were detected in serum ceruloplasmin concentrations over time. Perioperative administration of both carprofen and meloxicam did not significantly affect the concentrations of CRP, ceruloplasmin, and fibrinogen in dogs undergoing OVH. Thus, use of carprofen or meloxicam should not affect clinical interpretation of results for these 3 acute-phase proteins.

Retrospective Review of the Anaesthetic Management of Maxillectomies and Mandibulectomies for Benign Tumours in Sub-Saharan Africa.

PubMed

White, Michelle C; Horner, Katherine C; Lai, Peggy S

2016-01-01

Safe anaesthesia is a crucial component of safe surgical care, yet anaesthetic complications are common in resource-limited settings. We describe differences in anaesthetic needs for Mandibulectomy vs. Maxillectomy in three sub-Saharan African countries. Retrospective review of patients undergoing minor Mandibulectomy, major Mandibulectomy, or Maxillectomy in Togo, Guinea and Republic of the Congo. Surgeries were performed on the Africa Mercy, an international non-governmental hospital ship. Primary outcomes were need for advanced airway management and intra-operative blood loss. Secondary outcomes were time under general anaesthesia and hospital length of stay. Multivariate regression determined the association between operation type and each outcome measure. 105 patients were included (25 minor Mandibulectomy, 58 major Mandibulectomy, 22 Maxillectomy procedures). In-hospital mortality was 0%. 44/105 (41.9%) required an advanced airway management technique to achieve intubation, although in all cases this was anticipated prior to the procedure; no differences were noted between surgical procedure (p = 0.72). Operative procedure was a significant risk factor for intra-operative blood loss. Patients undergoing Maxillectomy lost on average 851.5 (413.3, 1289.8, p = 0.0003) mL more blood than patients undergoing minor Mandibulectomy, and 507.3 (150.3, 864.3, p = 0.007) mL more blood than patients undergoing major Mandibulectomy. Patients undergoing Maxillectomy had a significantly higher time under general anaesthesia than those undergoing minor Mandibulectomy. There was no significant difference in hospital length of stay between operation type. Anaesthetic considerations for minor Mandibulectomy, major Mandibulectomy, and Maxillectomy differ with respect to intra-operative blood loss and time under general anaesthesia, but not need for advanced airway management or length of stay. Although advanced airway management was required in 41.9% of patients, there were no unanticipated difficult airways. With appropriate training and resources, safe anaesthesia can be delivered to patients from low-income countries requiring major head and neck surgery.

Retrospective Review of the Anaesthetic Management of Maxillectomies and Mandibulectomies for Benign Tumours in Sub-Saharan Africa

PubMed Central

White, Michelle C.; Horner, Katherine C.; Lai, Peggy S.

2016-01-01

Background Safe anaesthesia is a crucial component of safe surgical care, yet anaesthetic complications are common in resource-limited settings. We describe differences in anaesthetic needs for Mandibulectomy vs. Maxillectomy in three sub-Saharan African countries. Materials and Methods Retrospective review of patients undergoing minor Mandibulectomy, major Mandibulectomy, or Maxillectomy in Togo, Guinea and Republic of the Congo. Surgeries were performed on the Africa Mercy, an international non-governmental hospital ship. Primary outcomes were need for advanced airway management and intra-operative blood loss. Secondary outcomes were time under general anaesthesia and hospital length of stay. Multivariate regression determined the association between operation type and each outcome measure. Results 105 patients were included (25 minor Mandibulectomy, 58 major Mandibulectomy, 22 Maxillectomy procedures). In-hospital mortality was 0%. 44/105 (41.9%) required an advanced airway management technique to achieve intubation, although in all cases this was anticipated prior to the procedure; no differences were noted between surgical procedure (p = 0.72). Operative procedure was a significant risk factor for intra-operative blood loss. Patients undergoing Maxillectomy lost on average 851.5 (413.3, 1289.8, p = 0.0003) mL more blood than patients undergoing minor Mandibulectomy, and 507.3 (150.3, 864.3, p = 0.007) mL more blood than patients undergoing major Mandibulectomy. Patients undergoing Maxillectomy had a significantly higher time under general anaesthesia than those undergoing minor Mandibulectomy. There was no significant difference in hospital length of stay between operation type. Conclusion Anaesthetic considerations for minor Mandibulectomy, major Mandibulectomy, and Maxillectomy differ with respect to intra-operative blood loss and time under general anaesthesia, but not need for advanced airway management or length of stay. Although advanced airway management was required in 41.9% of patients, there were no unanticipated difficult airways. With appropriate training and resources, safe anaesthesia can be delivered to patients from low-income countries requiring major head and neck surgery. PMID:27788172

Prophylactic antibiotics to prevent surgical site infection after breast cancer surgery.

PubMed

Bunn, Frances; Jones, Daniel J; Bell-Syer, Sophie

2012-01-18

Surgery has been used as part of breast cancer treatment for centuries; however any surgical procedure has the potential risk of infection. Infection rates for surgical treatment of breast cancer are documented at between 3% and 15%, higher than average for a clean surgical procedure. Pre- and perioperative antibiotics have been found to be useful in lowering infection rates in other surgical groups, yet there is no consensus on the use of prophylactic antibiotics for breast cancer surgery. To determine the effects of prophylactic (pre- or perioperative) antibiotics on the incidence of surgical site infection (SSI) after breast cancer surgery. For this second update we searched the Cochrane Wounds Group Specialised Register (searched 31 August 2011); the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 3); Ovid MEDLINE (2008 to August Week 3 2011); Ovid MEDLINE (In-Process & Other Non-Indexed Citations 30 August 2011); Ovid EMBASE (1980 to 2011 Week 34); and EBSCO CINAHL (2008 to 25 August 2011). We applied no language or date restrictions. Randomised controlled trials of pre- and perioperative antibiotics for patients undergoing surgery for breast cancer were included. Primary outcomes were rates of surgical site infection (SSI) and adverse reactions. Two review authors independently examined the title and abstracts of all studies identified by the search strategy, then assessed study quality and extracted data from those that met the inclusion criteria. A total of nine studies (2260 participants) is included in the review. Eight studies evaluated preoperative antibiotic compared with no antibiotic or placebo. One study evaluated perioperative antibiotic compared with no antibiotic. Pooling of the results demonstrated that prophylactic antibiotics administered preoperatively significantly reduce the incidence of SSI for patients undergoing breast cancer surgery without reconstruction (pooled risk ratio (RR) 0.71, 95% confidence interval (CI) 0.53 to 0.94). Analysis of the single study comparing perioperative antibiotic with no antibiotic found no statistically significant effect of antibiotics on the incidence of SSI (RR 0.11, 95% CI 0.01 to 1.95). No studies presented separate data for patients who underwent reconstructive surgery at the time of removal of the breast tumour. Prophylactic antibiotics administered preoperatively reduce the risk of SSI in patients undergoing surgery for breast cancer. Further studies involving patients undergoing immediate breast reconstruction are needed as studies have identified this group as being at higher risk of infection than those who do not undergo immediate breast reconstruction.

Acceptability, Knowledge, Beliefs, and Partners as Determinants of Zambian Men's Readiness to Undergo Medical Male Circumcision

PubMed Central

Jones, Deborah; Cook, Ryan; Arheart, Kris; Redding, Colleen A.; Zulu, Robert; Castro, Jose; Weiss, Stephen M.

2013-01-01

There is limited information about the influence of partners on medical male circumcision (MMC) uptake. This study aimed to evaluate attitudes, knowledge, and preferences about MMC among men and their partners, and their relative impact on male readiness to undergo the MMC procedure. Male participants (n = 354) and their partners (n = 273) were recruited from community health centers in Lusaka, Zambia. Men reported their readiness to undergo MMC, and both men and women were assessed regarding their attitudes and knowledge regarding MMC. Men who had discussed MMC with their partners, those who endorsed MMC for HIV risk reduction, and those viewing MMC as culturally acceptable reported increased readiness to undergo MMC. Additionally, endorsement of MMC by female partners was associated with increased men’s readiness. Results support promotion of cultural acceptability of MMC, and efforts to increase MMC uptake may benefit from incorporating partners in the decision making process. PMID:23757123

Relationship of postprandial nonesterified fatty acids, adipokines, and insulin across gender in human immunodeficiency virus-positive patients undergoing highly active antiretroviral therapy.

PubMed

Lu, Guijing; Thomas-Geevarghese, Asha; Anuurad, Erdembileg; Raghavan, Subhashree; Minolfo, Robert; Ormsby, Bernard; Karmally, Wahida; El-Sadr, Wafaa M; Albu, Jeanine; Berglund, Lars

2009-06-01

Metabolic derangements are common in human immunodeficiency virus (HIV)-positive subjects undergoing antiretroviral therapy, but little is known about postprandial conditions. We investigated the relationship between leptin, adiponectin, nonesterified fatty acids (NEFA), and insulin in response to a day-long meal pattern and evaluated gender differences in HIV-positive men (n = 12) and women (n = 13) undergoing highly active antiretroviral therapy (HAART). For both men and women, a significant decrease in postprandial NEFA levels was observed following breakfast (0.53 vs. 0.22 mmol/L, P < 0.001, baseline and at 3 hours, respectively), whereas day-long postprandial leptin and adiponectin levels showed small nonsignificant oscillations. In contrast to NEFA and adiponectin, postprandial leptin levels were significantly higher among women compared to men (P < 0.05). Postprandial NEFA levels correlated positively with fasting insulin levels (r(2) = 0.25, P = 0.016), and the postbreakfast decrease in NEFA levels correlated significantly with the postbreakfast increase in insulin levels (r(2) = 0.17, P = 0.038). No significant association between postprandial adipokines and insulin was observed. In HAART-treated, HIV-infected men and women, levels of NEFA, but not adipokines, showed significant postprandial variation. Furthermore, food intake resulted in significant NEFA suppression in proportion to the food-stimulated insulin increase.

Biological knee reconstruction for combined malalignment, meniscal deficiency, and articular cartilage disease.

PubMed

Harris, Joshua D; Hussey, Kristen; Wilson, Hillary; Pilz, Kyle; Gupta, Anil K; Gomoll, Andreas; Cole, Brian J

2015-02-01

The aim of this study was to analyze patient-reported outcomes in those undergoing the triad of simultaneous osteotomy, meniscal transplantation, and articular cartilage repair. Patients undergoing simultaneous meniscal transplantation, distal femoral or proximal tibial osteotomy, and articular cartilage surgery by a single surgeon (B.J.C.) were analyzed. Meniscal transplantation was performed using bone-in-slot techniques. Distal femoral and high tibial osteotomies were performed for valgus and varus malalignment, respectively. Microfracture, autologous chondrocyte implantation, and osteochondral autograft or allograft were performed for articular cartilage disease. Validated patient-reported and surgeon-measured outcomes were collected. Preoperative and postoperative outcomes and medial versus lateral disease were compared using Student t tests. Eighteen participants (mean age, 34 ± 7.8 years; symptomatic patients, 7.4 ± 5.6 years; 2.4 ± 1.0 surgical procedures before study enrollment; mean follow-up, 6.5 ± 3.2 years) were analyzed. Two thirds of participants had medial compartment pathologic conditions and one third had lateral compartment pathologic processes. At final follow-up, there were statistically significant clinically meaningful improvements in International Knee Documentation Committee (IKDC) subjective classification, Lysholm score, and 4 Knee Injury and Osteoarthritis Outcome Score (KOOS) subscores. Postoperative 12-item short form (SF-12) physical and mental component scores were not significantly different from preoperative scores. The Kellgren-Lawrence classification grade was 1.5 ± 1.1 at 2.5 ± 3.0 years after surgery. There was a significantly higher preoperative SF-12 physical composite score (PCS) in participants with lateral compartment pathologic conditions (v medial compartment conditions) (P = .011). Although there were 13 reoperations in 10 patients (55.5% reoperation rate), only one patient was converted to knee arthroplasty (5.6%) and one to revision cartilage surgery and meniscal transplantation (5.6% revision rate). The most common complication was arthrofibrosis (16.7%). Statistically significant and clinically meaningful improvements in validated patient-reported clinical outcome scores at long-term follow-up were observed in 18 participants undergoing combined meniscal transplantation, osteotomy, and articular cartilage surgery. Although there was a low rate of cartilage or meniscal revision (or both) and total knee arthroplasty, there was a high rate of reoperation. There was no significant difference in outcomes between participants with medial versus lateral pathologic conditions. Level IV, therapeutic case series. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Cognitive compensatory processes of older, clinically fit patients with hematologic malignancies undergoing chemotherapy: A longitudinal cohort study.

PubMed

Libert, Yves; Borghgraef, Cindy; Beguin, Yves; Delvaux, Nicole; Devos, Martine; Doyen, Chantal; Dubruille, Stéphanie; Etienne, Anne-Marie; Liénard, Aurore; Merckaert, Isabelle; Reynaert, Christine; Slachmuylder, Jean-Louis; Straetmans, Nicole; Van Den Neste, Eric; Bron, Dominique; Razavi, Darius

2017-12-01

Despite the well-known negative impacts of cancer and anticancer therapies on cognitive performance, little is known about the cognitive compensatory processes of older patients with cancer. This study was designed to investigate the cognitive compensatory processes of older, clinically fit patients with hematologic malignancies undergoing chemotherapy. We assessed 89 consecutive patients (age ≥ 65 y) without severe cognitive impairment and 89 age-, sex-, and education level-matched healthy controls. Cognitive compensatory processes were investigated by (1) comparing cognitive performance of patients and healthy controls in novel (first exposure to cognitive tasks) and non-novel (second exposure to the same cognitive tasks) contexts, and (2) assessing psychological factors that may facilitate or inhibit cognitive performance, such as motivation, psychological distress, and perceived cognitive performance. We assessed cognitive performance with the Trail-Making, Digit Span and FCSR-IR tests, psychological distress with the Hospital Anxiety and Depression Scale, and perceived cognitive performance with the FACT-Cog questionnaire. In novel and non-novel contexts, average cognitive performances of healthy controls were higher than those of patients and were associated with motivation. Cognitive performance of patients was not associated with investigated psychological factors in the novel context but was associated with motivation and psychological distress in the non-novel context. Older, clinically fit patients with hematologic malignancies undergoing chemotherapy demonstrated lower cognitive compensatory processes compared to healthy controls. Reducing distress and increasing motivation may improve cognitive compensatory processes of patients in non-novel contexts. Copyright © 2017 John Wiley & Sons, Ltd.

Visualizing Chemistry with Infrared Imaging

ERIC Educational Resources Information Center

Xie, Charles

2011-01-01

Almost all chemical processes release or absorb heat. The heat flow in a chemical system reflects the process it is undergoing. By showing the temperature distribution dynamically, infrared (IR) imaging provides a salient visualization of the process. This paper presents a set of simple experiments based on IR imaging to demonstrate its enormous…

Universal Design and Multimethod Approaches to Item Review

ERIC Educational Resources Information Center

Johnstone, Christopher J.; Thompson, Sandra J.; Bottsford-Miller, Nicole A.; Thurlow, Martha L.

2008-01-01

Test items undergo multiple iterations of review before states and vendors deem them acceptable to be placed in a live statewide assessment. This article reviews three approaches that can add validity evidence to states' item review processes. The first process is a structured sensitivity review process that focuses on universal design…

Basal ganglia, thalamus and neocortical atrophy predicting slowed cognitive processing in multiple sclerosis.

PubMed

Batista, Sonia; Zivadinov, Robert; Hoogs, Marietta; Bergsland, Niels; Heininen-Brown, Mari; Dwyer, Michael G; Weinstock-Guttman, Bianca; Benedict, Ralph H B

2012-01-01

Information-processing speed (IPS) slowing is a primary cognitive deficit in multiple sclerosis (MS). Basal ganglia, thalamus and neocortex are thought to have a key role for efficient information-processing, yet the specific relative contribution of these structures for MS-related IPS impairment is poorly understood. To determine if basal ganglia and thalamus atrophy independently contribute to visual and auditory IPS impairment in MS, after controlling for the influence of neocortical volume, we enrolled 86 consecutive MS patients and 25 normal controls undergoing 3T brain MRI and neuropsychological testing. Using Sienax and FIRST software, neocortical and deep gray matter (DGM) volumes were calculated. Neuropsychological testing contributed measures of auditory and visual IPS using the Paced Auditory Serial Addition Test (PASAT) and the Symbol Digit Modalities Test (SDMT), respectively. MS patients exhibited significantly slower IPS relative to controls and showed reduction in neocortex, caudate, putamen, globus pallidus, thalamus and nucleus accumbens volume. SDMT and PASAT were significantly correlated with all DGM regions. These effects were mitigated by controlling for the effects of neocortical volume, but all DGM volumes remained significantly correlated with SDMT, putamen (r = 0.409, p < 0.001) and thalamus (r = 0.362, p < 0.001) having the strongest effects, whereas for PASAT, the correlation was significant for putamen (r = 0.313, p < 0.01) but not for thalamus. We confirm the significant role of thalamus atrophy in MS-related IPS slowing and find that putamen atrophy is also a significant contributor to this disorder. These DGM structures have independent, significant roles, after controlling for the influence of neocortex atrophy.

A novel protocol for antibiotic prophylaxis based on preoperative kidney function in patients undergoing open heart surgery under cardiopulmonary bypass.

PubMed

Odaka, Mizuho; Minakata, Kenji; Toyokuni, Hideaki; Yamazaki, Kazuhiro; Yonezawa, Atsushi; Sakata, Ryuzo; Matsubara, Kazuo

2015-08-01

This study aimed to develop and assess the effectiveness of a protocol for antibiotic prophylaxis based on preoperative kidney function in patients undergoing open heart surgery. We established a protocol for antibiotic prophylaxis based on preoperative kidney function in patients undergoing open heart surgery. This novel protocol was assessed by comparing patients undergoing open heart surgery before (control group; n = 30) and after its implementation (protocol group; n = 31) at Kyoto University Hospital between July 2012 and January 2013. Surgical site infections (SSIs) were observed in 4 control group patients (13.3 %), whereas no SSIs were observed in the protocol group patients (P < 0.05). The total duration of antibiotic use decreased significantly from 80.7 ± 17.6 h (mean ± SD) in the control group to 55.5 ± 14.9 h in the protocol group (P < 0.05). Similarly, introduction of the protocol significantly decreased the total antibiotic dose used in the perioperative period (P < 0.05). Furthermore, antibiotic regimens were changed under suspicion of infection in 5 of 30 control group patients, whereas none of the protocol group patients required this additional change in the antibiotic regimen (P < 0.05). Our novel antibiotic prophylaxis protocol based on preoperative kidney function effectively prevents SSIs in patients undergoing open heart surgery.

Rheology of attractive emulsions

NASA Astrophysics Data System (ADS)

Datta, Sujit S.; Gerrard, Dustin D.; Rhodes, Travers S.; Mason, Thomas G.; Weitz, David A.

2011-10-01

We show how attractive interactions dramatically influence emulsion rheology. Unlike the repulsive case, attractive emulsions below random close packing, φRCP, can form soft gel-like elastic solids. However, above φRCP, attractive and repulsive emulsions have similar elasticities. Such compressed attractive emulsions undergo an additional shear-driven relaxation process during yielding. Our results suggest that attractive emulsions begin to yield at weak points through the breakage of bonds, and, above φRCP, also undergo droplet configurational rearrangements.

Nursing Care of Patients Undergoing Chemotherapy Desensitization: Part II.

PubMed

Jakel, Patricia; Carsten, Cynthia; Carino, Arvie; Braskett, Melinda

2016-04-01

Chemotherapy desensitization protocols are safe, but labor-intensive, processes that allow patients with cancer to receive medications even if they initially experienced severe hypersensitivity reactions. Part I of this column discussed the pathophysiology of hypersensitivity reactions and described the development of desensitization protocols in oncology settings. Part II incorporates the experiences of an academic medical center and provides a practical guide for the nursing care of patients undergoing chemotherapy desensitization.
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Rheology of attractive emulsions.

PubMed

Datta, Sujit S; Gerrard, Dustin D; Rhodes, Travers S; Mason, Thomas G; Weitz, David A

2011-10-01

We show how attractive interactions dramatically influence emulsion rheology. Unlike the repulsive case, attractive emulsions below random close packing, φ(RCP), can form soft gel-like elastic solids. However, above φ(RCP), attractive and repulsive emulsions have similar elasticities. Such compressed attractive emulsions undergo an additional shear-driven relaxation process during yielding. Our results suggest that attractive emulsions begin to yield at weak points through the breakage of bonds, and, above φ(RCP), also undergo droplet configurational rearrangements.

The economics of recovery after pancreatic surgery: detailed cost minimization analysis of an enhanced recovery program.

PubMed

Kagedan, Daniel J; Devitt, Katharine S; Tremblay St-Germain, Amélie; Ramjaun, Aliya; Cleary, Sean P; Wei, Alice C

2017-11-01

Clinical pathways (CPW) are considered safe and effective at decreasing postoperative length of stay (LoS), but the effect on economic costs is uncertain. This study sought to elucidate the effect of a CPW on direct hospitalization costs for patients undergoing pancreaticoduodenectomy (PD). A CPW for PD patients at a single Canadian institution was implemented. Outcomes included LoS, 30-day readmissions, and direct costs of hospital care. A retrospective cost minimization analysis compared patients undergoing PD prior to and following CPW implementation, using a bootstrapped t test and deviation-based cost modeling. 121 patients undergoing PD after CPW implementation were compared to 74 controls. Index LoS was decreased following CPW implementation (9 vs. 11 days, p = 0.005), as was total LoS (10 vs. 11 days, p = 0.003). The mean total cost of postoperative hospitalization per patient decreased in the CPW group ($15,678.45 CAD vs. $25,732.85 CAD, p = 0.024), as was the mean 30-day cost including readmissions ($16,627.15 CAD vs. $29,872.72 CAD, p = 0.016). Areas of significant cost savings included laboratory tests and imaging investigations. CPWs may generate cost savings by reducing unnecessary investigations, and improve quality of care through process standardization and decreasing practice variation. Copyright © 2017 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

Detection of Theileria parva in tissues of cattle undergoing severe East Coast fever disease show significant parasite DNA accumulation in the spleen.

PubMed

Olds, Cassandra L; Paul, Tasha; Scoles, Glen A

2016-12-15

Infiltration and proliferation of Theileria parva infected lymphocytes in bovine host lymphoid organs is one of the hallmarks of T. parva infection. The relative abundance of parasites within infected host tissues, both lymphoid and non-lymphoid is however unknown. Using quantitative PCR, we have shown that significantly higher concentrations of T. parva DNA are detected in the spleens of cattle undergoing severe disease compared to other organs. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Synchrotron-Based X-ray Microtomography Characterization of the Effect of Processing Variables on Porosity Formation in Laser Power-Bed Additive Manufacturing of Ti-6Al-4V

NASA Astrophysics Data System (ADS)

Cunningham, Ross; Narra, Sneha P.; Montgomery, Colt; Beuth, Jack; Rollett, A. D.

2017-03-01

The porosity observed in additively manufactured (AM) parts is a potential concern for components intended to undergo high-cycle fatigue without post-processing to remove such defects. The morphology of pores can help identify their cause: irregularly shaped lack of fusion or key-holing pores can usually be linked to incorrect processing parameters, while spherical pores suggest trapped gas. Synchrotron-based x-ray microtomography was performed on laser powder-bed AM Ti-6Al-4V samples over a range of processing conditions to investigate the effects of processing parameters on porosity. The process mapping technique was used to control melt pool size. Tomography was also performed on the powder to measure porosity within the powder that may transfer to the parts. As observed previously in experiments with electron beam powder-bed fabrication, significant variations in porosity were found as a function of the processing parameters. A clear connection between processing parameters and resulting porosity formation mechanism was observed in that inadequate melt pool overlap resulted in lack-of-fusion pores whereas excess power density produced keyhole pores.

Liver enzymes in patients with chronic kidney disease undergoing peritoneal dialysis and hemodialysis.

PubMed

Liberato, Isabella Ramos de Oliveira; Lopes, Edmundo Pessoa de Almeida; Cavalcante, Maria Alina Gomes de Mattos; Pinto, Tiago Costa; Moura, Izolda Fernades; Loureiro Júnior, Luiz

2012-01-01

The present study was designed to analyze the serum levels of aspartate and alanine aminotransferases, gamma-glutamyl transferase, and the hematocrit in patients with chronic kidney disease who were undergoing peritoneal dialysis or hemodialysis. Twenty patients on peritoneal dialysis and 40 on hemodialysis were assessed, and the patients were matched according to the length of time that they had been on dialysis. Blood samples were collected (both before and after the session for those on hemodialysis) to measure the enzymes and the hematocrit. In the samples from the patients who were undergoing peritoneal dialysis, the aspartate and alanine aminotransferase levels were slightly higher compared with the samples collected from the patients before the hemodialysis session and slightly lower compared with the samples collected after the hemodialysis session. The levels of gamma-glutamyl transferase in the hemodialysis patients were slightly higher than the levels in the patients who were undergoing peritoneal dialysis. In addition, the levels of aminotransferases and gamma-glutamyl transferase that were collected before the hemodialysis session were significantly lower than the values collected after the session. The hematocrit levels were significantly lower in the patients who were on peritoneal dialysis compared with the patients on hemodialysis (both before and after the hemodialysis session), and the levels were also significantly lower before hemodialysis compared with after hemodialysis. The aminotransferase levels in the patients who were undergoing peritoneal dialysis were slightly higher compared with the samples collected before the hemodialysis session, whereas the aminotransferase levels were slightly lower compared with the samples collected after the session. The hematocrits and the aminotransferase and gamma-glutamyl transferase levels of the samples collected after the hemodialysis session were significantly higher than the samples collected before the session. Taken together, the present data suggest that hemodilution could alter the serum levels of liver enzymes.

Accumulation of epicardial fat rather than visceral fat is an independent risk factor for left ventricular diastolic dysfunction in patients undergoing peritoneal dialysis.

PubMed

Lin, Heng-Hsu; Lee, Jen-Kuang; Yang, Chung-Yi; Lien, Yu-Chung; Huang, Jenq-Wen; Wu, Cho-Kai

2013-08-30

Symptoms of heart failure with preserved left ventricular systolic function are common among patients undergoing peritoneal dialysis (PD). Epicardial fat (EpF) is an ectopic fat depot with possible paracrine or mechanical effects on myocardial function. The aim of our current study is to assess the association between EpF and Left ventricular diastolic dysfunction (LVDD) in patients undergoing PD and to clarify the relationships among EpF, inflammation, and LVDD in this population. This was a cross-sectional study of 149 patients with preserved left ventricular systolic function who were undergoing PD. LVDD was diagnosed (according to the European Society of Cardiology guidelines) and EpF thickness measured by echocardiography. The patients without LVDD were used as controls. The serum inflammatory biomarker high-sensitivity C-reactive protein (hsCRP) was measured. The location and amount of adipose tissue were assessed by computed tomography (CT) at the level of the fourth lumbar vertebra. Subjects with LVDD had higher levels of hsCRP, more visceral and peritoneal fat, and thicker EpF (all p < 0.001) than controls. Visceral adipose tissue, hsCRP, and EpF all correlated significantly (p < 0.05) with LVDD. Multivariate regression analysis rendered the relationship between visceral adipose tissue and LVDD insignificant, whereas EpF was the most powerful determinant of LVDD (odds ratio = 2.41, 95% confidence interval = 1.43-4.08, p < 0.01). EpF thickness also correlated significantly with the ratio of transmitral Doppler early filling velocity to tissue Doppler early diastolic mitral annular velocity (E/e'; r = 0.27, p < 0.01). EpF thickness is significantly independently associated with LVDD in patients undergoing PD and may be involved in its pathogenesis.

Accumulation of epicardial fat rather than visceral fat is an independent risk factor for left ventricular diastolic dysfunction in patients undergoing peritoneal dialysis

PubMed Central

2013-01-01

Background Symptoms of heart failure with preserved left ventricular systolic function are common among patients undergoing peritoneal dialysis (PD). Epicardial fat (EpF) is an ectopic fat depot with possible paracrine or mechanical effects on myocardial function. The aim of our current study is to assess the association between EpF and Left ventricular diastolic dysfunction (LVDD) in patients undergoing PD and to clarify the relationships among EpF, inflammation, and LVDD in this population. Methods This was a cross-sectional study of 149 patients with preserved left ventricular systolic function who were undergoing PD. LVDD was diagnosed (according to the European Society of Cardiology guidelines) and EpF thickness measured by echocardiography. The patients without LVDD were used as controls. The serum inflammatory biomarker high-sensitivity C-reactive protein (hsCRP) was measured. The location and amount of adipose tissue were assessed by computed tomography (CT) at the level of the fourth lumbar vertebra. Results Subjects with LVDD had higher levels of hsCRP, more visceral and peritoneal fat, and thicker EpF (all p < 0.001) than controls. Visceral adipose tissue, hsCRP, and EpF all correlated significantly (p < 0.05) with LVDD. Multivariate regression analysis rendered the relationship between visceral adipose tissue and LVDD insignificant, whereas EpF was the most powerful determinant of LVDD (odds ratio = 2.41, 95% confidence interval = 1.43–4.08, p < 0.01). EpF thickness also correlated significantly with the ratio of transmitral Doppler early filling velocity to tissue Doppler early diastolic mitral annular velocity (E/e’; r = 0.27, p < 0.01). Conclusion EpF thickness is significantly independently associated with LVDD in patients undergoing PD and may be involved in its pathogenesis. PMID:24001037

Outcomes of Highly Sensitized Patients Undergoing Simultaneous Liver and Kidney Transplantation: A Single-Center Experience With Desensitization.

PubMed

Steggerda, J A; Kang, A; Pan, S-H; Sundaram, V; Nissen, N N; Klein, A S; Todo, T; Annamalai, A; Vo, A; Jordan, S C; Kim, I K

Preformed donor-specific human leukocyte antigen antibodies (DSAs) in patients undergoing simultaneous liver and kidney transplantation (SLKT) are an independent risk factor for poorer patient and renal allograft survival. The outcomes of patients highly sensitized (HS) against HLA antigens undergoing SLKT and select HS SLKT recipients undergoing desensitization at a high-volume desensitization center were investigated. Seventy-five patients undergoing SLKT at a high-volume desensitization center between January 1, 2001, and December 31, 2015, were retrospectively reviewed. HS patients were defined by panel-reactive antibody (PRA) >30% (n = 17 patients), 11 of whom received pre- or perioperative desensitization with high-dose intravenous immunoglobulin (IVIG) ± rituximab. HS patients had significantly higher class I and class II PRA (class I = 41.3% ± 40.0% vs 2.5% ± 6.3%; class II = 45.7% ± 36.4% vs 1.0% ± 2.9%; P < .001), were more likely to be female (P = .05), and more likely to have had a prior transplant (P = .03). HS patients demonstrated greater susceptibility to renal cell-mediated rejection (CMR) (23.5% vs 5.2%, P = .02) compared to nonsensitized patients. Higher renal antibody-mediated rejection (ABMR) was also observed in HS patients, 11.8% vs 3.4%, but did not reach significance (P = .18). Desensitization in select HS SLKT patients was well tolerated but did not improve patient and allograft survival or significantly curtail rejection. HS SLKT recipients demonstrated increased allograft rejection, particularly CMR, but patient and graft survival were not impacted in the first year post-transplant. Select HS SLKT patients tolerated desensitization with high-dose IVIG ± rituximab and may have received additional immunoprotection against ABMR but survival was not affected. Copyright © 2017 Elsevier Inc. All rights reserved.

KSC-98pc1160

NASA Image and Video Library

1998-09-27

KENNEDY SPACE CENTER, FLA. -- The Shuttle Carrier Aircraft with orbiter Atlantis on top touches down at the Shuttle Landing Facility. Atlantis returns home after a 10-month stay in the Palmdale, CA, orbiter processing facility undergoing extensive inspections and modifications. They included several upgrades enabling it to support International Space Station missions, such as adding an external airlock for ISS docking missions and installing thinner, lighter thermal protection blankets for weight reduction which will allow it to haul heavier cargo. The flight from Palmdale included a fueling stop in Ft. Hood, TX, and overnight stay at Ft. Campbell, KY. Atlantis will undergo preparations in the Orbiter Processing Facility at KSC for its planned flight in June 1999

KSC-98pc1167

NASA Image and Video Library

1998-09-28

Seen from behind, the orbiter Atlantis approaches the entrance of Orbiter Processing Facility 2 (OPF-2) where it will undergo preparations for its planned flight in June 1999. Atlantis spent 10 months in Palmdale, CA, undergoing extensive inspections and modifications in the orbiter processing facility there. The modifications included several upgrades enabling it to support International Space Station missions, such as adding an external airlock for ISS docking missions and installing thinner, lighter thermal protection blankets for weight reduction which will allow it to haul heavier cargo. OPF-2 consists of a 2,700-square-meter (29,000 square ft.) high bay. The building measures 29 meters (95 ft). high, 121 meters (397 ft.) long and 71 meters (233 ft.) wide

KSC-98pc1161

NASA Image and Video Library

1998-09-27

KENNEDY SPACE CENTER, FLA. -- The Shuttle Carrier Aircraft gently lands its piggyback cargo orbiter Atlantis at the Shuttle Landing Facility. Atlantis returns home after a 10-month stay in the Palmdale, CA, orbiter processing facility undergoing extensive inspections and modifications. They included several upgrades enabling it to support International Space Station missions, such as adding an external airlock for ISS docking missions and installing thinner, lighter thermal protection blankets for weight reduction which will allow it to haul heavier cargo. The flight from Palmdale included a fueling stop in Ft. Hood, TX, and overnight stay at Ft. Campbell, KY. Atlantis will undergo preparations in the Orbiter Processing Facility at KSC for its planned flight in June 1999

KSC-98pc1159

NASA Image and Video Library

1998-09-27

KENNEDY SPACE CENTER, FLA. -- The Shuttle Carrier Aircraft with orbiter Atlantis on top arrives at the Shuttle Landing Facility. Atlantis returns home after a 10-month stay in the Palmdale, CA, orbiter processing facility undergoing extensive inspections and modifications. They included several upgrades enabling it to support International Space Station missions, such as adding an external airlock for ISS docking missions and installing thinner, lighter thermal protection blankets for weight reduction which will allow it to haul heavier cargo. The flight from Palmdale included a fueling stop in Ft. Hood, TX, and overnight stay at Ft. Campbell, KY. Atlantis will undergo preparations in the Orbiter Processing Facility at KSC for its planned flight in June 1999

KSC-98pc1168

NASA Image and Video Library

1998-09-28

Seen from behind, the orbiter Atlantis moves into the Orbiter Processing Facility 2 (OPF-2) where it will undergo preparations for its planned flight in June 1999. Atlantis spent 10 months in Palmdale, CA, undergoing extensive inspections and modifications in the orbiter processing facility there. The modifications included several upgrades enabling it to support International Space Station missions, such as adding an external airlock for ISS docking missions and installing thinner, lighter thermal protection blankets for weight reduction which will allow it to haul heavier cargo. OPF-2 consists of two 2,700-square-meter (29,000 square feet) high bays. It measures 29 meters (95 ft). high, 121 meters (397 ft) long and 71 meters (233 ft) wide

A pilot randomized trial of pentoxifylline for the reduction of periprocedural myocardial injury in patients undergoing elective percutaneous coronary intervention.

PubMed

Aslanabadi, Naser; Shirzadi, Hamid Reza; Asghari-Soufi, Hossein; Dousti, Samaneh; Ghaffari, Samad; Sohrabi, Bahram; Mashayekhi, Simin Ozar; Hamishehkar, Hadi; Entezari-Maleki, Taher

2015-02-01

Periprocedural myocardial injury (PMI) following percutaneous coronary intervention (PCI) has received great attention due to its significant association with mortality and morbidity. Accordingly, cardioprotection during PCI is one of the important therapeutic concerns. Regarding the potential cardiovascular benefits of pentoxifylline this study was performed to evaluate whether the pretreatment pentoxifylline could reduce PMI in patients who are undergoing elective PCI. A randomized clinical trial on 85 patients undergoing elective PCI was performed. The intervention group (n = 41) received 1200 mg pentoxifylline in divided doses plus the standard treatment before PCI, while the control group (n = 44) received the standard treatment. For assessing myocardial damage during PCI, the levels of CK-MB and troponin-I were measured at baseline, 8, and 24 h after the procedure. Then, patients were followed up for a 1-month period regarding the major adverse cardiac effect. Comparing with the control group, no significant change of CK-MB at 8 (p = 0.315) and 24 h (p = 0.896) after PCI was documented in pentoxifylline group. Similarly, no significant change was found in troponin-I at 8 (p = 0.141) and 24 h (p = 0.256) after PCI. This study could not support the pretreatment with pentoxifylline in the prevention of PMI in patients undergoing elective PCI. However, the trend was toward the potential benefit of pentoxifylline.

An unexpected twist in viral capsid maturation

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

Gertsman, Ilya; Gan, Lu; Guttman, Miklos

2009-04-14

Lambda-like double-stranded (ds) DNA bacteriophage undergo massive conformational changes in their capsid shell during the packaging of their viral genomes. Capsid shells are complex organizations of hundreds of protein subunits that assemble into intricate quaternary complexes that ultimately are able to withstand over 50 atm of pressure during genome packaging. The extensive integration between subunits in capsids requires the formation of an intermediate complex, termed a procapsid, from which individual subunits can undergo the necessary refolding and structural rearrangements needed to transition to the more stable capsid. Although various mature capsids have been characterized at atomic resolution, no such procapsidmore » structure is available for a dsDNA virus or bacteriophage. Here we present a procapsid X-ray structure at 3.65 {angstrom} resolution, termed prohead II, of the lambda-like bacteriophage HK97, the mature capsid structure of which was previously solved to 3.44 {angstrom}. A comparison of the two largely different capsid forms has unveiled an unprecedented expansion mechanism that describes the transition. Crystallographic and hydrogen/deuterium exchange data presented here demonstrate that the subunit tertiary structures are significantly different between the two states, with twisting and bending motions occurring in both helical and -sheet regions. We also identified subunit interactions at each three-fold axis of the capsid that are maintained throughout maturation. The interactions sustain capsid integrity during subunit refolding and provide a fixed hinge from which subunits undergo rotational and translational motions during maturation. Previously published calorimetric data of a closely related bacteriophage, P22, showed that capsid maturation was an exothermic process that resulted in a release of 90 kJ mol{sup -1} of energy. We propose that the major tertiary changes presented in this study reveal a structural basis for an exothermic maturation process probably present in many dsDNA bacteriophage and possibly viruses such as herpesvirus, which share the HK97 subunit fold.« less

Peculiarities of methane clathrate hydrate formation and solid-state deformation, including possible superheating of water ice

USGS Publications Warehouse

Stern, L.A.; Kirby, S.H.; Durham, W.B.

1996-01-01

Slow, constant-volume heating of water ice plus methane gas mixtures forms methane clathrate hydrate by a progressive reaction that occurs at the nascent ice/liquid water interface. As this reaction proceeds, the rate of melting of metastable water ice may be suppressed to allow short-lived superheating of ice to at least 276 kelvin. Plastic flow properties measured on clathrate test specimens are significantly different from those of water ice; under nonhydrostatic stress, methane clathrate undergoes extensive strain hardening and a process of solid-state disproportionation or exsolution at conditions well within its conventional hydrostatic stability field.

A statistical method (cross-validation) for bone loss region detection after spaceflight

PubMed Central

Zhao, Qian; Li, Wenjun; Li, Caixia; Chu, Philip W.; Kornak, John; Lang, Thomas F.

2010-01-01

Astronauts experience bone loss after the long spaceflight missions. Identifying specific regions that undergo the greatest losses (e.g. the proximal femur) could reveal information about the processes of bone loss in disuse and disease. Methods for detecting such regions, however, remains an open problem. This paper focuses on statistical methods to detect such regions. We perform statistical parametric mapping to get t-maps of changes in images, and propose a new cross-validation method to select an optimum suprathreshold for forming clusters of pixels. Once these candidate clusters are formed, we use permutation testing of longitudinal labels to derive significant changes. PMID:20632144

KSC-01pp0249

NASA Image and Video Library

2001-02-03

An overhead crane lowers the Multi-Purpose Logistics Module Donatello onto a workstand. In the SSPF, Donatello will undergo processing by the payload test team, including integrated electrical tests with other Station elements in the SSPF, leak tests, electrical and software compatibility tests with the Space Shuttle (using the Cargo Integrated Test equipment) and an Interface Verification Test once the module is installed in the Space Shuttle’s payload bay at the launch pad. The most significant mechanical task to be performed on Donatello in the SSPF is the installation and outfitting of the racks for carrying the various experiments and cargo. Donatello will be launched on mission STS-130, currently planned for September 2004

Representations of Invariant Musical Categories Are Decodable by Pattern Analysis of Locally Distributed BOLD Responses in Superior Temporal and Intraparietal Sulci

PubMed Central

Klein, Mike E.; Zatorre, Robert J.

2015-01-01

In categorical perception (CP), continuous physical signals are mapped to discrete perceptual bins: mental categories not found in the physical world. CP has been demonstrated across multiple sensory modalities and, in audition, for certain over-learned speech and musical sounds. The neural basis of auditory CP, however, remains ambiguous, including its robustness in nonspeech processes and the relative roles of left/right hemispheres; primary/nonprimary cortices; and ventral/dorsal perceptual processing streams. Here, highly trained musicians listened to 2-tone musical intervals, which they perceive categorically while undergoing functional magnetic resonance imaging. Multivariate pattern analyses were performed after grouping sounds by interval quality (determined by frequency ratio between tones) or pitch height (perceived noncategorically, frequency ratios remain constant). Distributed activity patterns in spheres of voxels were used to determine sound sample identities. For intervals, significant decoding accuracy was observed in the right superior temporal and left intraparietal sulci, with smaller peaks observed homologously in contralateral hemispheres. For pitch height, no significant decoding accuracy was observed, consistent with the non-CP of this dimension. These results suggest that similar mechanisms are operative for nonspeech categories as for speech; espouse roles for 2 segregated processing streams; and support hierarchical processing models for CP. PMID:24488957

[Adherence to pharmacological treatment in adult patients undergoing hemodialysis].

PubMed

Sgnaolin, Vanessa; Figueiredo, Ana Elizabeth Prado Lima

2012-06-01

Adherence to treatment in patients on hemodialysis is not a simple process. Strategies to promote adherence will meet the need for improvements in the process of orientation concerning the disease and its pharmacological treatment. To identify compliance with pharmacological treatment of patients on hemodialysis and the main factors related to it we used the Adherence Scale. Observational, descriptive and cross-sectional study. Interviews were conducted to collect socioeconomic, pharmacological data, as well as those regarding self-reported adherence to drug. Out of the 65 participants, 55.4% showed non-compliance. The mean number of drugs used was 4.1 ± 2.5 (self-report) and 6.2 ± 3.0 (prescription). Statistical analysis showed significant differences concerning compliance at different ages (> 60 years are more adherent). A significant proportion of patients have difficulty to comply with treatment and the main factor was forgetfulness. Regarding age, elderly patients are more adherent to treatment. The low level of knowledge about the used drugs may be one of the reasons for the lack of adherence, and the patient's orientation process by a team of multiprofessionals involved in assisting is a strategy to promote adherence.

Proton magnetic resonance spectroscopy in adult cancer patients with delirium

PubMed Central

Yager, Jeffrey R.; Magnotta, Vincent A.; Mills, James A.; Vik, Stacie M.; Weckmann, Michelle T.; Capizzano, Aristides A.; Gingrich, Roger; Beglinger, Leigh J.

2010-01-01

Background Delirium is associated with a host of negative outcomes, including increased risk of mortality, longer hospital stay, and poor long-term cognitive function. The pathophysiology of delirium is not well understood. Cancer patients undergoing a bone marrow transplant (BMT) are at high risk for developing delirium and Proton Magnetic Resonance Spectroscopy (1H-MRS) could lead to better understanding of the delirium process. Methods Fourteen BMT patients and 10 controls completed 1H-MRS, positioned above the corpus callosum, shortly after delirium onset or at study end if no delirium occurred. Results In the BMT-delirium group, statistically significantly elevated tCho/tCr was found in contrast to the BMT-no delirium group (p<0.05). The BMT–delirium group also showed statistically significantly lesser NAA/tCho compared to both controls (p=0.01) and the BMT–no delirium group (p=0.04). Conclusions Elevated choline and reduced NAA indicate inflammatory processes and white matter damage as well as neuronal metabolic impairment. Further research is needed to separate the choline peaks, as well as more detailed collection of medication regimens to determine whether a higher choline concentration is a function of the delirium process or cancer treatment effects. PMID:21227658

Associations between ASA Physical Status and postoperative mortality at 48 h: a contemporary dataset analysis compared to a historical cohort.

PubMed

Hopkins, Thomas J; Raghunathan, Karthik; Barbeito, Atilio; Cooter, Mary; Stafford-Smith, Mark; Schroeder, Rebecca; Grichnik, Katherine; Gilbert, Richard; Aronson, Solomon

2016-01-01

In this study, we examined the association between American Society of Anesthesiologists Physical Status (ASA PS) designation and 48-h mortality for both elective and emergent procedures in a large contemporary dataset (patient encounters between 2009 and 2014) and compared this association with data from a landmark study published by Vacanti et al. in 1970. Patient history, hospital characteristics, anesthetic approach, surgical procedure, efficiency and quality indicators, and patient outcomes were prospectively collected for 732,704 consecutive patient encounters between January 1, 2009, and December 31, 2014, at 233 anesthetizing locations across 19 facilities in two US states and stored in the Quantum™ Clinical Navigation System (QCNS) database. The outcome (death within 48 h of procedure) was tabulated against ASA PS designations separately for patients with and without "E" status labels. To maintain consistency with the historical cohort from the landmark study performed by Vacanti et al. on adult men at US naval hospitals in 1970, we then created a comparison cohort in the contemporary dataset that consisted of 242,103 adult male patients (with/without E designations) undergoing elective and emergent procedures. Differences in the relationship between ASA PS and 48-h mortality in the historical and contemporary cohorts were assessed for patients undergoing elective and emergent procedures. As reported nearly five decades ago, we found a significant trend toward increased mortality with increasing ASA PS for patients undergoing both elective and emergent procedures in a large contemporary cohort ( p  < 0.0001). Additionally, the overall mortality rate at 48 h was significantly higher among patients undergoing emergent compared to elective procedures in the large contemporary cohort (1.27 versus 0.03 %, p  < 0.0001). In the comparative analysis with the historical cohort that focused on adult males, we found the overall 48-h mortality rate was significantly lower among patients undergoing elective procedures in the contemporary cohort (0.05 % now versus 0.24 % in 1970, p  < 0.0001) but not significantly lower among those undergoing emergent procedures (1.88 % now versus 1.22 % in 1970, p  < 0.0001). The association between increasing ASA PS designation (1-5) and mortality within 48 h of surgery is significant for patients undergoing both elective and emergent procedures in a contemporary dataset consisting of over 700,000 patient encounters. Emergency surgery was associated with a higher risk of patient death within 48 h of surgery in this contemporary dataset. These data trends are similar to those observed nearly five decades ago in a landmark study evaluating the association between ASA PS and 48-h surgical mortality on adult men at US naval hospitals. When a comparison cohort was created from the contemporary dataset and compared to this landmark historical cohort, the absolute 48-h mortality rate was significantly lower in the contemporary cohort for elective procedures but not significantly lower for emergency procedures. The underlying implications of these findings remain to be determined.

Patient rights protection in the Czech Republic: challenges of a transition from Communism to a modern legal system.

PubMed

Dostal, O

2007-03-01

The post-Communist countries in Central Europe, including the Czech Republic, underwent a rapid transformation of their legal systems, within which the concept of patient rights passed through revolutionary changes. This process however often left significant gaps in patient rights protection. There are practical difficulties for patients in defending their rights before the courts, such as problems with obtaining evidence and independent expert opinions, long delays and high costs of court proceedings, strict burden of proof rules and low compensation levels. Modern patient rights often collide with the systems of health care provision that are still unprepared for patient autonomy and responsibility. The experience gained in the transition process might be applicable also to other countries that undergo changes from traditional to modern system of patient rights protection.

Surface dynamics of voltage-gated ion channels.

PubMed

Heine, Martin; Ciuraszkiewicz, Anna; Voigt, Andreas; Heck, Jennifer; Bikbaev, Arthur

2016-07-03

Neurons encode information in fast changes of the membrane potential, and thus electrical membrane properties are critically important for the integration and processing of synaptic inputs by a neuron. These electrical properties are largely determined by ion channels embedded in the membrane. The distribution of most ion channels in the membrane is not spatially uniform: they undergo activity-driven changes in the range of minutes to days. Even in the range of milliseconds, the composition and topology of ion channels are not static but engage in highly dynamic processes including stochastic or activity-dependent transient association of the pore-forming and auxiliary subunits, lateral diffusion, as well as clustering of different channels. In this review we briefly discuss the potential impact of mobile sodium, calcium and potassium ion channels and the functional significance of this for individual neurons and neuronal networks.

Method for improving dissolution efficiency in gas-absorption and liquid extraction processes. [Patent application

DOEpatents

Kanak, B.E.; Stephenson, M.J.

1980-01-11

A method is described for improving dissolution efficiency in processes in which a feed fluid is introduced to a zone where it is contacted with a liquid solvent for preferentially removing a component of the feed and where part of the solvent so contacted undergoes transfer into the feed fluid to saturate the same. It has been found that such transfer significantly impairs dissolution efficiency. In accordance with the invention, an amount of the above-mentioned solvent is added to the feed fluid being introduced to the contact zone, the solvent being added in an amount sufficient to effect reduction or elimination of the above-mentioned transfer. Preferably, the solvent is added to the feed fluid in an amount saturating or supersaturating the feed fluid under the conditions prevailing in the contact zone.

Method for improving dissolution efficiency in gas-absorption and liquid extraction processes

DOEpatents

Kanak, Brant E.; Stephenson, Michael J.

1981-01-01

This invention is a method for improving dissolution efficiency in processes in which a feed fluid is introduced to a zone where it is contacted with a liquid solvent for preferentially removing a component of the feed and where part of the solvent so contacted undergoes transfer into the feed fluid to saturate the same. It has been found that such transfer significantly impairs dissolution efficiency. In accordance with the invention, an amount of the above-mentioned solvent is added to the feed fluid being introduced to the contact zone, the solvent being added in an amount sufficient to effect reduction or elimination of the above-mentioned transfer. Preferably, the solvent is added to the feed fluid in an amount saturating or supersaturating the feed fluid under the conditions prevailing in the contact zone.

Tinnitus. I: Auditory mechanisms: a model for tinnitus and hearing impairment.

PubMed

Hazell, J W; Jastreboff, P J

1990-02-01

A model is proposed for tinnitus and sensorineural hearing loss involving cochlear pathology. As tinnitus is defined as a cortical perception of sound in the absence of an appropriate external stimulus it must result from a generator in the auditory system which undergoes extensive auditory processing before it is perceived. The concept of spatial nonlinearity in the cochlea is presented as a cause of tinnitus generation controlled by the efferents. Various clinical presentations of tinnitus and the way in which they respond to changes in the environment are discussed with respect to this control mechanism. The concept of auditory retraining as part of the habituation process, and interaction with the prefrontal cortex and limbic system is presented as a central model which emphasizes the importance of the emotional significance and meaning of tinnitus.

Surface dynamics of voltage-gated ion channels

PubMed Central

Heine, Martin; Ciuraszkiewicz, Anna; Voigt, Andreas; Heck, Jennifer; Bikbaev, Arthur

2016-01-01

ABSTRACT Neurons encode information in fast changes of the membrane potential, and thus electrical membrane properties are critically important for the integration and processing of synaptic inputs by a neuron. These electrical properties are largely determined by ion channels embedded in the membrane. The distribution of most ion channels in the membrane is not spatially uniform: they undergo activity-driven changes in the range of minutes to days. Even in the range of milliseconds, the composition and topology of ion channels are not static but engage in highly dynamic processes including stochastic or activity-dependent transient association of the pore-forming and auxiliary subunits, lateral diffusion, as well as clustering of different channels. In this review we briefly discuss the potential impact of mobile sodium, calcium and potassium ion channels and the functional significance of this for individual neurons and neuronal networks. PMID:26891382

Micronuclei and other nuclear anomalies in normal human buccal mucosa cells of oral cancer patients undergoing radiotherapy: a field effect.

PubMed

Tak, A; Metgud, R; Astekar, M; Tak, M

2014-08-01

We evaluated micronuclei and other nuclear anomalies in exfoliated epithelial cells of the oral cavity on the side opposite the lesion targeted by radiotherapy and correlated them with radiation doses. Buccal smears were obtained from oral cancer patients undergoing radiotherapy with a cumulative dose of at least 1000 rad for 3 weeks and from controls matched for age, gender and habits. The exfoliated cells from the mucosa were collected using a cytobrush; smears were prepared, fixed in 80% methanol and stained using the Feulgen plus fast green method. The mean number of micronuclei and other nuclear anomalies/1000 cells was significantly greater in patients undergoing radiotherapy treatment, but the differences were not significant compared to radiation doses. It appears that radiotherapy has a potent clastogenic effect on buccal mucosal cells of oral cancer patients.

Correlative analysis of social support with anxiety and depression in men undergoing in vitro fertilization embryo transfer for the first time.

PubMed

Dong, Yue-Zhi; Yang, Xiao-Xia; Sun, Ying-Pu

2013-08-01

To explore the correlation between the level of social support and the extent of anxiety and depression in Chinese men undergoing in vitro fertilization embryo transfer (IVF-ET) for the first time, in order to provide a basis for male mental health counselling. Self-administered questionnaires covering general health status, anxiety (self-rating anxiety scale), depression (self-rating depression scale) and social support (social support rating scale) were completed by men undergoing their first round of IVF-ET. A total of 502 completed questionnaires were considered valid and were analysed. The anxiety, depression and social support scores for men undergoing their first round of IVF-ET were significantly higher than those for Chinese normative data. Social support was inversely correlated with anxiety and depression. These findings suggest that health care professionals should provide specific psychological counselling to Chinese men undergoing their first round of IVF-ET, in order to improve their psychological health and to facilitate increased levels of social support.

What Predicts Patients’ Willingness to Undergo Online Treatment and Pay for Online Treatment? Results from a Web-Based Survey to Investigate the Changing Patient-Physician Relationship

PubMed Central

Bidmon, Sonja; Terlutter, Ralf

2016-01-01

Background Substantial research has focused on patients’ health information–seeking behavior on the Internet, but little is known about the variables that may predict patients’ willingness to undergo online treatment and willingness to pay additionally for online treatment. Objective This study analyzed sociodemographic variables, psychosocial variables, and variables of Internet usage to predict willingness to undergo online treatment and willingness to pay additionally for online treatment offered by the general practitioner (GP). Methods An online survey of 1006 randomly selected German patients was conducted. The sample was drawn from an e-panel maintained by GfK HealthCare. Missing values were imputed; 958 usable questionnaires were analyzed. Variables with multi-item measurement were factor analyzed. Willingness to undergo online treatment and willingness to pay additionally for online treatment offered by the GP were predicted using 2 multiple regression models. Results Exploratory factor analyses revealed that the disposition of patients’ personality to engage in information-searching behavior on the Internet was unidimensional. Exploratory factor analysis with the variables measuring the motives for Internet usage led to 2 separate factors: perceived usefulness (PU) of the Internet for health-related information searching and social motives for information searching on the Internet. Sociodemographic variables did not serve as significant predictors for willingness to undergo online treatment offered by the GP, whereas PU (B=.092, P=.08), willingness to communicate with the GP more often in the future (B=.495, P<.001), health-related information–seeking personality (B=.369, P<.001), actual use of online communication with the GP (B=.198, P<.001), and social motive (B=.178, P=.002) were significant predictors. Age, gender, satisfaction with the GP, social motive, and trust in the GP had no significant impact on the willingness to pay additionally for online treatment, but it was predicted by health-related information–seeking personality (B=.127, P=.07), PU (B=–.098, P=.09), willingness to undergo online treatment (B=.391, P<.001), actual use of online communication with the GP (B=.192, P=.001), highest education level (B=.178, P<.001), monthly household net income (B=.115, P=.01), and willingness to communicate with the GP online more often in the future (B=.076, P=.03). Conclusions Age, gender, and trust in the GP were not significant predictors for either willingness to undergo online treatment or to pay additionally for online treatment. Willingness to undergo online treatment was partly determined by the actual use of online communication with the GP, willingness to communicate online with the GP, health information–seeking personality, and social motivation for such behavior. Willingness to pay extra for online treatment was influenced by the monthly household net income category and education level. The results of this study are useful for online health care providers and physicians who are considering offering online treatments as a viable number of patients would appreciate the possibility of undergoing an online treatment offered by their GP. PMID:26846162

What Predicts Patients' Willingness to Undergo Online Treatment and Pay for Online Treatment? Results from a Web-Based Survey to Investigate the Changing Patient-Physician Relationship.

PubMed

Roettl, Johanna; Bidmon, Sonja; Terlutter, Ralf

2016-02-04

Substantial research has focused on patients' health information-seeking behavior on the Internet, but little is known about the variables that may predict patients' willingness to undergo online treatment and willingness to pay additionally for online treatment. This study analyzed sociodemographic variables, psychosocial variables, and variables of Internet usage to predict willingness to undergo online treatment and willingness to pay additionally for online treatment offered by the general practitioner (GP). An online survey of 1006 randomly selected German patients was conducted. The sample was drawn from an e-panel maintained by GfK HealthCare. Missing values were imputed; 958 usable questionnaires were analyzed. Variables with multi-item measurement were factor analyzed. Willingness to undergo online treatment and willingness to pay additionally for online treatment offered by the GP were predicted using 2 multiple regression models. Exploratory factor analyses revealed that the disposition of patients' personality to engage in information-searching behavior on the Internet was unidimensional. Exploratory factor analysis with the variables measuring the motives for Internet usage led to 2 separate factors: perceived usefulness (PU) of the Internet for health-related information searching and social motives for information searching on the Internet. Sociodemographic variables did not serve as significant predictors for willingness to undergo online treatment offered by the GP, whereas PU (B=.092, P=.08), willingness to communicate with the GP more often in the future (B=.495, P<.001), health-related information-seeking personality (B=.369, P<.001), actual use of online communication with the GP (B=.198, P<.001), and social motive (B=.178, P=.002) were significant predictors. Age, gender, satisfaction with the GP, social motive, and trust in the GP had no significant impact on the willingness to pay additionally for online treatment, but it was predicted by health-related information-seeking personality (B=.127, P=.07), PU (B=-.098, P=.09), willingness to undergo online treatment (B=.391, P<.001), actual use of online communication with the GP (B=.192, P=.001), highest education level (B=.178, P<.001), monthly household net income (B=.115, P=.01), and willingness to communicate with the GP online more often in the future (B=.076, P=.03). Age, gender, and trust in the GP were not significant predictors for either willingness to undergo online treatment or to pay additionally for online treatment. Willingness to undergo online treatment was partly determined by the actual use of online communication with the GP, willingness to communicate online with the GP, health information-seeking personality, and social motivation for such behavior. Willingness to pay extra for online treatment was influenced by the monthly household net income category and education level. The results of this study are useful for online health care providers and physicians who are considering offering online treatments as a viable number of patients would appreciate the possibility of undergoing an online treatment offered by their GP.

Acute hypoxia stress induced abundant differential expression genes and alternative splicing events in heart of tilapia.

PubMed

Xia, Jun Hong; Li, Hong Lian; Li, Bi Jun; Gu, Xiao Hui; Lin, Hao Ran

2018-01-10

Hypoxia is one of the critical environmental stressors for fish in aquatic environments. Although accumulating evidences indicate that gene expression is regulated by hypoxia stress in fish, how genes undergoing differential gene expression and/or alternative splicing (AS) in response to hypoxia stress in heart are not well understood. Using RNA-seq, we surveyed and detected 289 differential expressed genes (DEG) and 103 genes that undergo differential usage of exons and splice junctions events (DUES) in heart of a hypoxia tolerant fish, Nile tilapia, Oreochromis niloticus following 12h hypoxic treatment. The spatio-temporal expression analysis validated the significant association of differential exon usages in two randomly selected DUES genes (fam162a and ndrg2) in 5 tissues (heart, liver, brain, gill and spleen) sampled at three time points (6h, 12h, and 24h) under acute hypoxia treatment. Functional analysis significantly associated the differential expressed genes with the categories related to energy conservation, protein synthesis and immune response. Different enrichment categories were found between the DEG and DUES dataset. The Isomerase activity, Oxidoreductase activity, Glycolysis and Oxidative stress process were significantly enriched for the DEG gene dataset, but the Structural constituent of ribosome and Structural molecule activity, Ribosomal protein and RNA binding protein were significantly enriched only for the DUES genes. Our comparative transcriptomic analysis reveals abundant stress responsive genes and their differential regulation function in the heart tissues of Nile tilapia under acute hypoxia stress. Our findings will facilitate future investigation on transcriptome complexity and AS regulation during hypoxia stress in fish. Copyright © 2017 Elsevier B.V. All rights reserved.

Improving patient survival with the colorectal cancer multi-disciplinary team.

PubMed

MacDermid, E; Hooton, G; MacDonald, M; McKay, G; Grose, D; Mohammed, N; Porteous, C

2009-03-01

There is little information on the impact of the colorectal multi-disciplinary team (MDT) in the United Kingdom. Our single operator presented his patients before and after the inception of an MDT meeting in June 2002. The aim of this study was to assess the effect of this on his patients' survival, and trends in the use of adjuvant chemotherapy. Data were collected on all patients (n = 310) undergoing colectomy for colorectal cancer by one surgeon. Excluding patients with Dukes A stage, the pre-MDT cohort from January 1997 to May 2002 was 176 and the post-MDT cohort from June 2002 to December 2005 was 134. Three-year survival rates were calculated using Kaplan-Meier life table analysis. Prognostic factors were analysed using Cox-proportional hazard regression, and chemotherapy data analysed using the chi-squared test. Independent prognostic indicators of chemotherapy prescription were examined using binary logistic testing. MDT status was shown to be an independent predictor of survival on hazard regression analysis (P = 0.044). A significantly greater number of patients were prescribed adjuvant chemotherapy in the post-MDT cohort (P = 0.0002). MDT status was shown to be a significant prognostic indicator of chemotherapy prescription (P < 0.0001). Three-year survival for Dukes C patients was 58% in the pre-MDT group, and 66% in the post-MDT group (P = 0.023). There was a significant increase in patients undergoing adjuvant postoperative chemotherapy after the inception of the MDT. This was associated with a significant survival benefit in patients with Dukes C disease. The data suggest that the MDT process has resulted in an increase in the prescription of adjuvant chemotherapy, with 3-year survival being greater after its inception.

Risk factors and outcomes of in-hospital cardiac arrest following pediatric heart operations of varying complexity.

PubMed

Gupta, Punkaj; Rettiganti, Mallikarjuna; Jeffries, Howard E; Scanlon, Matthew C; Ghanayem, Nancy S; Daufeldt, Jennifer; Rice, Tom B; Wetzel, Randall C

2016-08-01

Multi center data regarding cardiac arrest in children undergoing heart operations of varying complexity are limited. Children <18 years undergoing heart surgery (with or without cardiopulmonary bypass) in the Virtual Pediatric Systems (VPS, LLC) Database (2009-2014) were included. Multivariable mixed logistic regression models were adjusted for patient's characteristics, surgical risk category (STS-EACTS Categories 1, 2, and 3 classified as "low" complexity and Categories 4 and 5 classified as "high" complexity), and hospital characteristics. Overall, 26,909 patients (62 centers) were included. Of these, 2.7% had cardiac arrest after cardiac surgery with an associated mortality of 31%. The prevalence of cardiac arrest was lower among patients undergoing low complexity operations (low complexity vs. high complexity: 1.7% vs. 5.9%). Unadjusted outcomes after cardiac arrest were significantly better among patients undergoing low complexity operations (mortality: 21.6% vs. 39.1%, good neurological outcomes: 78.7% vs. 71.6%). In adjusted models, odds of cardiac arrest were significantly lower among patients undergoing low complexity operations (OR: 0.55, 95% CI: 0.46-0.66). Adjusted models, however, showed no difference in mortality or neurological outcomes after cardiac arrest regardless of surgical complexity. Further, our results suggest that incidence of cardiac arrest and mortality after cardiac arrest are a function of patient characteristics, surgical risk category, and hospital characteristics. Presence of around the clock in-house attending level pediatric intensivist coverage was associated with lower incidence of post-operative cardiac arrest, and presence of a dedicated cardiac ICU was associated with lower mortality after cardiac arrest. This study suggests that the patients undergoing high complexity operations are a higher risk group with increased prevalence of post-operative cardiac arrest. These data further suggest that patients undergoing high complexity operations can be rescued after cardiac arrest with a high survival rate. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Concurrent risk-reduction surgery in patients with increased lifetime risk for breast and ovarian cancer: an analysis of the National Surgical Quality Improvement Program (NSQIP) database.

PubMed

Elmi, Maryam; Azin, Arash; Elnahas, Ahmad; McCready, David R; Cil, Tulin D

2018-05-14

Patients with genetic susceptibility to breast and ovarian cancer are eligible for risk-reduction surgery. Surgical morbidity of risk-reduction mastectomy (RRM) with concurrent bilateral salpingo-oophorectomy (BSO) is unknown. Outcomes in these patients were compared to patients undergoing RRM without BSO using a large multi-institutional database. A retrospective cohort analysis was conducted using the American College of Surgeon's National Surgical Quality Improvement Program (NSQIP) 2007-2016 datasets, comparing postoperative morbidity between patients undergoing RRM with patients undergoing RRM with concurrent BSO. Patients with genetic susceptibility to breast/ovarian cancer undergoing risk-reduction surgery were identified. The primary outcome was 30-day postoperative major morbidity. Secondary outcomes included surgical site infections, reoperations, readmissions, length of stay, and venous thromboembolic events. A multivariate analysis was performed to determine predictors of postoperative morbidity and the adjusted effect of concurrent BSO on morbidity. Of the 5470 patients undergoing RRM, 149 (2.7%) underwent concurrent BSO. The overall rate of major morbidity and postoperative infections was 4.5% and 4.6%, respectively. There was no significant difference in the rate of postoperative major morbidity (4.5% vs 4.7%, p = 0.91) or any of the secondary outcomes between patients undergoing RRM without BSO vs. those undergoing RRM with concurrent BSO. Multivariable analysis showed Body Mass Index (OR 1.05; p < 0.001) and smoking (OR 1.78; p = 0.003) to be the only predictors associated with major morbidity. Neither immediate breast reconstruction (OR 1.02; p = 0.93) nor concurrent BSO (OR 0.94; p = 0.89) were associated with increased postoperative major morbidity. This study demonstrated that RRM with concurrent BSO was not associated with significant additional morbidity when compared to RRM without BSO. Therefore, this joint approach may be considered for select patients at risk for both breast and ovarian cancer.

Frequency of Dehiscence in Hand-Sutured and Stapled Intestinal Anastomoses in Dogs.

PubMed

Duell, Jason R; Thieman Mankin, Kelley M; Rochat, Mark C; Regier, Penny J; Singh, Ameet; Luther, Jill K; Mison, Michael B; Leeman, Jessica J; Budke, Christine M

2016-01-01

To determine the frequency of dehiscence of hand-sutured and stapled intestinal anastomoses in the dog and compare the surgery duration for the methods of anastomosis. Historical cohort study. Two hundred fourteen client-owned dogs undergoing hand-sutured (n = 142) or stapled (n = 72) intestinal anastomoses. Medical records from 5 referral institutions were searched for dogs undergoing intestinal resection and anastomosis between March 2006 and February 2014. Demographic data, presence of septic peritonitis before surgery, surgical technique (hand-sutured or stapled), surgery duration, surgeon (resident versus faculty member), indication for surgical intervention, anatomic location of resection and anastomosis, and if dehiscence was noted postoperatively were retrieved. Estimated frequencies were summarized and presented as proportions and 95% confidence intervals (CI) and continuous outcomes as mean (95% CI). Comparisons were made across methods of anastomosis. Overall, 29/205 dogs (0.14, 95% CI 0.10-00.19) had dehiscence, including 21/134 dogs (0.16, 0.11-0.23) undergoing hand-sutured anastomosis and 8/71 dogs (0.11, 0.06-0.21) undergoing stapled anastomosis. There was no significant difference in the frequency of dehiscence across anastomosis methods (χ(2), P = .389). The mean (95% CI) surgery duration of 140 minutes (132-147) for hand- sutured anastomoses and 108 minutes (99-119) for stapled anastomoses was significantly different (t-test, P < .001). No significant difference in frequency of dehiscence was noted between hand- sutured and stapled anastomoses in dogs but surgery duration is significantly reduced by the use of staples for intestinal closure. © Copyright 2015 by The American College of Veterinary Surgeons.

Cellular Profile and Expression of Immunologic Markers in Chronic Apical Periodontitis from HIV-infected Patients Undergoing Highly Active Antiretroviral Therapy.

PubMed

Gama, Túlio Gustavo Veiga; Pires, Fabio Ramoa; Armada, Luciana; Gonçalves, Lucio Souza

2016-06-01

This study tested the hypothesis that the inflammatory cell profile (CD3-, CD4-, CD8-, CD20-, and CD68-positive cells) and the expression of immunologic markers (tumor necrosis factor α, interferon-γ, interleukin-6, and interleukin-18) in chronic apical periodontitis are the same between non-HIV-infected patients and HIV-infected patients undergoing highly active antiretroviral therapy (HAART). Thirty-four surgically excised chronic apical periodontitis lesions were sampled from 34 patients (17 HIV-infected and 17 non-HIV-infected). The lesions were extracted from teeth with no previous endodontic treatment. All HIV-infected patients were undergoing HAART. The specimens were submitted to histopathologic and immunohistochemical analyses by using an optical microscope. Immunoexpression was graded into 2 levels, focal to weak and moderate to strong. The χ(2), Fisher exact, and Mann-Whitney tests were used to analyze all significant differences between groups. Periapical cysts represented 70.6% and 52.9% of the lesions in the HIV-infected and non-HIV-infected groups, respectively; however, no statistically significant difference was observed (P = .481). There were no statistically significant differences between groups for the inflammatory cell profile and for any of the immunologic markers (P > .05). There are no statistically significant differences of the cellular profile and expression of immunologic markers in chronic apical periodontitis between non-HIV-infected patients and HIV-infected patients undergoing HAART. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Perioperative depression or anxiety and postoperative mortality in cardiac surgery: a systematic review and meta-analysis.

PubMed

Takagi, Hisato; Ando, Tomo; Umemoto, Takuya

2017-12-01

We performed a systematic review and meta-analysis to determine whether perioperative depression and anxiety are associated with increased postoperative mortality in patients undergoing cardiac surgery. MEDLINE and EMBASE were searched through January 2017 using PubMed and OVID, to identify observational studies enrolling patients undergoing cardiac surgery and reporting relative risk estimates (RREs) (including odds, hazard, or mortality ratios) of short term (30 days or in-hospital) and/or late all-cause mortality for patients with versus without perioperative depression or anxiety. Study-specific estimates were combined using inverse variance-weighted averages of logarithmic RREs in the random-effects models. Our search identified 16 eligible studies. In total, the present meta-analysis included data on 236,595 patients undergoing cardiac surgery. Pooled analysis demonstrated that perioperative depression was significantly associated with increased both postoperative early (RRE, 1.44; 95% confidence interval [CI] 1.01-2.05; p = 0.05) and late mortality (RRE, 1.44; 95% CI 1.24-1.67; p < 0.0001), and that perioperative anxiety significantly correlated with increased postoperative late mortality (RRE, 1.81; 95% CI 1.20-2.72; p = 0.004). The relation between anxiety and early mortality was reported in only one study and not statistically significant. In the association of depression with late mortality, there was no evidence of significant publication bias and meta-regression indicated that the effects of depression are not modulated by the duration of follow-up. In conclusion, perioperative depression and anxiety may be associated with increased postoperative mortality in patients undergoing cardiac surgery.

Effects of Reiki on Pain, Anxiety, and Blood Pressure in Patients Undergoing Knee Replacement: A Pilot Study.

PubMed

Baldwin, Ann Linda; Vitale, Anne; Brownell, Elise; Kryak, Elizabeth; Rand, William

This blinded, controlled pilot study investigated the effects of Reiki on 46 patients undergoing knee replacement surgery. Of the 3 groups, Reiki, Sham Reiki, and Standard of Care, only the Reiki group showed significant reductions in pain, blood pressure, respiration rate, and state anxiety, which provides evidence for a full-scale clinical study.

Risk of iron overload is decreased in beating heart coronary artery surgery compared to conventional bypass.

PubMed

Mumby, S; Koh, T W; Pepper, J R; Gutteridge, J M

2001-11-29

Conventional cardiopulmonary bypass surgery (CCPB) increases the iron loading of plasma transferrin often to a state of plasma iron overload, with the presence of low molecular mass iron. Such iron is a potential risk factor for oxidative stress and microbial virulence. Here we assess 'off-pump' coronary artery surgery on the beating heart for changes in plasma iron chemistry. Seventeen patients undergoing cardiac surgery using the 'Octopus' myocardial wall stabilisation device were monitored at five time points for changes in plasma iron chemistry. This group was further divided into those (n=9) who had one- or two- (n=8) vessel grafts, and compared with eight patients undergoing conventional coronary artery surgery. Patients undergoing beating heart surgery had significantly lower levels of total plasma non-haem iron, and a decreased percentage saturation of their transferrin at all time points compared to conventional bypass patients. Plasma iron overload occurred in only one patient undergoing CCPB. Beating heart surgery appears to decrease red blood cell haemolysis, and tissue damage during the operative procedures and thereby significantly decreases the risk of plasma iron overload associated with conventional bypass.

Integral Color Anodizing of Aluminum Alloy 7075-T6 Upper Receivers of the M16A1 Rifle

DTIC Science & Technology

1981-06-01

and control upper receivers were carried, fired, and maintained by soldiers in the field undergoing basic and advanced Infantry training and by other...soldiers undergoing Ranger training . The test and control items were subjected to typical field usage conditions involving rough handhng, firing...ICA hardcoat treatment will provide a longer inservice life for the M16A1 rifle receivers than will the low- temperature hardcoat process. 12

Intravenous Sedation with Low-Dose Dexmedetomidine: Its Potential for Use in Dentistry

PubMed Central

Ogawa, Sachie; Seino, Hiroaki; Ito, Hiroshi; Yamazaki, Shinya; Ganzberg, Steven; Kawaai, Hiroyoshi

2008-01-01

This study investigated the physiologic and sedative parameters associated with a low-dose infusion of dexmedetomidine (Dex). Thirteen healthy volunteers were sedated with Dex at a loading dose of 6 mcg/kg/h for 5 minutes and a continuous infusion dose of 0.2 mcg/kg/h for 25 minutes. The recovery process was observed for 60 minutes post infusion. The tidal volume decreased significantly despite nonsignificant changes in respiratory rate, minute ventilation, oxygen saturation, and end-tidal carbon dioxide. The mean arterial pressure and heart rate also decreased significantly but within clinically acceptable levels. Amnesia to pin prick was present in 69% of subjects. A Trieger dot test plot error ratio did not show a significant change at 30 minutes post infusion despite a continued significant decrease in bispectral index. We conclude that sedation with a low dose of Dex appears to be safe and potentially efficacious for young healthy patients undergoing dental procedures. PMID:18788843

Anesthetic complications in dogs undergoing hepatic surgery: cholecystectomy versus non-cholecystectomy.

PubMed

Burns, Brigid R; Hofmeister, Erik H; Brainard, Benjamin M

2014-03-01

To determine if dogs that undergo laparotomy for cholecystectomy suffer from a greater number or magnitude of perianesthetic complications, including hypotension, hypothermia, longer recovery time, and lower survival rate, than dogs that undergo laparotomy for hepatic surgery without cholecystectomy. Retrospective cohort study. One hundred and three dogs, anesthetised between January 2007 and October 2011. The variables collected from the medical record included age, weight, gender, surgical procedure, pre-operative bloodwork, American Society of Anesthesiologists (ASA) status, emergency status, total bilirubin concentration, anesthetic agents administered, body temperature nadir, final body temperature, hypotension, duration of hypotension, blood pressure nadir, intraoperative drugs, anesthesia duration, surgery duration, time to extubation, final diagnosis, days spent in the intensive care unit (ICU), total bill, survival to discharge, and survival to follow-up. No significant difference in body temperature nadir, final temperature, presence of hypotension, duration of hypotension, blood pressure nadir, the use of inotropes, or final outcome was found between dogs undergoing cholecystectomy and dogs undergoing exploratory laparotomy for other hepatic disease. Dogs that had cholecystectomy had longer anesthesia durations and longer surgery durations than dogs that did not have cholecystectomy. No significant differences existed for temperature nadir (34.8 versus 35.3°C; non-cholecystectomy versus cholecystectomy), final temperature (35.6 versus 35.9°C), time to extubation (30 versus 49 minutes), duration of hypotension (27 versus 21 minutes), or MAP nadir (56 versus 55 mmHg). Hypotension occurred in 66% and 74% and inotropes were used in 64% and 53%, for non-cholecystectomy and cholecystectomy patients, respectively. Dogs that underwent cholecystectomies did not suffer a greater number of anesthesia complications than did dogs undergoing hepatic surgery without cholecystectomies. © 2013 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.

Effect of Single vs Bilateral Lung Transplantation on Plasma Surfactant Protein D Levels in Idiopathic Pulmonary Fibrosis

PubMed Central

Beers, Michael F.; Ahya, Vivek N.; Kawut, Steven M.; Sims, Karen D.; Lederer, David J.; Palmer, Scott M.; Wille, Keith; Lama, Vibha N.; Shah, Pali D.; Orens, Jonathan B.; Bhorade, Sangeeta; Crespo, Maria; Weinacker, Ann; Demissie, Ejigayehu; Bellamy, Scarlett; Christie, Jason D.; Ware, Lorraine B.

2011-01-01

Background: Serum levels of surfactant protein D (SP-D) have been suggested as reflecting epithelial damage in acute lung injury, COPD, and idiopathic pulmonary fibrosis (IPF). However, little is known about SP-D levels in the setting of lung transplantation. Methods: We examined plasma SP-D levels in 104 subjects from a prospective, multicenter cohort study of lung allograft recipients. Plasma SP-D was measured by enzyme-linked immunosorbent assay prior to transplant and daily for 3 days after transplant. Results: Subjects undergoing transplant for IPF had higher baseline SP-D levels (median, 325 ng/mL) compared with subjects with cystic fibrosis, COPD, and pulmonary hypertension (median, 100, 80, and 82 ng/mL, respectively; P = .0001). Among subjects with IPF undergoing bilateral transplant, SP-D levels declined rapidly postoperatively. In contrast, SP-D levels in subjects undergoing single lung transplant for IPF remained significantly higher than those of bilateral allograft recipients. Among subjects undergoing single lung transplant for IPF, the development of primary graft dysfunction (PGD) was associated with a subsequent rise in SP-D levels, whereas SP-D levels in IPF subjects undergoing bilateral transplant declined, even in the presence of grade 3 PGD. Importantly, single lung allograft recipients without PGD had higher postoperative SP-D levels than bilateral allograft recipients with PGD. Conclusions: Subjects undergoing lung transplant for IPF have significantly higher baseline plasma SP-D levels compared with those with other diagnoses. Plasma SP-D is likely a biomarker of the air-blood barrier integrity in the native IPF lung, but may be less useful as a biomarker of PGD after transplant. PMID:21349925

A Critical Analysis of the Utility of Intraoperative Angiography.

PubMed

Ares, William J; Kenmuir, Cynthia L; Panczykowski, David M; Weiner, Gregory M; Jadhav, Ashu P; Jovin, Tudor G; Gross, Bradley A; Jankowitz, Brian T

2018-02-01

Intraoperative digital subtraction angiography (ioDSA) is touted as the gold standard imaging evaluation for aneurysm clip constructs. Candid evaluations of its limitations are sparse. A prospectively collected hospital billing database was queried to identify craniotomies for aneurysm clipping from January 2010 to December 2013. We evaluated the rate of occult residual and parent vessel stenosis determined on follow-up angiography for patients undergoing ioDSA and those not undergoing ioDSA. Comparisons were performed via Fisher exact test, with P < 0.05 considered statistically significant. From our database search, we found 187 patients who underwent ioDSA after aneurysm clipping and an additional 91 patients who did not. Results from ioDSA influenced operative management in 17% of cases. Sixty-four patients with 70 treated aneurysms undergoing ioDSA had postoperative angiography; 7 occult residuals were discovered, yielding a 10% false-negative rate, with 10% of aneurysms showing residual. Occult residuals at the middle cerebral artery bifurcation represented most discovered residuals (6/7). Thirty-two patients with 37 treated aneurysms did not undergo ioDSA and had angiographic follow-up; 24% of patients were found to have residual aneurysms (P = 0.08 compared with patients undergoing ioDSA). Residuals at the anterior communicating artery (ACoA) represented 56% of all residuals, whereas the ACoA represented only 18% of aneurysms clipped. The rate of residuals was significantly higher than that for patients with clipped ACoA aneurysms undergoing ioDSA (P = 0.008). ioDSA influenced management in nearly one fifth of cases. It can be particularly beneficial in detecting residuals for ACoA aneurysms; its benefit was less apparent for middle cerebral artery aneurysms. Copyright © 2017 Elsevier Inc. All rights reserved.

The decision-making process of young adult women with cancer who considered fertility cryopreservation.

PubMed

Hershberger, Patricia E; Finnegan, Lorna; Pierce, Penny F; Scoccia, Bert

2013-01-01

To provide an in-depth description of the decision-making process that women who are diagnosed with cancer undergo as they decide whether to accept or decline fertility cryopreservation. A qualitative, grounded theory approach. Twenty-seven women (mean age = 29 years) who were diagnosed with cancer and were eligible for egg, embryo, or ovarian tissue cryopreservation were recruited from the Internet and two university centers. Each woman participated in a semistructured interview by phone (n = 21) or e-mail (n = 6). Data were analyzed using the constant-comparative method to inductively ascertain the women's decision-making process. NVivo 8 software was used to assist with data retrieval and analysis. The decision-making process consists of four major phases that women experience to actively formulate a decision: identify, contemplate, resolve, and engage. In the identify phase, women acquire knowledge and experience a "double hit" scenario that is often devastating. Within the contemplate phase, five interrelated dimensions emerged including constructing and/or endorsing preferences and values and undergoing decisional debriefing sessions. A decision is reached in the resolve phase and carried out in the engage phase. Among the participants, 14 declined fertility cryopreservation and 13 accepted egg and/or embryo cryopreservation. The descriptive theoretical framework clarifies the underlying processes that women with cancer undergo to decide about fertility cryopreservation. Quality of care for women with cancer can be improved by implementing appropriately timed information and tailored developmental and contextual counseling to support decision making. © 2012 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

Biotechnology stock prices before public announcements: evidence of insider trading?

PubMed

Overgaard, C B; van den Broek, R A; Kim, J H; Detsky, A S

2000-03-01

Unique financial challenges faced by biotechnology companies developing therapeutics have contributed to the creation of a highly sensitive market, where stock prices are capable of great fluctuation. The potential for significant financial reward and the nature of the scientific review process make this industry susceptible to illegal share trading on nonpublic information. We examined stock prices of biotechnology products before and after announcement of Phase III clinical trial and Food and Drug Administration (FDA) Advisory Panel results for indirect evidence of insider trading. Biotechnology stock prices were recorded for 98 products undergoing Phase III clinical trials and 49 products undergoing FDA Advisory Panel review between 1990 and 1998. Prices were recorded for 120 consecutive trading days before and after public announcement of these two events. We compared the average change in stock price of successful products ('winners') with unsuccessful products ('losers') before the public announcement of results for both critical events. The difference between average stock price change from 120 to 3 days before public announcement of results of Phase III clinical trial winners (+27%) and losers (-4%) was highly significant (P = 0.0007). A similar but non-significant difference was observed between the average stock price of winning (+27%) and losing products (+13%) before FDA Advisory Panel review announcements (P = 0.25). Our results provide indirect evidence that insider trading may be common in the biotechnology industry. Clinical investigators may wish to consider this issue before participating in any equity position in the biotechnology industry, especially if they are going to perform research for those companies.

Clinical predictors of elective total joint replacement in persons with end-stage knee osteoarthritis.

PubMed

Zeni, Joseph A; Axe, Michael J; Snyder-Mackler, Lynn

2010-05-06

Arthritis is a leading cause of disability in the United States. Total knee arthroplasty (TKA) has become the gold standard to manage the pain and disability associated with knee osteoarthritis (OA). Although more than 400,000 primary TKA surgeries are performed each year in the United States, not all individuals with knee OA elect to undergo the procedure. No clear consensus exists on criteria to determine who should undergo TKA. The purpose of this study was to determine which clinical factors will predict the decision to undergo TKA in individuals with end-stage knee OA. Knowledge of these factors will aid in clinical decision making for the timing of TKA. Functional data from one hundred twenty persons with end-stage knee OA were obtained through a database. All of the individuals complained of knee pain during daily activities and had radiographic evidence of OA. Functional and clinical tests, collectively referred to as the Delaware Osteoarthritis Profile, were completed by a physical therapist. This profile consisted of measuring height, weight, quadriceps strength and active knee range of motion, while functional mobility was assessed using the Timed Up and Go (TUG) test and the Stair Climbing Task (SCT). Self-perceived functional ability was measured using the activities of daily living subscale of the Knee Outcome Survey (KOS-ADLS). A logistic regression model was used to identify variables predictive of TKA use. Forty subjects (33%) underwent TKA within two years of evaluation. These subjects were significantly older and had significantly slower TUG and SCT times (p < 0.05). Persons that underwent TKA were also significantly weaker, had lower self-reported function and had less knee extension than persons who did not undergo TKA. No differences between groups were seen for BMI, gender, knee flexion ROM and unilateral versus bilateral joint disease. Using backward regression, age, knee extension ROM and KOS-ADLS together significantly predicted whether or not a person would undergo TKA (p

Detecting Anastasis In Vivo by CaspaseTracker Biosensor.

PubMed

Tang, Ho Man; Fung, Ming Chiu; Tang, Ho Lam

2018-02-01

Anastasis (Greek for "rising to life") is a recently discovered cell recovery phenomenon whereby dying cells can reverse late-stage cell death processes that are generally assumed to be intrinsically irreversible. Promoting anastasis could in principle rescue or preserve injured cells that are difficult to replace such as cardiomyocytes or neurons, thereby facilitating tissue recovery. Conversely, suppressing anastasis in cancer cells, undergoing apoptosis after anti-cancer therapies, may ensure cancer cell death and reduce the chances of recurrence. However, these studies have been hampered by the lack of tools for tracking the fate of cells that undergo anastasis in live animals. The challenge is to identify the cells that have reversed the cell death process despite their morphologically normal appearance after recovery. To overcome this difficulty, we have developed Drosophila and mammalian CaspaseTracker biosensor systems that can identify and permanently track the anastatic cells in vitro or in vivo. Here, we present in vivo protocols for the generation and use of the CaspaseTracker dual biosensor system to detect and track anastasis in Drosophila melanogaster after transient exposure to cell death stimuli. While conventional biosensors and protocols can label cells actively undergoing apoptotic cell death, the CaspaseTracker biosensor can permanently label cells that have recovered after caspase activation - a hallmark of late-stage apoptosis, and simultaneously identify active apoptotic processes. This biosensor can also track the recovery of the cells that attempted other forms of cell death that directly or indirectly involved caspase activity. Therefore, this protocol enables us to continuously track the fate of these cells and their progeny, facilitating future studies of the biological functions, molecular mechanisms, physiological and pathological consequences, and therapeutic implications of anastasis. We also discuss the appropriate controls to distinguish cells that undergo anastasis from those that display non-apoptotic caspase activity in vivo.

Video Material as an Effective Educational Tool to Address Informational and Educational Needs of Cancer Patients Undergoing Radiation Therapy.

PubMed

Nathoo, Dilshad

2017-06-01

With increasing rates of cancer patients undergoing radiation therapy, the treatment itself can cause patients significant amounts of anxiety and distress. This can be attributed to the diagnosis of the disease, lack of knowledge of what radiation therapy is, expectations and management of side effects, and the lack of knowledge of supportive care for patients and their families. Providing patients with effective educational tools to meet the informational needs of cancer patients undergoing radiation therapy can empower patients and allow them to participate in treatment decision-making and their own healthcare. This discussion paper will evaluate several studies on the psychological impact of cancer patients undergoing radiation therapy and how video material can effectively meet the informational and educational needs of this patient population group.

Changing selective pressure during antigenic changes in human influenza H3.

PubMed

Blackburne, Benjamin P; Hay, Alan J; Goldstein, Richard A

2008-05-02

The rapid evolution of influenza viruses presents difficulties in maintaining the optimal efficiency of vaccines. Amino acid substitutions result in antigenic drift, a process whereby antisera raised in response to one virus have reduced effectiveness against future viruses. Interestingly, while amino acid substitutions occur at a relatively constant rate, the antigenic properties of H3 move in a discontinuous, step-wise manner. It is not clear why this punctuated evolution occurs, whether this represents simply the fact that some substitutions affect these properties more than others, or if this is indicative of a changing relationship between the virus and the host. In addition, the role of changing glycosylation of the haemagglutinin in these shifts in antigenic properties is unknown. We analysed the antigenic drift of HA1 from human influenza H3 using a model of sequence change that allows for variation in selective pressure at different locations in the sequence, as well as at different parts of the phylogenetic tree. We detect significant changes in selective pressure that occur preferentially during major changes in antigenic properties. Despite the large increase in glycosylation during the past 40 years, changes in glycosylation did not correlate either with changes in antigenic properties or with significantly more rapid changes in selective pressure. The locations that undergo changes in selective pressure are largely in places undergoing adaptive evolution, in antigenic locations, and in locations or near locations undergoing substitutions that characterise the change in antigenicity of the virus. Our results suggest that the relationship of the virus to the host changes with time, with the shifts in antigenic properties representing changes in this relationship. This suggests that the virus and host immune system are evolving different methods to counter each other. While we are able to characterise the rapid increase in glycosylation of the haemagglutinin during time in human influenza H3, an increase not present in influenza in birds, this increase seems unrelated to the observed changes in antigenic properties.

Effect of marital status on the outcome of patients undergoing elective or urgent coronary revascularization.

PubMed

Barbash, Israel M; Gaglia, Michael A; Torguson, Rebecca; Minha, Sa'ar; Satler, Lowell F; Pichard, Augusto D; Waksman, Ron

2013-10-01

Marriage confers various health advantages in the general population. However, the added value of marriage among patients who undergo percutaneous coronary intervention (PCI) beyond the standard cardiovascular risk factors is not clear. This study aimed to assess the effects of marital status on outcomes of patients undergoing elective or urgent PCI. Clinical observational analysis of consecutive patients undergoing elective or urgent PCI from 1993 to 2011 was performed. Patients were stratified by marital status, comparing married to unmarried patients. Clinical outcome up to 12 months was obtained by telephone contact or office visit. A total of 11,216 patients were included in the present analysis; 55% were married and 45% unmarried. Significant differences in baseline characteristics were noted, including a lower prevalence of hypertension (86% vs 88%), diabetes (34% vs 38%), and smoking (19% vs 25%) among married vs unmarried patients, respectively (P < .001). However, married patients had a higher prevalence of hypercholesterolemia and family history of coronary artery disease. Early and late major adverse cardiac event rates were significantly lower for married vs unmarried patients up to 1 year (13.3% vs 8.2%, P < .001). Married status was independently associated with improved outcome in multivariable analysis (hazard ratio 0.7, 95% CI 0.6-0.9). Married patients who undergo urgent or elective PCI have superior short- and long-term outcomes up to 1 year when compared with unmarried patients. These benefits persist after adjustment for multiple traditional cardiovascular risk factors. © 2013.

Pain and Anxiety Levels of Patients Undergoing Tissue Expansion After Mastectomies: A Case Series Study.

PubMed

Le, Nicole K; García-Molina, Carla; Kumar, Ambuj; Griffin, Lisa; Dayicioglu, Deniz

2017-01-01

The tissue expansion process is done after mastectomies to increase the submuscular space in preparation for the placement of permanent breast implant. The process is often believed to be painful by patients who are often intimidated by the prospect of mechanically stretching out their skin and muscle. This study aims to quantify the pain experienced by patients and determine the different pain management techniques used. We used a case series approach, in which patients who were undergoing serial tissue expansion process were asked to rate their pain and anxiety on a scale from 1 to 10, using a questionnaire and the visual analog scale. Pain was rated during and after the expansion procedure, and patients were also surveyed to find the most commonly used and most effective pain management technique. Patients typically reported very little pain during and after the procedure, with an average of 0.4 to 2.5 pain experienced out of 10. The pain did not last, on average, longer than 1 day. Furthermore, the most widely used and most helpful pain medication was ibuprofen. During the tissue expansion procedure, the mean anxiety level was 0.64 (1.3). The findings show that tissue expansion process is a relatively low pain procedure and is not a contraindication for undergoing breast reconstruction. Ibuprofen, a mild treatment with few side effects, was efficacious in pain relief though most patients required no pain relief.

The Experience of Chinese Couples Undergoing In Vitro Fertilization Treatment: Perception of the Treatment Process and Partner Support.

PubMed

Ying, Li-Ying; Wu, Lai Har; Loke, Alice Yuen

2015-01-01

Couples undergoing In Vitro Fertilization (IVF) Treatment suffer as dyads from the stressful experience of the painful treatment and the fear that the IVF cycle will fail. They are likely to report that their marital relationship has become unstable due to the prolonged period of treatment. This is a qualitative study that was conducted to explore the experiences that Chinese couples have had with IVF treatment, especially their perceptions of the process and the support between couples. The interviews revealed that couples suffered from the process, experiencing physical and emotional pain, struggling with the urgency and inflexibility of bearing a child, and experiencing disturbances in their daily routines and work. The participants described how they endured the hardships as a couple and how it affected their relationship. The couples felt that sharing feelings and supporting each other contribute to psychological well-being and improves the marital relationship. They also identified some unfavorable aspects in their partner relationship. They were ambivalent about receiving social support from friends and family members. With the couples indicating that the support that they received from each other affected their experience during the treatment process, it is suggested that a supportive intervention that focuses on enhancing the partnership of the couples and dealing with their inflexibility on the issue of bearing a child might result in improvements in the psychological status and marital relationship of infertile couples undergoing IVF treatment.

The Experience of Chinese Couples Undergoing In Vitro Fertilization Treatment: Perception of the Treatment Process and Partner Support

PubMed Central

Ying, Li-Ying; Wu, Lai Har; Loke, Alice Yuen

2015-01-01

Background Couples undergoing In Vitro Fertilization (IVF) Treatment suffer as dyads from the stressful experience of the painful treatment and the fear that the IVF cycle will fail. They are likely to report that their marital relationship has become unstable due to the prolonged period of treatment. Methods This is a qualitative study that was conducted to explore the experiences that Chinese couples have had with IVF treatment, especially their perceptions of the process and the support between couples. Results The interviews revealed that couples suffered from the process, experiencing physical and emotional pain, struggling with the urgency and inflexibility of bearing a child, and experiencing disturbances in their daily routines and work. The participants described how they endured the hardships as a couple and how it affected their relationship. The couples felt that sharing feelings and supporting each other contribute to psychological well-being and improves the marital relationship. They also identified some unfavorable aspects in their partner relationship. They were ambivalent about receiving social support from friends and family members. Conclusions With the couples indicating that the support that they received from each other affected their experience during the treatment process, it is suggested that a supportive intervention that focuses on enhancing the partnership of the couples and dealing with their inflexibility on the issue of bearing a child might result in improvements in the psychological status and marital relationship of infertile couples undergoing IVF treatment. PMID:26431545

The treatment of female pattern hair loss and other applications of surgical hair restoration in women.

PubMed

Epstein, Jeffrey S

2004-05-01

In the specialty of surgical hair restoration, men comprise more than 90% of the patients treated; however, in the last few years the number of women undergoing the procedure has increased significantly. The reasons for this growth are many and include the increase in public awareness of the efficacy of hair transplantation from such sources as the media,the Internet, advertising and word of mouth. More importantly, advances in technique have significantly improved results, increasing the confidence level in women to undergo the procedure and in hair transplant specialists to offer it.

Perceived neighborhood ethnic diversity and social outcomes: Context-dependent effects within a postindustrial city undergoing regeneration

PubMed Central

Kearns, Ade; Whitley, Elise

2018-01-01

ABSTRACT This article examines whether perceived neighborhood ethnic diversity is associated with a range of social outcomes in a postindustrial city undergoing regeneration. The research included a survey in 3 types of deprived area in Glasgow: those undergoing regeneration, those directly adjoining regeneration areas, and those further removed from regeneration areas. In areas undergoing regeneration, perceived diversity was positively associated with many residential, cohesion, safety, and empowerment outcomes. This was also true, although to a lesser extent, in deprived areas at some distance from regeneration areas. In areas immediately surrounding the regeneration areas, perceived diversity had mixed associations with residential and safety outcomes and few associations with cohesion and empowerment outcomes. The results suggest that the effects of perceived diversity are context dependent within a city. Moreover, regeneration processes alter neighborhood contexts and therefore enable scale, timing, and duration of diversity to mediate the relationships between perceived diversity and social outcomes. PMID:29479290

Critical Moments in the Process of Educational Change: Understanding the Dynamics of Change among Teacher Educators

ERIC Educational Resources Information Center

Brody, David L.; Hadar, Linor Lea

2018-01-01

This study examines the complex process of change among teacher educators who have chosen to improve their practice in a professional development community. Storyline methodology was used to reveal the dynamic process which teacher educators undergo when they consider adopting innovative pedagogy. Findings reveal critical moments in professional…

The impact of managed care contracts on the admission and registration process.

PubMed

Tilley, B G

1993-04-01

With increasing demand placed on the admission and registration process, hospitals are undergoing dramatic operational changes. These changes are necessary to maintain the vital cash flow of the hospitals. A major factor forcing hospitals to rethink the front line process in the admission and registration area is the impact of managed care.

Blunted amygdala functional connectivity during a stress task in alcohol dependent individuals: A pilot study.

PubMed

Wade, Natasha E; Padula, Claudia B; Anthenelli, Robert M; Nelson, Erik; Eliassen, James; Lisdahl, Krista M

2017-12-01

Scant research has been conducted on neural mechanisms underlying stress processing in individuals with alcohol dependence (AD). We examined neural substrates of stress in AD individuals compared with controls using an fMRI task previously shown to induce stress, assessing amygdala functional connectivity to medial prefrontal cortex (mPFC). For this novel pilot study, 10 abstinent AD individuals and 11 controls completed a modified Trier stress task while undergoing fMRI acquisition. The amygdala was used as a seed region for whole-brain seed-based functional connectivity analysis. After controlling for family-wise error (p = 0.05), there was significantly decreased left and right amygdala connectivity with frontal (specifically mPFC), temporal, parietal, and cerebellar regions. Subjective stress, but not craving, increased from pre-to post-task. This study demonstrated decreased connectivity between the amygdala and regions important for stress and emotional processing in long-term abstinent individuals with AD. These results suggest aberrant stress processing in individuals with AD even after lengthy periods of abstinence.

Investigating the functional neuroanatomy of concrete and abstract word processing through direct electric stimulation (DES) during awake surgery.

PubMed

Orena, E F; Caldiroli, D; Acerbi, F; Barazzetta, I; Papagno, C

2018-06-05

Neuropsychological, neuroimaging and electrophysiological studies demonstrate that abstract and concrete word processing relies not only on the activity of a common bilateral network but also on dedicated networks. The neuropsychological literature has shown that a selective sparing of abstract relative to concrete words can be documented in lesions of the left anterior temporal regions. We investigated concrete and abstract word processing in 10 patients undergoing direct electrical stimulation (DES) for brain mapping during awake surgery in the left hemisphere. A lexical decision and a concreteness judgment task were added to the neuropsychological assessment during intra-operative monitoring. On the concreteness judgment, DES delivered over the inferior frontal gyrus significantly decreased abstract word accuracy while accuracy for concrete words decreased when the anterior temporal cortex was stimulated. These results are consistent with a lexical-semantic model that distinguishes between concrete and abstract words related to different neural substrates in the left hemisphere.

Adult Learners' Week in Russia.

ERIC Educational Resources Information Center

Litvinova, Nina

2002-01-01

In Russia International Adult Learners Week highlights the democratization process the country is undergoing. Government attention to rural development and training and agrarian policy is needed. (SK)

KSC-98pc1162

NASA Image and Video Library

1998-09-27

KENNEDY SPACE CENTER, FLA. -- The Shuttle Carrier Aircraft rolls to a stop with its piggyback cargo orbiter Atlantis at the Shuttle Landing Facility. In the background is the Vehicle Assembly Building. Atlantis returns home after a 10-month stay in the Palmdale, CA, orbiter processing facility undergoing extensive inspections and modifications. They included several upgrades enabling it to support International Space Station missions, such as adding an external airlock for ISS docking missions and installing thinner, lighter thermal protection blankets for weight reduction which will allow it to haul heavier cargo. The flight from Palmdale included a fueling stop in Ft. Hood, TX, and overnight stay at Ft. Campbell, KY. Atlantis will undergo preparations in the Orbiter Processing Facility at KSC for its planned flight in June 1999

KSC-98pc1163

NASA Image and Video Library

1998-09-27

KENNEDY SPACE CENTER, FLA. -- Stairs are rolled to the forward opening of the Shuttle Carrier Aircraft with its piggyback cargo, the orbiter Atlantis after it rolls to a stop at the Shuttle Landing Facility. Atlantis returns home after a 10-month stay in the Palmdale, CA, orbiter processing facility undergoing extensive inspections and modifications. They included several upgrades enabling it to support International Space Station missions, such as adding an external airlock for ISS docking missions and installing thinner, lighter thermal protection blankets for weight reduction which will allow it to haul heavier cargo. The flight from Palmdale included a fueling stop in Ft. Hood, TX, and overnight stay at Ft. Campbell, KY. Atlantis will undergo preparations in the Orbiter Processing Facility at KSC for its planned flight in June 1999

Mitigation of Cancer Therapy Side-Effects with Light

NASA Astrophysics Data System (ADS)

Nair, Raj; Bensadoun, René-Jean

2016-10-01

'Light' from low level laser therapy, through a process called photobiomodulation (PBM), has been in existence in supportive care in cancer, in particular in the management of oral mucositis (OM) in patients undergoing chemotherapy, radiation therapy and haematopoietic stem cell transplantation. In this book the authors attempt to portray the current status of the supportive care interventions that are possible with PBM using low level laser therapy (LLLT) in patients undergoing cancer treatment for solid tumours, harmatological malignancies, and head and neck cancers.

On peaceful coexistence: is the collapse postulate incompatible with relativity?

NASA Astrophysics Data System (ADS)

Myrvold, Wayne C.

In this paper, it is argued that the prima facie conflict between special relativity and the quantum-mechanical collapse postulate is only apparent, and that the seemingly incompatible accounts of entangled systems undergoing collapse yielded by different reference frames can be regarded as no more than differing accounts of the same processes and events. Attention to the transformation properties of quantum-mechanical states undergoing unitary, non-collapse evolution points the way to a treatment of collapse evolution consistent with the demands of relativity.

Severity of chronic obstructive pulmonary disease is associated with adverse outcomes in patients undergoing elective abdominal aortic aneurysm repair.

PubMed

Stone, David H; Goodney, Philip P; Kalish, Jeffrey; Schanzer, Andres; Indes, Jeffrey; Walsh, Daniel B; Cronenwett, Jack L; Nolan, Brian W

2013-06-01

Although chronic obstructive pulmonary disease (COPD) has been implicated as a risk factor for abdominal aortic aneurysm (AAA) rupture, its effect on surgical repair is less defined. Consequently, variation in practice persists regarding patient selection and surgical management. The purpose of this study was to analyze the effect of COPD on patients undergoing AAA repair. We reviewed a prospective regional registry of 3455 patients undergoing elective open AAA repair (OAR) and endovascular AAA repair (EVAR) from 23 centers in the Vascular Study Group of New England from 2003 to 2011. COPD was categorized as none, medical (medically treated but not oxygen [O2]-dependent), and O2-dependent. End points included in-hospital death, pulmonary complications, major postoperative adverse events (MAEs), extubation in the operating room, and 5-year survival. Survival was determined using life-table analysis based on the Social Security Death Index. Predictors of in-hospital and long-term mortality were determined by multivariate logistic regression and Cox proportional hazards analysis. During the study interval, 2043 patients underwent EVAR and 1412 patients underwent OAR with a nearly equal prevalence of COPD (35% EVAR vs 36% OAR). O2-dependent COPD (4%) was associated with significantly increased in-hospital mortality, pulmonary complications, and MAE and was also associated with significantly decreased extubation in the operating room among patients undergoing both EVAR and OAR. Five-year survival was significantly diminished among all patients undergoing AAA repair with COPD (none, 78%; medical, 72%; O2-dependent, 42%; P < .001). By multivariate analysis, O2-dependent COPD was independently associated with in-hospital mortality (odds ratio 2.02, 95% confidence interval, 1.0-4.0; P = .04) and diminished 5-year survival (hazard ratio, 3.02; 95% confidence interval, 2.2-4.1; P < .001). Patients with O2-dependent COPD undergoing AAA repair suffer increased pulmonary complications, overall MAE, and diminished long-term survival. This must be carefully factored into the risk-benefit analysis before recommending elective AAA repair in these patients. Copyright © 2013 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

A Stiffness Switch in Human Immunodeficiency Virus

PubMed Central

Kol, Nitzan; Shi, Yu; Tsvitov, Marianna; Barlam, David; Shneck, Roni Z.; Kay, Michael S.; Rousso, Itay

2007-01-01

After budding from the cell, human immunodeficiency virus (HIV) and other retrovirus particles undergo a maturation process that is required for their infectivity. During maturation, HIV particles undergo a significant internal morphological reorganization, changing from a roughly spherically symmetric immature particle with a thick protein shell to a mature particle with a thin protein shell and conical core. However, the physical principles underlying viral particle production, maturation, and entry into cells remain poorly understood. Here, using nanoindentation experiments conducted by an atomic force microscope (AFM), we report the mechanical measurements of HIV particles. We find that immature particles are more than 14-fold stiffer than mature particles and that this large difference is primarily mediated by the HIV envelope cytoplasmic tail domain. Finite element simulation shows that for immature virions the average Young's modulus drops more than eightfold when the cytoplasmic tail domain is deleted (930 vs. 115 MPa). We also find a striking correlation between the softening of viruses during maturation and their ability to enter cells, providing the first evidence, to our knowledge, for a prominent role for virus mechanical properties in the infection process. These results show that HIV regulates its mechanical properties at different stages of its life cycle (i.e., stiff during viral budding versus soft during entry) and that this regulation may be important for efficient infectivity. Our report of this maturation-induced “stiffness switch” in HIV establishes the groundwork for mechanistic studies of how retroviral particles can regulate their mechanical properties to affect biological function. PMID:17158573

Planet Formation in Binary Star Systems

NASA Astrophysics Data System (ADS)

Martin, Rebecca

About half of observed exoplanets are estimated to be in binary systems. Understanding planet formation and evolution in binaries is therefore essential for explaining observed exoplanet properties. Recently, we discovered that a highly misaligned circumstellar disk in a binary system can undergo global Kozai-Lidov (KL) oscillations of the disk inclination and eccentricity. These oscillations likely have a significant impact on the formation and orbital evolution of planets in binary star systems. Planet formation by core accretion cannot operate during KL oscillations of the disk. First, we propose to consider the process of disk mass transfer between the binary members. Secondly, we will investigate the possibility of planet formation by disk fragmentation. Disk self gravity can weaken or suppress the oscillations during the early disk evolution when the disk mass is relatively high for a narrow range of parameters. Thirdly, we will investigate the evolution of a planet whose orbit is initially aligned with respect to the disk, but misaligned with respect to the orbit of the binary. We will study how these processes relate to observations of star-spin and planet orbit misalignment and to observations of planets that appear to be undergoing KL oscillations. Finally, we will analyze the evolution of misaligned multi-planet systems. This theoretical work will involve a combination of analytic and numerical techniques. The aim of this research is to shed some light on the formation of planets in binary star systems and to contribute to NASA's goal of understanding of the origins of exoplanetary systems.

Outcomes after elective abdominal aortic aneurysm repair in obese versus nonobese patients.

PubMed

Locham, Satinderjit; Rizwan, Muhammad; Dakour-Aridi, Hanaa; Faateh, Muhammad; Nejim, Besma; Malas, Mahmoud

2018-06-07

Obesity is a worldwide epidemic, particularly in Western society. It predisposes surgical patients to an increased risk of adverse outcomes. The aim of our study was to use a nationally representative vascular database and to compare in-hospital outcomes in obese vs nonobese patients undergoing elective open aortic repair (OAR) and endovascular aneurysm repair (EVAR). All patients undergoing elective abdominal aortic aneurysm repair were identified in the Vascular Quality Initiative database (2003-2017). Obesity was defined as body mass index ≥30 kg/m 2 . Univariable (Student t-test and χ 2  test) and multivariable (logistic regression) analyses were implemented to compare in-hospital mortality and any major complications (wound infection, renal failure, and cardiopulmonary failure) in obese vs nonobese patients. We identified a total of 33,082 patients undergoing elective OAR (nonobese, n = 4605 [72.4%]; obese, n = 1754 [27.6%]) and EVAR (nonobese, n = 18,338 [68.6%]; obese, n = 8385 [31.4%]). Obese patients undergoing OAR and EVAR were relatively younger compared with nonobese patients (mean age [standard deviation], 67.55 [8.26] years vs 70.27 [8.30] years and 71.06 [8.22] years vs 74.55 [8.55] years), respectively; (both P < .001). Regardless of approach, obese patients had slightly longer operative time (OAR, 259.02 [109.97] minutes vs 239.37 [99.78] minutes; EVAR, 138.27 [70.64] minutes vs 134.34 [69.98] minutes) and higher blood loss (OAR, 2030 [1823] mL vs 1619 [1642] mL; EVAR, 228 [354] mL vs 207 [312] mL; both P < .001). There was no significant difference in mortality between the two groups undergoing OAR and EVAR (OAR, 2.9% vs 3.2% [P = .50]; EVAR, 0.5% vs 0.6% [P = .76]). On multivariable analysis, obese patients undergoing OAR had 33% higher odds of renal failure (adjusted odds ratio [OR], 1.33; 95% confidence interval [CI], 1.09-1.63; P = .006) and 75% higher odds of wound infections (adjusted OR, 1.75; 95% CI, 1.11-2.76; P = .02) compared with nonobese patients. However, in patients undergoing EVAR, no association was seen between obesity and any major complications. A significant interaction was found between obesity and surgical approach in the event of renal failure, in which obese patients undergoing OAR had significantly higher odds of renal failure compared with those in the EVAR group (OR interaction , 1.36; 95% CI, 1.05-1.75; P = .02). Using a large nationally representative database, we demonstrated an increased risk of renal failure and wound infections in obese patients undergoing OAR compared with nonobese patients. On the other hand, obesity did not seem to increase the odds of major adverse outcomes in patients undergoing EVAR. Further long-term prospective studies are needed to verify the effects of obesity after abdominal aortic aneurysm repair and the implications of these findings in clinical decision-making. Copyright © 2018 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Potential Role of Carotenoids as Antioxidants in Human Health and Disease

PubMed Central

Fiedor, Joanna; Burda, Květoslava

2014-01-01

Carotenoids constitute a ubiquitous group of isoprenoid pigments. They are very efficient physical quenchers of singlet oxygen and scavengers of other reactive oxygen species. Carotenoids can also act as chemical quenchers undergoing irreversible oxygenation. The molecular mechanisms underlying these reactions are still not fully understood, especially in the context of the anti- and pro-oxidant activity of carotenoids, which, although not synthesized by humans and animals, are also present in their blood and tissues, contributing to a number of biochemical processes. The antioxidant potential of carotenoids is of particular significance to human health, due to the fact that losing antioxidant-reactive oxygen species balance results in “oxidative stress”, a critical factor of the pathogenic processes of various chronic disorders. Data coming from epidemiological studies and clinical trials strongly support the observation that adequate carotenoid supplementation may significantly reduce the risk of several disorders mediated by reactive oxygen species. Here, we would like to highlight the beneficial (protective) effects of dietary carotenoid intake in exemplary widespread modern civilization diseases, i.e., cancer, cardiovascular or photosensitivity disorders, in the context of carotenoids’ unique antioxidative properties. PMID:24473231

Spaces of care in the third sector: understanding the effects of professionalization.

PubMed

Carey, Gemma; Braunack-Mayer, Annette; Barraket, Jo

2009-11-01

Increasingly the health and welfare needs of individuals and communities are being met by third sector, or not-for-profit, organizations. Since the 1980s third sector organizations have been subject to significant, sector-wide changes, such as the development of contractual funding and an increasing need to collaborate with governments and other sectors. In particular, the processes of 'professionalization' and 'bureaucratization' have received significant attention and are now well documented in third sector literature. These processes are often understood to create barriers between organizations and their community groups and neutralize alternative forms of service provision. In this article we provide a case study of an Australian third sector organization undergoing professionalization. The case study draws on ethnographic and qualitative interviews with staff and volunteers at a health-based third sector organization involved in service provision to marginalized community groups. We examine how professionalization alters organizational spaces and dynamics and conclude that professionalized third sector spaces may still be 'community' spaces where individuals may give and receive care and services. Moreover, we suggest that these community spaces hold potential for resisting the neutralizing effects of contracting.

Living with cochlear implants: experiences of 17 adult patients in Sweden.

PubMed

Hallberg, Lillemor R M; Ringdahl, Anders

2004-02-01

The aim of this grounded theory study was to gain a deeper understanding of what it means to profoundly deaf adults to undergo cochlear implantation and their experience of living with it daily. The aim of grounded theory is theorizing, i.e. constructing from data an explanatory scheme that systematically integrates various concepts and their relationships. The study group consisted of 10 women and seven men (age 29-78 years; mean age 56.5 years), who had had their cochlear implant (CI) for between 1 and 12 years (mean 4.1 years). Open taped interviews were carried out and analysed. The core category, coming back to life, defines a psychological process basic to existence, elucidating the existential value of hearing, including perceived harmony in life and becoming a part of the living world as important dimensions. This core concept is related to four additional emerging categories in a temporal order. Preventing disappointment concerns the decision to undergo the operation governed by the conception of having nothing to lose combined with low expectations of successful outcomes. Waiting in silence relates to experiences during the postoperative period such as sensations from the head and uncertainty about the outcome of surgery. The 'switch-on' was experienced as a significant revelation and the emotionally loaded starting point for their coming back to life. Retraining the brain concerns the lengthy audiovisual learning process. finally resulting in 'a car sounding like a car'. Strengthening of self-worth concerns psychosocial outcomes of cochlear implantation, in terms of less dependency and increased social participation. CIs provide a substantial improvement in the quality of life, as identified in the emerging generic process of coming back to life, fundamental for psychological existence.

Encoding of sound envelope transients in the auditory cortex of juvenile rats and adult rats.

PubMed

Lu, Qi; Jiang, Cuiping; Zhang, Jiping

2016-02-01

Accurate neural processing of time-varying sound amplitude and spectral information is vital for species-specific communication. During postnatal development, cortical processing of sound frequency undergoes progressive refinement; however, it is not clear whether cortical processing of sound envelope transients also undergoes age-related changes. We determined the dependence of neural response strength and first-spike latency on sound rise-fall time across sound levels in the primary auditory cortex (A1) of juvenile (P20-P30) rats and adult (8-10 weeks) rats. A1 neurons were categorized as "all-pass", "short-pass", or "mixed" ("all-pass" at high sound levels to "short-pass" at lower sound levels) based on the normalized response strength vs. rise-fall time functions across sound levels. The proportions of A1 neurons within each of the three categories in juvenile rats were similar to that in adult rats. In general, with increasing rise-fall time, the average response strength decreased and the average first-spike latency increased in A1 neurons of both groups. At a given sound level and rise-fall time, the average normalized neural response strength did not differ significantly between the two age groups. However, the A1 neurons in juvenile rats showed greater absolute response strength, longer first-spike latency compared to those in adult rats. In addition, at a constant sound level, the average first-spike latency of juvenile A1 neurons was more sensitive to changes in rise-fall time. Our results demonstrate the dependence of the responses of rat A1 neurons on sound rise-fall time, and suggest that the response latency exhibit some age-related changes in cortical representation of sound envelope rise time. Copyright © 2015 Elsevier Ltd. All rights reserved.

Time-of-Day and Appendicitis: Impact on Management and Outcomes

PubMed Central

Drake, Frederick Thurston; Mottey, Neli E.; Castelli, Anthony A.; Florence, Michael G.; Johnson, Morris G.; Steele, Scott R.; Thirlby, Richard C.; Flum, David R.

2017-01-01

Background Observational research has shown that delayed presentation is associated with perforation in appendicitis. Many factors that impact the ability to present for evaluation are influenced by time-of-day; for example, child care, work, transportation, and primary care office hours. Our objective was to evaluate for an association between care processes or clinical outcomes and presentation time. Methods Prospective cohort of 7,548 adults undergoing appendectomy at 56 hospitals across Washington State. Relative to presentation time, patient characteristics, time to surgery, imaging use, negative appendectomy (NA), and perforation were compared using univariate and multivariate methodologies. Results Overall, 63% of patients presented between noon and midnight. More men presented in the morning; however, race, insurance status, co-morbid conditions, and WBC count did not differ by presentation time. Daytime presenters (6AM-6PM) were less likely to undergo imaging (94% vs. 98% p<0.05) and had a nearly 50% decrease in median pre-operative time (6.0h vs. 8.7h p<0.001). Perforation significantly differed by time-of-day. Patients who presented during the workday (9AM-3PM) had a 30% increase in odds of perforation compared to early morning/late night presenters (adjusted OR 1.29, 95%CI 1.05–1.59). NA did not vary by time-of-day. Conclusions Most patients with appendicitis presented in afternoon/evening. Socioeconomic characteristics did not vary with time-of-presentation. Patients who presented during the workday more often had perforated appendicitis compared to those who presented early morning or late night. Processes of care differed (both time-to-surgery and imaging use). Time-of-day is associated with patient outcomes, process of care, and decisions to present for evaluation; this has implications for surgical workforce planning and quality improvement efforts. PMID:27592212

Male factor infertility and lack of openness about infertility as risk factors for depressive symptoms in males undergoing assisted reproductive technology treatment in Italy.

PubMed

Babore, Alessandra; Stuppia, Liborio; Trumello, Carmen; Candelori, Carla; Antonucci, Ivana

2017-04-01

To investigate the association between male factor infertility and openness to discussing assisted reproductive technology (ART) treatment with levels of depression among men undergoing infertility treatment. Cross-sectional. Not applicable. Three hundred forty participants (170 men and their partners) undergoing ART treatments. Administration of a set of questionnaires. Depressive symptoms were detected by means of the Zung Depression Self-Rating Scale. Participants' willingness to share their infertility treatment experience with other people was assessed by means of self-report questionnaires. In this study, 51.8% of males chose not to discuss their ART treatments with people other than their partner. In addition, the decision to discuss or not discuss the ART treatments with others was significantly associated with men's depressive symptoms. Male factor infertility was significantly associated with depression when considered together with the decision not to discuss ART treatments with others. A general disposition characterized by a lack of openness with others seemed to be a significant predictor of depression. There is a need for routine fertility care to pay greater attention to men's emotional needs. Before commencing reproductive treatment, male patients may benefit from undergoing routine screening for variables (i.e., male factor infertility and openness to others about ART) that may affect their risk of depression. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

The Effect of Music on Anxiety and Cardiovascular Indices in Patients Undergoing Coronary Artery Bypass Graft: A Randomized Controlled Trial.

PubMed

Heidari, Saeide; Babaii, Atye; Abbasinia, Mohammad; Shamali, Mahdi; Abbasi, Mohammad; Rezaei, Mahboobe

2015-12-01

The instability of cardiovascular indices and anxiety disorders are common among patients undergoing coronary artery bypass graft (CABG) and could interfere with their recovery. Therefore, improving the cardiovascular indices and anxiety is essential. This study aimed to investigate the effect of music therapy on anxiety and cardiovascular indices in patients undergoing CABG. In this randomized controlled trial, 60 patients hospitalized in the cardiovascular surgical intensive care unit of Shahid Beheshti Hospital in Qom city, Iran, in 2013 were selected using a consecutive sampling method and randomly allocated into the experimental and control groups. In the experimental group, patients received 30 minutes of light music, whereas in the control group, patients had 30 minutes of rest in bed. The cardiovascular indices and anxiety were measured immediately before, immediately after and half an hour after the study. Data were analyzed using the chi-square test and repeated measures analysis of variance. Compared to the immediately before intervention, the mean anxiety scores immediately after and 30 minutes after the intervention were significantly lower in the experimental group (P < 0.037) while it did not significantly change in the control group. However, there were no significant differences regarding the cardiovascular indices in the three consecutive measurements (P > 0.05). Music therapy is effective in decreasing anxiety among patients undergoing CABG. However, the intervention was not effective on cardiovascular indices. Music can effectively be used as a non-pharmacological method to manage anxiety after CABG.

Poor sleep quality predicts deficient emotion information processing over time in early adolescence.

PubMed

Soffer-Dudek, Nirit; Sadeh, Avi; Dahl, Ronald E; Rosenblat-Stein, Shiran

2011-11-01

There is deepening understanding of the effects of sleep on emotional information processing. Emotion information processing is a key aspect of social competence, which undergoes important maturational and developmental changes in adolescence; however, most research in this area has focused on adults. Our aim was to test the links between sleep and emotion information processing during early adolescence. Sleep and facial information processing were assessed objectively during 3 assessment waves, separated by 1-year lags. Data were obtained in natural environments-sleep was assessed in home settings, and facial information processing was assessed at school. 94 healthy children (53 girls, 41 boys), aged 10 years at Time 1. N/A. Facial information processing was tested under neutral (gender identification) and emotional (emotional expression identification) conditions. Sleep was assessed in home settings using actigraphy for 7 nights at each assessment wave. Waking > 5 min was considered a night awakening. Using multilevel modeling, elevated night awakenings and decreased sleep efficiency significantly predicted poor performance only in the emotional information processing condition (e.g., b = -1.79, SD = 0.52, confidence interval: lower boundary = -2.82, upper boundary = -0.076, t(416.94) = -3.42, P = 0.001). Poor sleep quality is associated with compromised emotional information processing during early adolescence, a sensitive period in socio-emotional development.

Stellar Content and Star Formation in Young Clusters Influenced by Massive Stars

NASA Astrophysics Data System (ADS)

Jose, J.

2014-09-01

Star Formation (SF) in extreme environment is always challenging and can be significantly different from that in quiet environments. This study presents the comprehensive multi-wavelength (optical, NIR, MIR and radio) observational analysis of three Galactic starforming regions associated with H II regions/young clusters and located at > 2 kpc, which are found to be evolving under the influence of massive stars within their vicinity. The candidate massive stars, young stellar objects, their mass, age, age spread, the form of K-band Luminosity Function (KLF), Initial Mass Function (IMF) and a possible formation history of each region are studied. The major results on Sh2-252, an extended H II region that appears to be undergoing multiple episodes of SF, are highlighted. Our analysis shows that all the regions are undergoing complex SF activity and the new generation of stars in each region seem to be an outcome of the influence by the presence of massive stars within them. SF process in these regions are likely to be multi-fold and the results suggest that multiple modes of triggering mechanism and hierarchial modes of SF are a common phenomena within young clusters.

Changes in the Golgi Apparatus of Neocortical and Hippocampal Neurons in the Hibernating Hamster.

PubMed

Antón-Fernández, Alejandro; León-Espinosa, Gonzalo; DeFelipe, Javier; Muñoz, Alberto

2015-01-01

Hibernating animals have been used as models to study several aspects of the plastic changes that occur in the metabolism and physiology of neurons. These models are also of interest in the study of Alzheimer's disease because the microtubule-associated protein tau is hyperphosphorylated during the hibernation state known as torpor, similar to the pretangle stage of Alzheimer's disease. Hibernating animals undergo torpor periods with drops in body temperature and metabolic rate, and a virtual cessation of neural activity. These processes are accompanied by morphological and neurochemical changes in neurons, which reverse a few hours after coming out of the torpor state. Since tau has been implicated in the structural regulation of the neuronal Golgi apparatus (GA) we have used Western Blot and immunocytochemistry to analyze whether the GA is modified in cortical neurons of the Syrian hamster at different hibernation stages. The results show that, during the hibernation cycle, the GA undergo important structural changes along with differential modifications in expression levels and distribution patterns of Golgi structural proteins. These changes were accompanied by significant transitory reductions in the volume and surface area of the GA elements during torpor and arousal stages as compared with euthermic animals.

Changes in the Golgi Apparatus of Neocortical and Hippocampal Neurons in the Hibernating Hamster

PubMed Central

Antón-Fernández, Alejandro; León-Espinosa, Gonzalo; DeFelipe, Javier; Muñoz, Alberto

2015-01-01

Hibernating animals have been used as models to study several aspects of the plastic changes that occur in the metabolism and physiology of neurons. These models are also of interest in the study of Alzheimer's disease because the microtubule-associated protein tau is hyperphosphorylated during the hibernation state known as torpor, similar to the pretangle stage of Alzheimer's disease. Hibernating animals undergo torpor periods with drops in body temperature and metabolic rate, and a virtual cessation of neural activity. These processes are accompanied by morphological and neurochemical changes in neurons, which reverse a few hours after coming out of the torpor state. Since tau has been implicated in the structural regulation of the neuronal Golgi apparatus (GA) we have used Western Blot and immunocytochemistry to analyze whether the GA is modified in cortical neurons of the Syrian hamster at different hibernation stages. The results show that, during the hibernation cycle, the GA undergo important structural changes along with differential modifications in expression levels and distribution patterns of Golgi structural proteins. These changes were accompanied by significant transitory reductions in the volume and surface area of the GA elements during torpor and arousal stages as compared with euthermic animals. PMID:26696838

Mouse embryonic stem cells undergo charontosis, a novel programmed cell death pathway dependent upon cathepsins, p53, and EndoG, in response to etoposide treatment.

PubMed

Tichy, Elisia D; Stephan, Zachary A; Osterburg, Andrew; Noel, Greg; Stambrook, Peter J

2013-05-01

Embryonic stem cells (ESCs) are hypersensitive to many DNA damaging agents and can rapidly undergo cell death or cell differentiation following exposure. Treatment of mouse ESCs (mESCs) with etoposide (ETO), a topoisomerase II poison, followed by a recovery period resulted in massive cell death with characteristics of a programmed cell death pathway (PCD). While cell death was both caspase- and necroptosis-independent, it was partially dependent on the activity of lysosomal proteases. A role for autophagy in the cell death process was eliminated, suggesting that ETO induces a novel PCD pathway in mESCs. Inhibition of p53 either as a transcription factor by pifithrin α or in its mitochondrial role by pifithrin μ significantly reduced ESC death levels. Finally, EndoG was newly identified as a protease participating in the DNA fragmentation observed during ETO-induced PCD. We coined the term charontosis after Charon, the ferryman of the dead in Greek mythology, to refer to the PCD signaling events induced by ETO in mESCs. Copyright © 2013 Elsevier B.V. All rights reserved.

Contribution of l-theanine to the formation of 2,5-dimethylpyrazine, a key roasted peanutty flavor in Oolong tea during manufacturing processes.

PubMed

Guo, Xiangyang; Song, Chuankui; Ho, Chi-Tang; Wan, Xiaochun

2018-10-15

l-Theanine, the most abundant amino acid in tea, is widely believed to be associated with the tea taste, however, its contribution to the formation of tea aroma is still unknown. Volatiles were determined and nitrogen-containing compounds formed during manufacturing processes were quantified. Lower levels of total sugar and l-theanine were detected in the Oolong tea product undergoing full fire processing (FFOT) suggesting that l-theanine probably involved in the volatile formation during manufacturing processes. Methylpyrazine and 2,5-dimethylpyrazine, two newly formed compounds in FFOT, together with other volatiles were successfully detected in a model thermal reaction of d-glucose and l-theanine (GT-MTR) but not detectable in thermal reactions with single d-glucose (G-MTR) or l-theanine (T-MTR). The concentration of 2,5-dimethylpyrazine increased significantly by adding additional l-theanine to 2nd roasted tea. Our study demonstrated that l-theanine, at least partly, contributed to the formation of 2,5-dimethylpyrazine, a key roasted peanutty flavor in Oolong tea. Copyright © 2018. Published by Elsevier Ltd.

The role of surface charge in the desolvation process of gelatin: implications in nanoparticle synthesis and modulation of drug release

PubMed Central

Ahsan, Saad M; Rao, Chintalagiri Mohan

2017-01-01

The process of moving hydrophobic amino acids into the core of a protein by desolvation is important in protein folding. However, a rapid and forced desolvation can lead to precipitation of proteins. Desolvation of proteins under controlled conditions generates nanoparticles – homogeneous aggregates with a narrow size distribution. The protein nanoparticles, under physiological conditions, undergo surface erosion due to the action of proteases, releasing the entrapped drug/gene. The packing density of protein nanoparticles significantly influences the release kinetics. We have investigated the desolvation process of gelatin, exploring the role of pH and desolvating agent in nanoparticle synthesis. Our results show that the desolvation process, initiated by the addition of acetone, follows distinct pathways for gelatin incubated at different pH values and results in the generation of nanoparticles with varying matrix densities. The nanoparticles synthesized with varying matrix densities show variations in drug loading and protease-dependent extra- and intracellular drug release. These results will be useful in fine-tuning the synthesis of nanoparticles with desirable drug release profiles. PMID:28182126

Practice variations in voice treatment selection following vocal fold mucosal resection.

PubMed

Moore, Jaime E; Rathouz, Paul J; Havlena, Jeffrey A; Zhao, Qianqian; Dailey, Seth H; Smith, Maureen A; Greenberg, Caprice C; Welham, Nathan V

2016-11-01

To characterize initial voice treatment selection following vocal fold mucosal resection in a Medicare population. Retrospective analysis of a large, nationally representative Medicare claims database. Patients with > 12 months of continuous Medicare coverage who underwent a leukoplakia- or cancer-related vocal fold mucosal resection (index) procedure during calendar years 2004 to 2009 were studied. The primary outcome of interest was receipt of initial voice treatment (thyroplasty, vocal fold injection, or speech therapy) following the index procedure. We evaluated the cumulative incidence of each postindex treatment type, treating the other treatment types as competing risks, and further evaluated postindex treatment utilization using the proportional hazards model for the subdistribution of a competing risk. Patient age, sex, and Medicaid eligibility were used as predictors. A total of 2,041 patients underwent 2,427 index procedures during the study period. In 14% of cases, an initial voice treatment event was identified. Women were significantly less likely to receive surgical or behavioral treatment compared to men. From age 65 to 75 years, the likelihood of undergoing surgical treatment increased significantly with each 5-year age increase; after age 75 years, the likelihood of undergoing either surgical or behavioral treatment decreased significantly every 5 years. Patients with low socioeconomic status were significantly less likely to undergo speech therapy. The majority of Medicare patients do not undergo voice treatment following vocal fold mucosal resection. Further, the treatments analyzed here appear disproportionally utilized based on patient sex, age, and socioeconomic status. Additional research is needed to determine whether these observations reflect clinically explainable differences or disparities in care. 2c. Laryngoscope, 126:2505-2512, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Practice variations in voice treatment selection following vocal fold mucosal resection

PubMed Central

Moore, Jaime E.; Rathouz, Paul J.; Havlena, Jeffrey A.; Zhao, Qianqian; Dailey, Seth H.; Smith, Maureen A.; Greenberg, Caprice C.; Welham, Nathan V.

2016-01-01

Objective To characterize initial voice treatment selection following vocal fold mucosal resection in a Medicare population. Study Design Retrospective analysis of a large, nationally-representative Medicare claims database. Methods Patients with >12 months of continuous Medicare coverage who underwent a leukoplakia- or cancer-related vocal fold mucosal resection (index) procedure during calendar years 2004–2009 were studied. The primary outcome of interest was receipt of initial voice treatment (thyroplasty, vocal fold injection, or speech therapy) following the index procedure. We evaluated the cumulative incidence of each post-index treatment type treating the other treatment types as competing risks, and further evaluated post-index treatment utilization using the proportional hazards model for the subdistribution of a competing risk. Patient age, sex and Medicaid eligibility were used as predictors. Results 2041 patients underwent 2427 index procedures during the study period. An initial voice treatment event was identified in 14% of cases. Women were significantly less likely to receive surgical or behavioral treatment compared to men. From age 65–75 years, the likelihood of undergoing surgical treatment increased significantly with each 5-year age increase; after age 75 years, the likelihood of undergoing either surgical or behavioral treatment decreased significantly every 5 years. Patients with low socioeconomic status were significantly less likely to undergo speech therapy. Conclusions The majority of Medicare patients do not undergo voice treatment following vocal fold mucosal resection. Further, the treatments analyzed here appear disproportionally utilized based on patient sex, age and socioeconomic status. Additional research is needed to determine whether these observations reflect clinically explainable differences or disparities in care. Level of Evidence 2c PMID:26972900

Temporal changes in outcomes of women and men undergoing percutaneous coronary intervention for chronic total occlusion: 2005-2013.

PubMed

Toma, Aurel; Stähli, Barbara E; Gick, Michael; Ferenc, Miroslaw; Mashayekhi, Kambis; Buettner, Heinz Joachim; Neumann, Franz-Josef; Gebhard, Catherine

2018-06-01

Percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) has undergone impressive progress during the last decade, both in strategies and equipment. It is unknown whether technical refinement has translated into improved outcomes in women undergoing CTO-PCI. A total of 2002 consecutive patients (17% females, mean age 65.2 ± 10.7 years) undergoing PCI of at least one CTO lesion at our center between 01/2005 and 12/2013 were evaluated. The incidence of adverse events was compared between two time series (2005-2009 and 2010-2013). A significant increase in adverse lesion characteristics over time was noted in both, women and men (p < 0.001), while technical success rates significantly increased in men but not in women (p trend  < 0.001 in men and p trend =0.9 in women). The incidence of procedural complications was significantly higher in women as compared to men and increased over the study period in women (p < 0.05) but not in men. Accordingly, multivariate logistic regression analysis identified female sex as a strong predictor of PCI-related complications in recent years, while this was not the case in earlier years (adjusted HR 2.03, 95% CI 0.62-6.6, p = 0.2 and adjusted HR 4.7, 95% CI 1.8-12.3, p = 0.002, respectively, p < 0.001 for log LH ratio). In addition, major adverse cardiovascular events (MACE) after a 3-year follow-up significantly declined in men (log rank = 0.046), while no changes were observed in women. While higher success rates and a reduced rate of MACE have been achieved in men, the incidence of procedural complications in women undergoing CTO-PCI has increased over time.

The impact of a 600-mg loading dose of clopidogrel in diabetic and non-diabetic patients undergoing elective PCI.

PubMed

Mohareb, Mina W; Abd Elghany, Mohamed; Sabry, Nirmeen A; Farid, Samar F

2016-08-01

High platelet reactivity (HPR) and suboptimal response to dual antiplatelet therapy (DAPT) may explain high recurrent rates of ischemic events in type 1 and 2 diabetes mellitus (DM) patients undergoing percutaneous coronary intervention (PCI). The aim of this study was to determine the effect of diabetes mellitus on clopidogrel activity in cardiac patients undergoing PCI. This is an observational study. Patients were categorized according to DM status into diabetic group (N.=30) and non-diabetic group (N.=33). All patients received clopidogrel in a loading dose of 600 mg before PCI. Platelet function was assessed using light transmittance aggregometry (LTA) technique at baseline (before clopidogrel administration), 24 hour after clopidogrel loading dose administration and 7-10 days after PCI. All patients were followed up for at least one year after PCI for recurrence of acute cardiac events. There was no statistically significant difference between the two groups with respect to 10 µm adenosine diphosphate (ADP)-induced platelet aggregation measured at baseline (P=0.64), 24 hours after PCI (P=0.874), and 7-10 days after PCI (0.643). Diabetics were not significantly different from non-diabetics in terms of post-PCI acute stent thrombosis (P=0.945), sub-acute stent thrombosis (P=0.945), unstable angina (P=0.29) and cardiac death (P=0.64). There was a statistically significant difference between patients with and without post-PCI acute events regarding ADP aggregation measured 24 hours and 7-10 days after PCI. The use of a high loading dose of clopidogrel (600 mg) in patients undergoing elective PCI can overcome the significant increase in post-PCI platelet aggregation and rate of acute cardiac events induced by diabetes mellitus as co-morbidity in those patients.

Analysis of follicular fluid retinoids in women undergoing in vitro fertilization: retinoic acid influences embryo quality and is reduced in women with endometriosis.

PubMed

Pauli, Samuel A; Session, Donna R; Shang, Weirong; Easley, Kirk; Wieser, Friedrich; Taylor, Robert N; Pierzchalski, Keely; Napoli, Joseph L; Kane, Maureen A; Sidell, Neil

2013-09-01

Retinol (ROL) and its biologically active metabolite, all-trans retinoic acid (ATRA), are essential for a number of reproductive processes. However, there is a paucity of information regarding their roles in ovarian folliculogenesis, oocyte maturation, and early embryogenesis. The objectives of this study were to quantify and compare peripheral plasma (PP) and follicular fluid (FF) retinoid levels, including ATRA in women undergoing in vitro fertilization (IVF) and to investigate the relationship between retinoid levels and embryo quality. Retinoid levels were evaluated in PP and FF from 79 women undergoing IVF at the time of oocyte retrieval and corresponding embryo quality assessed on a daily basis after retrieval for 3 days until uterine transfer. Analysis compared the retinoid levels with day 3 embryo grades and between endometriosis versus control patients. Results demonstrated distinctive levels of retinoid metabolites and isomers in FF versus PP. There was a significantly larger percentage of high-quality grade I embryos derived from the largest versus smallest follicles. An increase in follicle size also correlated with a >50% increase in FF ROL and ATRA concentrations. Independent of follicle size, FF yielding grade I versus nongrade I embryos showed higher mean levels of ATRA but not ROL. In a nested case-control analysis, control participants had 50% higher mean levels of ATRA in their FF and PP than women with endometriosis. These findings strongly support the proposition that ATRA plays a fundamental role in oocyte development and quality, and that reduced ATRA synthesis may contribute to decreased fecundity of participants with endometriosis.

Analysis of Follicular Fluid Retinoids in Women Undergoing In Vitro Fertilization

PubMed Central

Pauli, Samuel A.; Session, Donna R.; Shang, Weirong; Easley, Kirk; Wieser, Friedrich; Taylor, Robert N.; Pierzchalski, Keely; Napoli, Joseph L.; Kane, Maureen A.

2013-01-01

Retinol (ROL) and its biologically active metabolite, all-trans retinoic acid (ATRA), are essential for a number of reproductive processes. However, there is a paucity of information regarding their roles in ovarian folliculogenesis, oocyte maturation, and early embryogenesis. The objectives of this study were to quantify and compare peripheral plasma (PP) and follicular fluid (FF) retinoid levels, including ATRA in women undergoing in vitro fertilization (IVF) and to investigate the relationship between retinoid levels and embryo quality. Retinoid levels were evaluated in PP and FF from 79 women undergoing IVF at the time of oocyte retrieval and corresponding embryo quality assessed on a daily basis after retrieval for 3 days until uterine transfer. Analysis compared the retinoid levels with day 3 embryo grades and between endometriosis versus control patients. Results demonstrated distinctive levels of retinoid metabolites and isomers in FF versus PP. There was a significantly larger percentage of high-quality grade I embryos derived from the largest versus smallest follicles. An increase in follicle size also correlated with a >50% increase in FF ROL and ATRA concentrations. Independent of follicle size, FF yielding grade I versus nongrade I embryos showed higher mean levels of ATRA but not ROL. In a nested case–control analysis, control participants had 50% higher mean levels of ATRA in their FF and PP than women with endometriosis. These findings strongly support the proposition that ATRA plays a fundamental role in oocyte development and quality, and that reduced ATRA synthesis may contribute to decreased fecundity of participants with endometriosis. PMID:23427183

Scoping review of the literature on shoulder impairments and disability after neck dissection.

PubMed

Goldstein, David P; Ringash, Jolie; Bissada, Eric; Jaquet, Yves; Irish, Jonathan; Chepeha, Douglas; Davis, Aileen M

2014-02-01

The purpose of this article was to provide a review of the literature on shoulder disability after neck dissection. A literature review was performed using Ovid Medline and Embase databases. A total of 306 abstracts and 78 full-text articles were reviewed. Forty-two articles were eligible for inclusion. Patients undergoing nerve-sacrifice neck dissections have greater disability and lower quality of life scores than those undergoing neck dissections with the least manipulation (ie, selective neck dissections). Shoulder impairments can still occur in patients undergoing selective neck dissections. Disability typically improves over time in patients undergoing nerve-sparing neck dissections. There was significant variability in the literature in terms of the prevalence and recovery of shoulder morbidity after neck dissection. This variability may not just be related to surgical technique or rehabilitation, but also to study design, definitions, and the variability in disability questionnaires used. Copyright © 2013 Wiley Periodicals, Inc.

Cognitive function and adherence of older adults undergoing hemodialysis.

PubMed

Hain, Debra J

2008-01-01

As the number of older adults undergoing hemodialysis increases, it is important for nurses to consider cognitive impairment as a contributing factor to non-adherence. The purpose of this exploratory study was to identify cognitive markers that nurses can use to alert them to potential problems with adherence among older adults undergoing hemodialysis. Stories of the health challenge of making lifestyle change were analyzed with a linguistic analysis software program. A standardized instrument (3MS) that measures global cognitive function was administered. Determination of adherence level was the last activity of data collection. In this sample (n=63), 39.7% of the participants had evidence of cognitive impairment (3MS score less than 80); 58.2% of the 39.7% had evidence of non-adherence. There was a significant relationship between word use and cognitive function (p < .01). Cognitive impairment is prevalent among older adults undergoing hemodialysis and words might be a proxy for recognizing this.

Female Partner Acceptance as a Predictor of Men's Readiness to Undergo Voluntary Medical Male Circumcision in Zambia: The Spear and Shield Project.

PubMed

Cook, Ryan; Jones, Deborah; Redding, Colleen A; Zulu, Robert; Chitalu, Ndashi; Weiss, Stephen M

2016-11-01

The World Health Organization has recommended the scale-up of voluntary medical male circumcision (VMMC) for HIV prevention in sub-Saharan Africa; however, men are often uninterested in undergoing VMMC. The Spear & Shield project enrolled 668 men and female partners from ten Zambian community health centers into parallel interventions promoting VMMC for HIV prevention or time-matched control conditions. A mediation model was utilized to examine the relationships between changes in women's acceptance of VMMC and men's readiness to undergo the procedure. Results demonstrated that, at 12 months post-intervention, a 5.9 % increase in the likelihood of undergoing VMMC among men in the experimental condition could be attributed to increased women's acceptance. From a public health perspective, involving women in VMMC promotion interventions such as the Spear & Shield project could significantly impact the demand for VMMC in Zambia.

A comparison study of immune-inflammatory response in electroacupuncture and transcutaneous electrical nerve stimulation for patients undergoing supratentorial craniotomy

PubMed Central

Li, Guoyan; Li, Shuqin; Sun, Lizhi; Lin, Fangcai; Wang, Baoguo

2015-01-01

Objective: The effect of transcutaneous electrical nerve stimulation (TENS) on immuno-inflammatory response was tested and the differences between electroacupuncture (EA) and TENS in immuno-inflammatory response in patients undergoing supratentorial craniotomy were explored. Methods: 51 patients received craniotomy were randomly divided into 3 groups: control (group C, n=18), EA (group A, n=19) and TENS (group T, n=14) groups. Blood samples were collected before anesthesia (T0) and 30 min (T1), 2 h (T2) and 4 h (T3) after induction of anesthesia to measure the levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-8, IL-10, IgM, IgA and IgG. Results: No significant difference existed between group A and group T during craniotomy. IgM and IgA decreased significantly in group C compared with groups A and T at T2 and T3 time points. Compared with group C, there were significant differences in TNF-α, IgM and IgA levels at T0 in groups A and T; no significant difference was found in the levels of IgG, IL-10 and IL-8. Conclusion: EA and TENS could reduce immunosuppression in patients undergoing supratentorial craniotomy and it has significance in choice of treatment in immunosuppressive therapy. PMID:25785107

A comparison study of immune-inflammatory response in electroacupuncture and transcutaneous electrical nerve stimulation for patients undergoing supratentorial craniotomy

PubMed Central

Li, Guoyan; Li, Shuqin; Sun, Lizhi; Lin, Fangcai; Wang, Baoguo

2015-01-01

Objective: The effect of transcutaneous electrical nerve stimulation (TENS) on immuno-inflammatory response was tested and the differences between electroacupuncture (EA) and TENS in immuno-inflammatory response in patients undergoing supratentorial craniotomy were explored. Methods: 51 patients received craniotomy were divided randomly into 3 groups: control (group C, n=18), EA (group A, n=19) and TENS (group T, n=14) groups. Blood samples were collected before anesthesia (T0) and 30 min (T1), 2 h (T2) and 4 h (T3) after induction of anesthesia to measure the levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-8, IL-10, IgM, IgA and IgG.. Results: No significant difference existed between groups A and group T during craniotomy. IgM and IgA decreased significantly in group C compared with groups A and T at T2 and T3 time points. Compared with group C, there were significant difference in TNF-α, IgM and IgA level at T0 in groups A and T; no significant difference was found in the levels of IgG, IL-10 and IL-8. Conclusion: EA and TENS could reduce immunosuppression in patients undergoing supratentorial craniotomy and it has significance in choice of treatment in immunosuppressive therapy. PMID:25932216

Alternative splicing in plant immunity.

PubMed

Yang, Shengming; Tang, Fang; Zhu, Hongyan

2014-06-10

Alternative splicing (AS) occurs widely in plants and can provide the main source of transcriptome and proteome diversity in an organism. AS functions in a range of physiological processes, including plant disease resistance, but its biological roles and functional mechanisms remain poorly understood. Many plant disease resistance (R) genes undergo AS, and several R genes require alternatively spliced transcripts to produce R proteins that can specifically recognize pathogen invasion. In the finely-tuned process of R protein activation, the truncated isoforms generated by AS may participate in plant disease resistance either by suppressing the negative regulation of initiation of immunity, or by directly engaging in effector-triggered signaling. Although emerging research has shown the functional significance of AS in plant biotic stress responses, many aspects of this topic remain to be understood. Several interesting issues surrounding the AS of R genes, especially regarding its functional roles and regulation, will require innovative techniques and additional research to unravel.

Skin aging: are adipocytes the next target?

PubMed

Kruglikov, Ilja L; Scherer, Philipp E

2016-07-01

Dermal white adipose tissue (dWAT) is increasingly appreciated as a special fat depot. The adipocytes in this depot exert a variety of unique effects on their surrounding cells and can undergo massive phenotypic changes. Significant modulation of dWAT content can be observed both in intrinsically and extrinsically aged skin. Specifically, skin that has been chronically photo-damaged displays a reduction of the dWAT volume, caused by the replacement of adipocytes by fibrotic structures. This is likely to be caused by the recently uncovered process described as "adipocyte-myofibroblast transition" (AMT). In addition, contributions of dermal adipocytes to the skin aging processes are also indirectly supported by spatial correlations between the prevalence of hypertrophic scarring and the appearance of signs of skin aging in different ethnic groups. These observations could elevate dermal adipocytes to prime targets in strategies aimed at counteracting skin aging.

Skin aging: are adipocytes the next target?

PubMed Central

Kruglikov, Ilja L.; Scherer, Philipp E.

2016-01-01

Dermal white adipose tissue (dWAT) is increasingly appreciated as a special fat depot. The adipocytes in this depot exert a variety of unique effects on their surrounding cells and can undergo massive phenotypic changes. Significant modulation of dWAT content can be observed both in intrinsically and extrinsically aged skin. Specifically, skin that has been chronically photo-damaged displays a reduction of the dWAT volume, caused by the replacement of adipocytes by fibrotic structures. This is likely to be caused by the recently uncovered process described as “adipocyte-myofibroblast transition” (AMT). In addition, contributions of dermal adipocytes to the skin aging processes are also indirectly supported by spatial correlations between the prevalence of hypertrophic scarring and the appearance of signs of skin aging in different ethnic groups. These observations could elevate dermal adipocytes to prime targets in strategies aimed at counteracting skin aging. PMID:27434510

Benchmarking study of corporate research management and planning practices

NASA Astrophysics Data System (ADS)

McIrvine, Edward C.

1992-05-01

During 1983-84, Xerox Corporation was undergoing a change in corporate style through a process of training and altered behavior known as Leadership Through Quality. One tenet of Leadership Through Quality was benchmarking, a procedure whereby all units of the corporation were asked to compare their operation with the outside world. As a part of the first wave of benchmark studies, Xerox Corporate Research Group studied the processes of research management, technology transfer, and research planning in twelve American and Japanese companies. The approach taken was to separate `research yield' and `research productivity' (as defined by Richard Foster) and to seek information about how these companies sought to achieve high- quality results in these two parameters. The most significant findings include the influence of company culture, two different possible research missions (an innovation resource and an information resource), and the importance of systematic personal interaction between sources and targets of technology transfer.

6th International Conference on Nanomaterials by Severe Plastic Deformation (NanoSPD6)

NASA Astrophysics Data System (ADS)

2014-08-01

''NanoSPD'' means Nano-material by Severe Plastic Deformation (SPD), which is an efficient way to obtain bulk nano-structured materials. During SPD, the microstructure of the material is transformed into a very fine structure consisting of ultra fine grains (UFG) approaching even the nano-scale. SPD is different from classical large strain forming processes in two aspects: 1. The sample undergoes extremely large strains without significant change in its dimensions, 2. In most SPD processes high hydrostatic stress is applied which makes it possible to deform difficult-to-form materials. This conference is part of a series of conferences taking place every third year; the history of NanoSPD conferences began in 1999 in Moscow (Russia), followed by Vienna in 2002 (Austria), Fukuoka in 2005 (Japan), Goslar in 2008 (Germany), Nanjing in 2011 (China), and Metz in 2014 (France). The preface continues in the pdf.

Formation of charged nanoparticles in hydrocarbon flames: principal mechanisms

NASA Astrophysics Data System (ADS)

Starik, A. M.; Savel'ev, A. M.; Titova, N. S.

2008-11-01

The processes of charged gaseous and particulate species formation in sooting hydrocarbon/air flame are studied. The original kinetic model, comprising the chemistry of neutral and charged gaseous species, generation of primary clusters, which then undergo charging due to attachment of ions and electrons to clusters and via thermoemission, and coagulation of charged-charged, charged-neutral and neutral-neutral particles, is reported. The analysis shows that the principal mechanisms of charged particle origin in hydrocarbon flames are associated with the attachment of ions and electrons produced in the course of chemoionization reactions to primary small clusters and particles and coagulation via charged-charged and charged-neutral particle interaction. Thermal ionization of particles does not play a significant role in the particle charging. This paper was presented at the Third International Symposium on Nonequilibrium Process, combustion, and Atmospheric Phenomena (Dagomys, Sochi, Russia, 25-29 June 2007).

Hydroamination reactions of alkynes with ortho-substituted anilines in ball mills: synthesis of benzannulated N-heterocycles by a cascade reaction.

PubMed

Weiße, Maik; Zille, Markus; Jacob, Katharina; Schmidt, Robert; Stolle, Achim

2015-04-20

It was demonstrated that ortho-substituted anilines are prone to undergo hydroamination reactions with diethyl acetylenedicarboxylate in a planetary ball mill. A sequential coupling of the intermolecular hydroamination reaction with intramolecular ring closure was utilized for the syntheses of benzooxazines, quinoxalines, and benzothiazines from readily available building blocks, that is, electrophilic alkynes and anilines with OH, NH, or SH groups in the ortho position. For the heterocycle formation, it was shown that several stress conditions were able to initiate the reaction in the solid state. Processing in a ball mill seemed to be advantageous over comminution with mortar and pestle with respect to process control. In the latter case, significant postreaction modification occurred during solid-state analysis. Cryogenic milling proved to have an adverse effect on the molecular transformation of the reagents. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Ultrasound-Induced Organogel Formation Followed by Thin Film Fabrication via Simple Doctor Blading Technique for Field-Effect Transistor Applications.

PubMed

Xu, Jiaju; Wang, Yulong; Shan, Haiquan; Lin, Yiwei; Chen, Qian; Roy, V A L; Xu, Zongxiang

2016-07-27

We demonstrate doctor blading technique to fabricate high performance transistors made up of printed small molecular materials. In this regard, we synthesize a new soluble phthalocyanine, tetra-n-butyl peripheral substituted copper(II) phthalocaynine (CuBuPc), that can easily undergo gel formation upon ultrasonic irradiation, leading to the formation of three-dimensional (3D) network composed of one-dimensional (1D) nanofibers structure. Finally, taking the advantage of thixotropic nature of the CuBuPc organogel, we use the doctor blade processing technique that limits the material wastage for the fabrication of transistor devices. Due to the ultrasound induced stronger π-π interaction, the transistor fabricated by doctor blading based on CuBuPc organogel exhibits significant increase in charge carrier mobility in comparison with other solution process techniques, thus paving a way for a simple and economically viable preparation of electronic circuits.

The Choroid Plexus Functions as a Niche for T-Cell Stimulation Within the Central Nervous System

PubMed Central

Strominger, Itai; Elyahu, Yehezqel; Berner, Omer; Reckhow, Jensen; Mittal, Kritika; Nemirovsky, Anna; Monsonego, Alon

2018-01-01

The choroid plexus (CP) compartment in the ventricles of the brain comprises fenestrated vasculature and, therefore, it is permeable to blood-borne mediators of inflammation. Here, we explored whether T-cell activation in the CP plays a role in regulating central nervous system (CNS) inflammation. We show that CD4 T cells injected into the lateral ventricles adhere to the CP, transmigrate across its epithelium, and undergo antigen-specific activation and proliferation. This process is enhanced following peripheral immune stimulation and significantly impacts the immune signaling induced by the CP. Ex vivo studies demonstrate that T-cell harboring the CP through its apical surface is a chemokine- and adhesion molecule-dependent process. We suggest that, within the CNS, the CP serves an immunological niche, which rapidly responds to peripheral inflammation and, thereby, promotes two-way T-cell trafficking that impact adaptive immunity in the CNS. PMID:29868025

Interpretation of the characteristics of ocean-dumped sewage sludge related to remote sensing

NASA Technical Reports Server (NTRS)

Pagoria, P. S.; Kuo, C. Y.

1979-01-01

Wastewater sludge characteristics in general, and characteristics of wastewater sludges generated by the City of Philadelphia in particular, were addressed. The types and sources of wastewater sludges, a description of sludge treatment and disposal processes, examination of sludge generation and management for the City of Philadelphia, and definition of characteristics for typical east coast sludges undergoing ocean disposal were discussed. Specific differences exist between the characteristics of primary and secondary wastewater sludges, especially with the nature and size distribution of the solids particles. The sludges from the City of Philadelphia monitored during remote sensing experiments were mixtures of various sludge types and lacked distinguishing characteristics. In particular, the anaerobic digestion process exerted the most significant influence on sludge characteristics for the City of Philadelphia. The sludges generated by the City of Philadelphia were found to be typical and harbor no unique features.

Presbiphonya.

PubMed

Bruzzi, Caterina; Salsi, Daria; Minghetti, Domenico; Negri, Maurizio; Casolino, Delfo; Sessa, Michele

2017-04-28

This article attempts to describe the aging process of the vocal folds and the main features of the aged voice. In the world ageing population era, aging diseases and aging disorders are crucial. Voice disorders (presbyphonia) are common in the elderly and have a significant impact on communication and quality of life. Some of these disorders depend on the vocal folds, which consist of an extracellular matrix (ECM), fibrous proteins, interstitial proteins, and glycosaminoglycans. The density and spatial arrangement of these elements are important, as changes in their deposition can alter the biomechanical properties and vibratory function of the vocal folds. The aging voice process is analyzed in detail from mechanical factors like pulmonary bellows alteration, to hormonal factors and life style. The elderly people undergoe mechanical, anatomical and functional changes: alterations of the pulmonary bellows, systemic changes like hormonal disregulation, and laryngeal changes, that resulting in hoarseness, which is difficult to treat.

X-ray light curves of active galactic nuclei are phase incoherent

NASA Technical Reports Server (NTRS)

Krolik, Julian; Done, Chris; Madejski, Grzegorz

1993-01-01

We compute the Fourier phase spectra for the light curves of five low-luminosity active galactic nuclei observed by EXOSAT. There is no statistically significant phase coherence in any of them. This statement is equivalent, subject to a technical caveat, to a demonstration that their fluctuation statistics are Gaussian. Models in which the X-ray output is controlled wholly by a unitary process undergoing a nonlinear limit cycle are therefore ruled out, while models with either a large number of randomly excited independent oscillation modes or nonlinearly interacting spatially dependent oscillations are favored. We also demonstrate how the degree of phase coherence in light curve fluctuations influences the application of causality bounds on internal length scales.

Isotope Fractionation in the Interstellar Medium

NASA Technical Reports Server (NTRS)

Charnley, Steven

2011-01-01

Anomalously fractionated isotopic material is found in many primitive Solar System objects, such as meteorites and comets. It is thought, in some cases, to trace interstellar matter that was incorporated into the Solar Nebula without undergoing significant processing. We will present the results of models of the nitrogen, oxygen, and carbon fractionation chemistry in dense molecular clouds, particularly in cores where substantial freeze-out of molecules on to dust has occurred. The range of fractionation ratios expected in different interstellar molecules will be discussed and compared to the ratios measured in molecular clouds, comets and meteoritic material. These models make several predictions that can be tested in the near future by molecular line observations, particularly with ALMA.

Magnetotail boundary and energy transfer processes

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

Swift, D.W.; Lee, L.C.

1982-05-01

A particle code is used to simulate the magnetopause region in the high latitude geomagnetic tail in which the magnetic field undergoes a significant increase in going from the magnetosheath to the magnetotail lobe. The simulation indicates that plasma can flow from the magnetosheath to the lobe, which is accompanied by a drop in pressure and density. In the earth's inertial frame, the particles do work against the convection electric field. Hence the magnetopause region serves ass a dynamo. The simulation also shows that the width of th transition region increases with time. In the earth's inertial frame this ismore » seen as an expansion of the magnetopause thickness in the antisunward direction.« less

Thermal-Performance Instability in Piezoresistive Sensors: Inducement and Improvement

PubMed Central

Liu, Yan; Wang, Hai; Zhao, Wei; Qin, Hongbo; Fang, Xuan

2016-01-01

The field of piezoresistive sensors has been undergoing a significant revolution in terms of design methodology, material technology and micromachining process. However, the temperature dependence of sensor characteristics remains a hurdle to cross. This review focuses on the issues in thermal-performance instability of piezoresistive sensors. Based on the operation fundamental, inducements to the instability are investigated in detail and correspondingly available ameliorative methods are presented. Pros and cons of each improvement approach are also summarized. Though several schemes have been proposed and put into reality with favorable achievements, the schemes featuring simple implementation and excellent compatibility with existing techniques are still emergently demanded to construct a piezoresistive sensor with excellent comprehensive performance. PMID:27886125

Detection of BK virus and adenovirus in the urine from children after allogeneic stem cell transplantation.

PubMed

Hatakeyama, Naoki; Suzuki, Nobuhiro; Yamamoto, Masaki; Kuroiwa, Yuki; Hori, Tsukasa; Mizue, Nobuo; Tsutsumi, Hiroyuki

2006-01-01

The development of hemorrhagic cystitis (HC) and urinary excretion of polyoma BK virus (BKV) and adenovirus (ADV) was investigated by polymerase chain reaction in 20 children undergoing allogeneic stem cell transplantation. Five children developed HC, and all of them excreted BKV; however, only 1 excreted ADV, suggesting that BKV is more significant cause of HC than ADV in children undergoing stem cell transplantation.

The Role of Palliative Surgery in Gynecologic Cancer Cases

PubMed Central

Hope, Joanie Mayer

2013-01-01

The decision to undergo major palliative surgery in end-stage gynecologic cancer is made when severe disease symptoms significantly hinder quality of life. Malignant bowel obstruction, unremitting pelvic pain, fistula formation, tumor necrosis, pelvic sepsis, and chronic hemorrhage are among the reasons patients undergo palliative surgeries. This review discusses and summarizes the literature on surgical management of malignant bowel obstruction and palliative pelvic exenteration in gynecologic oncology. PMID:23299775

Acute normovolemic hemodilution is safe in neurosurgery.

PubMed

Oppitz, Paulo P; Stefani, Marco A

2013-01-01

To determine the safety of acute normovolemic hemodilution (ANH) for patients undergoing neurosurgical procedures. A group of 100 patients undergoing neurosurgical procedures was assigned prospectively to receive ANH. A group of 47 patients who underwent craniotomy for aneurysm clipping and standard anesthetic management was used as a control. Procedures conducted under ANH were performed without significant variations in physiologic parameters. Compared with controls, intraoperative blood loss, operative time, incidence and grade of complications, and length of hospital stay were similar between the two groups. Although the ANH group showed a difference in prothrombin levels before and after hemodilution procedures, the levels were still considered within physiologic parameters. Platelet counts and partial thromboplastin time (PTT) levels indicated no significant variations in either group. During the ANH procedure, a considerable reduction of brain oxygen extraction was observed in individuals with worse preoperative neurologic status (P < 0.05), indicating potential benefit. Among patients with cerebral aneurysm, patients with good initial clinical grades had better clinical results as indicated by Glasgow Outcome Scale scores (P < 0.02). ANH is a safe procedure for patients undergoing neurosurgical procedures. Further studies are necessary to confirm the improvement in brain oxygen extraction and the clinical impact. Nonetheless, patients undergoing aneurysm clipping with good clinical grades seem to profit from ANH. Copyright © 2013 Elsevier Inc. All rights reserved.

Feasible and promising modified trans-subxiphoid thoracoscopic extended thymectomy for patients with myasthenia gravis.

PubMed

Shiomi, Kazu; Kitamura, Eiji; Ono, Mototsugu; Kondo, Yasuto; Naito, Masahito; Mikubo, Masashi; Matsui, Yoshio; Nishiyama, Kazutoshi; Suda, Takashi; Satoh, Yukitoshi

2018-03-01

We have used a promising, minimally invasive thoracoscopic technique of extended thymectomy for patients with myasthenia gravis (MG). The aim of this study was to report our promising technique, a modified single-port trans-subxiphoid approach (MTXA) and to compare perioperative outcomes and effects on MG between our approach and sternotomy. We retrospectively reviewed records of all patients undergoing extended thymectomy for MG and/or thymoma between January 1, 2010 and December 31, 2016. The patients were divided into the MTXA group and Sternotomy group. Of the 50 consecutive patients undergoing extended thymectomy for MG, finally, 13 patients undergoing our MTXA extended thymectomy technique were compared with 20 patients undergoing extended thymectomy via sternotomy. Intraoperative blood loss, postoperative length of stay, and C-reactive protein value on postoperative day 1 were significantly more favorable in the MTXA group than the Sternotomy group (P<0.0001, P=0.0040 and P=0.0073, respectively). Furthermore, no significant differences in the frequency of patients with improvement of their Quantitative Myasthenia Gravis score and/or MG-Activities of Daily Living scale, decrease in the serum level of acetylcholine receptor antibody, and dose reduction of oral prednisone were seen between the two groups. Our approach to extended thymectomy might be more favorable than sternotomy in patients with MG.

Left atrial concomitant surgical ablation for treatment of atrial fibrillation in cardiac surgery: A meta-analysis of randomized controlled trials

PubMed Central

Wang, Chunguo; Ye, Minhua; Lin, Jiang; Jin, Jiang; Hu, Quanteng; Zhu, Chengchu; Chen, Baofu

2018-01-01

Introduction Surgical ablation is a generally established treatment for patients with atrial fibrillation undergoing concomitant cardiac surgery. Left atrial (LA) lesion set for ablation is a simplified procedure suggested to reduce the surgery time and morbidity after procedure. The present meta-analysis aims to explore the outcomes of left atrial lesion set versus no ablative treatment in patients with AF undergoing cardiac surgery. Methods A literature research was performed in six database from their inception to July 2017, identifying all relevant randomized controlled trials (RCTs) comparing left atrial lesion set versus no ablative treatment in AF patient undergoing cardiac surgery. Data were extracted and analyzed according to predefined clinical endpoints. Results Eleven relevant RCTs were included for analysis in the present study. The prevalence of sinus rhythm in ablation group was significantly higher at discharge, 6-month and 1-year follow-up period. The morbidity including 30 day mortality, late all-cause mortality, reoperation for bleeding, permanent pacemaker implantation and neurological events were of no significant difference between two groups. Conclusions The result of our meta-analysis demonstrates that left atrial lesion set is an effective and safe surgical ablation strategy for AF patients undergoing concomitant cardiac surgery. PMID:29360851

Neural Correlates of Olfactory Learning: Critical Role of Centrifugal Neuromodulation

ERIC Educational Resources Information Center

Fletcher, Max L.; Chen, Wei R.

2010-01-01

The mammalian olfactory system is well established for its remarkable capability of undergoing experience-dependent plasticity. Although this process involves changes at multiple stages throughout the central olfactory pathway, even the early stages of processing, such as the olfactory bulb and piriform cortex, can display a high degree of…

14 CFR 60.16 - Additional qualifications for a currently qualified FSTD.

Code of Federal Regulations, 2010 CFR

2010-01-01

... TRANSPORTATION (CONTINUED) AIRMEN FLIGHT SIMULATION TRAINING DEVICE INITIAL AND CONTINUING QUALIFICATION AND USE... required to undergo an additional qualification process if a user intends to use the FSTD for meeting... that FSTD. This process consists of the following: (1) The sponsor: (i) Must submit to the NSPM all...

Palomar College: A Technological Transformation.

ERIC Educational Resources Information Center

Halttunen, Lynda Gavigan

2002-01-01

Offers advice for colleges intending to undergo software conversions, asserting that sufficient resources are key to a smooth process. Describes the conversion process at Palomar College (California) in 1997, when Palomar purchased PeopleSoft enterprise-wide software in response to Y2K compliance issues. Stresses the ongoing need for training and…

System-Inspection Guidelines for Minnesota PK-12 School Construction Projects.

ERIC Educational Resources Information Center

Minnesota State Dept. of Children, Families, and Learning, St. Paul.

This document describes a 1998 commissioning statute passed by the Minnesota legislature requiring that mechanical HVAC systems undergo an inspection process to uncover and rectify problems before or shortly after a school building is occupied. The document presents the statute, describes the commissioning/system-inspection process and optional…

Return to Sport and Performance After Microfracture in the Knees of National Basketball Association Players

PubMed Central

Harris, Joshua D.; Walton, David M.; Erickson, Brandon J.; Verma, Nikhil N.; Abrams, Geoffrey D.; Bush-Joseph, Charles A.; Bach, Bernard R.; Cole, Brian J.

2013-01-01

Background: Use of microfracture in the knees of National Basketball Association (NBA) players is controversial. Hypotheses: (1) There would be a high rate of return to sport (RTS) in NBA players following microfracture, (2) players would RTS the season following surgery, (3) preoperative player performance would not be significantly different on RTS, and (4) there would be no significant difference in RTS rate or postoperative performance in players undergoing microfracture in comparison with an age-, position-, NBA experience–, and performance-matched control group. Study Design: Cohort study; Level of evidence, 3. Methods: NBA players undergoing microfracture were evaluated. Age-, body mass index–, position-, NBA experience–, and performance-matched controls were selected from the NBA during the same years as those undergoing microfracture. An index year was selected (controls) to match the number of seasons of NBA experience in microfracture cases. RTS and performance were analyzed and compared between cases and controls. Student t tests were performed for analysis of within- and between-group variables. Results: A total of 41 NBA players underwent microfracture and were compared with 41 demographic- and performance-matched controls. Rate of RTS after microfracture was 73% in the NBA and 83% in professional basketball (NBA, D-league, and International Basketball Federation [FIBA]). Time to RTS in NBA was 9.20 ± 4.88 months. Seventy-one percent (29/41) of players RTS the season following microfracture. Length of NBA career following microfracture (4.10 ± 3.91 years) was not significantly different from controls. After microfracture, case athletes played fewer games per season and with fewer points and steals per game (relative to premicrofracture; P < .05). Performance was better in control (after index year) versus case players (after microfracture) with regard to points per game, games played per season, and field goal and free throw percentage (P < .05). Conclusion: Eighty-three percent of NBA players undergoing microfracture returned to professional basketball. Career length was not significantly different between players undergoing microfracture and controls. However, following microfracture, players competed in fewer games per season with fewer points and steals. PMID:26535256

Return to Sport and Performance After Microfracture in the Knees of National Basketball Association Players.

PubMed

Harris, Joshua D; Walton, David M; Erickson, Brandon J; Verma, Nikhil N; Abrams, Geoffrey D; Bush-Joseph, Charles A; Bach, Bernard R; Cole, Brian J

2013-11-01

Use of microfracture in the knees of National Basketball Association (NBA) players is controversial. (1) There would be a high rate of return to sport (RTS) in NBA players following microfracture, (2) players would RTS the season following surgery, (3) preoperative player performance would not be significantly different on RTS, and (4) there would be no significant difference in RTS rate or postoperative performance in players undergoing microfracture in comparison with an age-, position-, NBA experience-, and performance-matched control group. Cohort study; Level of evidence, 3. NBA players undergoing microfracture were evaluated. Age-, body mass index-, position-, NBA experience-, and performance-matched controls were selected from the NBA during the same years as those undergoing microfracture. An index year was selected (controls) to match the number of seasons of NBA experience in microfracture cases. RTS and performance were analyzed and compared between cases and controls. Student t tests were performed for analysis of within- and between-group variables. A total of 41 NBA players underwent microfracture and were compared with 41 demographic- and performance-matched controls. Rate of RTS after microfracture was 73% in the NBA and 83% in professional basketball (NBA, D-league, and International Basketball Federation [FIBA]). Time to RTS in NBA was 9.20 ± 4.88 months. Seventy-one percent (29/41) of players RTS the season following microfracture. Length of NBA career following microfracture (4.10 ± 3.91 years) was not significantly different from controls. After microfracture, case athletes played fewer games per season and with fewer points and steals per game (relative to premicrofracture; P < .05). Performance was better in control (after index year) versus case players (after microfracture) with regard to points per game, games played per season, and field goal and free throw percentage (P < .05). Eighty-three percent of NBA players undergoing microfracture returned to professional basketball. Career length was not significantly different between players undergoing microfracture and controls. However, following microfracture, players competed in fewer games per season with fewer points and steals.

Relationship of Postprandial Nonesterified Fatty Acids, Adipokines, and Insulin Across Gender in Human Immunodeficiency Virus–Positive Patients Undergoing Highly Active Antiretroviral Therapy

PubMed Central

Lu, Guijing; Thomas-Geevarghese, Asha; Anuurad, Erdembileg; Raghavan, Subhashree; Minolfo, Robert; Ormsby, Bernard; Karmally, Wahida; El-Sadr, Wafaa M.; Albu, Jeanine

2009-01-01

Abstract Background Metabolic derangements are common in human immunodeficiency virus (HIV)-positive subjects undergoing antiretroviral therapy, but little is known about postprandial conditions. Methods We investigated the relationship between leptin, adiponectin, nonesterified fatty acids (NEFA), and insulin in response to a day-long meal pattern and evaluated gender differences in HIV-positive men (n = 12) and women (n = 13) undergoing highly active antiretroviral therapy (HAART). Results For both men and women, a significant decrease in postprandial NEFA levels was observed following breakfast (0.53 vs. 0.22 mmol/L, P < 0.001, baseline and at 3 hours, respectively), whereas day-long postprandial leptin and adiponectin levels showed small nonsignificant oscillations. In contrast to NEFA and adiponectin, postprandial leptin levels were significantly higher among women compared to men (P < 0.05). Postprandial NEFA levels correlated positively with fasting insulin levels (r2 = 0.25, P = 0.016), and the postbreakfast decrease in NEFA levels correlated significantly with the postbreakfast increase in insulin levels (r2 = 0.17, P = 0.038). No significant association between postprandial adipokines and insulin was observed. Conclusions In HAART-treated, HIV-infected men and women, levels of NEFA, but not adipokines, showed significant postprandial variation. Furthermore, food intake resulted in significant NEFA suppression in proportion to the food-stimulated insulin increase. PMID:19320559

Efficacy of intravenous fluid warming during goal-directed fluid therapy in patients undergoing laparoscopic colorectal surgery: a randomized controlled trial.

PubMed

Choi, Ji-Won; Kim, Duk-Kyung; Lee, Seung-Won; Park, Jung-Bo; Lee, Gyu-Hong

2016-06-01

To evaluate the clinical efficacy of intravenous (IV) fluid warming in patients undergoing laparoscopic colorectal surgery. Adult patients undergoing laparoscopic colorectal surgery were randomly assigned to receive either IV fluids at room temperature (control group) or warmed IV fluids (warm fluids group). Each patient received a standardized goal-directed fluid regimen based on stroke volume variances. Oesophageal temperature was measured at 15 min intervals for 2 h after induction of anaesthesia. A total of 52 patients were enrolled in the study. The drop in core temperature in the warm fluids group was significantly less than in the control group 2 h after the induction of anaesthesia. This significant difference was seen from 30 min after induction. IV fluid warming was associated with a smaller drop in core temperature than room temperature IV fluids in laparoscopic colorectal surgery incorporating goal-directed fluid therapy. © The Author(s) 2016.

Short interspersed transposable elements (SINEs) are excluded from imprinted regions in the human genome.

PubMed

Greally, John M

2002-01-08

To test whether regions undergoing genomic imprinting have unique genomic characteristics, imprinted and nonimprinted human loci were compared for nucleotide and retroelement composition. Maternally and paternally expressed subgroups of imprinted genes were found to differ in terms of guanine and cytosine, CpG, and retroelement content, indicating a segregation into distinct genomic compartments. Imprinted regions have been normally permissive to L1 long interspersed transposable element retroposition during mammalian evolution but universally and significantly lack short interspersed transposable elements (SINEs). The primate-specific Alu SINEs, as well as the more ancient mammalian-wide interspersed repeat SINEs, are found at significantly low densities in imprinted regions. The latter paleogenomic signature indicates that the sequence characteristics of currently imprinted regions existed before the mammalian radiation. Transitions from imprinted to nonimprinted genomic regions in cis are characterized by a sharp inflection in SINE content, demonstrating that this genomic characteristic can help predict the presence and extent of regions undergoing imprinting. During primate evolution, SINE accumulation in imprinted regions occurred at a decreased rate compared with control loci. The constraint on SINE accumulation in imprinted regions may be mediated by an active selection process. This selection could be because of SINEs attracting and spreading methylation, as has been found at other loci. Methylation-induced silencing could lead to deleterious consequences at imprinted loci, where inactivation of one allele is already established, and expression is often essential for embryonic growth and survival.

Short interspersed transposable elements (SINEs) are excluded from imprinted regions in the human genome

PubMed Central

Greally, John M.

2002-01-01

To test whether regions undergoing genomic imprinting have unique genomic characteristics, imprinted and nonimprinted human loci were compared for nucleotide and retroelement composition. Maternally and paternally expressed subgroups of imprinted genes were found to differ in terms of guanine and cytosine, CpG, and retroelement content, indicating a segregation into distinct genomic compartments. Imprinted regions have been normally permissive to L1 long interspersed transposable element retroposition during mammalian evolution but universally and significantly lack short interspersed transposable elements (SINEs). The primate-specific Alu SINEs, as well as the more ancient mammalian-wide interspersed repeat SINEs, are found at significantly low densities in imprinted regions. The latter paleogenomic signature indicates that the sequence characteristics of currently imprinted regions existed before the mammalian radiation. Transitions from imprinted to nonimprinted genomic regions in cis are characterized by a sharp inflection in SINE content, demonstrating that this genomic characteristic can help predict the presence and extent of regions undergoing imprinting. During primate evolution, SINE accumulation in imprinted regions occurred at a decreased rate compared with control loci. The constraint on SINE accumulation in imprinted regions may be mediated by an active selection process. This selection could be because of SINEs attracting and spreading methylation, as has been found at other loci. Methylation-induced silencing could lead to deleterious consequences at imprinted loci, where inactivation of one allele is already established, and expression is often essential for embryonic growth and survival. PMID:11756672

Surprise! The oft-ignored Moon might actually be important for changing the spins of asteroids during Earth flybys

NASA Astrophysics Data System (ADS)

Tuttle Keane, James; Siu, Hosea C.; Moskovitz, Nicholas A.; Binzel, Richard P.

2015-11-01

Analysis near-Earth asteroid archival data has revealed that asteroids with Earth MOIDs (minimum orbit intersection distance; a proxy for flyby distance) smaller than 1.0-1.5 lunar distances have a systematically larger dispersion in spin rate than more distant flybys (Siu, et al. 2015, DPS). While tidal torques during close encounters are expected to alter the spin states of asteroids (e.g. Scheeres et al. 2000, Icarus), there is no intrinsic reason to expect the observed sharp transition in spin rate distribution at 1.0-1.5 lunar distances, as tidal forces drop off smoothly with distance.While the Moon itself is too diminutive to directly alter the spin-states of asteroids, we show that its presence is enough to significantly affect asteroid encounter trajectories. Asteroids entering the Earth-Moon system are subject to three-body dynamics (due to the combined gravitational effects of the Earth and Moon). Depending on the flyby geometry, the Moon can act as a temporary sink for the asteroid's geocentric orbital energy. This allows some fraction of asteroids to have closer approaches with the Earth than expected when considering the Earth-Moon barycenter alone. In rare cases (~0.1%) this process enables the capture of temporary moons around the Earth (Granvik et al. 2012, Icarus). Asteroids that undergo these "enhanced" flybys can have both closer-than-expected encounter distances (resulting in more significant tidal perturbations), and repeated encounters with the Earth and Moon before leaving the system (resulting in the accumulation of multiple tidal interactions). By numerically solving the circular restricted three-body problem, we show that this process naturally produces a sharp transition in the asteroid population: asteroids with MOIDs less than 1.5 lunar distances can undergo these enhanced close approaches, possibly explaining the sharp transition in the dispersion of asteroid spin rates at this distance. Future work will investigate the efficiency of this process, and the relationship between the physical response of the asteroid to tidal perturbations and the statistical distribution of asteroid spin rates.

Incidence of deep vein thrombosis in patients undergoing breast reconstruction with autologous tissue transfer.

PubMed

Konoeda, Hisato; Yamaki, Takashi; Hamahata, Atsumori; Ochi, Masakazu; Osada, Atsuyoshi; Hasegawa, Yuki; Kirita, Miho; Sakurai, Hiroyuki

2017-05-01

Background Breast reconstruction is associated with multiple risk factors for venous thromboembolism. However, the incidence of deep vein thrombosis in patients undergoing breast reconstruction is uncertain. Objective The aim of this study was to prospectively evaluate the incidence of deep vein thrombosis in patients undergoing breast reconstruction using autologous tissue transfer and to identify potential risk factors for deep vein thrombosis. Methods Thirty-five patients undergoing breast reconstruction were enrolled. We measured patients' preoperative characteristics including age, body mass index (kg/m 2 ), and risk factors for deep vein thrombosis. The preoperative diameter of each venous segment in the deep veins was measured using duplex ultrasound. All patients received intermittent pneumatic pump and elastic compression stockings for postoperative thromboprophylaxis. Results Among the 35 patients evaluated, 11 (31.4%) were found to have deep vein thrombosis postoperatively, and one patient was found to have pulmonary embolism postoperatively. All instances of deep vein thrombosis developed in the calf and were asymptomatic. Ten of 11 patients underwent free flap transfer, and the remaining one patient received a latissimus dorsi pedicled flap. Deep vein thrombosis incidence did not significantly differ between patients with a free flap or pedicled flap (P = 0.13). Documented risk factors for deep vein thrombosis demonstrated no significant differences between patients with and without deep vein thrombosis. The diameter of the common femoral vein was significantly larger in patients who developed postoperative deep vein thrombosis than in those who did not ( P < 0.05). Conclusions The morbidity of deep vein thrombosis in patients who underwent breast reconstruction using autologous tissue transfer was relatively high. Since only the diameter of the common femoral vein was predictive of developing postoperative deep vein thrombosis, postoperative pharmacological thromboprophylaxis should be considered for all patients undergoing breast reconstruction regardless of operative procedure.

Comparison of patients' reported pain following office hysteroscopy with and without endometrial biopsy: a prospective study.

PubMed

New, Erika P; Sarkar, Papri; Sappenfield, Elisabeth; Mikhail, Emad; Plosker, Shayne; Imudia, Anthony N

2018-05-31

When performing office based gynecologic procedures, one must provide patients with appropriate counseling on anticipated pain prior to the procedure. The goal of this study was to investigate whether there is any difference in patients' pain perception when office hysteroscopy (OH) is performed alone compared with when it is performed with endometrial biopsy (EMB) for various gynecologic indications. A prospective study was performed of patients undergoing office hysteroscopy alone or in combination with endometrial biopsy between October 2015 and February 2017. Procedures were performed using standard gynecologic techniques. Patients described their post procedural pain using the visual analogue scale from 0-10 and data was compared between groups using SPSS version 24. Group 1 had OH alone (n=243) and group 2 had OH combined with EMB (n=80). Patients who underwent both procedures had significantly higher reported median (range) pain scores than those undergoing OH alone [7 (0-10) vs 5 (0-10), p=.004]. The patients in-group 2 were significantly older than those in group 1 (42.6±7.6 vs 36.6±6.5, p<.0001). The patients in group 2 had higher gravidity (2 vs 1, p=.04), were more likely to have a tenaculum used during the procedure (36.3% vs 21.4%, p=.01) and were more likely to be diagnosed with uterine fibroids (73% vs 31%, p<.0001). After controlling for patients age, gravidity, tenaculum use and diagnosis of fibroids using a multivariable regression model, patients undergoing OH with EMB had a 0.51-unit pain score greater than those that had OH alone; however, this difference was not statistically significant [95% CI (-0.32,1.33 p=.23)]. Patients undergoing both OH and EMB appear to report similar pain scores as those undergoing OH alone after controlling for confounding variables. The presence of fibroids was found to contribute to higher reported pain in the patients having OH in combination with EMB.

Effect of Intraoperative Dexamethasone on Pain Scores and Narcotic Consumption in Patients Undergoing Total Knee Arthroplasty.

PubMed

Samona, Jason; Cook, Carrie; Krupa, Kyle; Swatsell, Krystle; Jackson, Andrew; Dukes, Chase; Martin, Sidney

2017-02-01

To examine whether the addition of intravenous dexamethasone during total knee arthroplasty (TKA) would be effective at reducing postoperative pain scores and postoperative opioid consumption. A total of 102 patients undergoing TKA were placed into two groups: 55 subjects received intraoperative dexamethasone 8 mg intravenously (treatment group) and 47 did not receive dexamethasone at any time during the perioperative period. Comparison was made using the 0-10 numeric pain rating scale and the amount of opioids used in each group. Patients who received dexamethasone required significantly less oral opioids compared to the control group. Pain scores at 24 h post-surgery were significantly less for the dexamethasone group compared to the control group. There was no difference between groups in regards to patient-controlled analgesic dose or pain scores in the post-anesthesia care unit, at 12 or 48 h post-surgery. A single dose of dexamethasone given intraoperatively significantly decreased oral narcotic consumption and decreased pain scores 24 h postoperatively. Dexamethasone appears to be a safe modality to use to control pain in patients undergoing TKA. © 2017 Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.

Off-pump coronary artery bypass surgery in severe left ventricular dysfunction.

PubMed

Azarfarin, Rasoul; Pourafkari, Leili; Parvizi, Rezayat; Alizadehasl, Azin; Mahmoodian, Roghaiyeh

2010-02-01

Our aim was to examine hospital outcomes of coronary artery bypass surgery in patients with and without left ventricular dysfunction, with regard to the surgical technique (off- or on-pump). Between March 2007 and March 2008, 689 consecutive patients underwent isolated first-time coronary artery bypass; 127 had ejection fractions < or = 30% (group 1) and 562 had ejection fractions >30% (group 2). Data of preoperative risk profiles and hospital outcomes were collected prospectively. Off-pump operations were performed in 49 (38.6%) patients in group 1 and 196 (34.9%) in group 2. The incidences of infectious, neurologic, and cardiac complications postoperatively were significantly higher in group 1. In multivariate analysis, preoperative ejection fraction < or = 30% was found to be an independent risk factor for postoperative complications and hospital mortality. The subgroup of patients undergoing off-pump surgery in both groups had a significantly lower rate of total complications than those undergoing conventional on-pump operations, but no significant difference in mortality was observed between those undergoing off-pump or conventional surgery in either group. Off-pump surgery helped to limit the increased morbidity rate after coronary bypass in patients with ventricular dysfunction.

The Inequity of Bariatric Surgery: Publicly Insured Patients Undergo Lower Rates of Bariatric Surgery with Worse Outcomes.

PubMed

Hennings, Dietric L; Baimas-George, Maria; Al-Quarayshi, Zaid; Moore, Rachel; Kandil, Emad; DuCoin, Christopher G

2018-01-01

Bariatric surgery has been shown to be the most effective method of achieving weight loss and alleviating obesity-related comorbidities. Yet, it is not being used equitably. This study seeks to identify if there is a disparity in payer status of patients undergoing bariatric surgery and what factors are associated with this disparity. We performed a case-control analysis of National Inpatient Sample. We identified adults with body mass index (BMI) greater than or equal to 25 kg/m 2 who underwent bariatric surgery and matched them with overweight inpatient adult controls not undergoing surgery. The sample was analyzed using multivariate logistic regression. We identified 132,342 cases, in which the majority had private insurance (72.8%). Bariatric patients were significantly more likely to be privately insured than any other payer status; Medicare- and Medicaid-covered patients accounted for a low percentage of cases (Medicare 5.1%, OR 0.33, 95% CI 0.29-0.37, p < 0.001; Medicaid 8.7%, OR 0.21, 95% CI 0.18-0.25, p < 0.001). Medicare (OR 1.54, 95% CI 1.33-1.78, p < 0.001) and Medicaid (OR 1.31, 95% CI 1.08-1.60, p = 0.007) patients undergoing bariatric surgery had an increased risk of complications compared to privately insured patients. Publicly insured patients are significantly less likely to undergo bariatric surgery. As a group, these patients experience higher rates of obesity and related complications and thus are most in need of bariatric surgery.

Hip Fractures and the Bundle: A Cost Analysis of Patients Undergoing Hip Arthroplasty for Femoral Neck Fracture vs Degenerative Joint Disease.

PubMed

Grace, Trevor R; Patterson, Joseph T; Tangtiphaiboontana, Jennifer; Krogue, Justin D; Vail, Thomas P; Ward, Derek T

2018-06-01

The purpose of this study is to determine whether episode Target Prices in the Bundled Payment for Care Improvement (BPCI) initiative sufficiently match the complexities and expenses expected for patients undergoing hip arthroplasty for femoral neck fracture (FNF) as compared to hip degenerative joint disease (DJD). Claims data under BPCI Model 2 were collected for patients undergoing hip arthroplasty at a single institution over a 2-year period. Payments from the index hospitalization to 90 days postoperatively were aggregated by Medicare Severity Diagnosis-Related Group (469 or 470), indication (DJD vs FNF), and categorized as index procedure, postacute services, and related hospital readmissions. Actual episode costs and Target Prices were compared in both the FNF and DJD cohorts undergoing hip arthroplasty to gauge the cost discrepancy in each group. A total of 183 patients were analyzed (31 with FNFs, 152 with DJD). In total, the FNF cohort incurred a $415,950 loss under the current episode Target Prices, whereas the DJD cohort incurred a $172,448 gain. Episode Target Prices were significantly higher than actual episode prices for the DJD cohort ($32,573 vs $24,776, P < .001). However, Target Prices were significantly lower than actual episode prices for the FNF cohort ($32,672 vs $49,755, P = .021). Episode Target Prices in the current BPCI model fall dramatically short of the actual expenses incurred by FNF patients undergoing hip arthroplasty. Better risk-adjusting Target Prices for this fragile population should be considered to avoid disincentives and delays in care. Copyright © 2018 Elsevier Inc. All rights reserved.

Large-Scale Deformation and Uplift Associated with Serpentinization

NASA Astrophysics Data System (ADS)

Germanovich, L. N.; Lowell, R. P.; Smith, J. E.

2014-12-01

Geologic and geophysical data suggest that partially serpentinized peridotites and serpentinites are a significant part of the oceanic lithosphere. All serpentinization reactions are exothermic and result in volume expansion as high as 40%. Volume expansion beneath the seafloor will lead to surface uplift and elevated stresses in the neighborhood of the region undergoing serpentinization. The serpentinization-induced stresses are likely to result in faulting or tensile fracturing that promote the serpentinization process by creating new permeability and allowing fluid access to fresh peridotite. To explore these issues, we developed a first-order model of crustal deformation by considering an inclusion undergoing transformation strain in an elastic half-space. Using solutions for inclusions of different shapes, orientations, and depths, we calculate the surface uplift and mechanical stresses generated by the serpentinization processes. We discuss the topographic features at the TAG hydrothermal field (Mid-Atlantic Ridge, 26°N), uplift of the Miyazaki Plain (Southwestern Japan), and tectonic history of the Atlantic Massif (inside corner high of the Mid-Atlantic Ridge, 30°N, and the Atlantis Transform Fault). Our analysis suggests that an anomalous salient of 3 km in diameter and 100 m high at TAG may have resulted from approximately 20% transformational strain in a region beneath the footwall of the TAG detachment fault. This serpentinization process tends to promote slip along some overlying normal faults, which may then enhance fluid pathways to the deeper crust to continue the serpentinization process. The serpentinization also favors slip and seismicity along the antithetic faults identified below the TAG detachment fault. Our solution for the Miyazaki Plain above the Kyushu-Palau subduction zone explains the observed uplift of 120 m, but the transformational strain needs only be 3%. Transformational strains associated with serpentinization in this region may promote thrust-type events in the aseismic slip zone near the upper boundary of the subducting Philippine Sea Plate. Thermal effects of serpentinization in both regions are small.

Anticholinergic premedication to prevent bradycardia in combined spinal anesthesia and dexmedetomidine sedation: a randomized, double-blind, placebo-controlled study.

PubMed

Ahn, Eun Jin; Park, Jun Ha; Kim, Hyo Jin; Kim, Kyung Woo; Choi, Hey Ran; Bang, Si Ra

2016-12-01

When dexmedetomidine is used in patients undergoing spinal anesthesia, high incidence of bradycardia in response to parasympathetic activation is reported. Therefore, we aimed to evaluate the effectiveness of atropine premedication for preventing the incidence of bradycardia and the hemodynamic effect on patients undergoing spinal anesthesia with sedation by dexmedetomidine. Randomized, double-blind, placebo-controlled study. Operating room. One hundred fourteen patients (age range, 2-65 years; American Society of Anesthesiology class I-II) participated in this study, willing to be sedated and to undergo spinal anesthesia. The patients were divided into 2 groups: group A and group C. After performing spinal anesthesia, dexmedetomidine was infused at a loading dose of 0.6 μg/kg for 10 minutes, followed by an infusion at 0.25 μg/(kg h). Simultaneously with the loading dose of dexmedetomidine, patients in group A received an intravenous bolus of 0.5 mg atropine, whereas patients in group C received an intravenous normal saline bolus. Data on administration of atropine and ephedrine were collected. Hemodynamic data including heart rate, systolic blood pressure, diastolic blood pressure (DBP), and mean blood pressure (MBP) were also recorded. The incidence of bradycardia requiring atropine treatment was significantly higher in group C than group A (P=.035). However, the incidence of hypotension needing ephedrine treatment showed no significant difference between the 2 groups (P=.7). Systolic blood pressure and heart rate showed no significant differences between the 2 groups (P=.138 and .464, respectively). However, group A showed significant increases in DBP and MBP, and group C did not (P=.014 and .008, respectively). Prophylactic atropine reduces the incidence of bradycardia in patients undergoing spinal anesthesia with dexmedetomidine sedation. However, DBP and MBP showed significant increases in patients when prophylactic atropine was administrated. Therefore, atropine premedication should be administered cautiously. Copyright © 2016 Elsevier Inc. All rights reserved.

Prevalence of Clostridium Difficile Infection in Patients After Radical Cystectomy and Neoadjuvant Chemotherapy.

PubMed

Cotter, Katherine J; Fan, Yunhua; Sieger, Gretchen K; Weight, Christopher J; Konety, Badrinath R

2017-10-27

Clostridium Difficile is the most common cause of nosocomial infectious diarrhea. This study evaluates the prevalence and predictors of Clostridium Difficile infections in patients undergoing radical cystectomy with or without neoadjuvant chemotherapy. Retrospective chart review was performed of all patients undergoing cystectomy and urinary diversion at a single institution from 2011-2017. Infection was documented in all cases with testing for Clostridium Difficile polymerase chain reaction toxin B. Patient and disease related factors were compared for those who received neoadjuvant chemotherapy vs. those who did not in order to identify potential risk factors associated with C. Difficile infections. Chi squared test and logistic regression analysis were used to determine statistical significance. Of 350 patients who underwent cystectomy, 41 (11.7%) developed Clostridium Difficile in the 30 day post-operative period. The prevalence of C. Difficile infection was higher amongst the patients undergoing cystectomy compared to the non-cystectomy admissions at our hospital (11.7 vs. 2.9%). Incidence was not significantly different among those who underwent cystectomy for bladder cancer versus those who underwent the procedure for other reasons. Median time to diagnosis was 6 days (range 3-28 days). The prevalence of C. Diff infections was not significantly different among those who received neoadjuvant chemotherapy vs. those who did not (11% vs. 10.4% p  = 0.72). A significant association between C. Difficile infection was not seen with proton pump inhibitor use ( p  = 0.48), patient BMI ( p  = 0.67), chemotherapeutic regimen ( p  = 0.94), individual surgeon ( p  = 0.54), type of urinary diversion (0.41), or peri-operative antibiotic redosing ( p  = 0.26). Clostridium Difficile infection has a higher prevalence in patients undergoing cystectomy. No significant association between prevalence and exposure to neoadjuvant chemotherapy was seen.

Adiponectin and resistin in acute and chronic graft-vs-host disease patients undergoing allogeneic hematopoietic stem cell transplantation.

PubMed

Robak, Oliver; Kuzmina, Zoya; Winkler, Andreas; Kalhs, Peter; Rabitsch, Werner; Greinix, Hildegard

2016-06-30

To investigate the association of adiponectin and resistin levels in patients undergoing hematopoietic stem cell transplantation (HSCT) with the clinical outcome, including the occurrence of acute and chronic graft-vs-host disease (GVHD), non-relapse mortality, and overall survival. We prospectively collected serum samples from 40 patients undergoing either autologous (n=12; 10 male) or allogeneic (n=28; 11 male) HSCT for up to 12 months post HSCT and determined adiponectin and resistin serum concentrations using enzyme-linked immunosorbent assay. There were no significant differences in adiponectin levels (18.5 vs 9.3 μg/mL, P=0.071) and adiponectin/BMI ratio (0.82 vs 0.39, P=0.068) between patients with acute GVHD grades 2-4 and autologous controls. However, resistin values were significantly lower in patients with acute GVHD grades 2-4 than in autologous controls (4.6 vs 7.3 ng/mL, P=0.030). Adiponectin levels were higher in patients with chronic GVHD (n=17) than in autologous controls (13.5 vs 7.6 μg/mL, P=0.051), but the difference was not significant. Adiponectin/BMI ratio was significantly higher in patients with chronic GVHD than in autologous controls (0.59 vs 0.25, P=0.006). Patients dying from relapse also had significantly lower adiponectin levels (8.2 μg/mL) and adiponectin/BMI ratio (0.3) on admission than surviving allogeneic (15.8 µg/mL, P=0.030 and 0.7, P=0.004) and surviving autologous patients (19.2 μg/mL, P=0.031 and 0.7, P=0.021). Adiponectin and resistin levels were altered in patients with acute and chronic GVHD compared to autologous controls and were associated with overall survival and relapse mortality in patients undergoing allogeneic HSCT.

Adiponectin and resistin in acute and chronic graft-vs-host disease patients undergoing allogeneic hematopoietic stem cell transplantation

PubMed Central

Robak, Oliver; Kuzmina, Zoya; Winkler, Andreas; Kalhs, Peter; Rabitsch, Werner; Greinix, Hildegard

2016-01-01

Aim To investigate the association of adiponectin and resistin levels in patients undergoing hematopoietic stem cell transplantation (HSCT) with the clinical outcome, including the occurrence of acute and chronic graft-vs-host disease (GVHD), non-relapse mortality, and overall survival. Methods We prospectively collected serum samples from 40 patients undergoing either autologous (n = 12; 10 male) or allogeneic (n = 28; 11 male) HSCT for up to 12 months post HSCT and determined adiponectin and resistin serum concentrations using enzyme-linked immunosorbent assay. Results There were no significant differences in adiponectin levels (18.5 vs 9.3 µg/mL, P = 0.071) and adiponectin/BMI ratio (0.82 vs 0.39, P = 0.068) between patients with acute GVHD grades 2-4 and autologous controls. However, resistin values were significantly lower in patients with acute GVHD grades 2-4 than in autologous controls (4.6 vs 7.3 ng/mL, P = 0.030). Adiponectin levels were higher in patients with chronic GVHD (n = 17) than in autologous controls (13.5 vs 7.6 µg/mL, P = 0.051), but the difference was not significant. Adiponectin/BMI ratio was significantly higher in patients with chronic GVHD than in autologous controls (0.59 vs 0.25, P = 0.006). Patients dying from relapse also had significantly lower adiponectin levels (8.2 µg/mL) and adiponectin/BMI ratio (0.3) on admission than surviving allogeneic (15.8 µg/mL, P = 0.030 and 0.7, P = 0.004) and surviving autologous patients (19.2 µg/mL, P = 0.031 and 0.7, P = 0.021). Conclusion Adiponectin and resistin levels were altered in patients with acute and chronic GVHD compared to autologous controls and were associated with overall survival and relapse mortality in patients undergoing allogeneic HSCT. PMID:27374827

Multimodal airway evaluation in growing patients after rapid maxillary expansion.

PubMed

Fastuca, R; Meneghel, M; Zecca, P A; Mangano, F; Antonello, M; Nucera, R; Caprioglio, A

2015-06-01

The objective of this study was to evaluate the airway volume of growing patients combining a morphological approach using cone beam computed tomography associated with functional data obtained by polysomnography examination after rapid maxillary expansion treatment. 22 Caucasian patients (mean age 8.3±0.9 years) undergoing rapid maxillary expansion with Haas type expander banded on second deciduous upper molars were enrolled for this prospective study. Cone beam computed tomography scans and polysomnography exams were collected before placing the appliance (T0) and after 12 months (T1). Image processing with airway volume computing and analyses of oxygen saturation and apnoea/hypopnoea index were performed. Airway volume, oxygen saturation and apnea/hypopnea index underwent significant increase over time. However, no significant correlation was seen between their increases. The rapid maxillary expansion treatment induced significant increases in the total airway volume and respiratory performance. Functional respiratory parameters should be included in studies evaluating the RME treatment effects on the respiratory performance.

Hyper-activated motility in sperm capacitation is mediated by phospholipase D-dependent actin polymerization.

PubMed

Itach, Sarit Bar-Sheshet; Finklestein, Maya; Etkovitz, Nir; Breitbart, Haim

2012-02-15

In order to fertilize the oocyte, sperm must undergo a series of biochemical changes in the female reproductive tract, known as capacitation. Once capacitated, spermatozoon can bind to the zona pellucida of the egg and undergo the acrosome reaction (AR), a process that enables its penetration and fertilization of the oocyte. Important processes that characterize sperm capacitation are actin polymerization and the development of hyper-activated motility (HAM). Previously, we showed that Phospholipase D (PLD)-dependent actin polymerization occurs during sperm capacitation, however the role of this process in sperm capacitation is not yet known. In the present study, we showed for the first time the involvement of PLD-dependent actin polymerization in sperm motility during mouse and human capacitation. Sperm incubated under capacitation conditions revealed a time dependent increase in actin polymerization and HAM. Inhibition of Phosphatidic Acid (PA) formation by PLD using butan-1-ol, inhibited actin polymerization and motility, as well as in vitro fertilization (IVF) and the ability of the sperm to undergo the AR. The inhibition of sperm HAM by low concentration of butan-1-ol is completely restored by adding PA, further indicating the involvement of PLD in these processes. Furthermore, exogenous PA enhanced rapid actin polymerization that was followed by a rise in the HAM, as well as an increased in IVF rate. In conclusion, our results demonstrate that PLD-dependent actin polymerization is a critical step needed for the development of HAM during mouse and human sperm capacitation. Copyright © 2011 Elsevier Inc. All rights reserved.

Facilitation of blood donation amongst haemochromatosis patients.

PubMed

Marrow, B; Clarkson, J; Chapman, C E; Masson, S

2015-08-01

The standard medical therapy for haemochromatosis is iron removal by regular phlebotomy. Current guidelines suggest that this blood should be made available through national blood services. Here, we describe a pilot facilitating the process of blood donation amongst uncomplicated haemochromatosis patients. At a dedicated clinic, patients with uncomplicated haemochromatosis interested in becoming blood donors were offered an information leaflet and self-referral application. Upon receipt, members of the local Blood Service contacted them to confirm eligibility to donate. Data on demographics and clinical characteristics, including HFE (high Fe) genotype, co-morbidities, alcohol consumption and body mass index, were collected. Since establishing the clinic, 140 patients have attended (93 male) with median age 57. Most (n = 125; 89%) had uncomplicated haemochromatosis. Of these, 55 were potentially eligible blood donors. Amongst those eligible, there are now 29 regular blood donors, including 23 new. There is an interest and willingness to donate blood through the Blood Service amongst uncomplicated haemochromatosis patients undergoing therapeutic phlebotomy. Since the introduction of this facilitation process, we have significantly increased the number of regular donors amongst this cohort. If this process was to be replicated more widely across the UK, this could have a significant impact on the blood donor pool. © 2015 British Blood Transfusion Society.

Red cell surface changes in cold agglutination

PubMed Central

Salsbury, A. J.; Clarke, J. A.; Shand, W. S.

1968-01-01

Surface changes in red blood cells undergoing cold agglutination have been investigated using the Cambridge Stereoscan electron microscope. On incubation of red cells with a cold agglutinin of anti-I specificity at 4°C, circular shadows on the red cell membrane developed within 2 min. At the same time the membrane showed a granularity and processes began to develop on the surface. These processes increased in length, the processes of contiguous cells became interlinked and agglutination was complete after incubation of 1 hr. On warming an agglutinated specimen, the process was reversed with separation of red cells and retraction of the finger-like processes to yield discrete red cells of normal appearance. The addition of heparin in vivo prevented agglutination but did not inhibit surface changes completely. Complement appeared to play no part in the production of cold agglutination due to these antibodies or in the reversal of agglutination by warming. The significance of the surface changes described in relation to previous information on the mechanism of agglutination, has been discussed. ImagesFig. 1Fig. 2Fig. 3Fig. 4Fig. 5Fig. 6Fig. 7Fig. 8Fig. 9Fig. 10Fig. 11 PMID:5655472

Synthesis and review: African environmental processes and water-cycle dynamics

NASA Astrophysics Data System (ADS)

Ichoku, Charles; Adegoke, Jimmy

2016-12-01

Africa’s vast landmass harbors a variety of physical processes that affect the environment and the water cycle. This focus issue on ‘African Environmental Processes and Water-Cycle Dynamics’ contains eight articles that address these phenomena from different but complementary perspectives. Fires used for agricultural and related purposes play a major role in land-cover change, surface albedo modifications, and smoke emission; all of which affect the environment and the water cycle in different ways. However, emissions of aerosols and trace gases are not restricted to fires, but also emanate from other natural and human activities. The African water cycle undergoes significant perturbations that are attributable to several factors, including the aforesaid environmental processes. These changes in the water cycle have produced severe drought and flooding events in recent decades that affect societal wellbeing across sub-Saharan Africa. The combined effects of the environmental processes and water-cycle dynamics affect and are affected by climate variability and can be propagated beyond the continent. Future studies should utilize the wealth of observations and modeling tools that are constantly improving to clearly elucidate the interrelationships between all of these phenomena for the benefit of society.

Electroplating of aluminium microparticles with nickel to synthesise reactive core-shell structures for thermal joining applications

NASA Astrophysics Data System (ADS)

Schreiber, S.; Zaeh, M. F.

2018-06-01

Reactive particles represent a promising alternative for effectively joining components with freeform surfaces and different material properties. While the primary application of reactive systems is combustion synthesis for the production of high-performance alloys, the highly exothermic reaction can also be used to firmly bond thermosensitive joining partners. Core-shell structures are of special interest, since they function as separate microreactors. In this paper, a method to synthesise reactive nickel-aluminium core-shell structures via a two-step plating process is described. Based on an electroless process, the natural oxide layer of the aluminium particles is removed and substituted with a thin layer of nickel. Subsequently, the pre-treated particles are electroplated with nickel. The high reactivity of aluminium and the oxide layer play a significant role in adjusting the process parameters of the Watts bath. Additionally, the developed experimental set-up is introduced and the importance of process control is shown. In order to achieve reproducible results, the electroplating process was automated. Ignition tests with electromagnetic waves demonstrated that the particles undergo an exothermic reaction. Therefore, they can be used as a heat source in thermal joining applications.

Synthesis and review: African environmental processes and water-cycle dynamics.

PubMed

Ichoku, Charles; Adegoke, Jimmy

2016-12-01

Africa's vast landmass harbors a variety of physical processes that affect the environment and the water cycle. This focus issue on 'African Environmental Processes and Water-Cycle Dynamics' contains eight articles that address these phenomena from different but complementary perspectives. Fires used for agricultural and related purposes play a major role in land-cover change, surface albedo modifications, and smoke emission; all of which affect the environment and the water cycle in different ways. However, emissions of aerosols and trace gases are not restricted to fires, but also emanate from other natural and human activities. The African water cycle undergoes significant perturbations that are attributable to several factors, including the aforesaid environmental processes. These changes in the water cycle have produced severe drought and flooding events in recent decades that affect societal wellbeing across sub-Saharan Africa. The combined effects of the environmental processes and water-cycle dynamics affect and are affected by climate variability and can be propagated beyond the continent. Future studies should utilize the wealth of observations and modeling tools that are constantly improving to clearly elucidate the interrelationships between all of these phenomena for the benefit of society.

Synthesis and review: African environmental processes and water-cycle dynamics

PubMed Central

Ichoku, Charles; Adegoke, Jimmy

2018-01-01

Africa’s vast landmass harbors a variety of physical processes that affect the environment and the water cycle. This focus issue on ‘African Environmental Processes and Water-Cycle Dynamics’ contains eight articles that address these phenomena from different but complementary perspectives. Fires used for agricultural and related purposes play a major role in land-cover change, surface albedo modifications, and smoke emission; all of which affect the environment and the water cycle in different ways. However, emissions of aerosols and trace gases are not restricted to fires, but also emanate from other natural and human activities. The African water cycle undergoes significant perturbations that are attributable to several factors, including the aforesaid environmental processes. These changes in the water cycle have produced severe drought and flooding events in recent decades that affect societal wellbeing across sub-Saharan Africa. The combined effects of the environmental processes and water-cycle dynamics affect and are affected by climate variability and can be propagated beyond the continent. Future studies should utilize the wealth of observations and modeling tools that are constantly improving to clearly elucidate the interrelationships between all of these phenomena for the benefit of society. PMID:29682001

Pollen tube reuses intracellular components of nucellar cells undergoing programmed cell death in Pinus densiflora.

PubMed

Hiratsuka, Rie; Terasaka, Osamu

2011-04-01

Through the process known as programmed cell death (PCD), nucelli of Pinus densiflora serve as the transmitting tissue for growth of the pollen tube. We sought to clarify the processes of degradation of nucellar cell components and their transport to the pollen tube during PCD in response to pollen tube penetration of such nucelli. Stimulated by pollination, synthesis of large amounts of starch grains occurred in cells in a wide region of the nucellus, but as the pollen tube penetrated the nucellus, starch grains were degraded in amyloplasts of nucellar cells. In cells undergoing PCD, electron-dense vacuoles with high membrane contrast appeared, assumed a variety of autophagic structures, expanded, and ultimately collapsed and disappeared. Vesicles and electron-dense amorphous materials were released inside the thickened walls of cells undergoing PCD, and those vesicles and materials reaching the pollen tube after passing through the extracellular matrix were taken into the tube by endocytosis. These results show that in PCD of nucellar cells, intracellular materials are degraded in amyloplasts and vacuoles, and some of the degraded material is supplied to the pollen tube by vesicular transport to support tube growth.

Ultratrace Detection of Nitroaromatics: Picric Acid Responsive Aggregation/Disaggregation of Self-Assembled p-Terphenylbenzimidazolium-Based Molecular Baskets.

PubMed

Sandhu, Sana; Kumar, Rahul; Singh, Prabhpreet; Mahajan, Aman; Kaur, Manmeet; Kumar, Subodh

2015-05-20

1-(p-Terphenyl)-benzimidazolium (TRIPOD-TP) molecules undergo self-assembly to form rodlike structures in aqueous medium, as shown by field-emission scanning electron microscopy, transmission electron microscopy, and dynamic light scattering studies. Upon gradual addition of picric acid (PA), these aggregates undergo an aggregation/disaggregation process to complex morphological structures (10(-12)-10(-10) M PA) and spherical aggregates (10(-9)-10(-8) M PA). These spherical aggregates undergo further dissolution to well-dispersed spheres between 10(-7)-10(-6) M PA. During fluorescence studies, these aggregates demonstrate superamplified fluorescence quenching (>97%) in the presence of 10(-5) to 0.2 equiv of the probe concentration, an unprecedented process with PA. The lowest detection limits by solution of TRIPOD-TP are 5 × 10(-13) PA, 50 × 10(-12) M 2,4-dinitrophenol, 200 × 10(-12) M 2,4,6-trinitrotoluene, and 1 nM 1-chloro-2,4-dinitrobenzene. Paper strips dipped in the solution of TRIPOD-TP demonstrate quantitative fluorescence quenching between 10(-17) and 10(-6) M PA using front-surface steady state studies and can measure as low as 2.29 × 10(-20) g/cm(2) PA.

Information-processing under incremental levels of physical loads: comparing racquet to combat sports.

PubMed

Mouelhi Guizani, S; Tenenbaum, G; Bouzaouach, I; Ben Kheder, A; Feki, Y; Bouaziz, M

2006-06-01

Skillful performance in combat and racquet sports consists of proficient technique accompanied with efficient information-processing while engaged in moderate to high physical effort. This study examined information processing and decision-making using simple reaction time (SRT) and choice reaction time (CRT) paradigms in athletes of combat sports and racquet ball games while undergoing incrementally increasing physical effort ranging from low to high intensities. Forty national level experienced athletics in the sports of tennis, table tennis, fencing, and boxing were selected for this study. Each subject performed both simple (SRT) and four-choice reaction time (4-CRT) tasks at rest, and while pedaling on a cycle ergometer at 20%, 40%, 60%, and 80% of their own maximal aerobic power (Pmax). RM MANCOVA revealed significant sport-type by physical load interaction effect mainly on CRT. Least significant difference (LSD) posthoc contrasts indicated that fencers and tennis players process information faster with incrementally increasing workload, while different patterns were obtained for boxers and table-tennis players. The error rate remained stable for each sport type over all conditions. Between-sport differences in SRT and CRT among the athletes were also noted. Findings provide evidence that the 4-CRT is a task that more closely corresponds to the original task athletes are familiar with and utilize in their practices and competitions. However, additional tests that mimic the real world experiences of each sport must be developed and used to capture the nature of information processing and response-selection in specific sports.

Randomized controlled study of the safety and efficacy of nitrous oxide-sedated endoscopic ultrasound-guided fine needle aspiration for digestive tract diseases.

PubMed

Wang, Cai-Xia; Wang, Jian; Chen, Yuan-Yuan; Wang, Jia-Ni; Yu, Xin; Yang, Feng; Sun, Si-Yu

2016-12-14

To evaluate the efficacy and safety of nitrous oxide-sedated endoscopic ultrasound-guided fine needle aspiration. Enrolled patients were divided randomly into an experimental group (inhalation of nitrous oxide) and a control group (inhalation of pure oxygen) and heart rate, blood oxygen saturation, blood pressure, electrocardiogram (ECG) changes, and the occurrence of complications were monitored and recorded. All patients and physicians completed satisfaction questionnaires about the examination and scored the process using a visual analog scale. There was no significant difference in heart rate, blood oxygen saturation, blood pressure, ECG changes, or complication rate between the two groups of patients ( P > 0.05). However, patient and physician satisfaction were both significantly higher in the nitrous oxide compared with the control group ( P < 0.05). Nitrous oxide-sedation is a safe and effective option for patients undergoing endoscopic ultrasound-guided fine needle aspiration.

Global Warming on Triton

NASA Technical Reports Server (NTRS)

Elliot, J. L.; Hammel, H. B.; Wasserman, L. H.; Franz, O. G.; McDonald, S. W.; Person, M. J.; Olkin, C. B.; Dunham, E. J.; Spencer, J. R.; Stansberry, J. A.;

Supramolecular assembly/reassembly processes: molecular motors and dynamers operating at surfaces.

PubMed

Ciesielski, Artur; Samorì, Paolo

2011-04-01

Among the many significant advances within the field of supramolecular chemistry over the past decades, the development of the so-called "dynamers" features a direct relevance to materials science. Defined as "combinatorial dynamic polymers", dynamers are constitutional dynamic systems and materials resulting from the application of the principles of supramolecular chemistry to polymer science. Like supramolecular materials in general, dynamers are reversible dynamic multifunctional architectures, capable of modifying their constitution by exchanging, recombining, incorporating components. They may exhibit a variety of novel properties and behave as adaptive materials. In this review we focus on the design of responsive switchable monolayers, i.e. monolayers capable to undergo significant changes in their physical or chemical properties as a result of external stimuli. Scanning tunneling microscopy studies provide direct evidence with a sub-nanometre resolution, on the formation and dynamic response of these self-assembled systems featuring controlled geometries and properties.

KSC-04PD-0136

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. An engine pulls the container enclosing a segment of a solid rocket booster from the Rotation Processing and Surge Facility. The container will join others on the main track for a trip to Utah where the segments will undergo firing. The segments were part of the STS-114 stack. It is the first time actual flight segments that had been stacked for flight in the VAB are being returned for testing. They will undergo firing, which will enable inspectors to check the viability of the solid and verify the life expectancy for stacked segments.

Prospective Randomized Controlled Study on the Efficacy of Multimedia Informed Consent for Patients Scheduled to Undergo Green-Light High-Performance System Photoselective Vaporization of the Prostate

PubMed Central

Ham, Dong Yeub; Choi, Woo Suk; Song, Sang Hoon; Ahn, Young-Joon; Park, Hyoung Keun; Kim, Hyeong Gon

2016-01-01

Purpose The aim of this study was to evaluate the efficacy of a multimedia informed consent (IC) presentation on the understanding and satisfaction of patients who were scheduled to receive 120-W green-light high-performance system photoselective vaporization of the prostate (HPS-PVP). Materials and Methods A multimedia IC (M-IC) presentation for HPS-PVP was developed. Forty men with benign prostatic hyperplasia who were scheduled to undergo HPS-PVP were prospectively randomized to a conventional written IC group (W-IC group, n=20) or the M-IC group (n=20). The allocated IC was obtained by one certified urologist, followed by a 15-question test (maximum score, 15) to evaluate objective understanding, and questionnaires on subjective understanding (range, 0~10) and satisfaction (range, 0~10) using a visual analogue scale. Results Demographic characteristics, including age and the highest level of education, did not significantly differ between the two groups. No significant differences were found in scores reflecting the objective understanding of HPS-PVP (9.9±2.3 vs. 10.6±2.8, p=0.332) or in subjective understanding scores (7.5±2.1 vs. 8.6±1.7, p=0.122); however, the M-IC group showed higher satisfaction scores than the W-IC group (7.4±1.7 vs. 8.4±1.5, p=0.033). After adjusting for age and educational level, the M-IC group still had significantly higher satisfaction scores. Conclusions M-IC did not enhance the objective knowledge of patients regarding this surgical procedure. However, it improved the satisfaction of patients with the IC process itself. PMID:27169129

Effect of health education on severe thalassemia prevention and control in communities in Cambodia.

PubMed

Cheng, Kimhaung; Fucharoen, Supan; Sanchaisuriya, Kanokwan; Fucharoen, Goonnapa; Sanchaisuriya, Pattara; Jetsrisuparb, Arunee

2018-01-01

Severe thalassemia diseases are a major health problem in Southeast Asia. In Cambodia, there has never been a significant program for prevention or control of severe thalassemia. We, therefore, studied the effect of a health education program on severe thalassemia prevention and control in Phnom Penh, Cambodia. A quasi-experimental study in several communities around Phnom Penh was done. The respective intervention and control group comprised 124 and 117 people, between 18 and 40 years of age, male and female. Pre- and post-tests using a validated and reliable questionnaire were performed in the intervention group and one test was done in the control group. A health education program was organized to give important information to the intervention group and, at the end of the process, to the control group. The outcomes were evaluations of their knowledge and attitude vis-à-vis severe thalassemia prevention and control, and participating in thalassemia screening. Among participants in the intervention group, 105 (84.7%) considered undergoing blood screening vs. 65 (55.6%) in the control group ( p -value < 0.001). In the intervention group, the respective mean scores for knowledge and attitude to a prevention and control program for severe thalassemia before and after health education were 2.6 VS 6.5 ( p -value < 0.001) and 4.6 VS 6.5 ( p -value < 0.001). The intention to undergo screening was significantly higher in the intervention group than the control group. Knowledge and attitude towards prevention and control of severe thalassemia was significantly improved in the intervention group. Health education clearly heightens awareness and improves consideration of screening for prevention and control of severe thalassemia.

Examining the Effects of a Service-Trained Facility Dog on Stress in Children Undergoing Forensic Interview for Allegations of Child Sexual Abuse.

PubMed

Krause-Parello, Cheryl A; Thames, Michele; Ray, Colleen M; Kolassa, John

2018-04-01

Disclosure of child sexual abuse can be a stressful experience for the child. Gaining a better understanding of how best to serve the child, while preserving the quality of their disclosure, is an ever-evolving process. The data to answer this question come from 51 children aged 4-16 (M = 9.1, SD = 3.5), who were referred to a child advocacy center in Virginia for a forensic interview (FI) following allegations of sexual abuse. A repeated measures design was conducted to examine how the presence of a service-trained facility dog (e.g. animal-assisted intervention (AAI) may serve as a mode of lowering stress levels in children during their FIs. Children were randomized to one of the two FI conditions: experimental condition (service-trained facility dog present-AAI) or control condition (service-trained facility dog not present- standard forensic interview). Stress biomarkers salivary cortisol, alpha-amylase, immunoglobulin A (IgA), heart rate, and blood pressure, and Immunoglobulin A were collected before and after the FI. Self-report data were also collected. Results supported a significant decrease in heart rate for those in the experimental condition (p = .0086) vs the control condition (p = .4986). Regression models revealed a significant decrease in systolic and diastolic blood pressure in the experimental condition (p = .03285) and (p = .04381), respectively. Statistically significant changes in alpha-amylase and IgA were also found in relation to disclosure and type of offense. The results of this study support the stress reducing effects of a service-trained facility dog for children undergoing FI for allegations of child sexual abuse.

Preliminary findings on biomarker levels from extracerebral sources in patients undergoing trauma surgery: Potential implications for TBI outcome studies.

PubMed

Wolf, H; Krall, C; Pajenda, G; Hajdu, S; Widhalm, H; Leitgeb, J; Sarahrudi, K

2016-01-01

Despite several experimental studies on the role of S100B and NSE in fractures, no studies on the influence of surgery on the biomarker serum levels have been performed yet. The serum levels of S100B and NSE were analysed in patients with fractures that were located in the spine (group 1, n = 35) or in the lower extremity (group 2, n = 32) pre- and post-operatively. The mean S100B serum level showed a significant increase (p = 0.04) post-surgery in the patients of group 1. In patients undergoing acute surgery (< 24 hours) the mean S100B serum level was 0.23 ± 0.22 μg L(-1) pre-operatively and 1.24 ± 1.38 μg L(-1) post-operatively. Likewise, the mean S100B serum level significantly increased in group 2 after surgery (p < 0.0001). In this group patients undergoing acute surgery showed a mean S100B serum level of 0.23 ± 0.14 μg L(-1) and 1.11 ± 0.73 μg L(-1) pre- and post-operatively. This study demonstrates significant alterations of the biomarker S100B serum levels in patients undergoing surgery. Higher S100B serum levels were found within 24 hours and might be related to the acute fracture. The NSE serum levels were unchanged and this biomarker may offer the probability to serve as a future outcome predictor in studies with patients with traumatic brain injury and additional extracerebral injuries.

Effects of Peer-Facilitated, Video-Based and Combined Peer-and-Video Education on Anxiety Among Patients Undergoing Coronary Angiography: Randomised controlled trial.

PubMed

Habibzadeh, Hosein; Milan, Zahra D; Radfar, Moloud; Alilu, Leyla; Cund, Audrey

2018-02-01

Coronary angiography can be stressful for patients and anxiety-caused physiological responses during the procedure increase the risk of dysrhythmia, coronary artery spasms and rupture. This study therefore aimed to investigate the effects of peer, video and combined peer-and-video training on anxiety among patients undergoing coronary angiography. This single-blinded randomised controlled clinical trial was conducted at two large educational hospitals in Iran between April and July 2016. A total of 120 adult patients undergoing coronary angiography were recruited. Using a block randomisation method, participants were assigned to one of four groups, with those in the control group receiving no training and those in the three intervention groups receiving either peer-facilitated training, video-based training or a combination of both. A Persian-language validated version of the State-Trait Anxiety Inventory was used to measure pre- and post-intervention anxiety. There were no statistically significant differences in mean pre-intervention anxiety scores between the four groups (F = 0.31; P = 0.81). In contrast, there was a significant reduction in post-intervention anxiety among all three intervention groups compared to the control group (F = 27.71; P <0.01); however, there was no significant difference in anxiety level in terms of the type of intervention used. Peer, video and combined peer-and-video education were equally effective in reducing angiography-related patient anxiety. Such techniques are recommended to reduce anxiety amongst patients undergoing coronary angiography in hospitals in Iran.

Effect of virtual reality distraction on pain among patients with hand injury undergoing dressing change.

PubMed

Guo, Chunlan; Deng, Hongyan; Yang, Jian

2015-01-01

To assess the effect of virtual reality distraction on pain among patients with a hand injury undergoing a dressing change. Virtual reality distraction can effectively alleviate pain among patients undergoing a dressing change. Clinical research has not addressed pain control during a dressing change. A randomised controlled trial was performed. In the first dressing change sequence, 98 patients were randomly divided into an experimental group and a control group, with 49 cases in each group. Pain levels were compared between the two groups before and after the dressing change using a visual analog scale. The sense of involvement in virtual environments was measured using the Pearson correlation coefficient analysis, which determined the relationship between the sense of involvement and pain level. The difference in visual analog scale scores between the two groups before the dressing change was not statistically significant (t = 0·196, p > 0·05), but the scores became statistically significant after the dressing change (t = -30·792, p < 0·01). The correlation between the sense of involvement in a virtual environment and pain level during the dressing was statistically significant (R(2) = 0·5538, p < 0·05). Virtual reality distraction can effectively alleviate pain among patients with a hand injury undergoing a dressing change. Better results can be obtained by increasing the sense of involvement in a virtual environment. Virtual reality distraction can effectively relieve pain without side effects and is not reliant on a doctor's prescription. This tool is convenient for nurses to use, especially when analgesics are unavailable. © 2014 John Wiley & Sons Ltd.

The Effect of Music on Anxiety and Cardiovascular Indices in Patients Undergoing Coronary Artery Bypass Graft: A Randomized Controlled Trial

PubMed Central

Heidari, Saeide; Babaii, Atye; Abbasinia, Mohammad; Shamali, Mahdi; Abbasi, Mohammad; Rezaei, Mahboobe

2015-01-01

Background: The instability of cardiovascular indices and anxiety disorders are common among patients undergoing coronary artery bypass graft (CABG) and could interfere with their recovery. Therefore, improving the cardiovascular indices and anxiety is essential. Objectives: This study aimed to investigate the effect of music therapy on anxiety and cardiovascular indices in patients undergoing CABG. Patients and Methods: In this randomized controlled trial, 60 patients hospitalized in the cardiovascular surgical intensive care unit of Shahid Beheshti Hospital in Qom city, Iran, in 2013 were selected using a consecutive sampling method and randomly allocated into the experimental and control groups. In the experimental group, patients received 30 minutes of light music, whereas in the control group, patients had 30 minutes of rest in bed. The cardiovascular indices and anxiety were measured immediately before, immediately after and half an hour after the study. Data were analyzed using the chi-square test and repeated measures analysis of variance. Results: Compared to the immediately before intervention, the mean anxiety scores immediately after and 30 minutes after the intervention were significantly lower in the experimental group (P < 0.037) while it did not significantly change in the control group. However, there were no significant differences regarding the cardiovascular indices in the three consecutive measurements (P > 0.05). Conclusions: Music therapy is effective in decreasing anxiety among patients undergoing CABG. However, the intervention was not effective on cardiovascular indices. Music can effectively be used as a non-pharmacological method to manage anxiety after CABG. PMID:26835471

Barriers to surgical care in Nepal.

PubMed

van Loenhout, Joris Adriaan Frank; Delbiso, Tefera Darge; Gupta, Shailvi; Amatya, Kapendra; Kushner, Adam L; Gil Cuesta, Julita; Guha-Sapir, Debarati

2017-01-23

Various barriers exist that preclude individuals from undergoing surgical care in low-income countries. Our study assessed the main barriers in Nepal, and identified individuals most at risk for not receiving required surgical care. A countrywide survey, using the Surgeons OverSeas Assessment of Surgical Need (SOSAS) survey tool, was carried out in 2014, surveying 2,695 individuals with a response rate of 97%. Our study used data from a subset, namely individuals who required surgical care in the last twelve months. Data were collected on individual characteristics, transport characteristics, and reasons why individuals did not undergo surgical care. Of the 2,695 individuals surveyed, 207 individuals needed surgical care at least once in the previous 12 months. The main reasons for not undergoing surgery were affordability (n = 42), accessibility (n = 42) and fear/no trust (n = 34). A factor significantly associated with affordability was having a low education (OR = 5.77 of having no education vs. having secondary education). Living in a rural area (OR = 2.59) and a long travel time to a secondary and tertiary health facility (OR = 1.17 and 1.09, respectively) were some of the factors significantly associated with accessibility. Being a woman was significantly associated with fear/no trust (OR = 3.54). More than half of the individuals who needed surgical care did not undergo surgery due to affordability, accessibility, or fear/no trust. Providing subsidised transport, introducing mobile surgical clinics or organising awareness raising campaigns are measures that could be implemented to overcome these barriers to surgical care.

Computer tablet distraction reduces pain and anxiety in pediatric burn patients undergoing hydrotherapy: A randomized trial.

PubMed

Burns-Nader, Sherwood; Joe, Lindsay; Pinion, Kelly

2017-09-01

Distraction is often used in conjunction with analgesics to minimize pain in pediatric burn patients during treatment procedures. Computer tablets provide many options for distraction items in one tool and are often used during medical procedures. Few studies have examined the effectiveness of tablet distraction in improving the care of pediatric burn patients. This study examines the effectiveness of tablet distraction provided by a child life specialist to minimize pain and anxiety in pediatric burn patients undergoing hydrotherapy. Thirty pediatric patients (4-12) undergoing hydrotherapy for the treatment of burns participated in this randomized clinical trial. The tablet distraction group received tablet distraction provided by a child life specialist while those in the control group received standard care. Pain was assessed through self-reports and observation reports. Anxiety was assessed through behavioral observations. Length of procedure was also recorded. Nurses reported significantly less pain for the tablet distraction group compared to the control group. There was no significant difference between groups on self-reported pain. The tablet distraction group displayed significantly less anxiety during the procedure compared to the control group. Also, the tablet distraction group returned to baseline after the procedure while those in the control group displayed higher anxiety post-procedure. There was no difference in the length of the procedure between groups. These findings suggest tablet distraction provided by a child life specialist may be an effective method for improving pain and anxiety in children undergoing hydrotherapy treatment for burns. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Safety and efficacy of hysteroscopic sterilization compared with laparoscopic sterilization: an observational cohort study.

PubMed

Mao, Jialin; Pfeifer, Samantha; Schlegel, Peter; Sedrakyan, Art

2015-10-13

To compare the safety and efficacy of hysteroscopic sterilization with the "Essure" device with laparoscopic sterilization in a large, all-inclusive, state cohort. Population based cohort study. Outpatient interventional setting in New York State. Women undergoing interval sterilization procedure, including hysteroscopic sterilization with Essure device and laparoscopic surgery, between 2005 and 2013. Safety events within 30 days of procedures; unintended pregnancies and reoperations within one year of procedures. Mixed model accounting for hospital clustering was used to compare 30 day and 1 year outcomes, adjusting for patient characteristics and other confounders. Time to reoperation was evaluated using frailty model for time to event analysis. We identified 8048 patients undergoing hysteroscopic sterilization and 44,278 undergoing laparoscopic sterilization between 2005 and 2013 in New York State. There was a significant increase in the use of hysteroscopic procedures during this period, while use of laparoscopic sterilization decreased. Patients undergoing hysteroscopic sterilization were older than those undergoing laparoscopic sterilization and were more likely to have a history of pelvic inflammatory disease (10.3% v 7.2%, P<0.01), major abdominal surgery (9.4% v 7.9%, P<0.01), and cesarean section (23.2% v 15.4%, P<0.01). At one year after surgery, hysteroscopic sterilization was not associated with a higher risk of unintended pregnancy (odds ratio 0.84 (95% CI 0.63 to 1.12)) but was associated with a substantially increased risk of reoperation (odds ratio 10.16 (7.47 to 13.81)) compared with laparoscopic sterilization. Patients undergoing hysteroscopic sterilization have a similar risk of unintended pregnancy but a more than 10-fold higher risk of undergoing reoperation compared with patients undergoing laparoscopic sterilization. Benefits and risks of both procedures should be discussed with patients for informed decisions making. © Mao et al 2015.

[Changes in the distance between carina and orotracheal tube during open or videolaparoscopic bariatric surgery].

PubMed

de Figueiredo Locks, Giovani; Simões de Almeida, Maria Cristina; Sperotto Ceccon, Maurício; Campos Pastório, Karen Adriana

2015-01-01

To examine whether there are changes in the distance between the orotracheal tubeand carina induced by orthostatic retractor placement or by pneumoperitoneum insufflation in obese patients undergoing gastroplasty. 60 patients undergoing bariatric surgery by two techniques: open (G1) or videola-paroscopic (G2) gastroplasty were studied. After tracheal intubation, adequate ventilation of both hemitoraxes was confirmed by lung auscultation. The distance orotracheal tube-carina was estimated with the use of a fiber bronchoscope before and after installation of orthostatic retractors in G1 or before and after insufflation of pneumoperitoneum in patients in G2. G1 was composed of 22 and G2 of 38 patients. No cases of endobronchial intubationwere detected in either group. The mean orotracheal tube-carina distance variation was estimated in -0.03 cm (95% CI 0.06 to -0.13) in the group of patients undergoing open gastroplastyand in -0.42 cm (95% CI -0.56 to -1.4) in the group of patients undergoing videolaparoscopic gastroplasty. The extremes of variation in each group were: 0.5 cm to -1.6 cm in patients under-going open surgery and 0.1 cm to -2.2 cm in patients undergoing videolaparoscopic surgery. There was no significant change in orotracheal tube-CA distance after placementof orthostatic retractors in patients undergoing open gastroplasty. There was a reduction inorotracheal tube-CA distance after insufflation of pneumoperitoneum in patients undergoing videolaparoscopic gastroplasty. We recommend attention to lung auscultation and to signals of ventilation monitoring and reevaluation of orotracheal tube placement after peritoneal insufflation. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

Changes in the distance between carina and orotracheal tube during open or videolaparoscopic bariatric surgery.

PubMed

de Figueiredo Locks, Giovani; Simões de Almeida, Maria Cristina; Sperotto Ceccon, Maurício; Campos Pastório, Karen Adriana

2015-01-01

To examine whether there are changes in the distance between the orotracheal tube and carina induced by orthostatic retractor placement or by pneumoperitoneum insufflation in obese patients undergoing gastroplasty. 60 patients undergoing bariatric surgery by two techniques: open (G1) or videolaparoscopic (G2) gastroplasty were studied. After tracheal intubation, adequate ventilation of both hemitoraxes was confirmed by lung auscultation. The distance orotracheal tube-carina was estimated with the use of a fiber bronchoscope before and after installation of orthostatic retractors in G1 or before and after insufflation of pneumoperitoneum in patients in G2. G1 was composed of 22 and G2 of 38 patients. No cases of endobronchial intubation were detected in either group. The mean orotracheal tube-carina distance variation was estimated in -0.03cm (95% CI 0.06 to -0.13) in the group of patients undergoing open gastroplasty and in -0.42cm (95% CI -0.56 to -1.4) in the group of patients undergoing videolaparoscopic gastroplasty. The extremes of variation in each group were: 0.5cm to -1.6cm in patients undergoing open surgery and 0.1cm to -2.2cm in patients undergoing videolaparoscopic surgery. There was no significant change in orotracheal tube-CA distance after placement of orthostatic retractors in patients undergoing open gastroplasty. There was a reduction in orotracheal tube-CA distance after insufflation of pneumoperitoneum in patients undergoing videolaparoscopic gastroplasty. We recommend attention to lung auscultation and to signals of ventilation monitoring and reevaluation of orotracheal tube placement after peritoneal insufflation. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

Effects of recombinant human activated protein C on the fibrinolytic system of patients undergoing conventional or tight glycemic control.

PubMed

Polli, F; Savioli, M; Cugno, M; Taccone, P; Bellani, G; Spanu, P; Pesenti, A; Iapichino, G; Gattinoni, L

2009-01-01

Recombinant human activated protein C (rh-APC) and tight glycemic control (TGC) have been shown to reduce mortality in septic patients. Both interventions can reduce the plasma concentration and/or activity of the most powerful suppressor of fibrinolysis, plasminogen activator inhibitor-1 (PAI-1). Our aim was to evaluate the effects on the fibrinolytic system after the administration of rh-APC in septic patients undergoing conventional or TGC. Posthoc analysis of data was collected from 90 patients with severe sepsis/septic shock, randomized to either conventional or TGC groups. Independent of these treatments, patients with at least two organ dysfunctions simultaneously received rh-APC. Plasma levels of multiple biochemical markers for fibrinolysis, coagulation, and inflammation were determined every day for the 1st week and then on study days 9, 11, 13, 18, 23, and 28. Clinical data and sepsis-related organ failure assessment (SOFA) scores were also recorded. Patients who had received rh-APC exhibited significantly more impairments in fibrinolysis at baseline (PAI-1 activity 49.76 [24.61-71.82] vs 21.92 [6.47-55-83] IU/mL, P=0.03). The reductions in plasma PAI-1 activity over time associated with rh-APC treatment were different according to whether the treatment was administered to patients undergoing conventional or TGC (P=0.01). However, the most prominent reductions were in patients undergoing conventional glycemic control. Significant interactions between the two study interventions were also found for PAI-1 concentration (P<0.001), C-reactive protein (P=0.02), and interleukin-6 levels (P<0.001). Both rh-APC and TGC appear to improve fibrinolysis in septic patients. The reduction in the impairment of fibrinolysis associated with rh-APC treatment seems greater in patients undergoing conventional glycemic control than in those undergoing TGC.

Behavior of class-level landscape metrics across gradients of class aggregation and area

Treesearch

Maile C. Neel; Kevin McGarigal; Samuel A. Cushman

2004-01-01

Habitat loss and fragmentation processes strongly affect biodiversity conservation in landscapes undergoing anthropogenic land use changes. Many attempts have been made to use landscape structure metrics to quantify the independent and joint effects of these processes. Unfortunately, ecological interpretation of those metrics has been plagued by lack of thorough...

Adapting the Transtheoretical Model of Change to the Bereavement Process

ERIC Educational Resources Information Center

Calderwood, Kimberly A.

2011-01-01

Theorists currently believe that bereaved people undergo some transformation of self rather than returning to their original state. To advance our understanding of this process, this article presents an adaptation of Prochaska and DiClemente's transtheoretical model of change as it could be applied to the journey that bereaved individuals…

How Evaluation Processes Affect the Professional Development of Five Teachers in Higher Education

ERIC Educational Resources Information Center

Shagrir, Leah

2012-01-01

This paper presents research that investigates the nature of the connection between the professional development of five teachers in higher education and the evaluation processes they have to undergo. Since teaching, scholarship, and service are the three components that evaluation measures, this research examines how the teachers' professional…

The Prehistory of Discovery: Precursors of Representational Change in Solving Gear System Problems.

ERIC Educational Resources Information Center

Dixon, James A.; Bangert, Ashley S.

2002-01-01

This study investigated whether the process of representational change undergoes developmental change or different processes occupy different niches in the course of knowledge acquisition. Subjects--college, third-, and sixth-grade students--solved gear system problems over two sessions. Findings indicated that for all grades, discovery of the…

The Reform Process of Portuguese Higher Education Institutions: From Collegial to Managerial Governance

ERIC Educational Resources Information Center

Bruckmann, Sofia; Carvalho, Teresa

2014-01-01

Portuguese public higher education institutions have been undergoing a major reform process since 2007. The most noticeable changes were introduced by Law 62/2007, which gave higher education institutions the option to choose between two different institutional models (foundational and public institute), and allowed the implementation of new…

Continuous Self-Selection Processes in Teacher Education: The Way for Survival.

ERIC Educational Resources Information Center

Zak, Itai

1981-01-01

Three selection phases were found in a study investigating the selection process of students into the teaching profession: (1) self selection by the potential teacher; (2) admission to the teacher-training program; and (3) election to undergo the course of instruction. Results suggest that personality traits are more important than cognitive…

Efficacy of dry-ice blasting in preventive maintenance of auto robotic assemblies

NASA Astrophysics Data System (ADS)

Baluch, Nazim; Mohtar, Shahimi; Abdullah, Che Sobry

2016-08-01

Welding robots are extensively applied in the automotive assemblies and `Spot Welding' is the most common welding application found in the auto stamping assembly manufacturing. Every manufacturing process is subject to variations - with resistance welding, these include; part fit up, part thickness variations, misaligned electrodes, variations in coating materials or thickness, sealers, weld force variations, shunting, machine tooling degradation; and slag and spatter damage. All welding gun tips undergo wear; an elemental part of the process. Though adaptive resistance welding control automatically compensates to keep production and quality up to the levels needed as gun tips undergo wear so that the welds remain reliable; the system cannot compensate for deterioration caused by the slag and spatter on the part holding fixtures, sensors, and gun tips. To cleanse welding robots of slag and spatter, dry-ice blasting has proven to be an effective remedy. This paper describes Spot welding process, analyses the slag and spatter formation during robotic welding of stamping assemblies, and concludes that the dry ice blasting process's utility in cleansing of welding robots in auto stamping plant operations is paramount and exigent.

Review of Relationship Between Particle Deformation, Coating Microstructure, and Properties in High-Pressure Cold Spray

NASA Astrophysics Data System (ADS)

Rokni, M. R.; Nutt, S. R.; Widener, C. A.; Champagne, V. K.; Hrabe, R. H.

2017-08-01

In the cold spray (CS) process, deposits are produced by depositing powder particles at high velocity onto a substrate. Powders deposited by CS do not undergo melting before or upon impacting the substrate. This feature makes CS suitable for deposition of a wide variety of materials, most commonly metallic alloys, but also ceramics and composites. During processing, the particles undergo severe plastic deformation and create a more mechanical and less metallurgical bond with the underlying material. The deformation behavior of an individual particle depends on multiple material and process parameters that are classified into three major groups—powder characteristics, geometric parameters, and processing parameters, each with their own subcategories. Changing any of these parameters leads to evolution of a different microstructure and consequently changes the mechanical properties in the deposit. While cold spray technology has matured during the last decade, the process is inherently complex, and thus, the effects of deposition parameters on particle deformation, deposit microstructure, and mechanical properties remain unclear. The purpose of this paper is to review the parameters that have been investigated up to now with an emphasis on the existent relationships between particle deformation behavior, microstructure, and mechanical properties of various cold spray deposits.

29 CFR 780.519 - General scope of exempt operations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... the tobacco, improves its color, increases its combustibility, and eliminates the rawness and... each to undergo a “sweating” or “fermentation” process in which temperature and humidity are carefully...

29 CFR 780.519 - General scope of exempt operations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... the tobacco, improves its color, increases its combustibility, and eliminates the rawness and... each to undergo a “sweating” or “fermentation” process in which temperature and humidity are carefully...

29 CFR 780.519 - General scope of exempt operations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... the tobacco, improves its color, increases its combustibility, and eliminates the rawness and... each to undergo a “sweating” or “fermentation” process in which temperature and humidity are carefully...

29 CFR 780.519 - General scope of exempt operations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... the tobacco, improves its color, increases its combustibility, and eliminates the rawness and... each to undergo a “sweating” or “fermentation” process in which temperature and humidity are carefully...

75 FR 35817 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-23

... accountability. Furthermore, there was not standardization of required evaluation data from both health departments and CBOs. Changes to the evaluation and reporting process were necessary to ensure CDC receives...

Rheological changes of polyamide 12 under oscillatory shear

NASA Astrophysics Data System (ADS)

Mielicki, C.; Gronhoff, B.; Wortberg, J.

2014-05-01

Changes in material properties as well as process deviation prevent Laser Sintering (LS) technology from manufacturing of quality assured parts in a series production. In this context, the viscosity of Polyamide 12 (PA12) is assumed to possess the most significant influence, as it determines the sintering velocity, the resistance towards melt formation and the bonding strength of sintered layers. Moreover, the viscosity is directly related to the structure of the molten polymer. In particular, it has been recently reported that LS process conditions lead to structural changes of PA12 affecting viscosity and coalescence of adjacent polymer particles, i.e. melt formation significantly. Structural change of PA12 was understood as a post condensation. Its influence on viscosity was described by a time and temperature depending rheological model whereas time dependence was considered by a novel structural change shift factor which was derived from melt volume rate data. In combination with process data that was recorded using online thermal imaging, the model is suitable to control the viscosity (processability of the material) as result of material and process properties. However, as soon as laser energy is exposed to the powder bed PA12 undergoes a phase transition from solid to molten state. Above the melting point, structural change is expected to occur faster due to a higher kinetic energy and free volume of the molten polymer. Oscillatory shear results were used to study the influence of aging time and for validation of the novel structural change shift factor and its model parameters which were calibrated based on LS processing condition.

Obstetric outcomes in women with polycystic ovary syndrome and isolated polycystic ovaries undergoing in vitro fertilization: a retrospective cohort analysis.

PubMed

Wan, Hei Lok Tiffany; Hui, Pui Wah; Li, Hang Wun Raymond; Ng, Ernest Hung Yu

2015-03-01

This retrospective cohort study evaluated the obstetric outcomes in women with polycystic ovary syndrome (PCOS) and isolated polycystic ovaries (PCO) undergoing in vitro fertilization (IVF) treatment. We studied 104 women with PCOS, 184 with PCO and 576 age-matched controls undergoing the first IVF treatment cycle between 2002 and 2009. Obstetric outcomes and complications including gestational diabetes (GDM), gestational hypertension (GHT), gestational proteinuric hypertension (PET), intrauterine growth restriction (IUGR), gestation at delivery, baby's Apgar scores and admission to the neonatal intensive care unit (NICU) were reviewed. Among the 864 patients undergoing IVF treatment, there were 253 live births in total (25 live births in the PCOS group, 54 in the PCO group and 174 in the control group). The prevalence of obstetric complications (GDM, GHT, PET and IUGR) and the obstetric outcomes (gestation at delivery, birth weight, Apgar scores and NICU admissions) were comparable among the three groups. Adjustments for age and multiple pregnancies were made using multiple logistic regression and we found no statistically significant difference among the three groups. Patients with PCO ± PCOS do not have more adverse obstetric outcomes when compared with non-PCO patients undergoing IVF treatment.

Surgical RF ablation of atrial fibrillation in patients undergoing mitral valve repair for Barlow disease.

PubMed

Rostagno, Carlo; Droandi, G; Gelsomino, S; Carone, E; Gensini, G F; Stefàno, P L

2013-01-01

At present, limited experience exists on the treatment of atrial fibrillation (AF) in patients undergoing mitral valve repair (MVR) for Barlow disease. The aim of this investigation was to prospectively evaluate the radiofrequency ablation of AF in patients undergoing MVR for severe regurgitation due to Barlow disease. From January 1, 2007 to December 31, 2010, out of 85 consecutive patients with Barlow disease, 27 with AF underwent RF ablation associated with MVR. They were examined every 4 months in the first year after surgery and thereafter twice yearly. At follow-up, AF was observed in 4/25 (16.0%). NYHA (New York Heart Association) functional class improved significantly, with no patients in class III or IV (before surgery, 81.5% had been). Otherwise, among 58 patients in sinus rhythm, 6 (11%) developed AF during follow-up. No clinical or echocardiographic predictive factor was found in this subgroup. Results from our investigation suggest that radiofrequency ablation of AF in patients with Barlow disease undergoing MVR for severe regurgitation is effective and should be considered in every patient with Barlow disease and AF undergoing valve surgical repair. Copyright © 2013 S. Karger AG, Basel.

Long-Term Effects of Spironolactone in Peritoneal Dialysis Patients

PubMed Central

Mizuno, Masashi; Suzuki, Yasuhiro; Tamai, Hirofumi; Hiramatsu, Takeyuki; Ohashi, Hiroshige; Ito, Isao; Kasuga, Hirotake; Horie, Masanobu; Maruyama, Shoichi; Yuzawa, Yukio; Matsubara, Tatsuaki; Matsuo, Seiichi

2014-01-01

ESRD treated with dialysis is associated with increased left ventricular hypertrophy, which, in turn, is related to high mortality. Mineralocorticoid receptor antagonists improve survival in patients with chronic heart failure; however, the effects in patients undergoing dialysis remain uncertain. We conducted a multicenter, open-label, prospective, randomized trial with 158 patients receiving angiotensin-converting enzyme inhibitor or angiotensin type 1 receptor antagonist and undergoing peritoneal dialysis with and without (control group) spironolactone for 2 years. As a primary endpoint, rate of change in left ventricular mass index assessed by echocardiography improved significantly at 6 (P=0.03), 18 (P=0.004), and 24 (P=0.01) months in patients taking spironolactone compared with the control group. Rate of change in left ventricular ejection fraction improved significantly at 24 weeks with spironolactone compared with nontreatment (P=0.02). The benefits of spironolactone were clear in patients with reduced residual renal function. As secondary endpoints, renal Kt/V and dialysate-to-plasma creatinine ratio did not differ significantly between groups during the observation period. No serious adverse effects, such as hyperkalemia, occurred. In this trial, spironolactone prevented cardiac hypertrophy and decreases in left ventricular ejection fraction in patients undergoing peritoneal dialysis, without significant adverse effects. Further studies, including those to determine relative effectiveness in women and men and to evaluate additional secondary endpoints, should confirm these data in a larger cohort. PMID:24335969

Perioperative psychological and music interventions in elderly patients undergoing spinal anesthesia: effect on anxiety, heart rate variability, and postoperative pain.

PubMed

Wang, Yisha; Dong, Youjing; Li, Yang

2014-07-01

The aim of this study was to evaluate the effects of perioperative psychological and music interventions in elderly patients undergoing elective surgery on anxiety, post-operative pain, and changes in heart rate variability (HRV) to ascertain if perioperative psychological and music interventions can affect overall anxiety levels. Fourty elderly patients undergoing elective surgery were randomized to two groups; one group received psychological and music intervention, and the other was the control. The intervention group underwent psychological intervention and listening to music for 30 min before surgery. The mean change in HRV as determined by low frequency (LF) power measurements. After the intervention, the ratio of mean LF to high frequency (HF) power decreased significantly in the intervention group compared to before the intervention (p<0.05). In the control group, mean LF measurements and the ratio of LF:HF did not change significantly. In the intervention group, mean HF power was significantly higher after the procedure than before (p<0.01). Moreover, the mean self-rating anxiety score of the intervention group decreased after the procedure compared to before (p<0.05). The mean visual analogue score of the intervention group 6 hours after surgery was significantly lower than that of the control group (p<0.01). Perioperative psychological and music interventions can reduce anxiety and postoperative pain in elderly patients.

The Effect of Cognitive Behavior Therapy in Insomnia due to Methadone Maintenance Therapy: A Randomized Clinical Trial

PubMed Central

Soleimani, Robabeh; Modabbernia, Mohammad Jafar; Habibi, Sharareh; Roudsary, Maryam Habibi; Elahi, Masoumeh

2015-01-01

Background: Sleep disturbance is a common complaint of patients undergoing methadone maintenance therapy (MMT). There are limited studies about the effect of different treatments on insomnia due to MMT. In this study, we evaluated the effect of cognitive-behavioral treatment for insomnia (CBTI) on sleep disorders in patients undergoing MMT. Methods: Twenty-two patients with insomnia due to MMT (aged 18-60 years) participated in this randomized double-blind clinical trial. The intervention group received CBTI from a clinical psychologist for 8 weeks, whereas the control group received behavioral placebo therapy (BPT). The duration of individual sessions was 45 minutes, which was conducted once a week. The primary outcome was sleep disturbance assessed with Pittsburgh Sleep Quality Index (PSQI). Data were analyzed using SPSS software version 19. Results: Eleven patients were assigned to each group. Two groups were matched according to demographic characteristics (age, marital status, education, and daily methadone doses). Although PSQI score was significantly reduced during weeks 5 and 8 after both interventions, there was a significant difference in intervention versus time interaction (P<0.02). The effects of CBTI versus placebo were significantly different (P<0.001). The time course was also significant (P<0.001). Conclusion: This study showed that CBTI is more effective than BPT in overall sleep quality. We recommend further studies, with a larger sample, on CBTI in patients undergoing MMT. PMID:26379345

Postoperative Outcomes in Obstructive Sleep Apnea Patients Undergoing Cardiac Surgery: A Systematic Review and Meta-analysis of Comparative Studies.

PubMed

Nagappa, Mahesh; Ho, George; Patra, Jayadeep; Wong, Jean; Singh, Mandeep; Kaw, Roop; Cheng, Davy; Chung, Frances

2017-12-01

Obstructive sleep apnea (OSA) is a common comorbidity in patients undergoing cardiac surgery and may predispose patients to postoperative complications. The purpose of this meta-analysis is to determine the evidence of postoperative complications associated with OSA patients undergoing cardiac surgery. A literature search of Cochrane Database of Systematic Reviews, Medline, Medline In-process, Web of Science, Scopus, EMBASE, Cochrane Central Register of Controlled Trials, and CINAHL until October 2016 was performed. The search was constrained to studies in adult cardiac surgical patients with diagnosed or suspected OSA. All included studies must report at least 1 postoperative complication. The primary outcome is major adverse cardiac or cerebrovascular events (MACCEs) up to 30 days after surgery, which includes death from all-cause mortality, myocardial infarction, myocardial injury, nonfatal cardiac arrest, revascularization process, pulmonary embolism, deep venous thrombosis, newly documented postoperative atrial fibrillation (POAF), stroke, and congestive heart failure. Secondary outcome is newly documented POAF. The other exploratory outcomes include the following: (1) postoperative tracheal intubation and mechanical ventilation; (2) infection and/or sepsis; (3) unplanned intensive care unit (ICU) admission; and (4) duration of stay in hospital and ICU. Meta-analysis and meta- regression were conducted using Cochrane Review Manager 5.3 (Cochrane, London, UK) and OpenBUGS v3.0, respectively. Eleven comparative studies were included (n = 1801 patients; OSA versus non-OSA: 688 vs 1113, respectively). MACCEs were 33.3% higher odds in OSA versus non-OSA patients (OSA versus non-OSA: 31% vs 10.6%; odds ratio [OR], 2.4; 95% confidence interval [CI], 1.38-4.2; P = .002). The odds of newly documented POAF (OSA versus non-OSA: 31% vs 21%; OR, 1.94; 95% CI, 1.13-3.33; P = .02) was higher in OSA compared to non-OSA. Even though the postoperative tracheal intubation and mechanical ventilation (OSA versus non-OSA: 13% vs 5.4%; OR, 2.67; 95% CI, 1.03-6.89; P = .04) were significantly higher in OSA patients, the length of ICU stay and hospital stay were not significantly prolonged in patients with OSA compared to non-OSA. The majority of OSA patients were not treated with continuous positive airway pressure therapy. Meta-regression and sensitivity analysis of the subgroups did not impact the OR of postoperative complications for OSA versus non-OSA groups. Our meta-analysis demonstrates that after cardiac surgery, MACCEs and newly documented POAF were 33.3% and 18.1% higher odds in OSA versus non-OSA patients, respectively.

The Partnership and Coping Enhancement Programme for couples undergoing in vitro fertilization treatment: the development of a complex intervention in China.

PubMed

Ying, Liying; Chen, Xiaomin; Wu, Lai Har; Shu, Jing; Wu, Xiangli; Loke, Alice Yuen

2017-01-01

Couples as dyads suffer from the diagnosis of infertility and related treatment. These couples commonly experience emotional and physical pain and tension in their marital lives. The purpose of this study is to report on the process of developing a potentially feasible and effective complex intervention for couples undergoing in vitro fertilization treatment in China. The Medical Research Council (MRC) framework for developing and evaluating the complex intervention was adopted to guide the development of the Partnership and Coping Enhancement Programme (PCEP). In developing the PCEP, three steps were taken, namely, (1) identifying evidence by conducting literature reviews, a concept analysis and a qualitative study; (2) identifying/developing a theory-in this case, a preliminary Endurance with Partnership Conceptual Framework (P-EPCF) was proposed; and (3) modelling the process and outcomes of the PCEP. The PCEP that was developed is targeted mainly at the domains of the partnership mediators of stress in the P-EPCF. It consists of two sections-partnership and coping-and will be delivered to infertile couples on the day of embryo transfer. The main focuses of the programme are to facilitate mutual sharing and support in infertile couples, and to improve their individual and dyadic coping strategies while undergoing IVF treatment, especially in the period when they are waiting for the results of a pregnancy test and after the disclosure of a negative treatment outcome. The programme is couple-based, consisting of experience sharing, psychoeducation, meditation exercise, skill practise and supplemental written materials. The Partnership and Coping Enhancement Programme (PCEP) for couples undergoing in vitro fertilization treatment was developed according to the guideline of the MRC framework. It is recommended that a pilot study be conducted to evaluate its feasibility and to model the process and outcomes of the programme.

The effect of royal jelly on oral mucositis in patients undergoing radiotherapy and chemotherapy.

PubMed

Erdem, Ozden; Güngörmüş, Zeynep

2014-01-01

This study was conducted to evaluate the effect of royal jelly on oral mucositis in patients undergoing radiotherapy and chemotherapy. The study population consisted of 103 patients undergoing radiotherapy and chemotherapy. Oral mucositis was graded according to the World Health Organization criteria, and patients were divided into 2 groups. All patients received mouthwash therapy with benzydamine hydrochloride and nystatin rinses. In addition, patients in the experimental group received royal jelly. The mean resolution time of oral mucositis in the royal jelly group was significantly shorter than that of the control group. As a result, the study results demonstrate that royal jelly administrated by a certain procedure improved the signs and symptoms of oral mucositis and markedly shortened its healing time.

Material-dependent and material-independent selection processes in the frontal and parietal lobes: an event-related fMRI investigation of response competition

NASA Technical Reports Server (NTRS)

Hazeltine, Eliot; Bunge, Silvia A.; Scanlon, Michael D.; Gabrieli, John D E.

2003-01-01

The present study used the flanker task [Percept. Psychophys. 16 (1974) 143] to identify neural structures that support response selection processes, and to determine which of these structures respond differently depending on the type of stimulus material associated with the response. Participants performed two versions of the flanker task while undergoing event-related functional magnetic resonance imaging (fMRI). Both versions of the task required participants to respond to a central stimulus regardless of the responses associated with simultaneously presented flanking stimuli, but one used colored circle stimuli and the other used letter stimuli. Competition-related activation was identified by comparing Incongruent trials, in which the flanker stimuli indicated a different response than the central stimulus, to Neutral stimuli, in which the flanker stimuli indicated no response. A region within the right inferior frontal gyrus exhibited significantly more competition-related activation for the color stimuli, whereas regions within the middle frontal gyri of both hemispheres exhibited more competition-related activation for the letter stimuli. The border of the right middle frontal and inferior frontal gyri and the anterior cingulate cortex (ACC) were significantly activated by competition for both types of stimulus materials. Posterior foci demonstrated a similar pattern: left inferior parietal cortex showed greater competition-related activation for the letters, whereas right parietal cortex was significantly activated by competition for both materials. These findings indicate that the resolution of response competition invokes both material-dependent and material-independent processes.

Topology optimization of hyperelastic structures using a level set method

NASA Astrophysics Data System (ADS)

Chen, Feifei; Wang, Yiqiang; Wang, Michael Yu; Zhang, Y. F.

2017-12-01

Soft rubberlike materials, due to their inherent compliance, are finding widespread implementation in a variety of applications ranging from assistive wearable technologies to soft material robots. Structural design of such soft and rubbery materials necessitates the consideration of large nonlinear deformations and hyperelastic material models to accurately predict their mechanical behaviour. In this paper, we present an effective level set-based topology optimization method for the design of hyperelastic structures that undergo large deformations. The method incorporates both geometric and material nonlinearities where the strain and stress measures are defined within the total Lagrange framework and the hyperelasticity is characterized by the widely-adopted Mooney-Rivlin material model. A shape sensitivity analysis is carried out, in the strict sense of the material derivative, where the high-order terms involving the displacement gradient are retained to ensure the descent direction. As the design velocity enters into the shape derivative in terms of its gradient and divergence terms, we develop a discrete velocity selection strategy. The whole optimization implementation undergoes a two-step process, where the linear optimization is first performed and its optimized solution serves as the initial design for the subsequent nonlinear optimization. It turns out that this operation could efficiently alleviate the numerical instability and facilitate the optimization process. To demonstrate the validity and effectiveness of the proposed method, three compliance minimization problems are studied and their optimized solutions present significant mechanical benefits of incorporating the nonlinearities, in terms of remarkable enhancement in not only the structural stiffness but also the critical buckling load.

The effect of repeated light-dark shifts on uterine receptivity and early gestation in mice undergoing embryo transfer.

PubMed

Goldstein, Cathy A; O'Brien, Louise M; Bergin, Ingrid L; Saunders, Thomas L

2018-04-01

Female shift workers are at increased risk for negative reproductive outcomes, and animal evidence suggests that manipulation of the light-dark cycle is detrimental to early gestation in female mice. Specifically, failure of implantation may be responsible for these findings. The objective of this study was to better delineate which reproductive processes are vulnerable to detrimental effects of maternal circadian disturbance. We exposed mice undergoing embryo transfer to repetitive phase advances of the photoperiod. Embryos were derived from donor sperm and eggs from mice living in normal light-dark conditions to isolate the effects of photoperiod disruption on uterine receptivity and early gestation. Twenty-eight mice receiving embryo transfer underwent an experimental light-dark condition (advance of lights on and lights off by 6 hours every 4 days). Twenty-eight mice remained in a normal light-dark condition. Animals lived in their assigned light-dark condition beginning 2 weeks prior to embryo transfer and ending the day of uterine necropsy (post-coitus day 14.5). Wilcoxon-Mann-Whitney test demonstrated no significant differences between control and experimental light-dark conditions in pups (Z=0.10, p=.92), resorptions (Z=0.20, p=.84), or implantations (Z=-0.34, p=.73). Pup and placental weights were similar between groups. In this investigation, uterine receptivity and maintenance of early gestation were preserved despite recurrent phase advances in photoperiod. This finding, in the context of the current literature, suggests that the negative effects of circadian disruption are mediated by reproductive processes upstream of implantation.

Surfing the wave, cycle, life history, and genes/proteins expressed by testicular germ cells. Part 2: changes in spermatid organelles associated with development of spermatozoa.

PubMed

Hermo, Louis; Pelletier, R-Marc; Cyr, Daniel G; Smith, Charles E

2010-04-01

Spermiogenesis is a long process whereby haploid spermatids derived from the meiotic divisions of spermatocytes undergo metamorphosis into spermatozoa. It is subdivided into distinct steps with 19 being identified in rats, 16 in mouse and 8 in humans. Spermiogenesis extends over 22.7 days in rats and 21.6 days in humans. In this part, we review several key events that take place during the development of spermatids from a structural and functional point of view. During early spermiogenesis, the Golgi apparatus forms the acrosome, a lysosome-like membrane bound organelle involved in fertilization. The endoplasmic reticulum undergoes several topographical and structural modifications including the formation of the radial body and annulate lamellae. The chromatoid body is fully developed and undergoes structural and functional modifications at this time. It is suspected to be involved in RNA storing and processing. The shape of the spermatid head undergoes extensive structural changes that are species-specific, and the nuclear chromatin becomes compacted to accommodate the stream-lined appearance of the sperm head. Microtubules become organized to form a curtain or manchette that associates with spermatids at specific steps of their development. It is involved in maintenance of the sperm head shape and trafficking of proteins in the spermatid cytoplasm. During spermiogenesis, many genes/proteins have been implicated in the diverse dynamic events occurring at this time of development of germ cells and the absence of some of these have been shown to result in subfertility or infertility. Copyright 2009 Wiley-Liss, Inc.

People's experiences of suffering a lower limb fracture and undergoing surgery.

PubMed

Forsberg, Angelica; Söderberg, Siv; Engström, Åsa

2014-01-01

To describe people's experiences of suffering a lower limb fracture and undergoing surgery, from the time of injury through to the care given at the hospital and recovery following discharge. There is a lack of research on people's experiences of suffering a lower limb fracture and undergoing surgery - from injury to recovery. A qualitative approach was used. Interviews with nine participants were subjected to thematic content analysis. One theme was expressed: from realising the seriousness of the injury to regaining autonomy. Participants described feelings of frustration and helplessness when realising the seriousness of their injury. The wait prior to surgery was a strain and painful experience, and participants needed orientation for the future. They expressed feelings of vulnerability about being in the hands of staff during surgery. After surgery, in the postanaesthesia unit, participants expressed a need to have control and to feel safe in their new situation. To mobilise and regain their autonomy was a struggle, and participants stated that their recovery was extended. Participants found themselves in a new and unexpected situation and experienced pain, vulnerability and a striving for control during the process, that is, 'from realising the seriousness of the injury to regaining autonomy'. How this is managed depends on how the patient's needs are met by nurses. The nursing care received while suffering a lower limb fracture and undergoing surgery should be situation specific as well as individual specific. The safe performance of technical interventions and the nurse's comprehensive explanations of medical terms may help the patient to feel secure during the process. © 2013 John Wiley & Sons Ltd.

Monitoring acute phase proteins in retrovirus infected cats undergoing feline interferon-ω therapy.

PubMed

Leal, R O; Gil, S; Sepúlveda, N; McGahie, D; Duarte, A; Niza, M M R E; Tavares, L

2014-01-01

Recombinant feline interferon-ω therapy is an immunomodulator currently used in the treatment of different retroviral diseases including feline immune deficiency virus and feline leukaemia virus. Although its mechanism of action remains unclear, this drug appears to potentiate the innate response. Acute phase proteins are one of the key components of innate immunity and studies describing their use as a monitoring tool for the immune system in animals undergoing interferon-ω therapy are lacking. This study aimed to determine whether interferon-ω therapy influences acute phase protein concentrations namely serum amyloid-A, α-1-glycoprotein and C-reactive protein. A single-arm study was performed using 16 cats, living in an animal shelter, naturally infected with retroviruses and subjected to the interferon-ω therapy licensed protocol. Samples were collected before (D0), during (D10 and D30) and after therapy (D65). Serum amyloid-A and C-reactive protein were measured by specific enzyme-linked immunosorbent assay kits and α-1-glycoprotein by single radial immunodiffusion. All the acute phase proteins significantly increased in cats undergoing interferon-ω therapy (D0/D65: P<0·05) CLINICAL SIGNIFICANCE: Acute phase proteins appear to be reasonable predictors of innate-immune stimulation and may be useful in the individual monitoring of naturally retroviral infected cats undergoing interferon-ω therapy. © 2013 British Small Animal Veterinary Association.

Renal insufficiency predicts mortality in geriatric patients undergoing emergent general surgery.

PubMed

Yaghoubian, Arezou; Ge, Phillip; Tolan, Amy; Saltmarsh, Guy; Kaji, Amy H; Neville, Angela L; Bricker, Scott; De Virgilio, Christian

2011-10-01

Clinical predictors of perioperative mortality in geriatric patients undergoing emergent general surgery have not been well described. The purpose of this study was to determine the incidence of postoperative morbidity and mortality in geriatric patients and factors associated with mortality. A retrospective review of patients 65 years of age or older undergoing emergent general surgery at a public teaching hospital was performed over a 7-year period. Data collected included demographics, comorbidities, laboratory studies, perioperative morbidities, and mortality. Descriptive statistics and predictors of morbidity and mortality are described. The mean age was 74 years. Indications for surgery included small bowel obstruction (24%), diverticulitis (20%), perforated viscous (16%), and large bowel obstruction (9%). The overall complication rate was 41 per cent with six cardiac complications (14%) and seven perioperative (16%) deaths. Mean admission serum creatinine was significantly higher in patients who died (3.6 vs 1.5 mg/dL, P = 0.004). Mortality for patients with an admission serum creatinine greater than 2.0 mg/dL was 42 per cent (5 of 12) compared with 3 per cent (2 of 32) for those 2.0 mg/dL or less (OR, 10.7; CI, 1.7 to 67; P = 0.01). Morbidity and mortality in geriatric patients undergoing emergency surgery remains high with the most significant predictor of mortality being the presence of renal insufficiency on admission.

Mucositis and salivary antioxidants in patients undergoing bone marrow transplantation (BMT)

PubMed Central

Mazzeo, Marcelo A.; López, María M.; Linares, Jorge A.; Jarchum, Gustavo; Wietz, Fernando M.; Finkelberg, Ana B.

2014-01-01

Objectives: High doses of chemotherapy generate DNA damage in patients undergoing bone marrow transplantation (BMT), due to the production of reactive oxygen species (ROS). In order to evaluate the local defensive effectiveness of the patient undergoing BMT, the concentrations of the antioxidants superoxide dismutase (SOD) and uric acid (UA) were measured in saliva. Study Design: Basal saliva samples were collected from 20 patients undergoing BMT at the Oncology Department, Sanatorio Allende (Córdoba), in the stages: initial, prior to conditioning therapy (I); middle: 7 to 10 days after BMT (M) and final stage, 30 days after discharge from isolation (F). SOD levels were determined using a RANDOX kit (RANSOD superoxide dismutase manual), and for uric acid enzymatic UOD / PAP spectrophotometric method, ( Trinder Color Kit , Wiener Lab) was used. Results: 85% of the patients developed oral mucositis. SOD concentration in the M stage was significantly higher (p<0.01) compared with stage I, and it reversed in stage F. UA concentration was significantly lower (p<0.001) in stage M compared with stage I, and in stage F it recovered the initial values. Conclusions: SOD increase in stage M coincided with the appearance of mucositis, which could be interpreted as a defensive mechanism of saliva against oxidative stress produced by chemotherapy. UA decrease in stage M would favour the development of higher degrees of mucositis. Key words:Bone marrow transplantation, mucositis, superoxide dismutase, uric acid. PMID:24608218

Associations of Undergoing a Routine Medical Examination or Not with Prevalence Rates of Hypertension and Diabetes Mellitus: A Cross-Sectional Study.

PubMed

Zhang, Lin; Zhang, Wei; Zhang, Lingling; Tian, Danping; Li, Li; Deng, Xin; Deng, Jing; Ning, Peishan; Hu, Guoqing

2016-06-23

Undergoing a routine medical examination may be associated with the prevalence rate of chronic diseases from a population-based household interview survey. However, this important issue has not been examined so far. Data came from the first health service household interview of Hunan province, China, in 2013. A Rao-Scott chi-square test was performed to examine the difference in prevalence rates between subgroups. Adjusted odds ratio (OR) was calculated using the PROC SURVEYLOGISTIC procedure of SAS9.1 statistical software. In total, 24,282 residents of 8400 households were surveyed. A higher proportion of elderly adults had undergone a medical examination within the prior 12 months compared with young adults (≥65 years, 60%; 45-64 years, 46%; 18-44 years, 37%). After controlling for location, sex, and household income per capita, undergoing a medical examination was significantly associated with high prevalence rates of hypertension (adjusted OR: 2.0, 95% CI: 1.1-3.5) and of diabetes mellitus (adjusted OR: 3.3, 95% CI: 1.7-6.5) for young adults aged 18-44 years. The associations were not statistically significant for age groups 45-64 years and 65 years or older. The prevalence rates of hypertension and diabetes mellitus may be seriously underestimated for young adults not undergoing a routine medical examination in a health household interview survey.

Radiation or chemoradiation: initial utility study of selected therapy for local advanced stadium cervical cancer

NASA Astrophysics Data System (ADS)

Pramitasari, D. A.; Gondhowiardjo, S.; Nuranna, L.

2017-08-01

This study aimed to compare radiation only or chemo radiation treatment of local advanced cervical cancers by examining the initial response of tumors and acute side effects. An initial assessment employed value based medicine (VBM) by obtaining utility values for both types of therapy. The incidences of acute lower gastrointestinal, genitourinary, and hematology side effects in patients undergoing chemoradiation did not differ significantly from those undergoing radiation alone. Utility values for patients who underwent radiation alone were higher compared to those who underwent chemoradiation. It was concluded that the complete response of patients who underwent chemoradiation did not differ significantly from those who underwent radiation alone.

Evidence for the secondary sexual development of the anal fin in female kokanee salmon Oncorhynchus nerka.

PubMed

Thorn, M W; Morbey, Y E

2016-02-01

This study examines whether the anal fin undergoes secondary sexual development similar to other reproductive traits in salmonids. This hypothesis was tested by comparing the anal-fin size of female kokanee salmon Oncorhynchus nerka that were in the early and late stages of sexual development. Females in an advanced stage of maturation had significantly larger anal fins relative to females in an early state of maturation (+4-7%), indicating that the anal fin undergoes secondary sexual development. The magnitude of this secondary growth was comparable with snout length (+9-10%), which is known to undergo secondary sexual development in female salmonids. When morphological trait dimensions were compared between the sexes, the anal fin was the only morphological trait found to have a female-biased sexual size dimorphism. This is the first study to show that the anal fin of female salmonids undergoes secondary sexual development. © 2015 The Fisheries Society of the British Isles.

Pore dilation reconsidered

PubMed Central

Bean, Bruce P

2015-01-01

Previous experiments have suggested that many P2X family channels undergo a time-dependent process of pore dilation when activated by ATP. Li et al. now propose a different interpretation of the key experiments. PMID:26505561

Gametogenesis

USDA-ARS?s Scientific Manuscript database

Gametogenesis is the process of gamete formation, which includes microgametogenesis and megagametogenesis. Gametogenesis initiates after specialized cells in the sporophyte undergo meiosis, and subsequent mitotic divisions yield the gametophyte phase of the plant life cycle. In higher plants, microg...

77 FR 24173 - Notice of Funds Availability: Inviting Applications for the Emerging Markets Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-23

... promotions (e.g., in-store, restaurant advertising, labeling, etc.); advertising, administrative, and... additional evaluation criteria. 2. Review and Selection Process: All applications undergo a multi- phase...

78 FR 23890 - Notice of Funds Availability: Inviting Applications for the Emerging Markets Program

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-23

... promotions (e.g., in-store, restaurant advertising, labeling, etc.); advertising, administrative, and... and Selection Process: All applications undergo a multi- phase review within FAS, by appropriate FAS...

76 FR 21320 - Notice of Funds Availability: Inviting Applications for the Emerging Markets Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-15

... promotions (in-store, restaurant advertising, labeling, etc.); advertising, administrative, and operational... and Selection Process: All applications undergo a multi- phase review within FAS, by appropriate FAS...

29 CFR 780.519 - General scope of exempt operations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... each to undergo a “sweating” or “fermentation” process in which temperature and humidity are carefully... tobacco, and adding water. Proper fermentation or aging requires the bulk to be reconstructed several...

Effects of a new bicarbonate/lactate-buffered neutral peritoneal dialysis fluid for peritoneal failure in patients undergoing peritoneal dialysis.

PubMed

Hoshino, Taro; Ishii, Hiroki; Kitano, Taisuke; Shindo, Mitsutoshi; Miyazawa, Haruhisa; Yamada, Hodaka; Ito, Kiyonori; Ueda, Yuichiro; Kaku, Yoshio; Hirai, Keiji; Mori, Honami; Ookawara, Susumu; Tabei, Kaoru; Morishita, Yoshiyuki

2016-02-01

The highly concentrated lactate in peritoneal dialysis fluid (PDF) has been considered to contribute to peritoneal failure in patients undergoing PD. A new PDF containing a lower lactate concentration, physiological bicarbonate concentration, and neutral pH (bicarbonate/lactate-buffered neutral PDF) was recently developed. We compared the clinical effects of this bicarbonate/lactate-buffered neutral PDF and a lactate-buffered neutral PDF. Patients undergoing PD were changed from a lactate-buffered neutral PDF to a bicarbonate/lactate-buffered neutral PDF. We then investigated the changes in peritoneal functions as estimated by a peritoneal equilibration test (PET) and the following surrogate markers of peritoneal membrane failure in the drained dialysate: fibrin degradation products (FDP), vascular endothelial growth factor (VEGF), cancer antigen 125 (CA125), interleukin-6 (IL-6), and transforming growth factor beta 1 (TGF-β1). Fourteen patients undergoing PD were enrolled. The PET results were not different before and after use of the bicarbonate/lactate-buffered neutral PDF. The FDP concentration significantly decreased from 15.60 ± 13.90 to 6.04 ± 3.49 μg/mL (p = 0.02) and the VEGF concentration significantly decreased from 37.83 ± 15.82 to 27.70 ± 3.80 pg/mL (p = 0.02), while the CA125 and IL-6 concentrations remained unchanged before and after use of the bicarbonate/lactate-buffered neutral PDF. TGF-β1 was not detected in most patients. The bicarbonate/lactate-buffered neutral PDF decreased the FDP and VEGF concentrations in the drained dialysate. These results suggest that the decreased lactate level achieved by administration of bicarbonate with a neutral pH in PDF may contribute to decreased peritoneal membrane failure in patients undergoing PD.

Association of left subclavian artery coverage without revascularization and spinal cord ischemia in patients undergoing thoracic endovascular aortic repair: A Vascular Quality Initiative® analysis.

PubMed

Teixeira, Pedro Gr; Woo, Karen; Beck, Adam W; Scali, Salvatore T; Weaver, Fred A

2017-12-01

Objectives Investigate the impact of left subclavian artery coverage without revascularization on spinal cord ischemia development in patients undergoing thoracic endovascular aortic repair. Methods The Vascular Quality Initiative thoracic endovascular aortic repair module (April 2011-July 2014) was analyzed. Patients undergoing left subclavian artery coverage were divided into two groups according to revascularization status. The association between left subclavian artery revascularization with the primary outcome of spinal cord ischemia and the secondary outcome of stroke was assessed with multivariable analysis adjusting for between-group baseline differences. Results The left subclavian artery was covered in 508 (24.6%) of the 2063 thoracic endovascular aortic repairs performed. Among patients with left subclavian artery coverage, 58.9% underwent revascularization. Spinal cord ischemia incidence was 12.1% in the group without revascularization compared to 8.5% in the group undergoing left subclavian artery revascularization (odds ratio (95%CI): 1.48(0.82-2.68), P = 0.189). Multivariable analysis adjustment identified an independent association between left subclavian artery coverage without revascularization and the incidence of spinal cord ischemia (adjusted odds ratio (95%CI): 2.29(1.03-5.14), P = 0.043). Although the incidence of stroke was also higher for the group with a covered and nonrevascularized left subclavian artery (12.1% versus 8.5%), this difference was not statistically significant after multivariable analysis (adjusted odds ratio (95%CI): 1.55(0.74-3.26), P = 0.244). Conclusion For patients undergoing left subclavian artery coverage during thoracic endovascular aortic repair, the addition of a revascularization procedure was associated with a significantly lower incidence of spinal cord ischemia.

Extent of regional lymph node surgery and impact on outcomes in patients with early-stage breast cancer and limited axillary disease undergoing mastectomy.

PubMed

Picado, Omar; Khazeni, Kristina; Allen, Casey; Yakoub, Danny; Avisar, Eli; Kesmodel, Susan B

2018-06-05

Management of the axilla in patients with early-stage breast cancer (ESBC) has evolved. Recent trials support less extensive axillary surgery in patients undergoing mastectomy. We examine factors affecting regional lymph node (RLN) surgery and outcomes in patients with ESBC undergoing mastectomy. Women with clinical T1/2 N0 M0 invasive BC who underwent mastectomy with 1-2 positive nodes were selected from the National Cancer Database (2004-2015). Axillary surgery was defined by number of RLNs examined: 1-5 sentinel LN dissection (SLND), and ≥ 10 axillary LND (ALND). Binary logistic regression and survival analyses were performed to assess the association between axillary surgery and clinical characteristics, and overall survival (OS), respectively. 34,243 patients were included: 13,821 SLND (40%) and 20,422 ALND (60%). SLND significantly increased from 21% (2004) to 45% (2015) (p < .001). Independent factors associated with SLND were treatment year, non-Academic centers, geographic region, tumor histology, and postmastectomy radiotherapy (PMRT). Multivariable survival analysis showed that ALND was associated with better OS (HR 0.78, 95% CI 0.72-0.83, p < .001) relative to SLND; however, there was no difference in patients with LN micrometastases treated without RT (HR 0.87, 95% CI 0.73-1.05, p = .153) or patients receiving PMRT (HR 0.92, 95% CI 0.76-1.13, p = .433). SLND has significantly increased in patients undergoing mastectomy with limited axillary disease and is influenced by patient, tumor, and treatment factors. Survival outcomes did not differ by axillary treatment for patients with LN micrometastases treated without RT or patients who received PMRT. SLND may be considered in select patients with ESBC and limited axillary disease undergoing mastectomy.

Predictive value of preoperative electrocardiography for perioperative cardiovascular outcomes in patients undergoing noncardiac, nonvascular surgery.

PubMed

Biteker, Murat; Duman, Dursun; Tekkeşin, Ahmet Ilker

2012-08-01

The utility of routine preoperative electrocardiography (ECG) for assessing perioperative cardiovascular risk in patients undergoing noncardiac, nonvascular surgery (NCNVS) is unclear. There would be an association between preoperative ECG and perioperative cardiovascular outcomes in patients undergoing NCNVS. A total of 660 patients undergoing NCNVS were prospectively evaluated. Patients age >18 years who underwent an elective, nonday case, open surgical procedure were enrolled. Troponin I concentrations and 12-lead ECG were evaluated the day before surgery, immediately after surgery, and on the first 5 postoperative days. Preoperative ECG showing atrial fibrillation, left or right bundle branch block, left ventricular hypertrophy, frequent premature ventricular complexes, pacemaker rhythm, Q-wave, ST-segment changes, or sinus tachycardia or bradycardia were classified as abnormal. The patients were followed up during hospitalization and were evaluated for the presence of perioperative cardiovascular events (PCE). Eighty patients (12.1%) experienced PCE. Patients with abnormal ECG findings had a greater incidence of PCE than those with normal ECG results (16% vs 6.4%; P < 0.001). Mean QTc interval was significantly longer in the patients who had PCE (436.6 ± 31.4 vs 413.3 ± 16.7 ms; P < 0.001). Univariate analysis showed a significant association between preoperative atrial fibrillation, pacemaker rhythm, ST-segment changes, QTc prolongation, and in-hospital PCE. However, only QTc prolongation (odds ratio: 1.15, 95% confidence interval: 1.06-1.2, P < 0.001) was an independent predictor of PCE according to the multivariate analysis. Every 10-ms increase in QTc interval was related to a 13% increase for PCE. Prolongation of the QTc interval on the preoperative ECG was related with PCE in patients undergoing NCNVS. © 2011 Wiley Periodicals, Inc.

Assessment of cardiotoxicity during haemopoietic stem cell transplantation with plasma brain natriuretic peptide.

PubMed

Snowden, J A; Hill, G R; Hunt, P; Carnoutsos, S; Spearing, R L; Espiner, E; Hart, D N

2000-08-01

Cardiac failure is a known complication of haemopoietic stem cell transplantation (HSCT) and is often difficult to diagnose as patients may have multiple medical problems. Since brain natriuretic peptide (BNP) is largely a hormone of cardiac ventricular origin and is released early in the course of ventricular dysfunction, we have examined the value of serial plasma BNP levels for detecting cardiac failure in patients undergoing cytotoxic conditioning for HSCT. Fifteen patients undergoing HSCT were evaluated (10 undergoing autologous HSCT; five undergoing allogeneic HSCT). BNP was measured by radioimmunoassay prior to therapy and weekly for 5 weeks. Seven patients had a significant rise in BNP level (above a previously established threshold of 43 pmol/l associated with cardiac failure), occurring 1-4 weeks post commencement of conditioning. In three of these patients, cardiac failure was subsequently diagnosed clinically 3, 9 and 23 days after a BNP level of 43 pmol/l had been detected. These three patients had the highest peak BNP levels for the group and in each case elevation in BNP level occurred for a period exceeding 1 week. Although numbers were relatively small, a BNP >43 pmol/l was significantly associated with the inclusion of high-dose cyclophosphamide in the preparative regimen (P = 0.02). BNP levels showed no relationship to febrile episodes. In conclusion, these results show that plasma BNP may be used as a marker for early detection of cardiac dysfunction in patients undergoing HSCT, particularly if levels are increased for periods exceeding 1 week. Measurement of BNP during HSCT may be helpful in patients at risk of cardiac failure, in complex clinical situations and in monitoring the cardiotoxicity of preparative regimens.

Immune function, pain, and psychological stress in patients undergoing spinal surgery.

PubMed

Starkweather, Angela R; Witek-Janusek, Linda; Nockels, Russ P; Peterson, Jonna; Mathews, Herbert L

2006-08-15

This study was an exploratory repeated measures design comparing patients undergoing two magnitudes of surgery in the lumbar spine: lumbar herniated disc repair and posterior lumbar fusion. The present study evaluated and compared the effect of perceived pain, perceived stress, anxiety, and mood on natural killer cell activity (NKCA) and IL-6 production among adult patients undergoing lumbar surgery. Presurgical stress and anxiety can lead to detrimental patient outcomes after surgery, such as increased infection rates. It has been hypothesized that such outcomes are due to stress-immune alterations, which may be further exacerbated by the extent of surgery. However, psychologic stress, anxiety, and mood have not been previously characterized in patients undergoing spinal surgery. Pain, stress, anxiety, and mood were measured using self-report instruments at T1 (1 week before surgery), T2 (the day of surgery), T3 (the day after surgery), and T4 (6 weeks after surgery). Blood (30 mL) was collected for immune assessments at each time point. Pain, stress, anxiety, and mood state were elevated at baseline in both surgical groups and were associated with significant reduction in NKCA compared with the nonsurgical control group. A further decrease in NKCA was observed 24 hours after surgery in both surgical groups with a significant rise in stimulated IL-6 production, regardless of the magnitude of surgery. In the recovery period, NKCA increased to or above baseline values, which correlated with decreased levels of reported pain, perceived stress, anxiety, and mood state. This study demonstrated that patients undergoing elective spinal surgery are highly stressed and anxious, regardless of the magnitude of surgery and that such psychologic factors may mediate a reduction in NKCA.

[Development and evaluation of individualized fluid therapy in the elderly patients with coronary heart disease undergoing gastrointestinal surgery: a randomized, controlled trial].

PubMed

Zheng, Hong; Guo, Hai; Ye, Jian-rong; Chen, Lin

2012-06-01

To develop and evaluate an individualized fluid therapy in the elderly patients with coronary heart disease undergoing gastrointestinal surgery. In this prospective study, 60 coronary heart disease patients undergoing gastrointestinal surgery were included in the First Affiliated Hospital of Xinjiang Medical University from March 2009 to March 2012. Patients were randomized into the intervention group and the control group with 30 patients in each group. Individualized fluid therapy was used during surgery and postoperative period in the ICU, which was determined based on target controlled fluid therapy according to cardiac index, stroke volume, and stroke volume variation. Traditional fluid therapy was used in the control group in the intraoperative and postoperative period. The two groups were compared in terms of postoperative hemodynamic parameters, total fluid volume, incidence of adverse cardiac events, and recovery of bowel function. Compared with the control group, mean arterial pressure was significantly increased at the commencement of the surgery. The cardiac index was significantly elevated during surgery and at the end of the surgery. Stroke volume was significantly increased after induction of anesthesia, during the surgery, and at the early stay of ICU period(all P<0.05). Serum lactic acid in the intervention group was significantly lower at the end of surgery and during ICU stay than that in the control group (all P<0.05). During surgery and 24-hour stay in ICU, the total fluid volume, crystal usage, and urine were significantly less, while colloidal fluid use was significantly more in the intervention group as compared to the control group(all P<0.05). The perioperative adverse cardiac event rate was 36.7%(11/30) in the intervention group, lower than 56.7%(17/30) in the control group, but the difference was no statistically significance(P>0.05). In the intervention group, defecation time, time to first flatus, resumption of liquid intake, length of ICU stay and hospital stay were significantly less compared with the control group(P<0.05). In the elderly patients with coronary arterial disease undergoing gastrointestinal surgery, individualized fluid therapy can effectively decrease adverse cardiac events, improve postoperative gastrointestinal function, and reduce length of hospital stay.

Nonlinear digital signal processing in mental health: characterization of major depression using instantaneous entropy measures of heartbeat dynamics.

PubMed

Valenza, Gaetano; Garcia, Ronald G; Citi, Luca; Scilingo, Enzo P; Tomaz, Carlos A; Barbieri, Riccardo

2015-01-01

Nonlinear digital signal processing methods that address system complexity have provided useful computational tools for helping in the diagnosis and treatment of a wide range of pathologies. More specifically, nonlinear measures have been successful in characterizing patients with mental disorders such as Major Depression (MD). In this study, we propose the use of instantaneous measures of entropy, namely the inhomogeneous point-process approximate entropy (ipApEn) and the inhomogeneous point-process sample entropy (ipSampEn), to describe a novel characterization of MD patients undergoing affective elicitation. Because these measures are built within a nonlinear point-process model, they allow for the assessment of complexity in cardiovascular dynamics at each moment in time. Heartbeat dynamics were characterized from 48 healthy controls and 48 patients with MD while emotionally elicited through either neutral or arousing audiovisual stimuli. Experimental results coming from the arousing tasks show that ipApEn measures are able to instantaneously track heartbeat complexity as well as discern between healthy subjects and MD patients. Conversely, standard heart rate variability (HRV) analysis performed in both time and frequency domains did not show any statistical significance. We conclude that measures of entropy based on nonlinear point-process models might contribute to devising useful computational tools for care in mental health.

Management of antithrombotic therapy in patients undergoing electrophysiological device surgery.

PubMed

Zacà, Valerio; Marcucci, Rossella; Parodi, Guido; Limbruno, Ugo; Notarstefano, Pasquale; Pieragnoli, Paolo; Di Cori, Andrea; Bongiorni, Maria Grazia; Casolo, Giancarlo

2015-06-01

The aim of this review is to formulate practical recommendations for the management of antithrombotic therapy in patients undergoing cardiac implantable electronic device (CIED) surgery by providing indications for a systematic approach to the problem integrating general technical considerations with patient-specific elements based on a careful evaluation of the balance between haemorrhagic and thromboembolic risk. Hundreds of thousands patients undergo implantation or replacement of CIEDs annually in Europe, and up to 50% of these subjects receive antiplatelet agents or oral anticoagulants. The rate of CIED-related complications, mainly infective, has also significantly increased so that transvenous lead extraction procedures are, consequently, often required. Cardiac implantable electronic device surgery is peculiar and portends specific intrinsic risks of developing potentially fatal haemorrhagic complications; on the other hand, the periprocedural suspension of antithrombotic therapy in patients with high thromboembolic risk cardiac conditions may have catastrophic consequences. Accordingly, the management of the candidate to CIED surgery receiving concomitant antithrombotic therapy is a topic of great clinical relevance yet controversial and only partially, if at all, adequately addressed in evidence-based current guidelines. In spite of the fact that in many procedures it seems reasonably safe to proceed with aspirin only or without interruption of anticoagulants, restricting to selected cases the use of bridging therapy with parenteral heparins, there are lots of variables that may make the therapeutic choices challenging. The decision-making process applied in this document relies on the development of a stratification of the procedural haemorrhagic risk and of the risk deriving from the suspension of antiplatelet or anticoagulant therapy combined to generate different clinical scenarios with specific indications for optimal management of periprocedural antithrombotic therapy. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

Effect of piracetam on the cognitive performance of patients undergoing coronary bypass surgery: A meta-analysis

PubMed Central

FANG, YU; QIU, ZHANDONG; HU, WENTAO; YANG, JIA; YI, XIYAN; HUANG, LIANGJIANG; ZHANG, SUMING

2014-01-01

Cognitive impairments are observed in numerous patients following coronary bypass surgery, and piracetam are nootropic compounds that modulate cerebral functions by directly enhancing cognitive processes. The present meta-analysis was conducted to evaluate the protective effect of piracetam on the cognitive performance of patients undergoing coronary bypass surgery. The relevant studies were identified by searching Medline, EMBASE, PubMed and the Cochrane Library up to June 2013 and the pertinent bibliographies from the retrieved studies were reviewed. Data were selected from the studies according to predefined criteria. The meta-analysis included two randomized control trials involving 184 patients and including the Syndrom-Kurz test (SKT). Findings of the meta-analysis showed that following treatment the change from baseline observed in five SKT subtest scores, conducted with piracetam patients, indicated a significant advantage over those patients that were in the placebo group. The subtests included immediate pictured object recall, weighted mean difference (WMD)=0.91, 95% confidence interval (CI) 0.51–1.31, P<0.00001; delayed pictured object recall, WMD=0.74, 95% CI 0.19–1.28, P=0.008; delayed picture recognition, WMD=0.82, 95% CI 0.31–1.31, P=0.001; immediate word recall, WMD=0.87, 95% CI 0.47–1.28, P<0.0001; and letter interference, WMD=3.46, 95% CI −5.69 to −1.23, P=0.002. These results indicated that piracetam may have been effective in improving the short-term cognitive performance of patients undergoing coronary bypass surgery. High quality, well-controlled and longer randomized trials are required to corroborate this result. PMID:24396419

Coal liquefaction process

DOEpatents

Karr, Jr., Clarence

1977-04-19

An improved coal liquefaction process is provided which enables conversion of a coal-oil slurry to a synthetic crude refinable to produce larger yields of gasoline and diesel oil. The process is characterized by a two-step operation applied to the slurry prior to catalytic desulfurization and hydrogenation in which the slurry undergoes partial hydrogenation to crack and hydrogenate asphaltenes and the partially hydrogenated slurry is filtered to remove minerals prior to subsequent catalytic hydrogenation.

Magnesium Nanocomposites: Current Status and Prospects for Army Applications

DTIC Science & Technology

2011-09-01

and reinforcement that cannot be produced through melt-based processing . In mechanical alloying , the powder and milling media are placed into...mixing vessels that are agitated in a high-energy milling machine. During the mixing process , the powder particles undergo repeated cycles of cold ...welding and fracturing of interparticle bonds. At the end of the process , the powder has been alloyed to the desired composition. Although typically used

Dawn Spacecraft Processing

NASA Image and Video Library

2007-04-10

The Dawn spacecraft is seen here in clean room C of Astrotech's Payload Processing Facility. In the clean room, the spacecraft will undergo further processing. Dawn's mission is to explore two of the asteroid belt's most intriguing and dissimilar occupants: asteroid Vesta and the dwarf planet Ceres. The Dawn mission is managed by JPL, a division of the California Institute of Technology in Pasadena, for NASA's Science Mission Directorate in Washington, D.C.

Isotopic Fractionation in Primitive Material: Quantifying the Contribution of Interstellar Chemistry

NASA Technical Reports Server (NTRS)

Charnley, Steven

2010-01-01

Anomalously fractionated isotopic material is found in many primitive Solar System objects, such as meteorites and comets. It is thought, in some cases, to trace interstellar matter that was incorporated into the Solar Nebula without undergoing significant processing. We will present the results of models of the nitrogen, oxygen, and carbon fractionation chemistry in dense molecular clouds, particularly in cores where substantial freeze-out of molecules on to dust has occurred. The range of fractionation ratios expected in different interstellar molecules will be discussed and compared to the ratios measured in molecular clouds, comets and meteoritic material. These models make several predictions that can be tested in the near future by molecular line observations, particularly with ALMA.

The bench vs. the blackboard: learning to teach during graduate school.

PubMed

Ciaccia, Laura

2011-09-01

Many science, technology, engineering, and mathematics (STEM) graduate students travel through the academic career pipeline without ever learning how to teach effectively, an oversight that negatively affects the quality of undergraduate science education and cheats trainees of valuable professional development. This article argues that all STEM graduate students and postdoctoral fellows should undergo training in teaching to strengthen their resumes, polish their oral presentation skills, and improve STEM teaching at the undergraduate level. Though this may seem like a large undertaking, the author outlines a three-step process that allows busy scientists to fit pedagogical training into their research schedules in order to make a significant investment both in their academic career and in the continuing improvement of science education. Copyright © 2011.

Invariants of polarization transformations.

PubMed

Sadjadi, Firooz A

2007-05-20

The use of polarization-sensitive sensors is being explored in a variety of applications. Polarization diversity has been shown to improve the performance of the automatic target detection and recognition in a significant way. However, it also brings out the problems associated with processing and storing more data and the problem of polarization distortion during transmission. We present a technique for extracting attributes that are invariant under polarization transformations. The polarimetric signatures are represented in terms of the components of the Stokes vectors. Invariant algebra is then used to extract a set of signature-related attributes that are invariant under linear transformation of the Stokes vectors. Experimental results using polarimetric infrared signatures of a number of manmade and natural objects undergoing systematic linear transformations support the invariancy of these attributes.

[Cancer cachexia and white adipose tissue browning].

PubMed

Zhang, S T; Yang, H M

2016-08-01

Cancer cachexia occurs in a majority of advanced cancer patients. These patients with impaired physical function are unable to tolerance cancer treatment well and have a significantly reduced survival rate. Currently, there is no effective clinical treatment available for cancer cachexia, therefore, it is necessary to clarify the molecular mechanisms of cancer cachexia, moreover, new therapeutic targets for cancer cachexia treatment are urgently needed. Very recent studies suggest that, during cancer cachexia, white adipose tissue undergo a 'browning' process, resulting in increased lipid mobilization and energy expenditure, which may be necessary for the occurrence of cancer cachexia. In this article, we summarize the definition and characteristics of cancer cachexia and adipose tissue 'browning', then, we discuss the new study directions presented in latest research.

Algorithm and implementation of muon trigger and data transmission system for barrel-endcap overlap region of the CMS detector

NASA Astrophysics Data System (ADS)

Zabolotny, W. M.; Byszuk, A.

2016-03-01

The CMS experiment Level-1 trigger system is undergoing an upgrade. In the barrel-endcap transition region, it is necessary to merge data from 3 types of muon detectors—RPC, DT and CSC. The Overlap Muon Track Finder (OMTF) uses the novel approach to concentrate and process those data in a uniform manner to identify muons and their transversal momentum. The paper presents the algorithm and FPGA firmware implementation of the OMTF and its data transmission system in CMS. It is foreseen that the OMTF will be subject to significant changes resulting from optimization which will be done with the aid of physics simulations. Therefore, a special, high-level, parameterized HDL implementation is necessary.

The effect of assisted reproduction treatment on mental health in fertile women.

PubMed

Zivaridelavar, Maryam; Kazemi, Ashraf; Kheirabadi, Gholam Reza

2016-01-01

The process of assisted reproductive treatment is a stressful situation in the treatment of infertile couples and it would harm the mental health of women. Fertile women who started infertility treatment due to male factor infertility have reported to experience less stress and depression than other women before the assisted reproductive process but considering the cultural and social factors and also the etiology of the assisted reproductive process, it could affect the metal health of these women. Therefore, this study was conducted to evaluate the mental health of fertile women who undergo assisted reproductive treatment due to male factor infertility. This study was a prospective study on 70 fertile women who underwent assisted reproductive treatment due to male factor infertility. The exclusion criterion was to stop super ovulation induction. To assess mental health, anxiety and depression dimensions of the general health questionnaire were used. Before starting ovulation induction and after oocyte harvesting, the general health questionnaire was filled by women who were under treatment. Data were analyzed using multi-variable linear regression, paired t-test, and Chi-square. The results showed that the mean score of depression and anxiety before ovulation induction and after oocyte harvesting were not significantly different; but the rate of mental health disorder in the depression dimension was significantly decreased after oocytes harvesting (31.7% vs. 39.7%). Also, there was a significant relation between the level of anxiety and depression before ovulation induction and after oocyte harvesting (P < 0.05). The anxiety level after oocyte harvesting had a positive and significant correlation with the economic situation (P < 0.05). This study revealed that the process of assisted reproductive treatment does not affect the mental health in fertile women independently, but these women start assisted reproductive process with high levels of depression and anxiety. Therefore, prior to the assisted reproductive treatment mental health consultation is needed.

Third-Cycle Studies in Educational Sciences: Expectations and Competences Development

ERIC Educational Resources Information Center

Alves, Mariana Gaio; Azevedo, Nair Rios

2010-01-01

In Europe, third-cycle studies may be undergoing structural changes because of the orientation of the Bologna process. This article intends to shed light on the question of how and whether the ongoing changes might mean that we are in the process of reconstructing the university offer of doctoral degree studies. The authors look at the particular…

Self-Regulation and Approaches to Learning in English Composition Writing

ERIC Educational Resources Information Center

Magno, Carlo

2009-01-01

It is hypothesized in the present study that when learners are tasked to write a composition in a second language (such as English language for Filipinos), they use specific approaches to learning and eventually undergo self-regulatory processes. The present study tested a model showing the shift from process to outcome in writing (Zimmerman &…

Direct Measurement and Evaluation for Mechanical Engineering Programme Outcomes: Impact on Continuous Improvement

ERIC Educational Resources Information Center

Tahir, Mohd Faizal Mat; Khamis, Nor Kamaliana; Wahid, Zaliha; Ihsan, Ahmad Kamal Ariffin Mohd; Ghani, Jaharah Ab; Sabri, Mohd Anas Mohd; Sajuri, Zainuddin; Abdullah, Shahrum; Sulong, Abu Bakar

2013-01-01

Universiti Kebangsaan Malaysia (UKM) is a research university that continuously undergoes an audit and accreditation process for the management of its courses. The Faculty of Engineering and the Built Environment (FKAB) is subjected to such processes, one of them is the auditing conducted by the Engineering Accreditation Council (EAC), which gives…

The Storage and Processing of Morphologically Complex Words in L2 Spanish

ERIC Educational Resources Information Center

Foote, Rebecca

2017-01-01

Research with native speakers indicates that, during word recognition, regularly inflected words undergo parsing that segments them into stems and affixes. In contrast, studies with learners suggest that this parsing may not take place in L2. This study's research questions are: Do L2 Spanish learners store and process regularly inflected,…

Predictive modeling of infrared radiative heating in tomato dry-peeling process: Part II. Model validation and sensitivity analysis

USDA-ARS?s Scientific Manuscript database

A predictive mathematical model was developed to simulate heat transfer in a tomato undergoing double sided infrared (IR) heating in a dry-peeling process. The aims of this study were to validate the developed model using experimental data and to investigate different engineering parameters that mos...

A community in the wildland-urban interface

Treesearch

María Cecilia Ciampoli Halaman

2013-01-01

Communities located in the wildland-urban interface undergo a process of transformation until they can guard against fires occurring in the area. This study analyzed this process for the Estación neighborhood in the city of Esquel, Chubut Province, Argentina. The analysis was performed by comparing the level of danger diagnosed for each neighborhood home in 2004 with...

Temporal processes that contribute to nonlinearity in vegetation responses to ozone exposure and dose

Treesearch

Robert L. Heath; Allen S. Lefohn; Robert C. Musselman

2009-01-01

Ozone interacts with plant tissue through distinct temporal processes. Sequentially, plants are exposed to ambient O3 hat (1) moves through the leaf boundary layer, (2) is taken up into plant tissue primarily through stomata, and (3) undergoes chemical interaction within plant tissue, first by initiating alterations and then as part of plant...

A Comparison of Compliance and Aspirational Accreditation Models: Recounting a University's Experience with Both a Taiwanese and an American Accreditation Body

ERIC Educational Resources Information Center

Cheng, Nellie S.

2015-01-01

Despite the widespread adoption of accreditation processes and the belief in their effectiveness for improving educational quality, the search for good accreditation practices remains a critical issue. This article recounts one university's experiences when simultaneously undergoing the accreditation processes of both the Middle States Commission…

MULTIPROCESSOR AND DISTRIBUTED PROCESSING BIBLIOGRAPHIC DATA BASE SOFTWARE SYSTEM

NASA Technical Reports Server (NTRS)

Miya, E. N.

1994-01-01

Multiprocessors and distributed processing are undergoing increased scientific scrutiny for many reasons. It is more and more difficult to keep track of the existing research in these fields. This package consists of a large machine-readable bibliographic data base which, in addition to the usual keyword searches, can be used for producing citations, indexes, and cross-references. The data base is compiled from smaller existing multiprocessing bibliographies, and tables of contents from journals and significant conferences. There are approximately 4,000 entries covering topics such as parallel and vector processing, networks, supercomputers, fault-tolerant computers, and cellular automata. Each entry is represented by 21 fields including keywords, author, referencing book or journal title, volume and page number, and date and city of publication. The data base contains UNIX 'refer' formatted ASCII data and can be implemented on any computer running under the UNIX operating system. The data base requires approximately one megabyte of secondary storage. The documentation for this program is included with the distribution tape, although it can be purchased for the price below. This bibliography was compiled in 1985 and updated in 1988.

Use of donor milk in the neonatal intensive care unit.

PubMed

de Halleux, Virginie; Pieltain, Catherine; Senterre, Thibault; Rigo, Jacques

2017-02-01

Own mother's milk is the first choice in feeding preterm infants and provides multiple short- and long-term benefits. When it is unavailable, donor human milk is recommended as the first alternative. Donor milk undergoes processing (i.e. pasteurization) to reduce bacteriological and viral contaminants but influences its bioactive properties with potentially fewer benefits than raw milk. However, there is no clinical evidence of health benefit of raw compared to pasteurized human milk, and donor milk maintains documented advantages compared to formula. Nutrient content of donor and own mother's milk fails to meet the requirements of preterm infants. Adequate fortification is necessary to provide optimal growth. There are significant challenges in providing donor milk for premature infants; therefore, specific clinical guidelines for human milk banks and donor milk use in the neonatal intensive care unit should be applied and research should focus on innovative solutions to process human milk while preserving its immunological and nutritional components. In addition, milk banks are not the only instrument to collect, process and store donor milk but represent an excellent tool for breastfeeding promotion. Copyright © 2016 Elsevier Ltd. All rights reserved.

SIGNIFICANCE OF PREOPERATIVE EXTERNAL LIMITING MEMBRANE HEIGHT ON VISUAL PROGNOSIS IN PATIENTS UNDERGOING MACULAR HOLE SURGERY.

PubMed

Geenen, Caspar; Murphy, Declan C; Sandinha, Maria T; Rees, Jon; Steel, David H W

2018-03-05

To investigate the association between the vertical elevation of the external limiting membrane (ELM) and visual outcome in patients undergoing surgery for idiopathic full-thickness macular hole. Retrospective observational study of a consecutive cohort of patients undergoing vitrectomy to treat macular hole. The greatest vertical height of the central ELM above the retinal pigment epithelium (ELM height) was measured on spectral domain optical coherence tomography preoperatively. The relationship of ELM height to other preoperative and postoperative variables, including macular hole width and height, and visual acuity was analyzed. Data from 91 eyes of 91 patients who had undergone successful hole closure were included. The mean ELM height was 220 μm (range 100-394). There were significant correlations between the ELM height and the diameter of the hole, hole height, and worsening preoperative visual acuity. For holes less than 400 μm in width, better postoperative visual acuity was significantly predicted by a lower ELM height. The ELM height varies widely in idiopathic macular hole. It is higher in eyes where the hole is wider and also when the hole itself is higher. For holes of less than 400 μm in width, a lower ELM height is a strong independent predictor of a good postoperative outcome.

The effect of G-CSF on infertile women undergoing IVF treatment: A meta-analysis.

PubMed

Li, Jie; Mo, Sien; Chen, Yang

2017-08-01

Evidence for the effect of granulocyte colony stimulating factor (G-CSF) on infertile women undergoing in vitro fertilization (IVF) remains inconsistent. This study aimed to evaluate the effectiveness of G-CSF on infertile women undergoing IVF. PubMed and EMBASE databases were searched before August 2016. Comparing the transvaginal perfusion of G-CSF and placebo or no treatment, the available studies were considered. The pooled risk ratio (RR) with 95% confidence intervals (CIs) was used in the analysis and six studies were included. Transvaginal perfusion of G-CSF was significantly associated with a higher clinical pregnancy rate versus the placebo (RR=1.563, 95%CI: 1.122, 2.176), especially for the Asian population. Among patients with a thin endometrium or repeated IVF failure, the implantation and biochemical pregnancy rates were also significantly increased in patients with the use of G-CSF (implantation rate: RR = 1.887, 95% CI: 1.256, 2.833; biochemical pregnancy rate: RR = 2.385, 95% CI: 1.414, 4.023). However, no statistical significance in increasing endometrial thickness was detected. Transvaginal perfusion of G-CSF for infertile women may play a critical role in assisting human reproduction, especially for patients with a thin endometrium or repeated IVF failure in the Asian population.

The effects of nitrous oxide on vascular endothelial growth factor (VEGF) and its soluble receptor 1 (VEGFR1) in patient undergoing urological surgery

PubMed Central

Hakimoglu, Yasemin; Can, Murat; Hakimoglu, Sedat; Gorkem Mungan, Ayca; Acikgoz, Sereften; Cikcikoglu Yildirim, Nuran; Aydin Mungan, Necmettin; Ozkocak Turan, Isil

2014-01-01

Objective: Anesthesia and surgical intervention, leads to the development of systemic inflammatory response. The severity of the inflammatory response depends on the pharmacological effects of anesthetic agents and duration of anesthesia. Objective of the study was to investigate the effect of nitrous oxide on VEGF and VEGFR1 levels in patients undergoing surgery. Methods: Forty-four patients undergoing elective urological surgery were included in the study. Anesthesia maintenance was provided with 1-2 MAC sevoflurane, O2 50%, N2O 50% in 4L/m transporter gase for group 1 (n=22) and 1-2 MAC sevoflurane, O2 50%, air 50% in 4L/m transporter gase for group 2 (n=22) Venous blood samples for the measurement of VEGF and VEGFR1 were taken before the induction of anaesthesia, 60 minutes of anesthesia induction, at the end of anaesthesia and 24 hours after operation. In statistical analysis Bonferroni test and analysis of variance at the repeated measures were used Results: In the postoperative period serum VEGF levels had decreased significantly in both group whereas VEGFR1 did not show a significant change. Conclusions: Nitrous oxide showed significant effect on angiogenic parameters. Further detailed studies are required to evaluate the effect of nitrous oxide. PMID:24639829

The effects of nitrous oxide on vascular endothelial growth factor (VEGF) and its soluble receptor 1 (VEGFR1) in patient undergoing urological surgery.

PubMed

Hakimoglu, Yasemin; Can, Murat; Hakimoglu, Sedat; Gorkem Mungan, Ayca; Acikgoz, Sereften; Cikcikoglu Yildirim, Nuran; Aydin Mungan, Necmettin; Ozkocak Turan, Isil

2014-01-01

Anesthesia and surgical intervention, leads to the development of systemic inflammatory response. The severity of the inflammatory response depends on the pharmacological effects of anesthetic agents and duration of anesthesia. OBJECTIVE of the study was to investigate the effect of nitrous oxide on VEGF and VEGFR1 levels in patients undergoing surgery. Forty-four patients undergoing elective urological surgery were included in the study. Anesthesia maintenance was provided with 1-2 MAC sevoflurane, O2 50%, N2O 50% in 4L/m transporter gase for group 1 (n=22) and 1-2 MAC sevoflurane, O2 50%, air 50% in 4L/m transporter gase for group 2 (n=22) Venous blood samples for the measurement of VEGF and VEGFR1 were taken before the induction of anaesthesia, 60 minutes of anesthesia induction, at the end of anaesthesia and 24 hours after operation. In statistical analysis Bonferroni test and analysis of variance at the repeated measures were used Results: In the postoperative period serum VEGF levels had decreased significantly in both group whereas VEGFR1 did not show a significant change. Nitrous oxide showed significant effect on angiogenic parameters. Further detailed studies are required to evaluate the effect of nitrous oxide.

Polygamy and Risk of Coronary Artery Disease in Men Undergoing Angiography: An Observational Study.

PubMed

Daoulah, Amin; Lotfi, Amir; Al-Murayeh, Mushabab; Al-Kaabi, Salem; Al-Faifi, Salem M; Elkhateeb, Osama E; Alama, Mohamed N; Hersi, Ahmad S; Dixon, Ciaran M; Ahmed, Waleed; Al-Shehri, Mohamed; Youssef, Ali; Elimam, Ahmed Moustafa; Abougalambou, Ayman S; Murad, Waheed; Alsheikh-Ali, Alawi A

2017-01-01

Epidemiologic evidence suggests a link between psychosocial risk factors such as marital status and coronary artery disease (CAD). Polygamy (multiple concurrent wives) is a distinct marital status practiced in many countries in Asia and the Middle East, but its association with CAD is not well defined. We conducted a multicenter, observational study of consecutive patients undergoing coronary angiography during the period from April 1, 2013, to March 30, 2014. Of 1,068 enrolled patients, 687 were married men. Polygamy was reported in 32% of married men (1 wife: 68%, 2 wives: 19%, 3 wives: 10%, and 4 wives: 3%). When stratified by number of wives, significant baseline differences were observed in age, type of community (rural versus urban), prior coronary artery bypass grafting (CABG), and household income. After adjusting for baseline differences, there was a significant association between polygamy and CAD (adjusted OR 4.6 [95% CI 2.5, 8.3]), multivessel disease (MVD) (adjusted OR 2.6 [95% CI 1.8, 3.7]), and left main disease (LMD) (adjusted OR 3.5 [95% CI 2.1, 5.9]). Findings were consistent when the number of wives was analyzed as a continuous variable. In conclusion, among married men undergoing coronary angiography for clinical indications, polygamy is associated with the presence of significant CAD, MVD, and LMD.

Chorionic villous sampling: differences in patients' perspectives according to indication, ethnic group and religion.

PubMed

Dar, Hanna; Zuck, Chedva; Friedman, Svetlana; Merkshamer, Ruth; Gonen, Ron

2006-08-01

The decision to undergo prenatal testing may be influenced by ethnic or religious factors. To evaluate factors that might influence the decision of pregnant women to choose chorionic villous sampling for prenatal testing. The study group comprised 239 women referred for prenatal diagnosis who elected to undergo CVS. The data were analyzed according to indication, ethnic group and religion. Among women undergoing CVS because of advanced maternal age and anxiety, we noted a significantly high proportion of unbalanced families, i.e., with three or more children of the same gender and deviated gender ratio. We found a significant excess of males among the Jewish families and a significant excess of females among the non-Jewish families. Jews were over-represented in the monogenic group while Christian Arabs were over-represented in the maternal age/anxiety group. The proportion of women who chose CVS for prenatal diagnosis varied according to indication, ethnic group and religion. The data in this study indicate that CVS may have been utilized for balancing families with > or = 3 or more children of the same sex. Christian Arabs chose CVS more often than the other groups. Jewish women may have utilized CVS for family balancing of both sexes, while non-Jews may have utilized CVS for balancing families with > or = 3 daughters.

Comparison of high glucose concentration blood and crystalloid cardioplegia in paediatric cardiac surgery: a randomized clinical trial

PubMed Central

Mimic, Branko; Ilic, Slobodan; Vulicevic, Irena; Milovanovic, Vladimir; Tomic, Danijela; Mimic, Ana; Stankovic, Sanja; Zecevic, Tatjana; Davies, Ben; Djordjevic, Miroslav

2016-01-01

OBJECTIVES This study investigates the effects of high glucose content on patients undergoing cold crystalloid versus cold blood cardioplegia in terms of early clinical results, functional myocardial recovery and ischaemia–reperfusion injury in patients undergoing repair of acyanotic cardiac lesions. METHODS Patients were randomly assigned to receive either crystalloid (n = 31) or blood cardioplegia (n = 31). Early clinical results were assessed. Changes in left ventricular fractional shortening, arterial blood lactate levels, central venous saturation, cardiac Troponin I release and blood glucose concentration were measured during the first 24 h after ischaemia. RESULTS There was no significant difference in clinical outcomes and postoperative complication rates between groups. The postoperative changes in left ventricular function, lactate levels, central venous saturation and Troponin I were not significantly different between groups. The use of crystalloid cardioplegia was associated with significant increases in serum glucose compared with blood cardioplegia. CONCLUSIONS A high glucose content blood cardioplegia does not show any advantage compared with crystalloid cardioplegia in terms of clinical outcomes, functional recovery and the degree of ischaemic injury in infants and children undergoing repair of acyanotic heart lesions. High glucose concentration of the cardioplegic solution might potentiate ischaemia–reperfusion injury and diminish the beneficial effects of blood cardioplegia. PMID:26831677

Music therapy can lower the heart rates of severely sick children.

PubMed

Uggla, L; Bonde, L O; Svahn, B M; Remberger, M; Wrangsjö, B; Gustafsson, B

2016-10-01

Paediatric recipients of haematopoietic stem cell transplants (HSCT) are at increased risk of developing post-traumatic stress disorder (PTSD), and there is a need to identify interventions that can alleviate stress in this group. The aim of this study was to examine the previously unexplored effect of music therapy on children undergoing HSCT, by analysing physiological parameters and comparing them with a control group. We performed a randomised clinical pilot study of 24 patients up to the age of 16 undergoing HSCT at Karolinska University Hospital, Huddinge, Sweden. Music therapy, including expressive and receptive elements, was performed twice a week in the treatment group and compared to standard care in the control group. Physiological parameters were evaluated according to the hospital's protocols. The music therapy group had significantly reduced evening heart rates compared to the control group (p < 0.001), and the effect was sustainable for four to eight hours after the intervention. There were no significant differences in saturation or blood pressure observed between the groups. Music therapy significantly lowered the heart rate of children undergoing HSCT for at least four to eight hours, indicating reduced stress levels and potentially lowering the risk of developing PTSD. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Novel method for the high-throughput processing of slides for the comet assay

PubMed Central

Karbaschi, Mahsa; Cooke, Marcus S.

2014-01-01

Single cell gel electrophoresis (the comet assay), continues to gain popularity as a means of assessing DNA damage. However, the assay's low sample throughput and laborious sample workup procedure are limiting factors to its application. “Scoring”, or individually determining DNA damage levels in 50 cells per treatment, is time-consuming, but with the advent of high-throughput scoring, the limitation is now the ability to process significant numbers of comet slides. We have developed a novel method by which multiple slides may be manipulated, and undergo electrophoresis, in batches of 25 rather than individually and, importantly, retains the use of standard microscope comet slides, which are the assay convention. This decreases assay time by 60%, and benefits from an electrophoresis tank with a substantially smaller footprint, and more uniform orientation of gels during electrophoresis. Our high-throughput variant of the comet assay greatly increases the number of samples analysed, decreases assay time, number of individual slide manipulations, reagent requirements and risk of damage to slides. The compact nature of the electrophoresis tank is of particular benefit to laboratories where bench space is at a premium. This novel approach is a significant advance on the current comet assay procedure. PMID:25425241

Novel method for the high-throughput processing of slides for the comet assay.

PubMed

Karbaschi, Mahsa; Cooke, Marcus S

2014-11-26

Single cell gel electrophoresis (the comet assay), continues to gain popularity as a means of assessing DNA damage. However, the assay's low sample throughput and laborious sample workup procedure are limiting factors to its application. "Scoring", or individually determining DNA damage levels in 50 cells per treatment, is time-consuming, but with the advent of high-throughput scoring, the limitation is now the ability to process significant numbers of comet slides. We have developed a novel method by which multiple slides may be manipulated, and undergo electrophoresis, in batches of 25 rather than individually and, importantly, retains the use of standard microscope comet slides, which are the assay convention. This decreases assay time by 60%, and benefits from an electrophoresis tank with a substantially smaller footprint, and more uniform orientation of gels during electrophoresis. Our high-throughput variant of the comet assay greatly increases the number of samples analysed, decreases assay time, number of individual slide manipulations, reagent requirements and risk of damage to slides. The compact nature of the electrophoresis tank is of particular benefit to laboratories where bench space is at a premium. This novel approach is a significant advance on the current comet assay procedure.

Long-term effects of musical training and functional plasticity in salience system.

PubMed

Luo, Cheng; Tu, Shipeng; Peng, Yueheng; Gao, Shan; Li, Jianfu; Dong, Li; Li, Gujing; Lai, Yongxiu; Li, Hong; Yao, Dezhong

2014-01-01

Musicians undergoing long-term musical training show improved emotional and cognitive function, which suggests the presence of neuroplasticity. The structural and functional impacts of the human brain have been observed in musicians. In this study, we used data-driven functional connectivity analysis to map local and distant functional connectivity in resting-state functional magnetic resonance imaging data from 28 professional musicians and 28 nonmusicians. Compared with nonmusicians, musicians exhibited significantly greater local functional connectivity density in 10 regions, including the bilateral dorsal anterior cingulate cortex, anterior insula, and anterior temporoparietal junction. A distant functional connectivity analysis demonstrated that most of these regions were included in salience system, which is associated with high-level cognitive control and fundamental attentional process. Additionally, musicians had significantly greater functional integration in this system, especially for connections to the left insula. Increased functional connectivity between the left insula and right temporoparietal junction may be a response to long-term musical training. Our findings indicate that the improvement of salience network is involved in musical training. The salience system may represent a new avenue for exploration regarding the underlying foundations of enhanced higher-level cognitive processes in musicians.

Study on fluorescence of Maillard reaction compounds in breakfast cereals.

PubMed

Delgado-Andrade, Cristina; Rufián-Henares, José A; Morales, Francisco J

2006-09-01

During the advanced stage of the Maillard reaction (MR) in food processing and cooking, Amadori rearrangement products undergo dehydration and fission and fluorescent substances are formed. Free and total (free + linked to the protein backbone) fluorescence (FIC) due to Maillard compounds in 60 commercial breakfast cereals was evaluated. Pronase was used for efficient release of linked fluorescent Maillard compounds from the protein backbone. Results were correlated with some heat-induced markers of the extent of the MR or sugar caramelisation during cereal processing, such as hydroxymethylfurfural, furfural, glucosilisomaltol and furosine. The effect of sample composition (dietary-fibre added, protein, etc.) on levels of FIC, expressed as fluorescence intensity (FI) per milligram of sample, is discussed. FIC is significantly correlated to the protein content of the sample and fluorescent Maillard compounds are mainly linked to the protein backbone. The ratio of total-FIC to free-FIC was 10.4-fold for corn-based, wheat-based and multicereal-based breakfast cereals but significantly higher in rice-based samples. Addition of dietary fibre or honey increased the FIC values. Data support the usefulness of FIC measurement as an unspecific heat-induced marker in breakfast cereals.

Strength evolution of simulated carbonate-bearing faults: The role of normal stress and slip velocity

NASA Astrophysics Data System (ADS)

Mercuri, Marco; Scuderi, Marco Maria; Tesei, Telemaco; Carminati, Eugenio; Collettini, Cristiano

2018-04-01

A great number of earthquakes occur within thick carbonate sequences in the shallow crust. At the same time, carbonate fault rocks exhumed from a depth < 6 km (i.e., from seismogenic depths) exhibit the coexistence of structures related to brittle (i.e., cataclasis) and ductile deformation processes (i.e., pressure-solution and granular plasticity). We performed friction experiments on water-saturated simulated carbonate-bearing faults for a wide range of normal stresses (from 5 to 120 MPa) and slip velocities (from 0.3 to 100 μm/s). At high normal stresses (σn > 20 MPa) fault gouges undergo strain-weakening, that is more pronounced at slow slip velocities, and causes a significant reduction of frictional strength, from μ = 0.7 to μ = 0.47. Microstructural analysis show that fault gouge weakening is driven by deformation accommodated by cataclasis and pressure-insensitive deformation processes (pressure solution and granular plasticity) that become more efficient at slow slip velocity. The reduction in frictional strength caused by strain weakening behaviour promoted by the activation of pressure-insensitive deformation might play a significant role in carbonate-bearing faults mechanics.

The role of prophylactic internal iliac artery ligation in abnormally invasive placenta undergoing caesarean hysterectomy: a randomized control trial.

PubMed

Hussein, Ahmed M; Dakhly, Dina Mohamed Refaat; Raslan, Ayman N; Kamel, Ahmed; Abdel Hafeez, Ali; Moussa, Manal; Hosny, Ahmed Samir; Momtaz, Mohamed

2018-04-25

To identify the role of bilateral internal iliac artery (IIA) ligation on reducing blood loss in abnormally invasive placenta (AIP) undergoing caesarean hysterectomy. In this parallel-randomized control trial, 57 pregnant females with ultrasound features suggestive of AIP were enrolled. They were randomized into two groups; IIA group (n = 29 cases) performed bilateral IIA ligation followed by caesarean hysterectomies, while Control group (n = 28 cases) underwent caesarean hysterectomy only. The main outcome was the difference in the estimated intraoperative blood loss between the two groups. There was no significant difference between the two groups regarding the intraoperative estimated blood loss (1632 ± 804 versus 1698 ± 1251, p value .83). The operative procedure duration (minutes) (223 ± 66 versus 171 ± 41.4, p value .001) varied significantly between the two groups. Bilateral internal iliac artery ligation, in cases of AIP undergoing caesarean hysterectomy, is not recommended for routine practice to minimize blood loss intraoperatively.

Sevoflurane with or without antiemetic prophylaxis of dexamethasone in spontaneously breathing patients undergoing outpatient anorectal surgery.

PubMed

Wu, Jyh-I; Lu, Shao-Fong; Chia, Yuan-Yi; Yang, Lin-Cheng; Fong, Wen-Po; Tan, Ping-Heng

2009-11-01

To evaluate the prophylactic use of dexamethasone with sevoflurane in outpatient anorectal surgery. Randomized, controlled study. Operating room and Postanesthesia Care Unit of a general hospital. 60 adult, ASA physical status I and II outpatients undergoing anorectal surgery. Patients were randomized to receive either dexamethasone 5 mg intravenously (IV; Group D; n = 30) or an equal volume of saline (Group S; n = 30) before anesthesia induction. Anesthesia was induced with propofol 2.5 mg.kg(-1), fentanyl two microg.kg(-1), and 2% lidocaine one mg.kg(-1) followed by placement of a Laryngeal Mask Airway. Frequency of postoperative nausea and vomiting (PONV), visual analog scale (VAS) pain scores, and patient satisfaction were recorded. Frequency of PONV and VAS pain scores were significantly lower in Group D than Group S (P < 0.05). The time required for "home readiness" was significantly shorter in Group D than Group S (P < 0.05). The prophylactic administration of 5 mg dexamethasone IV can reduce the frequency of PONV, lower VAS pain scores, facilitate recovery to home readiness, and improve satisfaction in outpatients undergoing anorectal surgery.

COPD is a clear risk factor for increased use of resources and adverse outcomes in patients undergoing intervention for colorectal cancer: a nationwide study in Spain

PubMed Central

Baré, Marisa; Montón, Concepción; Mora, Laura; Redondo, Maximino; Pont, Marina; Escobar, Antonio; Sarasqueta, Cristina; Fernández de Larrea, Nerea; Briones, Eduardo; Quintana, Jose Maria

2017-01-01

Background We hypothesized that patients undergoing surgery for colorectal cancer (CRC) with COPD as a comorbidity would consume more resources and have worse in-hospital outcomes than similar patients without COPD. Therefore, we compared different aspects of the care process and short-term outcomes in patients undergoing surgery for CRC, with and without COPD. Methods This was a prospective study and it included patients from 22 hospitals located in Spain – 472 patients with COPD and 2,276 patients without COPD undergoing surgery for CRC. Clinical variables, postintervention intensive care unit (ICU) admission, use of invasive mechanical ventilation, and postintervention antibiotic treatment or blood transfusion were compared between the two groups. The reintervention rate, presence and type of complications, length of stay, and in-hospital mortality were also estimated. Hazard ratio (HR) for hospital mortality was estimated by Cox regression models. Results COPD was associated with higher rates of in-hospital complications, ICU admission, antibiotic treatment, reinterventions, and mortality. Moreover, after adjusting for other factors, COPD remained clearly associated with higher and earlier in-hospital mortality. Conclusion To reduce in-hospital morbidity and mortality in patients undergoing surgery for CRC and with COPD as a comorbidity, several aspects of perioperative management should be optimized and attention should be given to the usual comorbidities in these patients. PMID:28461746

Gender-based outcomes of bivalirudin versus heparin in patients undergoing percutaneous coronary interventions: Meta-analysis of randomized controlled trials.

PubMed

Mina, George S; Firouzbakht, Tina; Modi, Kalgi; Dominic, Paari

2017-11-01

We aimed to perform a gender-based meta-analysis of the outcome of bivalirudin versus heparin in patients undergoing percutaneous coronary interventions (PCI). Bivalirudin has been shown to decrease major bleeding when compared to heparin ± glycoprotein IIb/IIIa inhibitors (GPI) in patients undergoing PCI. It is unclear, however, if those differences in outcomes are the same for men and women. We included randomized controlled trials (RCTs) that compared bivalirudin to heparin with or without GPI in patients undergoing PCI and reported outcome data that were stratified by gender. Random effect model was used to pool odds ratio (OR) and 95% confidence intervals (CI). We included 9 trials with 33,224 patients. Bivalirudin decreased major bleeding when compared to heparin plus routine GPI in both men (OR: 0.51, P < 0.001) and women (OR: 0.55, P < 0.001). However, when GPI were used selectively with heparin, the bleeding lowering effect of bivalirudin was statistically significant in men (OR: 0.69, P = 0.02) but not in women (OR: 0.71, P = 0.21). When compared to heparin ± GPI, there was a nonstatistically significant trend toward lower all-cause mortality with bivalirudin in both men (OR: 0.76, P = 0.055) and women (OR: 0.79, P = 0.21). There were no significant differences in major adverse cardiovascular events between heparin and bivalirudin in both men and women. Bivalirudin decreases major bleeding in both men and women when compared to heparin plus routine GPI. However, when compared to heparin alone, the bleeding lowering benefit of bivalirudin is less evident in women. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Potential adverse effects of prophylactic bilateral salpingo-oophorectomy on skin aging in premenopausal women undergoing hysterectomy for benign conditions.

PubMed

Töz, Emrah; Özcan, Aykut; Balsak, Deniz; Avc, Muhittin Eftal; Eraslan, Arzu Görgülü; Balc, Didem Didar

2016-02-01

This study aimed to assess the effects of hysterectomy and bilateral salpingo-oophorectomy (BSO)--compared with the effects of hysterectomy alone--on skin aging in premenopausal women undergoing hysterectomy for benign conditions. One hundred thirty-five premenopausal women who underwent hysterectomy with BSO were compared with a control group of women who underwent hysterectomy alone based on skin parameters (including wrinkling, laxity/sagging, and texture/dryness) and Skindex-29 questionnaire scores. The inclusion criteria were as follows: aged between 40 and 50 years, follicle-stimulating hormone level lower than 40 mIU/mL, undergoing hysterectomy with or without BSO for benign conditions, and not receiving estrogen or progesterone treatment. The exclusion criteria were as follows: adrenocortical hyperplasia or Cushing's syndrome; use of corticosteroids for autoimmune diseases; malignancy, connective tissue diseases (eg, Ehlers-Danlos syndrome), or dermatological diseases (eg, lichen sclerosus); or regular use of medications known to interfere with the condition of the skin. All skin parameters in the hysterectomy group and the hysterectomy with BSO group worsened on weeks 24 and 48. Laxity/sagging and texture/dryness scores on weeks 24 and 48 were significantly worse in the BSO group; laxity/sagging and texture/dryness scores continued to worsen between 24 and 48 weeks. Scores for the Skindex-29 questionnaire emotion and symptom subscales were significantly higher in the BSO group compared with the non-BSO group. Prophylactic BSO during hysterectomy is a significant independent risk factor for worsening skin laxity/sagging and texture/dryness in premenopausal women undergoing hysterectomy for benign conditions. Prophylactic BSO in the presence of dermatological conditions is also associated with reduced quality of life.

Factors Associated With Work Ability in Patients Undergoing Surgery for Cervical Radiculopathy.

PubMed

Ng, Eunice; Johnston, Venerina; Wibault, Johanna; Löfgren, Håkan; Dedering, Åsa; Öberg, Birgitta; Zsigmond, Peter; Peolsson, Anneli

2015-08-15

Cross-sectional study. To investigate the factors associated with work ability in patients undergoing surgery for cervical radiculopathy. Surgery is a common treatment of cervical radiculopathy in people of working age. However, few studies have investigated the impact on the work ability of these patients. Patients undergoing surgery for cervical radiculopathy (n = 201) were recruited from spine centers in Sweden to complete a battery of questionnaires and physical measures the day before surgery. The associations between various individual, psychological, and work-related factors and self-reported work ability were investigated by Spearman rank correlation coefficient, multivariate linear regression, and forward stepwise regression analyses. Factors that were significant (P < 0.05) in each statistical analysis were entered into the successive analysis to reveal the factors most related to work ability. Work ability was assessed using the Work Ability Index. The mean Work Ability Index score was 28 (SD, 9.0). The forward stepwise regression analysis revealed 6 factors significantly associated with work ability, which explained 62% of the variance in the Work Ability Index. Factors highly correlated with greater work ability included greater self-efficacy in performing self-cares, lower physical load on the neck at work, greater self-reported chance of being able to work in 6 months' time, greater use of active coping strategies, lower frequency of hand weakness, and higher health-related quality of life. Psychological, work-related and individual factors were significantly associated with work ability in patients undergoing surgery for cervical radiculopathy. High self-efficacy was most associated with greater work ability. Consideration of these factors by surgeons preoperatively may provide optimal return to work outcomes after surgery. 3.

Fatigue experienced by patients receiving maintenance dialysis in hemodialysis units.

PubMed

Letchmi, Santhna; Das, Srijit; Halim, Hasliza; Zakariah, Farid Azizul; Hassan, Hamidah; Mat, Samsiah; Packiavathy, Ruth

2011-03-01

The fatigue that is observed in patients who are undergoing dialysis is usually associated with an impaired quality of life. The present cross-sectional study was conducted from January to April 2009 in three hemodialysis units in Kuala Lumpur, Malaysia. In this study, the Multidimensional Fatigue Inventory and Depression Anxiety and Stress Score 21 were used to determine the level of fatigue, depression, anxiety, and stress of patients who were undergoing dialysis. The data were obtained from a calculated sample of 116 and a total of 103 respondents participated in the study. A total of 56 (54.4%) and 47 (45.6%) respondents experienced a high level and a low level of fatigue, respectively. There was a significant relationship between the duration of treatment and the level of fatigue. The respondents who had been receiving treatment for > 2 years experienced more fatigue, compared to the respondents who had been undergoing hemodialysis for > 2 years. There was a significant difference in relation to the age of the participants regarding the level of fatigue. No significant relationship between the sex of the participants, anemia, depression, anxiety, stress, and the level of fatigue was observed. Special attention needs to be paid to both the younger and older adults who are receiving treatment. In addition, proper planning is needed for the patients regarding their daily activities in order to reduce fatigue. Nurses who work in hemodialysis units are recommended to provide exercise classes or group therapy in order to boost the energy levels among patients who are undergoing dialysis. Health professionals should provide appropriate treatment for patients who are experiencing fatigue in order to prevent any other complications that could arise. © 2011 Blackwell Publishing Asia Pty Ltd.

Association between vascular calcification scores on plain radiographs and fatty acid contents of erythrocyte membrane in hemodialysis patients.

PubMed

Son, Young K; Lee, Su M; Kim, Seong E; Kim, Ki H; Lee, Seon Y; Bae, Hae R; Han, Jin Y; Park, Yongsoon; An, Won S

2012-01-01

Vascular calcification (VC) scores determined by using simple plain radiographic films are known to be associated with coronary artery disease and mortality in patients undergoing hemodialysis (HD). Omega-3 fatty acid (FA) has been shown to reduce ectopic calcifications in an animal model, and it has also been shown that erythrocyte membrane omega-3 FA content is an independent discriminator of coronary artery disease. The present study was designed to demonstrate relations between VC scores and erythrocyte membrane FA contents in patients undergoing HD. A cross-sectional study was carried out. The study was carried out at an outpatient hemodialysis unit at Dong-A University Hospital, Busan, Republic of Korea. A total of 31 patients undergoing HD were recruited. Patients with significant malnutrition, a short duration of dialysis (<12 months), a history of recent infection, malignancy, or liver disease were excluded. Plain radiographic films of the feet, hands, pelvis, and lateral lumbar spine were examined and VC scores were determined using previously reported methods. Erythrocyte membrane FA contents were analyzed by gas chromatography. The erythrocyte membrane contents of eicosapentaenoic acid and docosahexaenoic acid were not found to be related with VC on simple plain radiographic films. However, erythrocyte membrane contents of oleic acid and total monounsaturated FA (MUFA) were significantly higher in patients with significant VC scores. Furthermore, erythrocyte membrane contents of MUFA and oleic acid were found to be negatively associated with high-density lipoprotein cholesterol level and positively associated with triglyceride level. Erythrocyte membrane contents of MUFA and oleic acid were found to be associated with VC scores determined using plain radiographs and with dyslipidemia in patients undergoing HD. Copyright © 2012 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Effect of listening to Vedic chants and Indian classical instrumental music on patients undergoing upper gastrointestinal endoscopy: A randomized control trial.

PubMed

Padam, Anita; Sharma, Neetu; Sastri, O S K S; Mahajan, Shivani; Sharma, Rajesh; Sharma, Deepak

2017-01-01

A high level of preoperative anxiety is common among patients undergoing medical and surgical procedures. Anxiety impacts of gastroenterological procedures on psychological and physiological responses are worth consideration. To analyze the effect of listening to Vedic chants and Indian classical instrumental music on anxiety levels and on blood pressure (BP), heart rate (HR), and oxygen saturation in patients undergoing upper gastrointestinal (GI) endoscopy. A prospective, randomized controlled trial was done on 199 patients undergoing upper GI endoscopy. On arrival, their anxiety levels were assessed using state and trait scores and various physiological parameters such as HR, BP, and SpO 2 . Patients were randomly divided into three groups: Group I of 67 patients who were made to listen prerecorded Vedic chants for 10 min, Group II consisting of 66 patients who listened to Indian classical instrumental music for 10 min, and Group III of 66 controls who remained seated for same period in the same environment. Thereafter, their anxiety state scores and physiological parameters were reassessed. A significant reduction in anxiety state scores was observed in the patients in Group I (from 40.4 ± 8.9 to 38.5 ± 10.7; P < 0.05) and Group II (from 41.8 ± 9.9 to 38.0 ± 8.6; P < 0.001) while Group III controls showed no significant change in the anxiety scores. A significant decrease in systolic BP ( P < 0.001), diastolic BP ( P < 0.05), and SpO 2 ( P < 0.05 was also observed in Group II. Listening to Vedic chants and Indian classical instrumental music has beneficial effects on alleviating anxiety levels induced by apprehension of invasive procedures and can be of therapeutic use.

In-hospital management and outcome of patients on warfarin undergoing coronary stent implantation: results of the multicenter, prospective WARfarin and coronary STENTing (WAR-STENT) registry.

PubMed

Rubboli, Andrea; Sciahbasi, Alessandro; Briguori, Carlo; Saia, Francesco; Palmieri, Cataldo; Moroni, Luigi Andrea; Calabrò, Paolo; Leone, Antonio Maria; Franco, Nicoletta; Valgimigli, Marco; Varani, Elisabetta; Santi, Michela; Pasqualini, Paola; Capecchi, Alessandro; Piccalò, Giacomo; Margheri, Massimo; di Pasquale, Giuseppe; Galvani, Marcello; Bolognese, Leonardo; Gonzini, Lucio; Maggioni, Aldo Pietro

2013-04-01

The in-hospital management of patients on warfarin undergoing coronary stent implantation (PCI-S) is variable, and the in-hospital outcome incompletely defined. To determine the adherence to the current recommendations, and the incidence of adverse events, we carried out the prospective, multicenter, observational WARfarin and coronary STENTing (WAR-STENT) registry (ClinicalTrials.gov identifier NCT00722319). All consecutive patients on warfarin undergoing PCI-S at 37 Italian centers were enrolled and followed for 12 months. Outcome measures were: major adverse cardiovascular events (MACE), including cardiovascular death, non-fatal myocardial infarction, need for urgent revascularization, stroke, and venous thromboembolism, and major and minor bleeding. In this paper, we report the in-hospital findings. Out of the 411 patients enrolled, 92% were at non-low (ie, moderate or high) thromboembolic risk. The radial approach and bare-metal stents were used in 61% and 60% of cases, respectively. Drug-eluting stents were essentially reserved to patients with diabetes, which in turn, significantly predicted the implantation of drug-eluting stents (odds ratio [OR], 2.02; 95% confidence interval [CI], 1.29-3.17; P=.002). The in-hospital MACE and major bleeding rates were 2.7% and 2.1%, respectively. At discharge, triple therapy (TT) of warfarin, aspirin, and clopidogrel was prescribed to 76% of patients. Prescription of TT was significantly more frequent in the non-low thromboembolic risk group. Non-low thromboembolic risk, in turn, was a significant predictor of TT prescription (OR, 11.2; 95% CI, 4.83-26.3; P<.0001). In conclusion, real-world warfarin patients undergoing PCI-S are largely managed according to the current recommendations. As a consequence, the risk of in-hospital MACE and major bleedings appears limited and acceptable.

Contrast media use in patients with chronic kidney disease undergoing coronary angiography: A systematic review and meta-analysis of randomized trials.

PubMed

Pandya, Bhavi; Chalhoub, Jean M; Parikh, Valay; Gaddam, Sainath; Spagnola, Jonathan; El-Sayegh, Suzanne; Bogin, Marc; Kandov, Ruben; Lafferty, James; Bangalore, Sripal

2017-02-01

Patients with chronic kidney disease (CKD) undergoing coronary angiography (CA), adequate hydration and minimizing volume of contrast media (CM) are class 1b recommendations for preventing contrast induced nephropathy (CIN). Current data are insufficient to justify specific recommendations about isoosmolar vs. low-osmolar contrast media by the ACCF/AHA/SCAI guidelines. Randomized trials comparing IOCM to LOCM in CKD stage 3 and above patients undergoing CA, and reporting incidence of CIN (defined by a rise in creatinine of 25% from baseline) were included in the analysis. The secondary outcome of the study was the incidence of serum creatinine increase by >1mg/dl. A total of 2839 patients were included in 10 trials, in which 1430 patients received IOCM and 1393 received LOCM. When compared to LOCM, IOCM was not associated with significant benefit in preventing CIN (OR=0.72, [CI: 0.50-1.04], P=0.08, I2=59%). Subgroup analysis revealed non-significant difference in incidence of CIN based on baseline use of N-acetylcystine (NAC), diabetes status, ejection fraction, and whether percutaneous coronary intervention vs coronary angiography alone was performed. The difference between IOCM and LOCM was further attenuated when restricted to studies with larger sample size (>250 patients) (OR=0.93; [CI: 0.66-1.30]) or when compared with non-ionic LOCM (OR=0.79, [CI: 0.52-1.21]). In patients with CKD stage 3 and above undergoing coronary angiography, use of IOCM showed overall non-significant difference in incidence of CIN compared to LOCM. The difference was further attenuated when IOCM was compared with non-ionic LOCM. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

[Thunder-fire Moxibustion for Qi Deficiency-induced Fatigue in Breast Cancer Patients Under-going Chemotherapy].

PubMed

Lu, Lu; Li, Wei-Han; Guo, Xiao-Chuan; Fu, Wen-Bin

2018-02-25

To observe the clinical effect of thunder-fire moxibustion in the treatment of qi deficiency-induced fatigue in breast cancer patients undergoing chemotherapy. Sixty breast cancer patients undergoing chemotherapy were randomly divided into thunder-fire moxibustion (Moxi) and conventional nursing (nursing) groups ( n ＝30 in each group). Patients in the Moxi group were treated with thunder-fire moxibustion applied to the back part of body from Pishu (BL 20) to Qihaishu (BL 24) on the bilateral sides and to the abdominal part from Zhongwan (CV 12) to Guanyuan (CV 4) for 30 min, once a day for 14 days. Patients in the nursing group were treated with health education and conventional nursing care. The simple fatigue scale, traditional Chinese medicine (TCM) syndrome score, clinical curative effect were observed before and after the treatment, and white blood cell (WBC) count was observed 5 days ofter chemotherapy and after the treatment respectively. After the treatment, the simple fatigue scales and TCM syndrome scores were significantly decreased and WBC counts were significantly increased in both groups relevant to their individual pre-treatment ( P <0.01). The therapeutic effect of the Moxi group was appa-rently superior to that of the nursing group in lowering the simple fatigue scale and TCM syndrome score and in up-regulating WBC count ( P <0.01, P <0.05). The total effective rate of the Moxi group was significantly higher than that of the nursing group (83.3%[25/30]vs 36.7% [11/30], P <0.01). Thunder-fire moxibustion can effectively relieve the degree of fatigue and the symptoms of qi deficiency in breast cancer patients undergoing chemotherapy.

Efficacy of transversus abdominis plane block with liposomal bupivacaine during open abdominal wall reconstruction.

PubMed

Fayezizadeh, Mojtaba; Majumder, Arnab; Neupane, Ruel; Elliott, Heidi L; Novitsky, Yuri W

2016-09-01

Transversus abdominis plane block (TAPb) is an analgesic adjunct used for abdominal surgical procedures. Liposomal bupivacaine (LB) demonstrates prolonged analgesic effects, up to 72 hours. We evaluated the analgesic efficacy of TAPb using LB for patients undergoing open abdominal wall reconstruction (AWR). Fifty patients undergoing AWR with TAPb using LB (TAP-group) were compared with a matched historical cohort undergoing AWR without TAPb (control group). Outcome measures included postoperative utilization of morphine equivalents, numerical rating scale pain scores, time to oral narcotics, and length of stay (LOS). Cohorts were matched demographically. No complications were associated with TAPb or LB. TAP-group evidenced significantly reduced narcotic requirements on operative day (9.5 mg vs 16.5 mg, P = .004), postoperative day (POD) 1 (26.7 mg vs 39.5 mg, P = .01) and POD2 (29.6 mg vs 40.7 mg, P = .047) and pain scores on operative day (5.1 vs 7.0, P <.001), POD1 (4.2 vs 5.5, P = .002), and POD2 (3.9 vs 4.8, P = .04). In addition, TAP-group demonstrated significantly shorter time to oral narcotics (2.7 days vs 4.0 days, P <.001) and median LOS (5.2 days vs 6.8 days, P = .004). TAPb with LB demonstrated significant reductions in narcotic consumption and improved pain control. TAPb allowed for earlier discontinuation of intravenous narcotics and shorter LOS. Intraoperative TAPb with LB appears to be an effective adjunct for perioperative analgesia in patients undergoing open AWR. Copyright © 2016 Elsevier Inc. All rights reserved.

Association Between Clinical Pathways Leading to Medical Management and Prognosis in Patients With NSTEACS.

PubMed

Bueno, Héctor; Pocock, Stuart; Medina, Jesús; Danchin, Nicolas; Annemans, Lieven; Licour, Muriel; Gregson, John; Vega, Ana María; van de Werf, Frans

2017-10-01

A large proportion of patients with non-ST-segment elevation acute coronary syndrome (NSTEACS) are initially selected for medical management (MM) and do not undergo coronary revascularization during or immediately after the index event. The aim of this study was to explore the clinical pathways leading to MM in NSTEACS patients and their influence on prognosis. Patient characteristics, pathways leading to MM, and 2-year outcomes were recorded in a prospective cohort of 5591 NSTEACS patients enrolled in 555 hospitals in 20 countries across Europe and Latin America. Cox models were used to assess the impact of hospital management on postdischarge mortality. Medical management was the selected strategy in 2306 (41.2%) patients, of whom 669 (29%) had significant coronary artery disease (CAD), 451 (19.6%) had nonsignificant disease, and 1186 (51.4%) did not undergo coronary angiography. Medically managed patients were older and had higher risk features than revascularized patients. Two-year mortality was higher in medically managed patients than in revascularized patients (11.0% vs 4.4%; P < .001), with higher mortality rates in patients who did not undergo angiography (14.6%) and in those with significant CAD (9.3%). Risk-adjusted mortality was highest for patients who did not undergo angiography (HR = 1.81; 95%CI, 1.23-2.65), or were not revascularized in the presence of significant CAD (HR = 1.90; 95%CI, 1.23-2.95) compared with revascularized patients. Medically managed NSTEACS patients represent a heterogeneous population with distinct risk profiles and outcomes. These differences should be considered when designing future studies in this population. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Use of tailored loading-dose clopidogrel in patients undergoing selected percutaneous coronary intervention based on adenosine diphosphate-mediated platelet aggregation.

PubMed

Meng, Kang; Lü, Shu-Zheng; Zhu, Hua-Gang; Chen, Xin; Ge, Chang-Jiang; Song, Xian-Tao

2010-12-01

Adenosine phosphate-mediated platelet aggregation is a prognostic factor for major adverse cardiac events in patients who have undergone selective percutaneous coronary interventions. This study aimed to assess whether an adjusted loading dose of clopidogrel could more effectively inhibit platelet aggregation in patients undergoing selected percutaneous coronary intervention. A total of 205 patients undergoing selected percutaneous coronary intervention were enrolled in this multicenter, prospective, randomized study. Patients receiving domestic clopidogrel (n = 104) served as the Talcom (Taijia) group; others (n = 101) received Plavix, the Plavix group. Patients received up to 3 additional 300-mg loading doses of clopidogrel to decrease the adenosine phosphate-mediated platelet aggregation index by more than 50% (the primary endpoint) compared with the baseline. The secondary endpoint was major adverse cardiovascular events at 12 months. Compared with the rational loading dosage, the tailored loading dosage better inhibited platelet aggregation based on a > 50% decrease in adenosine phosphate-mediated platelet aggregation (rational loading dosage vs. tailored loading dosage, 48% vs. 73%, P = 0.028). There was no significant difference in the eligible index between the Talcom and Plavix groups (47% vs. 49% at 300 mg; 62% vs. 59% at 600 mg; 74% vs. 72% at 900 mg; P > 0.05) based on a standard adenosine diphosphate-mediated platelet aggregation decrease of > 50%. After 12 months of follow-up, there were no significant differences in major adverse cardiac events (2.5% vs. 2.9%, P = 5.43). No acute or subacute stent thrombosis events occurred. An adjusted loading dose of clopidogrel could have significant effects on antiplatelet aggregation compared with a rational dose, decreasing 1-year major adverse cardiac events in patients undergoing percutaneous coronary interventions based on adenosine phosphate-mediated platelet aggregation with no increase in bleeding.

Xenon as an Adjuvant to Propofol Anesthesia in Patients Undergoing Off-Pump Coronary Artery Bypass Graft Surgery: A Pragmatic Randomized Controlled Clinical Trial.

PubMed

Al Tmimi, Layth; Devroe, Sarah; Dewinter, Geertrui; Van de Velde, Marc; Poortmans, Gert; Meyns, Bart; Meuris, Bart; Coburn, Mark; Rex, Steffen

2017-10-01

Xenon was shown to cause less hemodynamic instability and reduce vasopressor needs during off-pump coronary artery bypass (OPCAB) surgery when compared with conventionally used anesthetics. As xenon exerts its organ protective properties even in subanesthetic concentrations, we hypothesized that in patients undergoing OPCAB surgery, 30% xenon added to general anesthesia with propofol results in superior hemodynamic stability when compared to anesthesia with propofol alone. Fifty patients undergoing elective OPCAB surgery were randomized to receive general anesthesia with 30% xenon adjuvant to a target-controlled infusion of propofol or with propofol alone. The primary end point was the total intraoperative dose of norepinephrine required to maintain an intraoperative mean arterial pressure >70 mm Hg. Secondary outcomes included the perioperative cardiorespiratory profile and the incidence of adverse and serious adverse events. Adding xenon to propofol anesthesia resulted in a significant reduction of norepinephrine required to attain the predefined hemodynamic goals (cumulative intraoperative dose: median [interquartile range]: 370 [116-570] vs 840 [335-1710] µg, P = .001). In the xenon-propofol group, significantly less propofol was required to obtain a similar depth of anesthesia as judged by clinical signs and the bispectral index (propofol effect site concentration [mean ± SD]: 1.8 ± 0.5 vs 2.8 ± 0.3 mg, P≤ .0001). Moreover, the xenon-propofol group required significantly less norepinephrine during the first 24 hours on the intensive care unit (median [interquartile range]: 1.5 [0.1-7] vs 5 [2-8] mg, P = .048). Other outcomes and safety parameters were similar in both groups. Thirty percent xenon added to propofol anesthesia improves hemodynamic stability by decreasing norepinephrine requirements in patients undergoing OPCAB surgery.

Unemployment risk among individuals undergoing medical treatment for chronic diseases.

PubMed

Nakaya, N; Nakamura, T; Tsuchiya, N; Tsuji, I; Hozawa, A; Tomita, H

2016-03-01

Chronic diseases increase the risk of unemployment even in non-disaster settings; therefore, in post-disaster settings, special attention needs to be paid to the employment status of those suffering from chronic diseases. To examine the association between chronic disease and the risk of unemployment in a disaster area. This cross-sectional study was conducted in Shichigahama Town, Miyagi, north-eastern Japan, where had been severely inundated by the 2011 tsunami. Logistic regression analyses were used to evaluate the association between undergoing medical treatment for a combination of chronic diseases (stroke, cancer, myocardial infarction and angina) and unemployment risk. Confounders such as psychological distress and levels of daily life activity were considered. Among the 2588 individuals studied, there was a statistically significant association between undergoing medical treatment for chronic disease and the risk of unemployment [odds ratio (OR) = 1.7, 95% confidence interval (CI) 1.02-2.7, P < 0.05]. In participants with a lower degree of psychological distress and better levels of daily life activity (n = 1967), no significant associations were observed (OR = 1.1, 95% CI 0.6-2.1). Conversely, in 536 participants with a higher degree of psychological distress and/or poorer levels of daily life activity, statistically significant associations were found (OR = 2.6, 95% CI 1.01-6.6, P < 0.05). The association between undergoing medical treatment for chronic disease and unemployment risk was observed only in participants with a higher degree of psychological distress and/or poorer levels of daily life activity. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Endoscopic Spatulation of the Intramural Ureter: A Technique to Prevent Stenosis of the Ureterovesical Junction in Patients Undergoing Resection of the Ureteral Orifice.

PubMed

Creta, Massimiliano; Mirone, Vincenzo; Di Meo, Sergio; Buonopane, Roberto; Fusco, Ferdinando; Imperatore, Vittorio

2016-08-01

Wide resection of the ureteral orifice (UO) may result in scarring and stenosis of the ureterovesical junction (UVJ). We aimed to describe a technique of endoscopic spatulation of the intramural ureter in patients undergoing resection of the UO at the time of transurethral resection of bladder tumor (TURBT) and compare the surgical and oncological outcomes of this procedure with those of patients undergoing conventional UO resection. The clinical records of patients who underwent TURBT at a single institution were retrospectively analyzed. Patients who underwent conventional UO resection or UO resection followed by endoscopic spatulation of the intramural ureter were included in the analysis. The two groups were compared in terms of intra- and postoperative outcomes. A total of 227 patients were included in the final comparative analyses. Of them, 104 underwent conventional UO resection and 123 underwent UO resection followed by endoscopic spatulation of the intramural ureter. The two groups were comparable for demographic and clinical features. There were not statistically significant differences in terms of mean operative times. The incidence of transient postoperative hydronephrosis as well as UVJ scarring and stenosis was significantly lower in patients undergoing endoscopic spatulation of the intramural ureter. The two groups were similar in terms of incidence of vesicoureteral reflux (VUR) and upper urinary tract cancer recurrence. Endoscopic spatulation of the intramural ureter after UO resection is a safe and quick procedure that significantly reduces the incidence of transient early postoperative hydronephrosis and late UVJ stricture if compared with UO resection alone. This procedure is quick to perform, safe, and does not increase the risk of VUR.

Arrestin binding to the G protein-coupled N-formyl peptide receptor is regulated by the conserved "DRY" sequence.

PubMed

Bennett, T A; Maestas, D C; Prossnitz, E R

2000-08-11

Following activation by ligand, the N-formyl peptide receptor (FPR) undergoes processing events initiated by phosphorylation that lead to receptor desensitization and internalization. Our previous results have shown that FPR internalization can occur in the absence of receptor desensitization, suggesting that FPR desensitization and internalization are controlled by distinct mechanisms. More recently, we have provided evidence that internalization of the FPR occurs via a mechanism that is independent of the actions of arrestin, dynamin, and clathrin. In the present report, we demonstrate that stimulation of the FPR with agonist leads to a significant translocation of arrestin-2 from the cytosol to the membrane. Fluorescence microscopy revealed that the translocated arrestin-2 is highly colocalized with the ligand-bound FPR. A D71A mutant FPR, which does not undergo activation or phosphorylation in response to ligand, did not colocalize with arrestin-2. Surprisingly, an R123G mutant FPR, which does not bind G protein but does become phosphorylated and subsequently internalized, also did not bind arrestin. These results indicate that arrestin binding is not required for FPR internalization and demonstrate for the first time that a common motif, the conserved "DRY" domain of G protein-coupled receptors, is essential for phosphorylation-dependent arrestin binding, as well as G protein activation.

Association between thymic function and allogeneic hematopoietic stem cell transplantation outcome: results of a pediatric study.

PubMed

Saglio, Francesco; Cena, Silvia; Berger, Massimo; Quarello, Paola; Boccasavia, Viola; Ferrando, Federica; Pittana, Laura; Bruno, Benedetto; Fagioli, Franca

2015-06-01

Robust T cell function recovery has been shown to be crucial in determining allogeneic hematopoietic stem cell transplantation (HSCT) outcome, and there is growing evidence that the thymus plays a central role in regulating this process. We performed a long-term analysis of the role of thymic activity recovery in a population of pediatric patients undergoing allogeneic HSCT by signal joint T cell receptor excision circle (sjTREC) quantification. In this study, characterized by a long-term follow-up (median, 72 months), we found patients with higher levels of sjTRECs before transplantation had a statistically significant reduced risk of death compared with patients with lower values (relative risk, .31; 95% confidence interval, .30 to .32; P = .02), showing this different outcome was mainly related to a reduction of relapse incidence (14% versus 43%, P = .02). Unlike previous reports, we observed no correlation between sjTREC levels and lymphocyte recovery. Moreover, we confirmed that only graft-versus-host disease influenced thymic activity after transplantation. In conclusion, our results suggest an association between pretransplantation thymic activity and the long-term outcome of pediatric patients undergoing HSCT, mainly through a reduction of relapse opportunities. Copyright © 2015 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

Evidence for heterogeneity of astrocyte de-differentiation in vitro: astrocytes transform into intermediate precursor cells following induction of ACM from scratch-insulted astrocytes.

PubMed

Yang, Hao; Qian, Xin-Hong; Cong, Rui; Li, Jing-wen; Yao, Qin; Jiao, Xi-Ying; Ju, Gong; You, Si-Wei

2010-04-01

Our previous study definitely demonstrated that the mature astrocytes could undergo a de-differentiation process and further transform into pluripotential neural stem cells (NSCs), which might well arise from the effect of diffusible factors released from scratch-insulted astrocytes. However, these neurospheres passaged from one neurosphere-derived from de-differentiated astrocytes possessed a completely distinct characteristic in the differentiation behavior, namely heterogeneity of differentiation. The heterogeneity in cell differentiation has become a crucial but elusive issue. In this study, we show that purified astrocytes could de-differentiate into intermediate precursor cells (IPCs) with addition of scratch-insulted astrocyte-conditioned medium (ACM) to the culture, which can express NG2 and A2B5, the IPCs markers. Apart from the number of NG2(+) and A2B5(+) cells, the percentage of proliferative cells as labeled with BrdU progressively increased with prolonged culture period ranging from 1 to 10 days. Meanwhile, the protein level of A2B5 in cells also increased significantly. These results revealed that not all astrocytes could de-differentiate fully into NSCs directly when induced by ACM, rather they generated intermediate or more restricted precursor cells that might undergo progressive de-differentiation to generate NSCs.

L-Dopa decarboxylase expression profile in human cancer cells.

PubMed

Chalatsa, Ioanna; Nikolouzou, Eleftheria; Fragoulis, Emmanuel G; Vassilacopoulou, Dido

2011-02-01

L-Dopa decarboxylase (DDC) catalyses the decarboxylation of L-Dopa. It has been shown that the DDC gene undergoes alternative splicing within its 5'-untranslated region (UTR), in a tissue-specific manner, generating identical protein products. The employment of two alternative 5'UTRs is thought to be responsible for tissue-specific expression of the human DDC mRNA. In this study, we focused on the investigation of the nature of the mRNA expression in human cell lines of neural and non-neural origin. Our results show the expression of a neural-type DDC mRNA splice variant, lacking exon 3 in all cell lines studied. Co-expression of the full length non-neural DDC mRNA and the neural-type DDC splice variant lacking exon 3 was detected in all cell lines. The alternative DDC protein isoform, Alt-DDC, was detected in SH-SY5Y and HeLa cells. Our findings suggest that the human DDC gene undergoes complex processing, leading to the formation of multiple mRNA isoforms. The study of the significance of this phenomenon of multiple DDC mRNA isoforms could provide us with new information leading to the elucidation of the complex biological pathways that the human enzyme is involved in.

A Taguchi approach on optimal process control parameters for HDPE pipe extrusion process

NASA Astrophysics Data System (ADS)

Sharma, G. V. S. S.; Rao, R. Umamaheswara; Rao, P. Srinivasa

2017-06-01

High-density polyethylene (HDPE) pipes find versatile applicability for transportation of water, sewage and slurry from one place to another. Hence, these pipes undergo tremendous pressure by the fluid carried. The present work entails the optimization of the withstanding pressure of the HDPE pipes using Taguchi technique. The traditional heuristic methodology stresses on a trial and error approach and relies heavily upon the accumulated experience of the process engineers for determining the optimal process control parameters. This results in setting up of less-than-optimal values. Hence, there arouse a necessity to determine optimal process control parameters for the pipe extrusion process, which can ensure robust pipe quality and process reliability. In the proposed optimization strategy, the design of experiments (DoE) are conducted wherein different control parameter combinations are analyzed by considering multiple setting levels of each control parameter. The concept of signal-to-noise ratio ( S/ N ratio) is applied and ultimately optimum values of process control parameters are obtained as: pushing zone temperature of 166 °C, Dimmer speed at 08 rpm, and Die head temperature to be 192 °C. Confirmation experimental run is also conducted to verify the analysis and research result and values proved to be in synchronization with the main experimental findings and the withstanding pressure showed a significant improvement from 0.60 to 1.004 Mpa.

Amniocentesis compared with antenatal corticosteroids prior to early term scheduled cesarean delivery.

PubMed

Zafman, Kelly B; Fox, Nathan S

2018-05-06

There are a variety of maternal or fetal conditions that require late preterm or early term delivery. In cases where early delivery is indicated, optimal management is not always clear. Historically, obstetricians used amniocentesis to document fetal lung maturity, but recently, many have transitioned to administration of antenatal corticosteroids (ACS). The objective of this study was to compare neonatal outcomes between women undergoing amniocentesis or receiving ACS prior to scheduled cesarean delivery (CD) less than 39 weeks. This was a retrospective cohort study of women undergoing scheduled CD by one maternal-fetal medicine practice between 36 and 38 6/7 weeks, from 2005 to 2017. We identified women who underwent amniocentesis or received ACS within 2 weeks prior to delivery. Neonatal outcomes were compared between the two groups, with the primary outcome being neonatal intensive care unit (NICU) admission. A total of 502 women were included, of whom 313 (62.4%) underwent amniocentesis and 189 (37.6%) received ACS. Overall, 55 (11.0%) of neonates were admitted to the NICU. NICU admission was not significantly different between groups (11.8 versus 9.5%, p=.46). This held true after adjusting for gestational age and other differences in baseline characteristics. There were no significant differences between groups for all other neonatal outcomes, including NICU admission for respiratory indications, respiratory support, neonatal greater than maternal length of stay, low Apgar scores, and neonatal death. Rates of hypoglycemia were low and not significantly different between groups (2.2% in the amniocentesis group versus 0.5% in the ACS group, p=.27). Diabetes was the only covariate significantly associated with NICU admission (aOR 3.19, 95% CI 1.35, 7.54). In women undergoing scheduled CD between 36 and 38 6/7 weeks, administration of ACS is associated with similar neonatal outcomes compared to amniocentesis. This supports the current notion that outcomes are similar with ACS compared to amniocentesis for late preterm and early term deliveries. Brief rationale: The objective of this study was to compare neonatal outcomes between women undergoing amniocentesis or receiving antenatal corticosteroids (ACS) prior to scheduled cesarean delivery (CD) less than 39 weeks. We found that in women undergoing scheduled cesarean delivery between 36 and 38 6/7 weeks, administration of antenatal corticosteroids is associated with similar neonatal outcomes compared to amniocentesis.

Outcomes of Osteochondral Allograft Transplantation With and Without Concomitant Meniscus Allograft Transplantation: A Comparative Matched Group Analysis.

PubMed

Frank, Rachel M; Lee, Simon; Cotter, Eric J; Hannon, Charles P; Leroux, Timothy; Cole, Brian J

2018-03-01

Osteochondral allograft transplantation (OCA) is often performed with concomitant meniscus allograft transplantation (MAT) as a strategy for knee joint preservation, although to date, the effect of concomitant MAT on outcomes and failure rates after OCA has not been assessed. To determine clinical outcomes for patients undergoing OCA with MAT as compared with a matched cohort of patients undergoing isolated OCA. Control study; Level of evidence, 3. Patients who underwent OCA of the medial or lateral femoral condyle without concomitant MAT by a single surgeon were compared with a matched group of patients who underwent OCA with concomitant MAT (ipsilateral compartment). The patients were matched per age, sex, body mass index, and number of previous ipsilateral knee operations ±1. Patient-reported outcomes, complications, reoperations, and survival rates were compared between groups. One hundred patients undergoing OCA (50 isolated, 50 with MAT) with a mean ± SD follow-up of 4.9 ± 2.7 years (minimum, 2 years) were included (age, 31.7 ± 9.8 years; 52% male). Significantly more patients underwent OCA to the medial femoral condyle (n = 59) than the lateral femoral condyle (n = 41, P < .0001). Patients underwent 2.7 ± 1.7 operations on the ipsilateral knee before OCA. There were no significant differences between the groups regarding reoperation rate (n = 18 for OCA with MAT, n = 17 for OCA without MAT, P = .834), time to reoperation (2.2 ± 2.4 years for OCA with MAT, 3.4 ± 2.7 years for OCA without MAT, P = .149), or failure rates (n = 7 [14%] for OCA with MAT, n = 7 [14%] for OCA without MAT, P > .999). There were no significant differences in patient-reported clinical outcome scores between the groups at final follow-up. There was no significant difference in failure rates between patients undergoing medial femoral condyle OCA (n = 12, 15.3%) and lateral femoral condyle OCA (n = 5, 12.2%, P = .665). These results imply that with appropriate surgical indications to address meniscus deficiency in patients otherwise indicated for OCA and despite the added surgical time and complexity of concomitant MAT, outcomes are favorable, with an 86% OCA graft survivorship at 5 years. This information can be used to counsel patients undergoing OCA with concomitant MAT as part of a knee joint preservation strategy.

Tryptophan Depletion and Emotional Processing in Healthy Volunteers at High Risk for Depression

PubMed Central

Feder, Adriana; Skipper, Jamie; Blair, James R.; Buchholz, Katherine; Mathew, Sanjay J.; Schwarz, Markus; Doucette, John T.; Alonso, Angelique; Collins, Katherine A.; Neumeister, Alexander; Charney, Dennis S.

2014-01-01

Background Studies in depressed patients have demonstrated the presence of emotional bias toward negative stimuli, as well as dysregulated brain serotonin function. The present study compared the effects of acute tryptophan depletion (ATD) on both an emotional processing and a planning task in never-depressed healthy volunteers at high and low familial risk for depression. Methods Young adults with no personal psychiatric history were stratified into two groups based on family history (n = 25). Participants were enrolled in a randomized, double-blind, placebo-controlled crossover ATD study and completed the affective go/no-go and Tower of London tasks once during each condition. Results There was a significant treatment by valence by group interaction on the affective go/no-go, driven primarily by a greater frequency of inappropriate responses to sad than to happy distracters in the high-risk group during ATD. No group differences were observed on the Tower of London. Conclusions Asymptomatic individuals at high familial risk for depression showed abnormalities in emotional processing while undergoing experimentally induced tryptophan depletion. These findings support emotional processing disturbances as potential trait-level abnormalities associated with the risk of mood disorder. PMID:21377656

I used to cry every day: a model of the family process of managing displacement.

PubMed

Greene, Danielle; Tehranifar, Parisa; Hernandez-Cordero, Lourdes J; Fullilove, Mindy Thompson

2011-06-01

Community displacing events, natural or human made, are increasing in frequency. By the end of 2009, over 36 million people were known to be displaced worldwide. Displacement is a traumatic experience with significant short- and long-term health consequences. The losses and costs associated with displacement-social connections, employment, property, and economic capital-are felt not only by the displaced individuals but also the communities they have left behind, and the communities that receive displaced individuals. Many researchers have explored the link between health and reduced social, cultural, and economic capital. Most of the displacement literature focuses on the effect of displacement on the displaced individual; however, many families move as a group. In this study, we examined the family process of managing displacement and its associated capital losses by conducting interviews with 20 families. We found that families undergo a four-phase process of displacement: antecedent, uprooting, transition, and resettlement. The losses families experience impact the health and well-being of individuals, families, and communities. The degree to which the displacement process ends successfully, or ends at all, can be affected by efforts to both create connections within the new communities and rebuild economic and social capital.

Fully solution-processed transparent electrodes based on silver nanowire composites for perovskite solar cells.

PubMed

Kim, Areum; Lee, Hongseuk; Kwon, Hyeok-Chan; Jung, Hyun Suk; Park, Nam-Gyu; Jeong, Sunho; Moon, Jooho

2016-03-28

We report all-solution-processed transparent conductive electrodes based on Ag nanowire (AgNW)-embedded metal oxide composite films for application in organometal halide perovskite solar cells. To address the thermal instability of Ag nanowires, we used combustive sol-gel derived thin films to construct ZnO/ITO/AgNW/ITO composite structures. The resulting composite configuration effectively prevented the AgNWs from undergoing undesirable side-reactions with halogen ions present in the perovskite precursor solutions that significantly deteriorate the optoelectrical properties of Ag nanowires in transparent conductive films. AgNW-based composite electrodes had a transmittance of ∼80% at 550 nm and sheet resistance of 18 Ω sq(-1). Perovskite solar cells fabricated using a fully solution-processed transparent conductive electrode, Au/spiro-OMeTAD/CH3NH3PbI3 + m-Al2O3/ZnO/ITO/AgNW/ITO, exhibited a power conversion efficiency of 8.44% (comparable to that of the FTO/glass-based counterpart at 10.81%) and were stable for 30 days in ambient air. Our results demonstrate the feasibility of using AgNWs as a transparent bottom electrode in perovskite solar cells produced by a fully printable process.

Optimization of IVF pregnancy outcomes with donor spermatozoa.

PubMed

Wang, Jeff G; Douglas, Nataki C; Prosser, Robert; Kort, Daniel; Choi, Janet M; Sauer, Mark V

2009-03-01

To identify risk factors for suboptimal IVF outcomes using insemination with donor spermatozoa and to define a lower threshold that may signal a conversion to fertilization by ICSI rather than insemination. Retrospective, age-matched, case-control study of women undergoing non-donor oocyte IVF cycles using either freshly ejaculated (N=138) or cryopreserved donor spermatozoa (N=69). Associations between method of fertilization, semen sample parameters, and pregnancy rates were analyzed. In vitro fertilization of oocytes with donor spermatozoa by insemination results in equivalent fertilization and pregnancy rates compared to those of freshly ejaculated spermatozoa from men with normal semen analyses when the post-processing motility is greater than or equal to 88%. IVF by insemination with donor spermatozoa when the post-processing motility is less than 88% is associated with a 5-fold reduction in pregnancy rates when compared to those of donor spermatozoa above this motility threshold. When the post-processing donor spermatozoa motility is low, fertilization by ICSI is associated with significantly higher pregnancy rates compared to those of insemination. While ICSI does not need to be categorically instituted when using donor spermatozoa in IVF, patients should be counseled that conversion from insemination to ICSI may be recommended based on low post-processing motility.

Interaction of dissolution, sorption and biodegradation on transport of BTEX in a saturated groundwater system: Numerical modeling and spatial moment analysis

NASA Astrophysics Data System (ADS)

Valsala, Renu; Govindarajan, Suresh Kumar

2018-06-01

Interaction of various physical, chemical and biological transport processes plays an important role in deciding the fate and migration of contaminants in groundwater systems. In this study, a numerical investigation on the interaction of various transport processes of BTEX in a saturated groundwater system is carried out. In addition, the multi-component dissolution from a residual BTEX source under unsteady flow conditions is incorporated in the modeling framework. The model considers Benzene, Toluene, Ethyl Benzene and Xylene dissolving from the residual BTEX source zone to undergo sorption and aerobic biodegradation within the groundwater aquifer. Spatial concentration profiles of dissolved BTEX components under the interaction of various sorption and biodegradation conditions have been studied. Subsequently, a spatial moment analysis is carried out to analyze the effect of interaction of various transport processes on the total dissolved mass and the mobility of dissolved BTEX components. Results from the present numerical study suggest that the interaction of dissolution, sorption and biodegradation significantly influence the spatial distribution of dissolved BTEX components within the saturated groundwater system. Mobility of dissolved BTEX components is also found to be affected by the interaction of these transport processes.

A new structural framework for integrating replication protein A into DNA processing machinery

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

Brosey, Chris A; Yan, Chunli; Tsutakawa, Susan E

2013-01-01

By coupling the protection and organization of ssDNA with the recruitment and alignment of DNA processing factors, Replication Protein A (RPA) lies at the heart of dynamic multi-protein DNA processing machinery. Nevertheless, how RPA manages to coordinate the biochemical functions of its eight domains remains unknown. We examined the structural biochemistry of RPA s DNA binding activity, combining small-angle x-ray and neutron scattering with all-atom molecular dynamics simulations to investigate the architecture of RPA s DNA-binding core. It has been long held that RPA engages ssDNA in three stages, but our data reveal that RPA undergoes two rather than threemore » transitions as it binds ssDNA. In contrast to previous models, RPA is more compact when fully engaged on 20-30 nucleotides of ssDNA than when DNA-free, and there is no evidence for significant population of a highly compacted structure in the initial 8-10 nucleotide binding mode. These results provide a new framework for understanding the integration of ssDNA into DNA processing machinery and how binding partners may manipulate RPA architecture to gain access to the substrate.« less

Effects of preoperative aspirin on cardiocerebral and renal complications in non-emergent cardiac surgery patients: a sub-group and cohort study.

PubMed

Cao, Longhui; Silvestry, Scott; Zhao, Ning; Diehl, James; Sun, Jianzhong

2012-01-01

Postoperative cardiocerebral and renal complications are a major threat for patients undergoing cardiac surgery. This study was aimed to examine the effect of preoperative aspirin use on patients undergoing cardiac surgery. An observational cohort study was performed on consecutive patients (n = 1879) receiving cardiac surgery at this institution. The patients excluded from the study were those with preoperative anticoagulants, unknown aspirin use, or underwent emergent cardiac surgery. Outcome events included were 30-day mortality, renal failure, readmission and a composite outcome--major adverse cardiocerebral events (MACE) that include permanent or transient stroke, coma, perioperative myocardial infarction (MI), heart block and cardiac arrest. Of all patients, 1145 patients met the inclusion criteria and were divided into two groups: those taking (n = 858) or not taking (n = 287) aspirin within 5 days preceding surgery. Patients with aspirin presented significantly more with history of hypertension, diabetes, peripheral arterial disease, previous MI, angina and older age. With propensity scores adjusted and multivariate logistic regression, however, this study showed that preoperative aspirin therapy (vs. no aspirin) significantly reduced the risk of MACE (8.4% vs. 12.5%, odds ratio [OR] 0.585, 95% CI 0.355-0.964, P = 0.035), postoperative renal failure (2.6% vs. 5.2%, OR 0.438, CI 0.203-0.945, P = 0.035) and dialysis required (0.8% vs. 3.1%, OR 0.230, CI 0.071-0.742, P = 0.014), but did not significantly reduce 30-day mortality (4.1% vs. 5.8%, OR 0.744, CI 0.376-1.472, P = 0.396) nor it increased readmissions in the patients undergoing cardiac surgery. Preoperative aspirin therapy is associated with a significant decrease in the risk of MACE and renal failure and did not increase readmissions in patients undergoing non-emergent cardiac surgery.

Predicted versus observed 30-day perioperative outcomes using the ACS NSQIP surgical risk calculator in patients undergoing partial nephrectomy for renal cell carcinoma.

PubMed

Blair, Brian M; Lehman, Erik B; Jafri, Syed M; Kaag, Matthew G; Raman, Jay D

2018-06-04

The purpose of the study was to evaluate the accuracy of the American College of Surgeons NSQIP Surgical Risk Calculator for predicting risk-adjusted 30-day outcomes for patients undergoing partial nephrectomy (PN) for renal cell carcinoma (RCC). A single institution, multi-surgeon, prospectively maintained database was queried for patients undergoing PN for RCC from 1998 to 2015. 21 preoperative factors were analyzed for each patient with predicted risk for 30-day complications, mortality, and length of stay (LOS) calculated. Differences between the mean predicted risk and observed rate of surgical outcomes were determined using two-sided one-sample t test with significance at p < 0.05. Subgroup analyses of outcomes stratified by surgical approach were also performed. 470 patients undergoing PN for RCC were analyzed. Comparing NSQIP predicted to observed outcomes, clinically significant underestimations occurred with rates of overall complications (9.16 vs. 16.81%, p < 0.001), surgical site infections [SSI] (1.65 vs. 2.77%, p < 0.001), urinary tract infection [UTI] (1.41 vs. 3.40%, p < 0.001), and LOS (3.25 vs. 3.73 days, p < 0.001). On subgroup analysis, 209 open PN and 261 minimally invasive PN (MIPN) were performed. The NSQIP calculator consistently underestimated overall complications, SSI, UTI, and LOS (p < 0.001) among both surgical approaches, while overestimating MIPN severe complications (p < 0.001). Clinically important differences persisted when stratifying the MIPN group by laparoscopic (N = 111) and robotic (N = 150) approaches. The ACS NSQIP Surgical Risk Calculator had significant discrepancies among observed and predicted outcomes. Additional analyses confirmed these differences remained significant irrespective of surgical approach. These findings emphasize the need for urologic oncology-specific calculators to better predict surgical outcomes in this complex patient population.

Risk Factors for Urinary Tract Infections in Cardiac Surgical Patients

PubMed Central

Gillen, Jacob R.; Isbell, James M.; Michaels, Alex D.; Lau, Christine L.

2015-01-01

Abstract Background: Risk factors for catheter-associated urinary tract infections (CAUTIs) in patients undergoing non-cardiac surgical procedures have been well documented. However, the variables associated with CAUTIs in the cardiac surgical population have not been clearly defined. Therefore, the purpose of this study was to investigate risk factors associated with CAUTIs in patients undergoing cardiac procedures. Methods: All patients undergoing cardiac surgery at a single institution from 2006 through 2012 (4,883 patients) were reviewed. Patients with U.S. Centers for Disease Control (CDC) criteria for CAUTI were identified from the hospital's Quality Assessment database. Pre-operative, operative, and post-operative patient factors were evaluated. Univariate and multivariable analyses were used to identify significant correlations between perioperative characteristics and CAUTIs. Results: There were 55 (1.1%) documented CAUTIs in the study population. On univariate analysis, older age, female gender, diabetes mellitus, cardiogenic shock, urgent or emergent operation, packed red blood cell (PRBC) units transfused, and intensive care unit length of stay (ICU LOS) were all significantly associated with CAUTI [p<0.05]. On multivariable logistic regression, older age, female gender, diabetes mellitus, and ICU LOS remained significantly associated with CAUTI. Additionally, there was a significant association between CAUTI and 30-d mortality on univariate analysis. However, when controlling for common predictors of operative mortality on multivariable analysis, CAUTI was no longer associated with mortality. Conclusions: There are several identifiable risk factors for CAUTI in patients undergoing cardiac procedures. CAUTI is not independently associated with increased mortality, but it does serve as a marker of sicker patients more likely to die from other comorbidities or complications. Therefore, awareness of the high-risk nature of these patients should lead to increased diligence and may help to improve peri-operative outcomes. Recognizing patients at high risk for CAUTI may lead to improved measures to decrease CAUTI rates within this population. PMID:26115336

Outcome of patients with reduced ankle brachial index undergoing open heart surgery with cardiopulmonary bypass.

PubMed

Meyborg, Matthias; Abdi-Tabari, Zila; Hoffmeier, Andreas; Engelbertz, Christiane; Lüders, Florian; Freisinger, Eva; Malyar, Nasser M; Martens, Sven; Reinecke, Holger

2016-05-01

In open heart surgery using cardiopulmonary bypass, perfusion of the lower extremities is markedly reduced which may induce critical ischaemia in patients with pre-existing peripheral artery disease. Whether these patients have an increased risk for amputation and should better undergo peripheral revascularization prior to surgery remains unclear. From 1 January 2009 to 31 December 2010, 785 consecutive patients undergoing open heart surgery were retrospectively included. In 443 of these patients, preoperative ankle brachial index (ABI) measurements were available. The cohort was divided into four groups: (i) ABI < 0.5, (ii) ABI 0.5-0.69, (iii) ABI 0.7-0.89 or (iv) ABI ≥ 0.9. Follow-up data of 413 (93.2%) patients were analysed with regard to mortality and amputations. The groups differed significantly in terms of age, cardiac risk factors, performed cardiac surgery and renal function. Postoperative delayed wound healing was significantly associated with lower ABI (25.9, 15.2, 27.0 and 9.6% in Groups I-IV, respectively, P = 0.003), whereas 30-day mortality was not significantly higher in patients with lower ABI (0, 4.3, 8.1 and 3.9%, respectively, P = 0.4). Kaplan-Meier models showed a significantly lower long-term survival over 4 years in patients with reduced ABI (P = 0.001, long-rank test) while amputations occurred rarely with only one minor amputation in Group II (P = 0.023). Patients with reduced ABIs undergoing heart surgery showed more wound-healing disturbances, and higher long-term mortality compared with those with normal ABIs. However, no perioperative ischaemia requiring amputation occurred. Thus, reduced ABIs were not associated with increased peripheral risks in open heart surgery but ABI may be helpful in selecting the site for saphenectomy to potentially avoid delayed healing of related wounds in legs with severely impaired arterial perfusion. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Risk Factors for Urinary Tract Infections in Cardiac Surgical Patients.

PubMed

Gillen, Jacob R; Isbell, James M; Michaels, Alex D; Lau, Christine L; Sawyer, Robert G

2015-10-01

Risk factors for catheter-associated urinary tract infections (CAUTIs) in patients undergoing non-cardiac surgical procedures have been well documented. However, the variables associated with CAUTIs in the cardiac surgical population have not been clearly defined. Therefore, the purpose of this study was to investigate risk factors associated with CAUTIs in patients undergoing cardiac procedures. All patients undergoing cardiac surgery at a single institution from 2006 through 2012 (4,883 patients) were reviewed. Patients with U.S. Centers for Disease Control (CDC) criteria for CAUTI were identified from the hospital's Quality Assessment database. Pre-operative, operative, and post-operative patient factors were evaluated. Univariate and multivariable analyses were used to identify significant correlations between perioperative characteristics and CAUTIs. There were 55 (1.1%) documented CAUTIs in the study population. On univariate analysis, older age, female gender, diabetes mellitus, cardiogenic shock, urgent or emergent operation, packed red blood cell (PRBC) units transfused, and intensive care unit length of stay (ICU LOS) were all significantly associated with CAUTI [p<0.05]. On multivariable logistic regression, older age, female gender, diabetes mellitus, and ICU LOS remained significantly associated with CAUTI. Additionally, there was a significant association between CAUTI and 30-d mortality on univariate analysis. However, when controlling for common predictors of operative mortality on multivariable analysis, CAUTI was no longer associated with mortality. There are several identifiable risk factors for CAUTI in patients undergoing cardiac procedures. CAUTI is not independently associated with increased mortality, but it does serve as a marker of sicker patients more likely to die from other comorbidities or complications. Therefore, awareness of the high-risk nature of these patients should lead to increased diligence and may help to improve peri-operative outcomes. Recognizing patients at high risk for CAUTI may lead to improved measures to decrease CAUTI rates within this population.

Novel Airborne Imaging Polarimeter Undergoes High-Altitude Flight Testing

NASA Technical Reports Server (NTRS)

Diner, David J.; Pingree, Paula J.; Chipman, Russell A.

2015-01-01

Optical and signal processing technologies for high-accuracy polarimetric imaging, aimed at studying the impact of atmospheric haze and clouds on Earth's climate, have been demonstrated on checkout flights aboard NASA's ER-2 aircraft.

Outcomes of complex robot-assisted extravesical ureteral reimplantation in the pediatric population.

PubMed

Arlen, Angela M; Broderick, Kristin M; Travers, Curtis; Smith, Edwin A; Elmore, James M; Kirsch, Andrew J

2016-06-01

While open ureteral reimplantation remains the gold standard for surgical treatment of vesicoureteral reflux (VUR), minimally invasive approaches offer potential benefits. This study evaluated the outcomes of children undergoing complex robot-assisted laparoscopic ureteral reimplantation (RALUR) for failed previous anti-reflux surgery, complex anatomy, or ureterovesical junction obstruction (UVJO), and compared them with patients undergoing open extravesical repair. Children undergoing complex RALUR or open extravesical ureteral reimplantation (OUR) were identified. Reimplantation was classified as complex if ureters: 1) had previous anti-reflux surgery, 2) required tapering and/or dismembering, or 3) had associated duplication or diverticulum. Seventeen children underwent complex RALUR during a 24-month period, compared with 41 OUR. The mean follow-up was 16.6 ± 6.5 months. The RALUR children were significantly older (9.3 ± 3.7 years) than the OUR patients (3.1 ± 2.7 years; P < 0.001). All RALUR patients were discharged on postoperative day one, while 24.4% of children in the open group required longer hospitalization (mean 1.3 ± 0.7 days; P = 0.03). Adjusting for age, there was no significant difference in inpatient analgesic usage between the two cohorts. Three OUR patients (7.3%) developed postoperative febrile urinary tract infection compared with a single child (5.9%) undergoing RALUR (P = 1.00). There was no significant difference in complication rate between the two groups (12.2% OUR versus 11.8% RALUR; P = 1.00). A postoperative cystogram was performed in the majority of RALUR patients, with no persistent VUR detected, and one child (6.7%) was diagnosed with contralateral reflux. Reported VUR resolution rates following robot-assisted ureteral reimplantation are varied. In the present series, children undergoing RALUR following failed previous anti-reflux surgery, with complex anatomy, or UVJO experienced a shorter length of stay but had similar analgesic requirements to those undergoing open repair. Radiographic, clinical success rates and complication risk were comparable. This study had several limitations, aside from lack of randomization. Analgesic use was limited to an inpatient setting, and pain scores were not assessed. Not all children underwent a postoperative VCUG, so the true radiographic success rate is unknown. A larger patient cohort with longer follow-up is necessary to determine predictors of radiographic and clinical failure. Older children with a previous history of anti-reflux surgery were more likely to undergo RALUR. These children had success and complication rates comparable to younger patients following complex open extravesical reimplantation, which underscores the expanding role of robot-assisted lower urinary tract reconstructive surgery in the pediatric population. Copyright © 2015 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Acetaminophen and Meloxicam Inhibit Platelet Aggregation and Coagulation in Blood Samples from Humans

DTIC Science & Technology

2014-01-01

not change by acetaminophen at any of the tested doses. Consistent to our results, prolonged aPTT from meloxicam has been reported in dogs undergoing...orthopedic surgery [16] as well as in healthy dogs [17]. The significant changes in aPTT and lack of changes in PT by meloxicam suggest that melox- icam...Papazoglou LG, Rallis T, Tsimopoulos G, Adamama-Moraitou K, Tea A. Effects of meloxicam on the haemostatic profile of dogs undergoing orthopaedic