An economic model to evaluate cost-effectiveness of computer assisted knee replacement surgery in Norway.

PubMed

Gøthesen, Øystein; Slover, James; Havelin, Leif; Askildsen, Jan Erik; Malchau, Henrik; Furnes, Ove

2013-07-06

The use of Computer Assisted Surgery (CAS) for knee replacements is intended to improve the alignment of knee prostheses in order to reduce the number of revision operations. Is the cost effectiveness of computer assisted surgery influenced by patient volume and age? By employing a Markov model, we analysed the cost effectiveness of computer assisted surgery versus conventional arthroplasty with respect to implant survival and operation volume in two theoretical Norwegian age cohorts. We obtained mortality and hospital cost data over a 20-year period from Norwegian registers. We presumed that the cost of an intervention would need to be below NOK 500,000 per QALY (Quality Adjusted Life Year) gained, to be considered cost effective. The added cost of computer assisted surgery, provided this has no impact on implant survival, is NOK 1037 and NOK 1414 respectively for 60 and 75-year-olds per quality-adjusted life year at a volume of 25 prostheses per year, and NOK 128 and NOK 175 respectively at a volume of 250 prostheses per year. Sensitivity analyses showed that the 10-year implant survival in cohort 1 needs to rise from 89.8% to 90.6% at 25 prostheses per year, and from 89.8 to 89.9% at 250 prostheses per year for computer assisted surgery to be considered cost effective. In cohort 2, the required improvement is a rise from 95.1% to 95.4% at 25 prostheses per year, and from 95.10% to 95.14% at 250 prostheses per year. The cost of using computer navigation for total knee replacements may be acceptable for 60-year-old as well as 75-year-old patients if the technique increases the implant survival rate just marginally, and the department has a high operation volume. A low volume department might not achieve cost-effectiveness unless computer navigation has a more significant impact on implant survival, thus may defer the investments until such data are available.

The application of capillary microsampling in GLP toxicology studies.

PubMed

Verhaeghe, Tom; Dillen, Lieve; Stieltjes, Hans; Zwart, Loeckie de; Feyen, Bianca; Diels, Luc; Vroman, Ann; Timmerman, Philip

2017-04-01

Capillary microsampling (CMS) to collect microplasma volumes is gradually replacing traditional, larger volume sampling from rats in GLP toxicology studies. About 32 µl of blood is collected with a capillary, processed to plasma and stored in a 10- or 4-µl capillary which is washed out further downstream in the laboratory. CMS has been standardized with respect to materials, assay validation experiments and application for sample analysis. The implementation of CMS has resulted in blood volume reductions in the rat from 300 to 32 µl per time point and the elimination of toxicokinetic satellite groups in the majority of the rat GLP toxicology studies. The technique has been successfully applied in 26 GLP studies for 12 different projects thus far.

Rapid Damage Assessment. Volume I. Methodology for Selecting Repair Area of Ordnance-Damaged Pavements.

DTIC Science & Technology

1980-09-01

this system be given no further consideration. 14AGNETOMETER TECHNIQUES Four types of magnetometers are commonly in use today: fluxgate , proton...that are cumbersome to operate and less accurate than fluxgate and proton mag- netometers. The proton magnetometer is also gradually replacing the... fluxgate magnetometer because of its greater sensitivity (I gamma or better), absolute accuracy, nonmoving parts, and its ability Lo measure absolute

A prototype software methodology for the rapid evaluation of biomanufacturing process options.

PubMed

Chhatre, Sunil; Francis, Richard; O'Donovan, Kieran; Titchener-Hooker, Nigel J; Newcombe, Anthony R; Keshavarz-Moore, Eli

2007-10-01

A three-layered simulation methodology is described that rapidly evaluates biomanufacturing process options. In each layer, inferior options are screened out, while more promising candidates are evaluated further in the subsequent, more refined layer, which uses more rigorous models that require more data from time-consuming experimentation. Screening ensures laboratory studies are focused only on options showing the greatest potential. To simplify the screening, outputs of production level, cost and time are combined into a single value using multi-attribute-decision-making techniques. The methodology was illustrated by evaluating alternatives to an FDA (U.S. Food and Drug Administration)-approved process manufacturing rattlesnake antivenom. Currently, antivenom antibodies are recovered from ovine serum by precipitation/centrifugation and proteolyzed before chromatographic purification. Alternatives included increasing the feed volume, replacing centrifugation with microfiltration and replacing precipitation/centrifugation with a Protein G column. The best alternative used a higher feed volume and a Protein G step. By rapidly evaluating the attractiveness of options, the methodology facilitates efficient and cost-effective process development.

Development of polymer nano composite patterns using fused deposition modeling for rapid investment casting process

NASA Astrophysics Data System (ADS)

Vivek, Tiwary; Arunkumar, P.; Deshpande, A. S.; Vinayak, Malik; Kulkarni, R. M.; Asif, Angadi

2018-04-01

Conventional investment casting is one of the oldest and most economical manufacturing techniques to produce intricate and complex part geometries. However, investment casting is considered economical only if the volume of production is large. Design iterations and design optimisations in this technique proves to be very costly due to time and tooling cost for making dies for producing wax patterns. However, with the advent of Additive manufacturing technology, plastic patterns promise a very good potential to replace the wax patterns. This approach can be very useful for low volume production & lab requirements, since the cost and time required to incorporate the changes in the design is very low. This research paper discusses the steps involved for developing polymer nanocomposite filaments and checking its suitability for investment castings. The process parameters of the 3D printer machine are also optimized using the DOE technique to obtain mechanically stronger plastic patterns. The study is done to develop a framework for rapid investment casting for lab as well as industrial requirements.

The effects of contrast media volume on acute kidney injury after transcatheter aortic valve replacement: a systematic review and meta-analysis.

PubMed

Thongprayoon, Charat; Cheungpasitporn, Wisit; Podboy, Alexander J; Gillaspie, Erin A; Greason, Kevin L; Kashani, Kianoush B

2016-11-01

The goal of this systematic review was to assess the effects of contrast media volume on transcatheter aortic valve replacement-related acute kidney injury. A literature search was performed using Medline, EMbase, the Cochrane Database of Systematic Reviews, and clinicaltrials.gov from the inception of these databases through December 2015. Studies that reported relative risk, odds ratio, or hazard ratio comparing the risks of acute kidney injury following transcatheter aortic valve replacement in patients who received high contrast media volume were included. Pooled risk ratio (RR) and 95% confidence intervals (95% CI) were calculated using a random-effect, generic inverse variance method. Four cohort studies composed of 891 patients were included in the analyses to assess the risk of acute kidney injury after transcatheter aortic valve replacement in patients who received high contrast media volume. The pooled RR of acute kidney injury after transcatheter aortic valve replacement in patients who received a large volume of contrast media was 1.41 (95% CI, 0.87 to 2.28) compared with low contrast media volume. The meta-analysis was limited to studies using standard acute kidney injury definitions, and the pooled RR of acute kidney injury in patients who received high contrast media volume is 1.12 (95% CI, 0.78 to 1.62). Our meta-analysis shows no significant association between contrast media volume and risk of acute kidney injury after transcatheter aortic valve replacement. © 2016 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.

Technique of after-loading interstitial implants.

PubMed

Syed, A M; Feder, B H

1977-01-01

Interstitial implants are either removable or permanent (and occasionally a combination of both). Permanent implants are generally utilized where tumors are not accessible enough to permit easy removal of sources or where accurate source distribution is less critical. They are useful for cancers of the lung, pancreas, prostate, bladder, lymph nodes, etc. Radon and gold-198 have been largely replaced by iodine-125. Our major interests are in the removable after-loading iridium-192 implant techniques. Template (steel guide) and non-template (plastic tube) techniques are utilized. Templates are preferred where the tumor volume can only be approached from one side and where accurate positioning of sources would otherwise be difficult. They are useful for cancers of the cervix, vagina, urethra, and rectum. Non-template (plastic tube) techniques are preferred where the tumor volume can be approached from at least two sides and where templates are either not feasible or not essential for accurate positioning of sources. The single needle non-template approach is useful for cancers of lip, nodes, and breast (plastic button) and for cancers of the oral cavity and oropharynx (gold button). The paired needle non-template approach is useful for cancers of the gum, retromolar trigone, and base of tongue (loop technique) and for cancers of the palate (arch technique). Procedures for each technique are described in detail.

Choice of the replacement fluid during large volume plasma-exchange.

PubMed

Nydegger, U E

1983-01-01

The replacement fluid used during therapeutic large volume plasma-exchange can be seen as an important factor influencing the result of such treatment. The choice includes fluids such as electrolyte solutions, gelatin, hydroxyethyl-starch, albumin and fresh frozen plasma. By evaluating the pathophysiology of the underlying disease, it is possible to choose between merely replacing the removed volume by non-protein fluids or rather to introduce plasma protein components into the patient's circulation by substituting with purified or enriched proteins such as albumin, clotting factors, antithrombin III or fresh frozen plasma. This paper analyzes the rationale for the choice of the appropriate replacement fluid taking into account pathophysiologic, pharmacologic and logistic criteria.

Kinetic-rheological insights uncovered by the self-accelerating brucite-for-periclase replacement - but only if adjusted on volume. The blind spot of geochemists

NASA Astrophysics Data System (ADS)

Merino, E.

2013-12-01

Geochemists of weathering, metamorphism, dolomitization, etc., have long adjusted mineral reactions conserving one or another component among the minerals, but paying no attention to whether the volumetric consequences of such adjustments are consistent with independent petrographic evidence. In fact the widespread occurrence of replacement in all types of water-rock interaction implies that the mineral reactions involved did conserve solid volume, not a component. The conflict has been hidden in a blind spot that geochemists appear to be unaware of having. Characteristically, replacement preserves both volume and morphological details of the host. It originates not by dissolution-precipitation, but by guest-growth-driven pressure solution of host by guest (Merino/Dewers 1998; Merino/Canals 2011) The replacement of periclase by brucite common in magnesian marbles is attributed (Turner 1965; Ferry 2000) to: MgO(per) + H2O = Mg(OH)2(bruc), (EQ 1), which conserves Mg between the two minerals. But with formula volumes of pericl & bruc ~11 & 25 cm3, this reaction cannot preserve mineral volume; it conflicts with excellent petrographic evidence that mineral volume was preserved. However, by adjusting the local mass balance on volume, as observed, 2.2MgO(per) + 2.4H+ = Mg(OH)2(bruc) + 1.2Mg++ + 0.2H2O (EQ 2), we gain striking dynamic/geochemical insights: (I) Seeing that Mg++ is locally released to the pore fluid, we suddenly grasp why the brucite is typically surrounded by a rim of dolomite replacing matrix calcite. As it is released, the Mg++ reacts with calcite and produces dolomite that replaces calcite, also isovolumetrically, as observed. (II) The second replacement (dolo-for-calc) was simultaneous and thus adjacent to the first, and must have happened at the same T,P, and at the same rate, as the first. (In the conventional view, the dolomite rim is attributed, ad hoc, to the reaction bruc + calc + CO2 = dolo + water, which necessarily happens later and at different T,P; which doesn't preserve volume; and which tells us nothing about rates.) (III) The Mg++ released by each increment of bruc-for-pericl replacement must increase the local ion-activity product for brucite growth from its ions, and thus the growth rate of the next increment of replacement, and so on: The bruc-for-pericl replacement is self-accelerating. This is why it always reaches completion - the brucite keeps replacing periclase faster and faster until all the periclase is gone. (Also self-accelerating are the dolo-for-calc replacement in dolomitization [Merino/Canals, 2011], and the serp-for-oliv replacement in serpentinization.) (IV) A dramatic feedback arises: As a self-accelerating replacement takes place in a non-newtonian rock of the strain-rate-softening kind (as crystalline carbonates and dunites are), it must reduce the local rock viscosity more and more, and, unless a needed reactant is used up first, the viscosity may become low enough for the growth of the guest mineral to gradually pass by itself from replacive to displacive (both régimes being driven by the guest-growth induced stress). This is how thin, displacive zebra veins form routinely in burial dolomitization (Merino/Canals 2006, 2011) and in serpentinization of dunite.

Efficient Development of High Fidelity Structured Volume Grids for Hypersonic Flow Simulations

NASA Technical Reports Server (NTRS)

Alter, Stephen J.

2003-01-01

A new technique for the control of grid line spacing and intersection angles of a structured volume grid, using elliptic partial differential equations (PDEs) is presented. Existing structured grid generation algorithms make use of source term hybridization to provide control of grid lines, imposing orthogonality implicitly at the boundary and explicitly on the interior of the domain. A bridging function between the two types of grid line control is typically used to blend the different orthogonality formulations. It is shown that utilizing such a bridging function with source term hybridization can result in the excessive use of computational resources and diminishes robustness. A new approach, Anisotropic Lagrange Based Trans-Finite Interpolation (ALBTFI), is offered as a replacement to source term hybridization. The ALBTFI technique captures the essence of the desired grid controls while improving the convergence rate of the elliptic PDEs when compared with source term hybridization. Grid generation on a blunt cone and a Shuttle Orbiter is used to demonstrate and assess the ALBTFI technique, which is shown to be as much as 50% faster, more robust, and produces higher quality grids than source term hybridization.

Semantic layers for illustrative volume rendering.

PubMed

Rautek, Peter; Bruckner, Stefan; Gröller, Eduard

2007-01-01

Direct volume rendering techniques map volumetric attributes (e.g., density, gradient magnitude, etc.) to visual styles. Commonly this mapping is specified by a transfer function. The specification of transfer functions is a complex task and requires expert knowledge about the underlying rendering technique. In the case of multiple volumetric attributes and multiple visual styles the specification of the multi-dimensional transfer function becomes more challenging and non-intuitive. We present a novel methodology for the specification of a mapping from several volumetric attributes to multiple illustrative visual styles. We introduce semantic layers that allow a domain expert to specify the mapping in the natural language of the domain. A semantic layer defines the mapping of volumetric attributes to one visual style. Volumetric attributes and visual styles are represented as fuzzy sets. The mapping is specified by rules that are evaluated with fuzzy logic arithmetics. The user specifies the fuzzy sets and the rules without special knowledge about the underlying rendering technique. Semantic layers allow for a linguistic specification of the mapping from attributes to visual styles replacing the traditional transfer function specification.

Regulation of intramembranous absorption and amniotic fluid volume by constituents in fetal sheep urine

PubMed Central

Jonker, Sonnet S.; Louey, Samantha; Cheung, Cecilia Y.; Brace, Robert A.

2013-01-01

Our objective was to test the hypothesis that fetal urine contains a substance(s) that regulates amniotic fluid volume by altering the rate of intramembranous absorption of amniotic fluid. In late gestation ovine fetuses, amniotic fluid volumes, urine, and lung liquid production rates, swallowed volumes and intramembranous volume and solute absorption rates were measured over 2-day periods under control conditions and when urine was removed and continuously replaced at an equal rate with exogenous fluid. Intramembranous volume absorption rate decreased by 40% when urine was replaced with lactated Ringer solution or lactated Ringer solution diluted 50% with water. Amniotic fluid volume doubled under both conditions. Analysis of the intramembranous sodium and chloride fluxes suggests that the active but not passive component of intramembranous volume absorption was altered by urine replacement, whereas both active and passive components of solute fluxes were altered. We conclude that fetal urine contains an unidentified substance(s) that stimulates active intramembranous transport of amniotic fluid across the amnion into the underlying fetal vasculature and thereby functions as a regulator of amniotic fluid volume. PMID:23824958

Enteral nutrition in patients with acute renal failure.

PubMed

Fiaccadori, Enrico; Maggiore, Umberto; Giacosa, Roberto; Rotelli, Carlo; Picetti, Edoardo; Sagripanti, Sibilla; Melfa, Luigi; Meschi, Tiziana; Borghi, Loris; Cabassi, Aderville

2004-03-01

Systematic studies on safety and efficacy of enteral nutrition in patients with acute renal failure (ARF) are lacking. We studied enteral nutrition-related complications and adequacy of nutrient administration during 2525 days of artificial nutrition in 247 consecutive patients fed exclusively by the enteral route: 65 had normal renal function, 68 had ARF not requiring renal replacement therapy, and 114 required renal replacement therapy. No difference was found in gastrointestinal or mechanical complications between ARF patients and patients with normal renal function, except for high gastric residual volumes, which occurred in 3.1% of patients with normal renal function, 7.3% of patients with ARF not requiring renal replacement therapy, 13.2% of patients with ARF on renal replacement therapy (P= 0.02 for trend), and for nasogastric tube obstruction: 0.0%, 5.9%, 14%, respectively (P < 0.001). Gastrointestinal complications were the most frequent cause of suboptimal delivery; the ratio of administered to prescribed daily volume was well above 90% in all the three groups. Definitive withdrawal of enteral nutrition due to complications was documented in 6.1%, 13.2%. and 14.9% of patients, respectively (P= 0.09 for trend). At regimen, mean delivered nonprotein calories were 19.8 kcal/kg (SD 4.6), 22.6 kcal/kg (8.4), 23.4 kcal/kg (6.5); protein intake was 0.92 g/kg (0.21), 0.87 g/kg (0.25), and 0.92 g/kg (0.21), the latter value being below that currently recommended for ARF patients on renal replacement therapy. Median fluid intake with enteral nutrition was 1440 mL (range 720 to 1960), 1200 (720 to 2400), and 960 (360 to 1920). Enteral nutrition is a safe and effective nutritional technique to deliver artificial nutrition in ARF patients. Parenteral amino acid supplementation may be required, especially in patients with ARF needing renal replacement therapy.

Chronic resuscitation after trauma-hemorrhage and acute fluid replacement improves hepatocellular function and cardiac output.

PubMed

Remmers, D E; Wang, P; Cioffi, W G; Bland, K I; Chaudry, I H

1998-01-01

To determine whether prolonged (chronic) resuscitation has any beneficial effects on cardiac output and hepatocellular function after trauma-hemorrhage and acute fluid replacement. Acute fluid resuscitation after trauma-hemorrhage restores but does not maintain the depressed hepatocellular function and cardiac output. Male Sprague-Dawley rats underwent a 5-cm laparotomy (i.e., trauma was induced) and were bled to and maintained at a mean arterial pressure of 40 mmHg until 40% of maximal bleed-out volume was returned in the form of Ringer's lactate (RL). The animals were acutely resuscitated with RL using 4 times the volume of maximum bleed-out over 60 minutes, followed by chronic resuscitation of 0, 5, or 10 mL/kg/hr RL for 20 hours. Hepatocellular function was determined by an in vivo indocyanine green clearance technique. Hepatic microvascular blood flow was assessed by laser Doppler flowmetry. Plasma levels of interleukin-6 (IL-6) were determined by bioassay. Chronic resuscitation with 5 mL/kg/hr RL, but not with 0 or 10 mL/kg/hr RL, restored cardiac output, hepatocellular function, and hepatic microvascular blood flow at 20 hours after hemorrhage. The regimen above also reduced plasma IL-6 levels. Because chronic resuscitation with 5 mL/kg/hr RL after trauma-hemorrhage and acute fluid replacement restored hepatocellular function and hepatic microvascular blood flow and decreased plasma levels of IL-6, we propose that chronic fluid resuscitation in addition to acute fluid replacement should be routinely used in experimental studies of trauma-hemorrhage.

Modern Radiation Therapy for Nodal Non-Hodgkin Lymphoma—Target Definition and Dose Guidelines From the International Lymphoma Radiation Oncology Group

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

Illidge, Tim, E-mail: Tim.Illidge@ics.manchester.ac.uk; Specht, Lena; Yahalom, Joachim

2014-05-01

Radiation therapy (RT) is the most effective single modality for local control of non-Hodgkin lymphoma (NHL) and is an important component of therapy for many patients. Many of the historic concepts of dose and volume have recently been challenged by the advent of modern imaging and RT planning tools. The International Lymphoma Radiation Oncology Group (ILROG) has developed these guidelines after multinational meetings and analysis of available evidence. The guidelines represent an agreed consensus view of the ILROG steering committee on the use of RT in NHL in the modern era. The roles of reduced volume and reduced doses aremore » addressed, integrating modern imaging with 3-dimensional planning and advanced techniques of RT delivery. In the modern era, in which combined-modality treatment with systemic therapy is appropriate, the previously applied extended-field and involved-field RT techniques that targeted nodal regions have now been replaced by limiting the RT to smaller volumes based solely on detectable nodal involvement at presentation. A new concept, involved-site RT, defines the clinical target volume. For indolent NHL, often treated with RT alone, larger fields should be considered. Newer treatment techniques, including intensity modulated RT, breath holding, image guided RT, and 4-dimensional imaging, should be implemented, and their use is expected to decrease significantly the risk for normal tissue damage while still achieving the primary goal of local tumor control.« less

Free Wake Analysis of Helicopter Rotor Blades in Hover Using a Finite Volume Technique

DTIC Science & Technology

1988-10-01

inboard, and root) which were replaced by a far wake model after four revolutions. Murman and Stremel 1121 calculated j two-dimensional unsteady wake...distributed to a fixed mesh, on which the velocities were calculated by a finite difference solution of Laplace’s equation. Stremel [131 applied this two...Analysis of a Hovering Rotor," Vertica, Vol. 6, No. 2, 1982. 12. Murman, E.M., and Stremel , P.M., "A Vortex Wake Capturing Method Po- tential Flow

Tracheal volume in the pupa of the Saturniid moth Hyalophora cecropia determined with inert gases.

PubMed

Bridges, C R; Kestler, P; Scheid, P

1980-06-01

Tracheal volume (VTr) was measured in pupae of the Giant silkworm moth Hyalophora cecropia (Saturniidae, Lepidoptera, Insecta) using inert gas wash-out techniques. The animal was placed in a small vessel that was continuously ventilated (rate, V) by a gas mixture containing 20% O2 in N2; the inflowing (F1) and outflowing gas fractions (FE) of the vessel could be continuously measured by a respiratory mass spectrometer. At the onset of a spiracular constriction period, which was evidenced from the FECO2 trace, the mixture was rapidly replaced by pure Ar. At the subsequent burst, the amount of N2 emerging from the animal, MN2, was calculated from V and the difference (FE--F1)N2. VTr was calculated from MN2 and the N2 concentration in the tracheal system before constriction (assumed to equal that in the ventilating gas before replacement by Ar). Measurements were repeated with N2 and Ar replacing each other. VTr average 48 microliter . g-1 (range 39 to 59) for animals of 5.8 g average body weight (range 3.4 to 9.9), when inert gas solubility in body fluids was accounted for. Both size and stage in pupal development appear to affect VTr. These values show reasonable agreement with literature data, mostly obtained by emptying the tracheal gas space by mechanical compression.

Evolution of high tooth replacement rates in sauropod dinosaurs.

PubMed

D'Emic, Michael D; Whitlock, John A; Smith, Kathlyn M; Fisher, Daniel C; Wilson, Jeffrey A

2013-01-01

Tooth replacement rate can be calculated in extinct animals by counting incremental lines of deposition in tooth dentin. Calculating this rate in several taxa allows for the study of the evolution of tooth replacement rate. Sauropod dinosaurs, the largest terrestrial animals that ever evolved, exhibited a diversity of tooth sizes and shapes, but little is known about their tooth replacement rates. We present tooth replacement rate, formation time, crown volume, total dentition volume, and enamel thickness for two coexisting but distantly related and morphologically disparate sauropod dinosaurs Camarasaurus and Diplodocus. Individual tooth formation time was determined by counting daily incremental lines in dentin. Tooth replacement rate is calculated as the difference between the number of days recorded in successive replacement teeth. Each tooth family in Camarasaurus has a maximum of three replacement teeth, whereas each Diplodocus tooth family has up to five. Tooth formation times are about 1.7 times longer in Camarasaurus than in Diplodocus (315 vs. 185 days). Average tooth replacement rate in Camarasaurus is about one tooth every 62 days versus about one tooth every 35 days in Diplodocus. Despite slower tooth replacement rates in Camarasaurus, the volumetric rate of Camarasaurus tooth replacement is 10 times faster than in Diplodocus because of its substantially greater tooth volumes. A novel method to estimate replacement rate was developed and applied to several other sauropodomorphs that we were not able to thin section. Differences in tooth replacement rate among sauropodomorphs likely reflect disparate feeding strategies and/or food choices, which would have facilitated the coexistence of these gigantic herbivores in one ecosystem. Early neosauropods are characterized by high tooth replacement rates (despite their large tooth size), and derived titanosaurs and diplodocoids independently evolved the highest known tooth replacement rates among archosaurs.

Evolution of High Tooth Replacement Rates in Sauropod Dinosaurs

PubMed Central

Smith, Kathlyn M.; Fisher, Daniel C.; Wilson, Jeffrey A.

2013-01-01

Background Tooth replacement rate can be calculated in extinct animals by counting incremental lines of deposition in tooth dentin. Calculating this rate in several taxa allows for the study of the evolution of tooth replacement rate. Sauropod dinosaurs, the largest terrestrial animals that ever evolved, exhibited a diversity of tooth sizes and shapes, but little is known about their tooth replacement rates. Methodology/Principal Findings We present tooth replacement rate, formation time, crown volume, total dentition volume, and enamel thickness for two coexisting but distantly related and morphologically disparate sauropod dinosaurs Camarasaurus and Diplodocus. Individual tooth formation time was determined by counting daily incremental lines in dentin. Tooth replacement rate is calculated as the difference between the number of days recorded in successive replacement teeth. Each tooth family in Camarasaurus has a maximum of three replacement teeth, whereas each Diplodocus tooth family has up to five. Tooth formation times are about 1.7 times longer in Camarasaurus than in Diplodocus (315 vs. 185 days). Average tooth replacement rate in Camarasaurus is about one tooth every 62 days versus about one tooth every 35 days in Diplodocus. Despite slower tooth replacement rates in Camarasaurus, the volumetric rate of Camarasaurus tooth replacement is 10 times faster than in Diplodocus because of its substantially greater tooth volumes. A novel method to estimate replacement rate was developed and applied to several other sauropodomorphs that we were not able to thin section. Conclusions/Significance Differences in tooth replacement rate among sauropodomorphs likely reflect disparate feeding strategies and/or food choices, which would have facilitated the coexistence of these gigantic herbivores in one ecosystem. Early neosauropods are characterized by high tooth replacement rates (despite their large tooth size), and derived titanosaurs and diplodocoids independently evolved the highest known tooth replacement rates among archosaurs. PMID:23874921

Do Hospitals Performing Frequent Neuraxial Anesthesia for Hip and Knee Replacements Have Better Outcomes?

PubMed

Memtsoudis, Stavros G; Poeran, Jashvant; Zubizarreta, Nicole; Olson, Ashley; Cozowicz, Crispiana; Mörwald, Eva E; Mariano, Edward R; Mazumdar, Madhu

2018-06-07

Neuraxial anesthesia is increasingly recommended for hip/knee replacements as some studies show improved outcomes on the individual level. With hospital-level studies lacking, we assessed the relationship between hospital-level neuraxial anesthesia utilization and outcomes. National data on 808,237 total knee and 371,607 hip replacements were included (Premier Healthcare 2006 to 2014; 550 hospitals). Multivariable associations were measured between hospital-level neuraxial anesthesia volume (subgrouped into quartiles) and outcomes (respiratory/cardiac complications, blood transfusion/intensive care unit need, opioid utilization, and length/cost of hospitalization). Odds ratios (or percent change) and 95% CI are reported. Volume-outcome relationships were additionally assessed by plotting hospital-level neuraxial anesthesia volume against predicted hospital-specific outcomes; trend tests were applied with trendlines' R statistics reported. Annual hospital-specific neuraxial anesthesia volume varied greatly: interquartile range, 3 to 78 for hips and 6 to 163 for knees. Increasing frequency of neuraxial anesthesia was not associated with reliable improvements in any of the study's clinical outcomes. However, significant reductions of up to -14.1% (95% CI, -20.9% to -6.6%) and -15.6% (95% CI, -22.8% to -7.7%) were seen for hospitalization cost in knee and hip replacements, respectively, both in the third quartile of neuraxial volume. This coincided with significant volume effects for hospitalization cost; test for trend P < 0.001 for both procedures, R 0.13 and 0.41 for hip and knee replacements, respectively. Increased hospital-level use of neuraxial anesthesia is associated with lower hospitalization cost for lower joint replacements. However, additional studies are needed to elucidate all drivers of differences found before considering hospital-level neuraxial anesthesia use as a potential marker of quality.

Compliance of the respiratory system in newborn infants pre- and postsurfactant replacement therapy.

PubMed

Kelly, E; Bryan, H; Possmayer, F; Frndova, H; Bryan, C

1993-04-01

Surfactant administration causes a rapid and dramatic improvement in gas exchange, but paradoxically, studies have failed to show an improvement in the mechanical properties of the lung. We have measured dynamic and static (passive flow-volume technique) compliance before and after a single dose of bovine lipid extract surfactant in 22 premature infants with RDS. This had no effect on the measured dynamic compliance. In contrast, surfactant significantly increased static compliance from 0.41 +/- 0.02 to 0.55 +/- 0.04 mL/cm H2O/kg. This improvement was the result of a substantial recruitment of lung volume after surfactant administration. This led us to reduce ventilator pressures, which produced an increase in both dynamic and static compliance, but did not recruit additional volume. We conclude that surfactant causes a substantial increase in static compliance due to volume recruitment, which is consistent with reports of increase in the measured FRC. However, despite this improvement, the compliance is still below our normal range.

18F-fluorocholine PET-guided target volume delineation techniques for partial prostate re-irradiation in local recurrent prostate cancer.

PubMed

Wang, Hui; Vees, Hansjörg; Miralbell, Raymond; Wissmeyer, Michael; Steiner, Charles; Ratib, Osman; Senthamizhchelvan, Srinivasan; Zaidi, Habib

2009-11-01

We evaluate the contribution of (18)F-choline PET/CT in the delineation of gross tumour volume (GTV) in local recurrent prostate cancer after initial irradiation using various PET image segmentation techniques. Seventeen patients with local-only recurrent prostate cancer (median=5.7 years) after initial irradiation were included in the study. Rebiopsies were performed in 10 patients that confirmed the local recurrence. Following injection of 300 MBq of (18)F-fluorocholine, dynamic PET frames (3 min each) were reconstructed from the list-mode acquisition. Five PET image segmentation techniques were used to delineate the (18)F-choline-based GTVs. These included manual delineation of contours (GTV(man)) by two teams consisting of a radiation oncologist and a nuclear medicine physician each, a fixed threshold of 40% and 50% of the maximum signal intensity (GTV(40%) and GTV(50%)), signal-to-background ratio-based adaptive thresholding (GTV(SBR)), and a region growing (GTV(RG)) algorithm. Geographic mismatches between the GTVs were also assessed using overlap analysis. Inter-observer variability for manual delineation of GTVs was high but not statistically significant (p=0.459). In addition, the volumes and shapes of GTVs delineated using semi-automated techniques were significantly higher than those of GTVs defined manually. Semi-automated segmentation techniques for (18)F-choline PET-guided GTV delineation resulted in substantially higher GTVs compared to manual delineation and might replace the latter for determination of recurrent prostate cancer for partial prostate re-irradiation. The selection of the most appropriate segmentation algorithm still needs to be determined.

Application of holographic optical techniques to bulk memory.

NASA Technical Reports Server (NTRS)

Anderson, L. K.

1971-01-01

Current efforts to exploit the spatial redundancy and built-in imaging of holographic optical techniques to provide high information densities without critical alignment and tight mechanical tolerances are reviewed. Read-write-erase in situ operation is possible but is presently impractical because of limitations in available recording media. As these are overcome, it should prove feasible to build holographic bulk memories with mechanically replaceable hologram plates featuring very fast (less than 2 microsec) random access to large (greater than 100 million bit) data blocks and very high throughput (greater than 500 Mbit/sec). Using volume holographic storage it may eventually be possible to realize random-access mass memories which require no mechanical motion and yet provide very high capacity.

Head ballistocardiogram based on wireless multi-location sensors.

PubMed

Onizuka, Kohei; Sodini, Charles G

2015-08-01

Recently a wearable BCG monitoring technique based on an accelerometer worn at the ear was demonstrated to replace a conventional bulky BCG acquisition system. In this work, a multi-location wireless vital signs monitor was developed, and at least two common acceleration vectors correlating to sitting-BCG were found in the supine position by using head PPG signal as a reference for eight healthy human subjects. The head side amplitude in the supine position is roughly proportional to the sitting amplitude that is in turn proportional to the stroke volume. Signal processing techniques to identify J-waves in a subject having small amplitude was also developed based on the two common vectors at the head side and top.

Mitochondrial replacement techniques: egg donation, genealogy and eugenics.

PubMed

Palacios-González, César

2016-03-01

Several objections against the morality of researching or employing mitochondrial replacement techniques have been advanced recently. In this paper, I examine three of these objections and show that they are found wanting. First I examine whether mitochondrial replacement techniques, research and clinical practice, should not be carried out because of possible harms to egg donors. Next I assess whether mitochondrial replacement techniques should be banned because they could affect the study of genealogical ancestry. Finally, I examine the claim that mitochondrial replacement techniques are not transferring mitochondrial DNA but nuclear DNA, and that this should be prohibited on ethical grounds.

Automatic localization of landmark sets in head CT images with regression forests for image registration initialization

NASA Astrophysics Data System (ADS)

Zhang, Dongqing; Liu, Yuan; Noble, Jack H.; Dawant, Benoit M.

2016-03-01

Cochlear Implants (CIs) are electrode arrays that are surgically inserted into the cochlea. Individual contacts stimulate frequency-mapped nerve endings thus replacing the natural electro-mechanical transduction mechanism. CIs are programmed post-operatively by audiologists but this is currently done using behavioral tests without imaging information that permits relating electrode position to inner ear anatomy. We have recently developed a series of image processing steps that permit the segmentation of the inner ear anatomy and the localization of individual contacts. We have proposed a new programming strategy that uses this information and we have shown in a study with 68 participants that 78% of long term recipients preferred the programming parameters determined with this new strategy. A limiting factor to the large scale evaluation and deployment of our technique is the amount of user interaction still required in some of the steps used in our sequence of image processing algorithms. One such step is the rough registration of an atlas to target volumes prior to the use of automated intensity-based algorithms when the target volumes have very different fields of view and orientations. In this paper we propose a solution to this problem. It relies on a random forest-based approach to automatically localize a series of landmarks. Our results obtained from 83 images with 132 registration tasks show that automatic initialization of an intensity-based algorithm proves to be a reliable technique to replace the manual step.

77 FR 1969 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-12

... Numerical Thresholds With Percentage Thresholds for the Investor Tiers' Volume Requirements January 6, 2012... replace numerical thresholds with percentage thresholds for the Investor Tiers' volume requirements. The...: Replacing Numerical Thresholds With Percentage Thresholds Effective June 1, 2011, NYSE Arca introduced two...

Effects of estrogen replacement therapy on the myelin sheath ultrastructure of myelinated fibers in the white matter of middle-aged ovariectomized rats.

PubMed

He, Qi; Luo, Yanmin; Lv, Fulin; Xiao, Qian; Chao, Fenglei; Qiu, Xuan; Zhang, Lei; Gao, Yuan; Xiu, Yun; Huang, Chunxia; Tang, Yong

2018-04-01

The effects of estrogen replacement therapy (ORT) on white matter and the myelin sheath ultrastructure in the white matter of middle-aged ovariectomized (OVX) rats were investigated in this study. Middle-aged rats were ovariectomized and divided into a placebo replacement (OVX + O) group and an estrogen replacement (OVX + E) group. Then, the Morris water maze, electron microscope techniques, and stereological methods were used to investigate the effects of ORT on spatial learning capacity, white matter volume and the myelin sheath ultrastructure in the white matter. We found that the spatial learning capacity of the OVX + E rats was significantly improved compared with that of the OVX + O rats. When compared with that of OVX + O rats, the total volume of the myelin sheaths in the white matter of the OVX + E rats was significantly increased by 27%, and the difference between the outer perimeter and inner perimeter of the myelin sheaths of the white matter in the OVX + E rats increased significantly by 12.6%. The myelinated fibers with mean diameters of 1.2-1.4 μm were significantly longer (46.1%) in the OVX + E rats; the difference between the mean diameter of myelinated fibers and the mean diameter of axons (0-0.4 μm) was significantly increased by 21.6% in the OVX + E rats. These results suggested that ORT had positive protective effects on the spatial learning ability and on the myelin sheath ultrastructure in the white matter of middle-aged OVX rats. © 2017 Wiley Periodicals, Inc.

Repair of Electronics for Long Duration Spaceflight

NASA Technical Reports Server (NTRS)

Pettegrew, Richard D.; Easton, John; Struk, Peter

2007-01-01

To reduce mission risk, long duration spaceflight and exploration activities will require greater degrees of self-sufficiency with regards to repair capability than have ever been employed before in space exploration. The current repair paradigm of replacing Orbital Replacement Units (ORUs) of malfunctioning avionics and electronic hardware will be impractical, since carrying all of the spares that could possibly be needed for a long duration mission would require upmass and volume at unprecedented and unacceptable levels. A strategy of component-level repair for electronics, however, could significantly reduce the mass and volume necessary for spares and enhance mission safety via a generic contingency capability. This approach is already used to varying degrees by the U.S. Navy, where vessels at sea experience some similar constraints such as the need for self sufficiency for moderately long time periods, and restrictions on volume of repair spares and infrastructure. The concept of conducting component-level repairs of electronics in spacecraft requires the development of design guidelines for future avionics (to enable repair), development of diagnostic techniques to allow an astronaut to pinpoint the faulty component aboard a vastly complex vehicle, and development of tools and methodologies for dealing with the physical processes of replacing the component. This physical process includes tasks such as conformal coating removal and replacement, component removal, replacement, and alignment--all in the difficulty of a reduced gravity environment. Further, the gravitational effects on the soldering process must be characterized and accounted for to ensure reliability of the newly repaired components. The Component-Level Electronics-Assembly Repair (CLEAR) project under the NASA Supportability program was established to develop and demonstrate the practicality of this repair approach. CLEAR involves collaborative efforts between NASA s Glenn Research Center, Langley Research Center, Johnson Space Center, the National Center for Space Exploration Research, and the U.S. Navy. The project goals are 1) develop and demonstrate a manually-operated electronics repair capability to be conducted in a spacecraft environment; and 2) develop guidelines for designs of electronics that facilitates component-level repair for future space exploration efforts. This multi-faceted program utilizes a cross-disciplinary approach to examine pre- and post-repair diagnostics, conformal coating removal and replacement, component soldering, and electronics design for supportability. These areas are investigated by a combination of trade studies, ground based testing, reduced gravity aircraft testing, and actual spaceflight testing on the International Space Station (ISS) in multiple experiments. This paper details the efforts of this program, with emphasis on early trade study results, ground-based efforts, and two upcoming ISS experiments.

Replacement of Mushroom Cage Gastrostomy Tube Using a Modified Technique to Allow Percutaneous Replacement with an Endoscopic Tube in Patients with Amyotrophic Lateral Sclerosis

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

Ammar, Thoraya; Rio, Alan; Ampong, Mary Ann

2010-06-15

Radiologic inserted gastrostomy (RIG) is the preferred method in our institution for enteral feeding in amyotrophic lateral sclerosis (ALS). Skin-level primary-placed mushroom cage gastrostomy tubes become tight with weight gain. We describe a minimally invasive radiologic technique for replacing mushroom gastrostomy tubes with endoscopic mushroom cage tubes in ALS. All patients with ALS who underwent replacement of a RIG tube were included. Patients were selected for a modified replacement when the tube length of the primary placed RIG tube was insufficient to allow like-for-like replacement. Replacement was performed under local anesthetic and fluoroscopic guidance according to a preset technique, withmore » modification of an endoscopic mushroom cage gastrostomy tube to allow percutaneous placement. Assessment of the success, safety, and durability of the modified technique was undertaken. Over a 60-month period, 104 primary placement mushroom cage tubes in ALS were performed. A total of 20 (19.2%) of 104 patients had a replacement tube positioned, 10 (9.6%) of 104 with the modified technique (male n = 4, female n = 6, mean age 65.5 years, range 48-85 years). All tubes were successfully replaced using this modified technique, with two minor complications (superficial wound infection and minor hemorrhage). The mean length of time of tube durability was 158.5 days (range 6-471 days), with all but one patient dying with a functional tube in place. We have devised a modification to allow percutaneous replacement of mushroom cage gastrostomy feeding tubes with minimal compromise to ALS patients. This technique allows tube replacement under local anesthetic, without the need for sedation, an important consideration in ALS.« less

Shifts and future trends in the forest resources of the Central Hardwood region

Treesearch

Thomas L. Schmidt; William H. McWilliams

2003-01-01

Forests in the Central Hardwood region are undergoing change in terms of area, volume, species composition, and forest structure. These forests are dominated by deciduous species; are increasing their average stand size, volume, and age; and, are experiencing woody plant species replacement as shade intolerant species are being replaced by more shade tolerant species....

Shifts and future trends in the forest resources of the Central Hardwood Region

Treesearch

Thomas L. Schmidt; William H. McWilliams

2003-01-01

Forests in the Central Hardwood region are undergoing change in terms of area, volume, species composition, and forest structure. These forests are dominated by deciduous species; are increasing their average stand size, volume, and age; and, are experiencing woody plant species replacement as shade intolerant species are being replaced by more shade tolerant species....

Modern Radiation Therapy for Hodgkin Lymphoma: Field and Dose Guidelines From the International Lymphoma Radiation Oncology Group (ILROG)

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

Specht, Lena, E-mail: lena.specht@regionh.dk; Yahalom, Joachim; Illidge, Tim

2014-07-15

Radiation therapy (RT) is the most effective single modality for local control of Hodgkin lymphoma (HL) and an important component of therapy for many patients. These guidelines have been developed to address the use of RT in HL in the modern era of combined modality treatment. The role of reduced volumes and doses is addressed, integrating modern imaging with 3-dimensional (3D) planning and advanced techniques of treatment delivery. The previously applied extended field (EF) and original involved field (IF) techniques, which treated larger volumes based on nodal stations, have now been replaced by the use of limited volumes, based solelymore » on detectable nodal (and extranodal extension) involvement at presentation, using contrast-enhanced computed tomography, positron emission tomography/computed tomography, magnetic resonance imaging, or a combination of these techniques. The International Commission on Radiation Units and Measurements concepts of gross tumor volume, clinical target volume, internal target volume, and planning target volume are used for defining the targeted volumes. Newer treatment techniques, including intensity modulated radiation therapy, breath-hold, image guided radiation therapy, and 4-dimensional imaging, should be implemented when their use is expected to decrease significantly the risk for normal tissue damage while still achieving the primary goal of local tumor control. The highly conformal involved node radiation therapy (INRT), recently introduced for patients for whom optimal imaging is available, is explained. A new concept, involved site radiation therapy (ISRT), is introduced as the standard conformal therapy for the scenario, commonly encountered, wherein optimal imaging is not available. There is increasing evidence that RT doses used in the past are higher than necessary for disease control in this era of combined modality therapy. The use of INRT and of lower doses in early-stage HL is supported by available data. Although the use of ISRT has not yet been validated in a formal study, it is more conservative than INRT, accounting for suboptimal information and appropriately designed for safe local disease control. The goal of modern smaller field radiation therapy is to reduce both treatment volume and treatment dose while maintaining efficacy and minimizing acute and late sequelae. This review is a consensus of the International Lymphoma Radiation Oncology Group (ILROG) Steering Committee regarding the modern approach to RT in the treatment of HL, outlining a new concept of ISRT in which reduced treatment volumes are planned for the effective control of involved sites of HL. Nodal and extranodal non-Hodgkin lymphomas (NHL) are covered separately by ILROG guidelines.« less

Modern radiation therapy for Hodgkin lymphoma: field and dose guidelines from the international lymphoma radiation oncology group (ILROG).

PubMed

Specht, Lena; Yahalom, Joachim; Illidge, Tim; Berthelsen, Anne Kiil; Constine, Louis S; Eich, Hans Theodor; Girinsky, Theodore; Hoppe, Richard T; Mauch, Peter; Mikhaeel, N George; Ng, Andrea

2014-07-15

Radiation therapy (RT) is the most effective single modality for local control of Hodgkin lymphoma (HL) and an important component of therapy for many patients. These guidelines have been developed to address the use of RT in HL in the modern era of combined modality treatment. The role of reduced volumes and doses is addressed, integrating modern imaging with 3-dimensional (3D) planning and advanced techniques of treatment delivery. The previously applied extended field (EF) and original involved field (IF) techniques, which treated larger volumes based on nodal stations, have now been replaced by the use of limited volumes, based solely on detectable nodal (and extranodal extension) involvement at presentation, using contrast-enhanced computed tomography, positron emission tomography/computed tomography, magnetic resonance imaging, or a combination of these techniques. The International Commission on Radiation Units and Measurements concepts of gross tumor volume, clinical target volume, internal target volume, and planning target volume are used for defining the targeted volumes. Newer treatment techniques, including intensity modulated radiation therapy, breath-hold, image guided radiation therapy, and 4-dimensional imaging, should be implemented when their use is expected to decrease significantly the risk for normal tissue damage while still achieving the primary goal of local tumor control. The highly conformal involved node radiation therapy (INRT), recently introduced for patients for whom optimal imaging is available, is explained. A new concept, involved site radiation therapy (ISRT), is introduced as the standard conformal therapy for the scenario, commonly encountered, wherein optimal imaging is not available. There is increasing evidence that RT doses used in the past are higher than necessary for disease control in this era of combined modality therapy. The use of INRT and of lower doses in early-stage HL is supported by available data. Although the use of ISRT has not yet been validated in a formal study, it is more conservative than INRT, accounting for suboptimal information and appropriately designed for safe local disease control. The goal of modern smaller field radiation therapy is to reduce both treatment volume and treatment dose while maintaining efficacy and minimizing acute and late sequelae. This review is a consensus of the International Lymphoma Radiation Oncology Group (ILROG) Steering Committee regarding the modern approach to RT in the treatment of HL, outlining a new concept of ISRT in which reduced treatment volumes are planned for the effective control of involved sites of HL. Nodal and extranodal non-Hodgkin lymphomas (NHL) are covered separately by ILROG guidelines. Copyright © 2014 Elsevier Inc. All rights reserved.

Measurement of pelvic osteolytic lesions in follow-up studies after total hip arthroplasty

NASA Astrophysics Data System (ADS)

Castaneda, Benjamin; Tamez-Pena, Jose G.; Totterman, Saara; O'Keefe, Regis; Looney, R. John

2006-03-01

Previous studies have demonstrated the plausibility of using volumetric computerized tomography to provide an accurate representation and measurement of volume for pelvic osteolytic lesions following total hip joint replacement. These studies have been performed manually (or computed-assisted) by expert radiologists with the disadvantage of poor reproducibility of the experiment. The purpose of this work is to minimize the effect of user interaction in these experiments by introducing Laplacian level set methods in the volume segmentation process and using temporal articulated registration in order to follow the evolution of a lesion over time. Laplacian level set methods reduce the inter and intra-observer variability by attaching the segmented contour to edges defined in the image while keeping smoothness. The registration process allows the information of the lesion from the first visit to be used in the segmentation process of the current visit. This work compares the automated results on 7 volunteers versus the volume measured manually. Results have shown that the proposed technique is able to track osteolytic lesions and detect changes in volume over time. Intra-reader and inter-observer variabilities were reduced.

Soft tissue augmentation with artecoll: 10-year history, indications, techniques, and complications.

PubMed

Lemperle, Gottfried; Romano, James J; Busso, Mariano

2003-06-01

Most of the biologic filler materials that increase the thickness of the corium in a wrinkle line are phagocytosed within a certain time. Therefore, a lasting effect can only be achieved with nonresorbable synthetic substances. Artefill consists of 20 volume percent microspheres of polymethyl-methacrylate and 80 volume percent of bovine collagen. Beneath the crease, the microspheres with their exceptional surface smoothness stimulate fibroblasts to encapsulate each individual one of the 6-million microspheres contained in 1 mL of Artefill. Collagen is merely a carrier substance that prevents the microspheres from agglomerating during tissue ingrowth. The 20 volume percent of microspheres in Artefill provides the scaffold for the 80% volume of connective tissue deposition, a complete replacement of the injected collagen. The filler material beneath a crease acts like a splint and prevents the possibility of its further folding, thereby allowing the diminished thickness of the corium in a crease to recover. This recovery process is well known even in older patients with facial paralysis or after a stroke, whose facial wrinkles and furrows on the paralyzed side disappear over time.

Redo surgery after permanent pacemaker implantation: performance indicator of surgical techniques and pacing technology.

PubMed

Bharat, Vijaya

2004-01-01

The incidence of permanent pacemaker-related complications is reducing due to advancement of technology and increasing operator experience. There are only few series from India reporting the annual complication rates from a single center over the years. This is a series of 782 pacemakers implanted over 20 years in a secondary healthcare set-up. Eighty-two patients underwent redo surgery, either for a procedure-related complication (n=34) or for replacement of a malfunctioning/end-of-life pacemaker (n=48). Through critical analysis and corrective measures, all the procedural complications were reduced to less than 4% of the annual implantations. The introduction of a pacemaker follow-up clinic contributed to reducing the rate of elective replacement for battery depletion from 19.17% of the implanted VVI pacemakers to 0.63%. Despite being a low-volume center, with less than 100 pacemakers implanted annually, the performance of our pacing practice has shown continuous improvement.

Immediate Partial Breast Reconstruction with Endoscopic Latissimus Dorsi Muscle Flap Harvest

PubMed Central

Yang, Chae Eun; Roh, Tai Suk; Yun, In Sik; Lew, Dae Hyun

2014-01-01

Background Currently, breast conservation therapy is commonly performed for the treatment of early breast cancer. Depending on the volume excised, patients may require volume replacement, even in cases of partial mastectomy. The use of the latissimus dorsi muscle is the standard method, but this procedure leaves an unfavorable scar on the donor site. We used an endoscope for latissimus dorsi harvesting to minimize the incision, thus reducing postoperative scars. Methods Ten patients who underwent partial mastectomy and immediate partial breast reconstruction with endoscopic latissimus dorsi muscle flap harvest were reviewed retrospectively. The total operation time, hospital stay, and complications were reviewed. Postoperative scarring, overall shape of the reconstructed breast, and donor site deformity were assessed using a 10-point scale. Results In the mean follow-up of 11 weeks, no tumor recurrence was reported. The mean operation time was 294.5 (±38.2) minutes. The postoperative hospital stay was 11.4 days. Donor site seroma was reported in four cases and managed by office aspiration and compressive dressing. Postoperative scarring, donor site deformity, and the overall shape of the neobreast were acceptable, scoring above 7. Conclusions Replacement of 20% to 40% of breast volume in the upper and the lower outer quadrants with a latissimus dorsi muscle flap by using endoscopic harvesting is a good alternative reconstruction technique after partial mastectomy. Short incision benefits from a very acceptable postoperative scar, less pain, and early upper extremity movement. PMID:25276643

Prosthetic valve sparing aortic root replacement: an improved technique.

PubMed

Leacche, Marzia; Balaguer, Jorge M; Umakanthan, Ramanan; Byrne, John G

2008-10-01

We describe a modified surgical technique to treat patients with a previous history of isolated aortic valve replacement who now require aortic root replacement for an aneurysmal or dissected aorta. This technique consists of replacing the aortic root with a Dacron conduit, leaving intact the previously implanted prosthesis, and re-implanting the coronary arteries in the Dacron graft. Our technique differs from other techniques in that we do not leave behind any aortic tissue remnant and also in that we use a felt strip to obliterate any gap between the old sewing ring and the newly implanted graft. In our opinion, this promotes better hemostasis. We demonstrate that this technique is safe, feasible, and results in acceptable outcomes.

Imaging challenges in biomaterials and tissue engineering

PubMed Central

Appel, Alyssa A.; Anastasio, Mark A.; Larson, Jeffery C.; Brey, Eric M.

2013-01-01

Biomaterials are employed in the fields of tissue engineering and regenerative medicine (TERM) in order to enhance the regeneration or replacement of tissue function and/or structure. The unique environments resulting from the presence of biomaterials, cells, and tissues result in distinct challenges in regards to monitoring and assessing the results of these interventions. Imaging technologies for three-dimensional (3D) analysis have been identified as a strategic priority in TERM research. Traditionally, histological and immunohistochemical techniques have been used to evaluate engineered tissues. However, these methods do not allow for an accurate volume assessment, are invasive, and do not provide information on functional status. Imaging techniques are needed that enable non-destructive, longitudinal, quantitative, and three-dimensional analysis of TERM strategies. This review focuses on evaluating the application of available imaging modalities for assessment of biomaterials and tissue in TERM applications. Included is a discussion of limitations of these techniques and identification of areas for further development. PMID:23768903

Early improvement in left atrial remodeling and function after mitral valve repair or replacement in organic symptomatic mitral regurgitation assessed by three-dimensional echocardiography.

PubMed

Le Bihan, David C S; Della Togna, Dorival Julio; Barretto, Rodrigo B M; Assef, Jorge Eduardo; Machado, Lúcia Romero; Ramos, Auristela Isabel de Oliveira; Abdulmassih Neto, Camilo; Moisés, Valdir Ambrosio; Sousa, Amanda G M R; Campos, Orlando

2015-07-01

Left atrial (LA) dilation is associated with worse prognosis in various clinical situations including chronic mitral regurgitation (MR). Real time three-dimensional echocardiography (3DE) has allowed a better assessment of LA volumes and function. Little is known about LA size and function in early postoperative period in symptomatic patients with chronic organic MR. We aimed to investigate these aspects. By means of 3DE, 43 patients with symptomatic chronic organic MR were prospectively studied before and 30 days after surgery (repair or bioprosthetic valve replacement). Twenty subjects were studied as controls. Maximum (Vol-max), minimum, and preatrial contraction LA volumes were measured and total, passive, and active LA emptying fractions were calculated. Before surgery patients had higher LA volumes (P < 0.001) but smaller LA emptying fractions than controls (P < 0.01). After surgery there was a reduction in all 3 LA volumes and an increase in active atrial emptying fraction (AAEF). Multivariate analysis showed that independent predictors of early postoperative Vol-max reduction were preoperative diastolic blood pressure (coefficient = -0.004; P = 0.02), lateral mitral annular early diastolic velocity (e') (coefficient = 0.023; P = 0.008), and the mean transmitral diastolic gradient increment (coefficient = -0.035; P < 0.001). Furthermore, e' was also independently associated with AAEF increase (odds ratio = 1.66, P = 0.027). Early LA reverse remodeling and functional improvement occur after successful surgery of symptomatic organic MR regardless of surgical technique. Diastolic blood pressure and transmitral mean gradient augmentation are variables negatively related to Vol-max reduction. Besides, e' is positively correlated with both Vol-max reduction and AAEF increase. © 2014, Wiley Periodicals, Inc.

Experimental replacement of calcium carbonates by fluorite: high volume changes and porosity generation

NASA Astrophysics Data System (ADS)

Trindade Pedrosa, Elisabete; Putnis, Andrew

2015-04-01

Pseudomorphic mineral replacement reactions are a common phenomena in nature, and often described as interface-coupled dissolution-reprecipitation processes. The generation of porosity is a key factor for its progression since it creates the pathway for fluid infiltration towards an ongoing reaction front. The generation of porosity depends on two key factors: the molar volume differences between parent and product phase, and the relative solubilities of the parent and product in the fluid at the mineral-fluid interface (Pollok et al., 2011). Jamtveit et al., (2009) demonstrated that the permeability of the parent rock may also be enhanced by the development of fractures as a response to stresses generated by local volume changes at the reaction interface, which in turn increases the reaction rate. The replacement of calcite (CaCO3) by fluorite (CaF2) involves a molar volume decrease of 33.5 %. If indeed high volume changes generate high local stresses, a fragmentation process is expected to be driven by this replacement reaction. To test this hypothesis, a number of hydrothermal experiments were performed. Small cubes of calcite rock (Carrara marble), and single crystals of calcite were used as parent materials. Two fluoride solutions (ammonium fluoride and sodium fluoride) were used as reactants. Samples were reacted at temperatures up to 200°C for various times and quenched to room temperature. After drying, samples were mounted in epoxy holders, cross sections through the centre of the samples were cut and polished, and analysed using scanning electron microscopy (SEM), X-ray diffraction (XRD), and electron microprobe analysis (EMP). The replacement end product of all experiments was confirmed to be fluorite. In every case the external shape of the samples was perfectly maintained. No reaction induced fracturing was visible in any of the samples (rock or single crystals) although the texture of the replaced material was quite complex, often with a 'V' shaped reaction front. The main difference between single crystals and rock was that in the former, grain boundaries were rapid transport pathways for fluid infiltration resulting in the precipitation of fluorite within the sample at locations further from the main reaction front. The porosity formed was very high and complex, its texture depending on the shape and orientation of the replaced material. Very large hollow spaces with diameter >30 μm formed in several samples. In this system the large volume decrease is accommodated by a high porosity rather than fracturing. Jamtveit B., Putnis C.V. & Malthe-Sørenssen A. (2009). Reaction induced fracturing during replacement processes. Contrib. Min. Pet., 157 127-133 Pollok K., Putnis C.V. & Putnis A. (2011) Mineral replacement reactions in solid solution-aqueous solution systems: Volume changes, reaction paths and end points using the example of model salt systems. Am. J. Sci., 311, 211-236

Long palatal connective tissue rolled pedicle graft with demineralized freeze-dried bone allograft plus platelet-rich fibrin combination: A novel technique for ridge augmentation - Three case reports

PubMed Central

Reddy, Pathakota Krishnajaneya; Bolla, Vijayalakshmi; Koppolu, Pradeep; Srujan, Peruka

2015-01-01

Replacement of missing maxillary anterior tooth with localized residual alveolar ridge defect is challenging, considering the high esthetic demand. Various soft and hard tissue procedures were proposed to correct alveolar ridge deformities. Novel techniques have evolved in treating these ridge defects to improve function and esthetics. In the present case reports, a novel technique using long palatal connective tissue rolled pedicle graft with demineralized freeze-dried bone allografts (DFDBAs) plus Platelet-rich fibrin (PRF) combination was proposed to correct the Class III localized anterior maxillary anterior alveolar ridge defect. The present technique resulted in predictable ridge augmentation, which can be attributed to the soft and hard tissue augmentation with a connective tissue pedicle and DFDBA plus PRF combination. This technique suggests a variation in roll technique with DFDBA plus PRF and appears to promise in gaining predictable volume in the residual ridge defect and can be considered for the treatment of moderate to severe maxillary anterior ridge defects. PMID:26015679

Buccal Fat Pad: An Effective Option for Facial Reconstruction and Aesthetic Augmentation.

PubMed

Kim, Jeong Tae; Sasidaran, Ramesh

2017-12-01

Autogenous grafting with lipoaspirate and dermo-fat grafting are popular techniques employed by plastic surgeons for correcting small volume facial defects and contour deformities. These techniques however present certain disadvantages. In this article, we present the use of the buccal fat pad graft as an alternative method of correcting such facial deformities. Free buccal fat pad grafting was carried out in 15 patients in our institution. All were harvested using an intraoral approach. The buccal fat pad graft was used to correct periorbital contour depressions, nasal tip deformities, as a camouflage graft over exposed silicon nasal implants and as a filler in the depression deformity after mass excision. All 15 patients demonstrated good contour deformity correction without a significant graft resorption up to 3 years of follow-up. There were no donor site complications. The amount used ranged from 1 to 5 cc in volume as a spacer or barrier for the moderate-sized volume defect or depression, even though more than 5 cc of fat graft could be harvested if required. In conclusion, the buccal fat pad graft represents an easy, expedient and exceptional tool for the correction of contour deformities, volume replacement or for aesthetic augmentation. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

[State of the art in fluid and volume therapy : A user-friendly staged concept].

PubMed

Rehm, M; Hulde, N; Kammerer, T; Meidert, A S; Hofmann-Kiefer, K

2017-03-01

Adequate fluid therapy is highly important for the perioperative outcome of our patients. Both, hypovolemia and hypervolemia can lead to an increase in perioperative complications and can impair the outcome. Therefore, perioperative infusion therapy should be target-oriented. The main target is to maintain the patient's preoperative normovolemia by using a sophisticated, rational infusion strategy.Perioperative fluid losses should be discriminated from volume losses (surgical blood loss or interstitial volume losses containing protein). Fluid losses as urine or perspiratio insensibilis (0.5-1.0 ml/kg/h) should be replaced by balanced crystalloids in a ratio of 1:1. Volume therapy step 1: Blood loss up to a maximum value of 20% of the patient's blood volume should be replaced by balanced crystalloids in a ratio of 4(-5):1. Volume therapy step 2: Higher blood losses should be treated by using iso-oncotic, preferential balanced colloids in a ratio of 1:1. For this purpose hydroxyethyl starch can also be used perioperatively if there is no respective contraindication, such as sepsis, burn injuries, critically ill patients, renal impairment or renal replacement therapy, and severe coagulopathy. Volume therapy step 3: If there is an indication for red cell concentrates or coagulation factors, a differentiated application of blood and blood products should be performed.

Redesigning a joint replacement program using Lean Six Sigma in a Veterans Affairs hospital.

PubMed

Gayed, Benjamin; Black, Stephen; Daggy, Joanne; Munshi, Imtiaz A

2013-11-01

In April 2009, an analysis of joint replacement surgical procedures at the Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana, revealed that total hip and knee replacements incurred $1.4 million in non-Veterans Affairs (VA) care costs with an average length of stay of 6.1 days during fiscal year 2008. The Joint Replacement Program system redesign project was initiated following the Vision-Analysis-Team-Aim-Map-Measure-Change-Sustain (VA-TAMMCS) model to increase efficiency, decrease length of stay, and reduce non-VA care costs. To determine the effectiveness of Lean Six Sigma process improvement methods applied in a VA hospital. Perioperative processes for patients undergoing total joint replacement were redesigned following the VA-TAMMCS model--the VA's official, branded method of Lean Six Sigma process improvement. A multidisciplinary team including the orthopedic surgeons, frontline staff, and executive management identified waste in the current processes and initiated changes to reduce waste and increase efficiency. Data collection included a 1-year baseline period and a 20-month sustainment period. The primary endpoint was length of stay; a secondary analysis considered non-VA care cost reductions. Length of stay decreased 36% overall, decreasing from 5.3 days during the preproject period to 3.4 days during the 20-month sustainment period (P < .001). Non-VA care was completely eliminated for patients undergoing total hip and knee replacement at the Richard L. Roudebush Veterans Affairs Medical Center, producing an estimated return on investment of $1 million annually when compared with baseline cost and volumes. In addition, the volume of total joint replacements at this center increased during the data collection period. The success of the Joint Replacement Program demonstrates that VA-TAMMCS is an effective tool for Lean and Six Sigma process improvement initiatives in a surgical practice, producing a 36% sustained reduction in length of stay and completely eliminating non-VA care for total hip and knee replacements while increasing total joint replacement volume at this medical center.

Dosimetric and radiobiological characterizations of prostate intensity-modulated radiotherapy and volumetric-modulated arc therapy: A single-institution review of ninety cases

PubMed Central

Khan, Muhammad Isa; Jiang, Runqing; Kiciak, Alexander; ur Rehman, Jalil; Afzal, Muhammad; Chow, James C. L.

2016-01-01

This study reviewed prostate volumetric-modulated arc therapy (VMAT) plans with intensity-modulated radiotherapy (IMRT) plans after prostate IMRT technique was replaced by VMAT in an institution. Characterizations of dosimetry and radiobiological variation in prostate were determined based on treatment plans of 40 prostate IMRT patients (planning target volume = 77.8–335 cm3) and 50 VMAT patients (planning target volume = 120–351 cm3) treated before and after 2013, respectively. Both IMRT and VMAT plans used the same dose-volume criteria in the inverse planning optimization. Dose-volume histogram, mean doses of target and normal tissues (rectum, bladder and femoral heads), dose-volume points (D99% of planning target volume; D30%, D50%, V30 Gy and V35 Gy of rectum and bladder; D5%, V14 Gy, V22 Gy of femoral heads), conformity index (CI), homogeneity index (HI), gradient index (GI), prostate tumor control probability (TCP), and rectal normal tissue complication probability (NTCP) based on the Lyman-Burman-Kutcher algorithm were calculated for each IMRT and VMAT plan. From our results, VMAT plan was found better due to its higher (1.05%) CI, lower (0.83%) HI and (0.75%) GI than IMRT. Comparing doses in normal tissues between IMRT and VMAT, it was found that IMRT mostly delivered higher doses of about 1.05% to the normal tissues than VMAT. Prostate TCP and rectal NTCP were found increased (1%) for VMAT than IMRT. It is seen that VMAT technique can decrease the dose-volume evaluation criteria for the normal tissues. Based on our dosimetric and radiobiological results in treatment plans, it is concluded that our VMAT implementation could produce comparable or slightly better target coverage and normal tissue sparing with a faster treatment time in prostate radiotherapy. PMID:27651562

Properties of concrete modified with waste Low Density Polyethylene and saw dust ash

NASA Astrophysics Data System (ADS)

Srimanikandan, P.; Sreenath, S.

2017-07-01

The increase in industrialization creates need for disposal of large quantity of by-products. To overcome the difficulty of disposal, these by-products can be used as a replacement for raw material. In this concern, non-conventional industrial wastes such as plastic bags, PET bottles, pulverized waste Low Density Polyethylene (LDPE) and biological waste such as saw-dust ash, coconut coir were used as a replacement in concrete. In this project, saw-dust ash and pulverized waste LDPE were introduced as the partial replacement for cement and fine aggregates respectively. 0%, 5%, 10%, 15% and 20% of sand by volume was replaced with LDPE and 0%, 1%, 3%, 5% and 10% of cement by volume was replaced with saw dust ash. Standard cube, cylinder and prism specimens were cast to assess the compressive strength, split tensile strength and flexural strength of modified concrete after 28 days of curing. Optimum percentage of replacement was found by comparing the test results. The mix with 5% of LDPE and 3% of saw dust ash showed a better result among the other mixes.

Two-fold sustainability – Adobe with sawdust as partial sand replacement

NASA Astrophysics Data System (ADS)

Jokhio, Gul A.; Syed Mohsin, Sharifah M.; Gul, Yasmeen

2018-04-01

Adobe is a material that is economic, environment friendly, and provides better indoor air quality. The material required for the preparation of adobe include clay, sand, and sometimes straw or other organic materials. These materials do not require industrial processing or transportation, however, sand mining has been recently posing a threat to the environment. Therefore, to enhance the existing sustainability of adobe, sand can be partially or fully replaced by other waste materials. This approach will not only solve the problem of excessive sand mining, it will also address the issue of waste management. Sawdust is one such waste material that can be used to partially replace sand in Adobe. This paper presents the results of compressive and flexural test carried out on Adobe samples with partial sand replacement by sawdust. The results show that about 4% sand replacement by volume produces higher compressive strength, whereas the flexural strength reduces with the use of sawdust. However, since flexural strength is not a critical property for adobe, it is concluded that replacing sand with sawdust by about 4% of volume will be beneficial.

Characterization of Polyester Matrix Reinforced with Banana Fibers Thermal Properties by Photoacoustic Technique

NASA Astrophysics Data System (ADS)

de Assis, Foluke S.; Netto, Pedro A.; Margem, Frederico M.; Monteiro, Artur R. P. Junior Sergio N.

Synthetic fibers are being replaced gradually by natural materials such as lignocellulosic fibers. Compared to synthetic fibers, natural fibers have shown advantages in technical aspects such as environmental and economic. So there is a growing international interest in the use of those fibers. The banana fiber presents significant properties to be studied, but until now few thermal properties on banana fiber as reinforcement of polyester matrix were performed. The present work had as its objective to investigate, by photoacoustic spectroscopy and photothermal techniques the thermal properties of diffusivity, specific heat capacity and conductivity for polyester composites reinforced with banana fibers. In the polyester matrix will be added up to 30% in volume of continuous and aligned banana fibers. These values show that the incorporation of banana fibers in the polyester matrix changes its thermal properties.

Automatic segmentation of the left ventricle in a cardiac MR short axis image using blind morphological operation

NASA Astrophysics Data System (ADS)

Irshad, Mehreen; Muhammad, Nazeer; Sharif, Muhammad; Yasmeen, Mussarat

2018-04-01

Conventionally, cardiac MR image analysis is done manually. Automatic examination for analyzing images can replace the monotonous tasks of massive amounts of data to analyze the global and regional functions of the cardiac left ventricle (LV). This task is performed using MR images to calculate the analytic cardiac parameter like end-systolic volume, end-diastolic volume, ejection fraction, and myocardial mass, respectively. These analytic parameters depend upon genuine delineation of epicardial, endocardial, papillary muscle, and trabeculations contours. In this paper, we propose an automatic segmentation method using the sum of absolute differences technique to localize the left ventricle. Blind morphological operations are proposed to segment and detect the LV contours of the epicardium and endocardium, automatically. We test the benchmark Sunny Brook dataset for evaluation of the proposed work. Contours of epicardium and endocardium are compared quantitatively to determine contour's accuracy and observe high matching values. Similarity or overlapping of an automatic examination to the given ground truth analysis by an expert are observed with high accuracy as with an index value of 91.30% . The proposed method for automatic segmentation gives better performance relative to existing techniques in terms of accuracy.

Importance of increased ultrafiltration volume and impact on mortality: sepsis and cytokine story and the role for CVVH.

PubMed

Ronco, C; Ricci, Z; Bellomo, R

2002-01-01

There is growing interest in extracorporeal blood purification therapies (EBPT) as adjuvants in the complex therapy of sepsis and multiple organ dysfunction syndrome (MODS). Nowadays the only routinely used purification technique is 'renal replacement therapy' (RRT) during acute renal failure (ARF), one of the almost inevitable and deadly components of MODS. RRT has been the first and still is the most utilised and effective type of EBPT. Evidence is growing about its ability to maintain homeostatic balance in critically ill patients, and specifically in septic patients with MODS. Clinical trials have been recently designed to modify or improve these therapies. In detail, the following issues have been currently addressed: effects on blood purification provided by different therapies, adequacy of prescription and delivery of therapy, toxins and solutes to be removed with these techniques. Based on these speculations we will briefly review the current understanding of these issues and the rationale for application of RRT in the intensive care unit (ICU). In particular, we will focus on the importance of increased ultrafiltration volume and its impact on mortality in the general ICU population and in septic patients.

Post-Dilution on Line Haemodiafiltration with Citrate Dialysate: First Clinical Experience in Chronic Dialysis Patients

PubMed Central

Panichi, Vincenzo; Fiaccadori, Enrico; Fanelli, Roberto; Bernabini, Giada; Pizzarelli, Francesco

2013-01-01

Background. Citrate has anticoagulative properties and favorable effects on inflammation, but it has the potential hazards of inducing hypocalcemia. Bicarbonate dialysate (BHD) replacing citrate for acetate is now used in chronic haemodialysis but has never been tested in postdilution online haemodiafiltration (OL-HDF). Methods. Thirteen chronic stable dialysis patients were enrolled in a pilot, short-term study. Patients underwent one week (3 dialysis sessions) of BHD with 0.8 mmol/L citrate dialysate, followed by one week of postdilution high volume OL-HDF with standard bicarbonate dialysate, and one week of high volume OL-HDF with 0.8 mmol/L citrate dialysate. Results. In citrate OL-HDF pretreatment plasma levels of C-reactive protein and β2-microglobulin were significantly reduced; intra-treatment plasma acetate levels increased in the former technique and decreased in the latter. During both citrate techniques (OL-HDF and HD) ionized calcium levels remained stable within the normal range. Conclusions. Should our promising results be confirmed in a long-term study on a wider population, then OL-HDF with citrate dialysate may represent a further step in improving dialysis biocompatibility. PMID:24367243

The Kite Latissimus Dorsi Flap for Breast Reconstruction: An Attempt to Reduce Lateral Chest Wall Deformity and Axillary Bulking.

PubMed

Correia Anacleto, J; Mavioso, C; Gouveia, P F; Magalhães, A; Bastos Martins, J; Moura, A; Pinto, D; Cardoso, M J

2016-08-01

The latissimus dorsi flap is a commonly used tissue transfer for volume replacement in partial or total breast reconstruction. In this era of cosmetic awareness and oncoplastic breast surgery, two main defects are related to the conventional technique: the back scar and the bulkiness on the lateral chest wall, under the axilla. Axillary bulking, a disturbing defect for the majority of patients, is a persistent consequence, independent of the technique used, even when the proximal tendon is cut. We describe a new approach, the kite latissimus dorsi flap, consisting of harvesting the flap, partially or totally, with pedicle dissection from the muscle, extending dissection, perforator style if needed, until the external border of the breast (anterior axillary line) is reached. The muscle is then cut at that level, leaving no unnecessary volume under the axilla, which would cause bulkiness and chest wall deformity. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Are critical pathways and implant standardization programs effective in reducing costs in total knee replacement operations?

PubMed

Ho, David M; Huo, Michael H

2007-07-01

Total knee replacement (TKR) operation is one of the most effective procedures, both clinically and in terms of cost. Because of increased volume and cost for this procedure during the past 3 decades, TKRs are often targeted for cost reduction. The purpose of this study was to evaluate the efficacy of two cost reducing methodologies, establishment of critical clinical pathways, and standardization of implant costs. Ninety patients (90 knees) were randomly selected from a population undergoing primary TKR during a 2-year period at a tertiary teaching hospital. Patients were assigned to three groups that corresponded to different strategies implemented during the evolution of the joint-replacement program. Medical records were reviewed for type of anesthesia, operative time, length of stay, and any perioperative complications. Financial information for each patient was compared among the three groups. Data analysis demonstrated that the institution of a critical pathway significantly shortened length of hospital stay and was effective in reducing the hospital costs by 18% (p < 0.05). In addition, standardization of surgical techniques under the care of a single surgeon substantially reduced the operative time. Selection of implants from a single vendor did not have any substantial effect in additionally reducing the costs. Standardized postoperative management protocols and critical clinical pathways can reduce costs and operative time. Future efforts must focus on lowering the costs of the prostheses, particularly with competitive bidding or capitation of prostheses costs. Although a single-vendor approach was not effective in this study, it is possible that a cost reduction could have been realized if more TKRs were performed, because the pricing contract was based on projected volume of TKRs to be done by the hospital.

Posterior leaflet preservation during mitral valve replacement for rheumatic mitral stenosis.

PubMed

Djukić, P L; Obrenović-Kirćanski, B B; Vranes, M R; Kocica, M J; Mikić, A Dj; Velinović, M M; Kacar, S M; Kovacević, N S; Parapid, B J

2006-01-01

Mitral valve replacement with posterior leaflet preservation was shown beneficial for postoperative left vetricular (LV) performance in patients with mitral regurgitation. Some authors find it beneficial even for the long term LV function. We investigated a long term effect of this technique in patients with rheumatic mitral stenosis. We studied 20 patents with mitral valve replacement due to rheumatic mitral stenosis, in the period from January 1988 to December 1989. In group A (10 patients) both leaflets and coresponding chordal excision was performed, while in group B (10 patients) the posterior leaflet was preserved. In all patients a Carbomedics valve was inserted. We compared clinical pre and postoperative status, as well as hemodynamic characteristics of the valve and left ventricle in both groups. Control echocardiographyc analysis included: maximal (PG) and mean (MG) gradients; effective valve area (AREA); telediastolic (TDV) and telesystolic (TSV) LV volume; stroke volume (SV); ejection fraction (EF); fractional shortening (FS) and segmental LV motion. The mean size of inserted valve was 26.6 in group A and 27.2 in group B. Hemodynamic data: PG (10.12 vs 11.1); MG (3.57 vs 3.87); AREA (2.35 vs 2.30); TDV 126.0 vs 114.5); TSV (42.2 vs 36.62); SV (83.7 vs 77.75); EF (63.66 vs 67.12); FS (32.66 vs 38.25). Diaphragmal segmental hypokinesis was evident in one patient from group A and in two patients from group B. In patients with rheumatic stenosis, posterior leaflet preservation did not have increased beneficial effect on left ventricular performance during long-term follow-up. An adequate posterior leaflet preservation does not change hemodynamic valvular characteristics even after long-term follow-up.

Radioenzymatic analysis of neurotransmitters

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

Philips, S.R.

Since the late 1960's, radioenzymatic assays have gradually come to replace the less sensitive and less specific spectrofluorometric and bioassay procedures previously used to determine many of the neurotransmitters. These assays provide the means to measure picogram quantities of most of these substances, and have enabled determinations to be made in very small volumes of body fluids, in brain perfusates and individual brain nuclei, and in large individual cells of some simple animals. This paper reviews briefly some of the radioenzymatic techniques presently available for assaying norepinephrine (NE), epinephrine (E), dopamine (DA), serotonin, and the trace amines octopamine (OA), phenylethanolaminemore » (PEOHA), phenylethylamine (PEA), tyramine (TA) and tryptamine (T).« less

Design and performance of a large vocabulary discrete word recognition system. Volume 1: Technical report. [real time computer technique for voice data processing

NASA Technical Reports Server (NTRS)

1973-01-01

The development, construction, and test of a 100-word vocabulary near real time word recognition system are reported. Included are reasonable replacement of any one or all 100 words in the vocabulary, rapid learning of a new speaker, storage and retrieval of training sets, verbal or manual single word deletion, continuous adaptation with verbal or manual error correction, on-line verification of vocabulary as spoken, system modes selectable via verification display keyboard, relationship of classified word to neighboring word, and a versatile input/output interface to accommodate a variety of applications.

Aerospace Environmental Technology Conference: Exectutive summary

NASA Technical Reports Server (NTRS)

Whitaker, A. F. (Editor)

1995-01-01

The mandated elimination of CFC's, Halons, TCA, and other ozone depleting chemicals and specific hazardous materials has required changes and new developments in aerospace materials and processes. The aerospace industry has been involved for several years in providing product substitutions, redesigning entire production processes, and developing new materials that minimize or eliminate damage to the environment. These activities emphasize replacement cleaning solvents and their application verifications, compliant coatings including corrosion protection systems, and removal techniques, chemical propulsion effects on the environment, and the initiation of modifications to relevant processing and manufacturing specifications and standards. The papers from this conference are being published in a separate volume as NASA CP-3298.

O*NET Final Technical Report. Volume I [and] Volume II [and] Volume III.

ERIC Educational Resources Information Center

Peterson, Norman G.; Mumford, Michael D.; Borman, Walter C.; Jeanneret, P. Richard; Fleishman, Edwin A.; Levin, Kerry Y.

This document contains the three volumes of the technical report for development of the prototype of the Occupational Information Network (O*NET), which is intended to replace the "Dictionary of Occupational Titles.""General Introduction" (Norman G. Peterson) presents an overview of O*NET's purpose, content, and structure.…

Developing cost effective plans for low volume bridges

DOT National Transportation Integrated Search

2006-09-01

There is currently an escalating concern across the state of Kansas with respect to the age : and condition of low volume bridges and methods available to modify or replace them. A : high percentage of low volume bridges in the state of Kansas requir...

Surgical outcomes analysis of pediatric peritoneal dialysis catheter function in a rural region.

PubMed

Stone, Matthew L; LaPar, Damien J; Barcia, John P; Norwood, Victoria F; Mulloy, Daniel P; McGahren, Eugene D; Rodgers, Bradley M; Kane, Bartholomew J

2013-07-01

The purpose of this study was to analyze the experience with peritoneal dialysis (PD) at a high-volume, single center institution that supports a rural population. From 2000 to 2010, 88 children (median age: 1.98 years, [range: 2 days-20.2 years]) received 134 PD catheters for the management of acute and chronic renal failure. The primary outcome of interest was the incidence of primary PD catheter failure (replacement or revision within 60 days). Operative technique, longitudinal outcomes, and time intervals to transplantation were analyzed. Median time to transplant from the institution of dialysis was 1.4 years [range: 0.3-6.4 years]. Primary catheter failure occurred in 24.6% of cases. Infants less than 6 months of age demonstrated an increased incidence of primary catheter failure (p = 0.02). The operative technique for catheter placement was not associated with the incidence of primary failure. Postoperative complications included peritonitis (22.7%), omental plugging (11.9%), pericatheter drainage (9.0%), and exit site infection (3.0%). Peritoneal dialysis provides a safe and effective renal replacement therapy for regional pediatric centers that serve a rural population. However, primary catheter failure rates remain high at 24.6%. The surgical technique for placement had no effect on this failure rate in our patient population. Infants less than 6 months of age are at increased risk for primary catheter failure and warrant intensive surveillance. Copyright © 2013. Published by Elsevier Inc.

EPA’s Permeable Pavement Research

EPA Science Inventory

A deteriorated parking area on EPA’s Edison Environmental Center needed replacement. The replacement offered an opportunity for the facility managers to reduce the impervious footprint and the reduce stormwater runoff volume. This also provided researchers from the National Risk ...

Standard Terminal Automation Replacement System Human Factors Review Volume 1

DOT National Transportation Integrated Search

1997-12-18

The Federal Aviation Administration formed a Standard Terminal Automation Replacement : System (STARS) Working Group to identify and resolve human factors concerns with the Early : Display Capability (EDC) system before it is introduced in the field....

Developing cost effective plans for low volume bridges

DOT National Transportation Integrated Search

2006-09-01

There is currently an escalating concern across the state of Kansas with respect to the age and condition of low volume bridges and methods available to modify or replace them. A high percentage of low volume bridges in the state of Kansas require or...

Metallic artifact mitigation and organ-constrained tissue assignment for Monte Carlo calculations of permanent implant lung brachytherapy.

PubMed

Sutherland, J G H; Miksys, N; Furutani, K M; Thomson, R M

2014-01-01

To investigate methods of generating accurate patient-specific computational phantoms for the Monte Carlo calculation of lung brachytherapy patient dose distributions. Four metallic artifact mitigation methods are applied to six lung brachytherapy patient computed tomography (CT) images: simple threshold replacement (STR) identifies high CT values in the vicinity of the seeds and replaces them with estimated true values; fan beam virtual sinogram replaces artifact-affected values in a virtual sinogram and performs a filtered back-projection to generate a corrected image; 3D median filter replaces voxel values that differ from the median value in a region of interest surrounding the voxel and then applies a second filter to reduce noise; and a combination of fan beam virtual sinogram and STR. Computational phantoms are generated from artifact-corrected and uncorrected images using several tissue assignment schemes: both lung-contour constrained and unconstrained global schemes are considered. Voxel mass densities are assigned based on voxel CT number or using the nominal tissue mass densities. Dose distributions are calculated using the EGSnrc user-code BrachyDose for (125)I, (103)Pd, and (131)Cs seeds and are compared directly as well as through dose volume histograms and dose metrics for target volumes surrounding surgical sutures. Metallic artifact mitigation techniques vary in ability to reduce artifacts while preserving tissue detail. Notably, images corrected with the fan beam virtual sinogram have reduced artifacts but residual artifacts near sources remain requiring additional use of STR; the 3D median filter removes artifacts but simultaneously removes detail in lung and bone. Doses vary considerably between computational phantoms with the largest differences arising from artifact-affected voxels assigned to bone in the vicinity of the seeds. Consequently, when metallic artifact reduction and constrained tissue assignment within lung contours are employed in generated phantoms, this erroneous assignment is reduced, generally resulting in higher doses. Lung-constrained tissue assignment also results in increased doses in regions of interest due to a reduction in the erroneous assignment of adipose to voxels within lung contours. Differences in dose metrics calculated for different computational phantoms are sensitive to radionuclide photon spectra with the largest differences for (103)Pd seeds and smallest but still considerable differences for (131)Cs seeds. Despite producing differences in CT images, dose metrics calculated using the STR, fan beam + STR, and 3D median filter techniques produce similar dose metrics. Results suggest that the accuracy of dose distributions for permanent implant lung brachytherapy is improved by applying lung-constrained tissue assignment schemes to metallic artifact corrected images.

Controlling the pressure within an annular volume of a wellbore

DOEpatents

Hermes, Robert E.; Gonzalez, Manuel E.; Llewellyn, Brian C.; Bloys, James B.

2008-10-28

A process is described for replacing at least a portion of the liquid within the annular volume of a casing system within a wellbore with a second liquid. The second liquid is preselected to provide a measure of control of the pressure within the annular volume as the fluid within the volume is being heated.

Controlling the pressure within an annular volume of a wellbore

DOEpatents

Hermes, Robert E [Los Alamos, NM; Gonzalez, Manuel E [Kingwood, TX; Llewellyn, Brian C [Kingwood, TX; Bloys, James B [Katy, TX; Coates, Don M [Santa Fe, NM

2011-05-31

A process is described for replacing at least a portion of the liquid within the annular volume of a casing system within a wellbore with a second liquid. The second liquid is preselected to provide a measure of control of the pressure within the annular volume as the fluid within the volume is being heated.

Controlling the pressure within an annular volume of a wellbore

DOEpatents

Hermes, Robert E [Los Alamos, NM; Gonzalez, Manuel E [Kingwood, TX; Llewellyn, Brian C [Kingwood, TX; Bloys, James B [Katy, TX

2011-01-18

A process is described for replacing at least a portion of the liquid within the annular volume of a casing system within a wellbore with a second liquid. The second liquid is preselected to provide a measure of control of the pressure within the annular volume as the fluid within the volume is being heated.

Controlling the pressure within an annular volume of a wellbore

DOEpatents

Hermes, Robert E.; Gonzalez, Manuel E.; Llewellyn, Brian C.; Bloys, James B.

2010-06-29

A process is described for replacing at least a portion of the liquid within the annular volume of a casing system within a wellbore with a second liquid. The second liquid is preselected to provide a measure of control of the pressure within the annular volume as the fluid within the volume is being heated.

Controlling the pressure within an annular volume of a wellbore

DOEpatents

Hermes, Robert E [Los Alamos, NM; Gonzalez, Manuel E [Kingwood, NM; Llewellyn, Brian C [Kingwood, TX; Bloys, James B [Katy, TX; Coates, Don M [Santa Fe, NM

2011-06-21

A process is described for replacing at least a portion of the liquid within the annular volume of a casing system within a wellbore with a second liquid. The second liquid is preselected to provide a measure of control of the pressure within the annular volume as the fluid within the volume is being heated.

Medical Surveillance Monthly Report (MSMR). Volume 22, Number 5, May 2015

DTIC Science & Technology

2015-05-01

aTotal column equals one joint replacement per person per period. bAn individual could be counted once in each of the types of joint replacements. cRate...Percentages of joint replace- ment cases who remained in service or had left service, 2 years post-joint replacement, by gender , active component...Musculoskeletal-related disability in US Army personnel: prevalence, gender and military occupational specialties. J Occup Environ Med. 1997;39(1):68–78

Standard Terminal Automation Replacement System Human Factors Review Supporting Documents Volume 2

DOT National Transportation Integrated Search

1997-12-18

The Federal Aviation Administration formed a Standard Terminal Automation Replacement : System (STARS) Working Group to identify and resolve human factors concerns with the Early : Display Capability (EDC) system before it is introduced in the field....

Characterisation of a cell swelling-activated K+-selective conductance of Ehrlich mouse ascites tumour cells

PubMed Central

Niemeyer, María Isabel; Hougaard, Charlotte; Hoffmann, Else K; Jørgensen, Finn; Stutzin, Andrés; Sepúlveda, Francisco V

2000-01-01

The K+ and Cl− currents activated by hypotonic cell swelling were studied in Ehrlich ascites tumour cells using the whole-cell recording mode of the patch-clamp technique. Currents were measured in the absence of added intracellular Ca2+ and with strong buffering of Ca2+. K+ current activated by cell swelling was measured as outward current at the Cl− equilibrium potential (ECl) under quasi-physiological gradients. It could be abolished by replacing extracellular Na+ with K+, thereby cancelling the driving force. Replacement with other cations suggested a selectivity sequence of K+ > Rb+ > NH4≈ Na+≈ Li+; Cs+ appeared to be inhibitory. The current-voltage relationship of the volume-sensitive K+ current was well fitted with the Goldman-Hodgkin-Katz current equation between -130 and +20 mV with a permeability coefficient of around 10−6 cm s−1 with both physiological and high-K+ extracellular solutions. The class III antiarrhythmic drug clofilium blocked the volume-sensitive K+ current in a voltage-independent manner with an IC50 of 32 μM. Clofilium was also found to be a strong inhibitor of the regulatory volume decrease response of Ehrlich cells. Cell swelling-activated K+ currents of Ehrlich cells are voltage and calcium insensitive and are resistant to a range of K+ channel inhibitors. These characteristics are similar to those of the so-called background K+ channels. Noise analysis of whole-cell current was consistent with a unitary conductance of 5.5 pS for the single channels underlying the K+ current evoked by cell swelling, measured at 0 mV under a quasi-physiological K+ gradient. PMID:10790156

Mid-term results of cardiac autotransplantation as method to treat permanent atrial fibrillation and mitral disease.

PubMed

Troise, Giovanni; Cirillo, Marco; Brunelli, Federico; Tasca, Giordano; Amaducci, Andrea; Mhagna, Zen; Tomba, Margherita Dalla; Quaini, Eugenio

2004-06-01

The results of current surgical options for the treatment of permanent atrial fibrillation (AF) associated with mitral surgery are widely different, particularly in very enlarged left atria. The aim of this study was to assess the mid-term efficacy of cardiac autotransplantation for this goal, through a consistent reduction of left atrium volume and a complete isolation of the pulmonary veins. From April 2000 to September 2002, 30 patients (male/female 5/25) underwent cardiac autotransplantation for the treatment of mitral valve disease and concomitant permanent AF (>1 year). Surgical technique of bicaval heart transplantation was modified maintaining the connection of inferior vena cava in all but three cases. Twenty-eight patients had mitral valve replacement and two had mitral valve repair. Associated procedures were: aortic valve replacement (6 cases), tricuspid valve repair (2 cases), coronary re-vascularization (2 cases) and right atrium volume reduction (4 cases). No hospital death occurred; 1 patient died 3 months post-operatively for pneumonia. At a mean follow-up of 21.1+/-7.7 months (range 6-35), 26 patients (89.7%) were in sinus rhythm and 3 (10.3%) in AF. Santa Cruz Score was 0 in 3 patients, 2 in 2 patients and 4 in the remaining 24 patients (82.7%). Mean left atrial diameter and volume decreased from 65.1+/-16.4 mm (range 50-130 mm) to 49.9+/-8.4 mm (range 37-78) (P < 0.001) and from 118.3+/-68.4 ml (range 60-426) to 69.4+/-34.1 ml (range 31-226) (P = 0.001), respectively, after the operation. Cardiac autotransplantation is a safe and effective option for the treatment of permanent AF in patients with mitral valve disease and severe dilation of left atrium.

State of the art in fluid and volume therapy : A user-friendly staged concept. English version.

PubMed

Rehm, M; Hulde, N; Kammerer, T; Meidert, A S; Hofmann-Kiefer, K

2017-04-10

Adequate intraoperative infusion therapy is essential for the perioperative outcome of a patient. Both hypo- and hypervolemia can lead to an increased rate of perioperative complications and to a worse outcome. Perioperative infusion therapy should therefore be needs-based. The primary objective is the maintenance of preoperative normovolemia using a rational infusion strategy. Perioperative fluid losses should be differentiated from volume losses due to surgical bleeding or protein losses into the interstitial space. Fluid loss via urine excretion or insensible perspiration (0.5-1.0 ml/kg/h) should be replaced with balanced, isooncotic, crystalloid infusion solutions in a ratio of 1:1. Volume therapy stage 1: intraoperative volume losses up to a blood loss corresponding to 20% of the patient's total blood volume are compensated for by balanced crystalloids in a ratio of 4-5:1. Stage 2: blood losses exceeding this level are to be treated with isooncotic colloids (preferably balanced) in a 1:1 ratio. In this regard taking into consideration the contraindications, e. g., sepsis, burns, critical illness (usually patients in the intensive care unit), impaired renal function or renal replacement therapy, intracranial hemorrhage, or severe coagulopathy, artificial colloids such as hydroxyethyl starch (HES) can be used perioperatively for volume replacement. Stage 3: if an allogeneic blood transfusion is indicated, blood and blood products are applied in a differentiated manner.

X-ray tomography as a non-destructive tool for evaluating the preservation of primary isotope signatures and mineralogy of Mesozoic fossils

NASA Astrophysics Data System (ADS)

Santillan, J. D.; Boyce, J. W.; Eagle, R.; Martin, T.; Tuetken, T.; Eiler, J.

2010-12-01

The stable isotope compositions of carbonate and phosphate components in fossil teeth and bone are widely used to infer information on paleoclimate and the physiology of extinct organisms. Recently the potential for measuring the body temperatures of extinct vertebrates from analyses of 13C-18O bond ordering in fossil teeth has been demonstrated (Eagle et al. 2010). The interpretation of these isotopic signatures relies on an assessment of the resistance of fossil bioapatite to alteration, as diffusion within, and partial recrystallization, or replacement of the original bioapatite will lead to measured compositions that represent mixtures between primary and secondary phases and/or otherwise inaccurate apparent temperatures. X-ray computed tomography (CT) allows 3-D density maps of teeth to be made at micron-scale resolution. Such density maps have the potential to record textural evidence for alteration, recrystallization, or replacement of enamel. Because it is non-destructive, CT can be used prior to stable isotope analysis to identify potentially problematic samples without consuming or damaging scientifically significant specimens. As a test, we have applied CT to tooth fragments containing both dentin and enamel from Late Jurassic sauropods and a Late Cretaceous theropod that yielded a range of clumped isotope temperatures from anomalously high ˜60oC to physiologically plausible ≤40oC. This range of temperatures suggests partial, high-temperature modification of some specimens, but possible preservation of primary signals in others. Three-dimensional CT volumes generated using General Electric Phoenix|x-ray CT instruments were compared with visible light and back-scattered electron images of the same samples. The tube-detector combination used for the CT study consisted of a 180 kV nanofocus transmission tube coupled with a 127 micron pixel pitch detector ( ˜3-12μ m voxel edges), allowing us to clearly map out alteration zones in high contrast, while reducing edge effects and beam hardening artifacts. CT images of these teeth show a range of replacement textures. One tooth -- thought to be the least altered -- shows only localized positive density anomalies near fractures, while a second -- thought to be highly altered -- contains high-density replacement mineralization. A third tooth -- one suspected of possible partial alteration -- shows a network of rectilinear density anomalies in the enamel similar to 2-D transmitted light and back-scattered electron images. This may represent recrystallization or replacement of the primary bioapatite. Unlike 2-D imaging techniques, 3-D volumes can be used to quickly and easily make quantitative measurements of the volumes of altered and unaltered materials: For example, in the enamel of sample 3, we observe a ratio of high density to low density material of ˜ 3:2.

47 CFR 0.415 - The rules and regulations (looseleaf service).

Code of Federal Regulations, 2010 CFR

2010-10-01

...) In this service, the rules are divided into 10 volumes, each containing several related parts. Each volume may be purchased separately from the Superintendent of Documents. The purchase price for a volume includes a subscription to replacement pages reflecting changes in the rules contained therein until such...

47 CFR 0.415 - The rules and regulations (looseleaf service).

Code of Federal Regulations, 2011 CFR

2011-10-01

...) In this service, the rules are divided into 10 volumes, each containing several related parts. Each volume may be purchased separately from the Superintendent of Documents. The purchase price for a volume includes a subscription to replacement pages reflecting changes in the rules contained therein until such...

Plasma exchange in the intensive care unit: Technical aspects and complications.

PubMed

Lemaire, Aurélie; Parquet, Nathalie; Galicier, Lionel; Boutboul, David; Bertinchamp, Rémi; Malphettes, Marion; Dumas, Guillaume; Mariotte, Eric; Peraldi, Marie-Noëlle; Souppart, Virginie; Schlemmer, Benoit; Azoulay, Elie; Canet, Emmanuel

2017-12-01

Data on plasma exchange therapy in the intensive care unit (ICU) setting are scarce. We aimed to describe the technical aspects and the adverse events associated with the procedure in critically ill patients. All adult patients treated by plasma exchange in the medical ICU of the Saint-Louis university hospital between January 1, 2013 and March 31, 2015 were prospectively included. We report on 260 plasma exchange procedures performed in 50 patients. The centrifugation technique was used for 159 (61%) procedures and the filtration technique for the other 101 (39%) procedures. Both techniques had similar efficacy to treat hyperviscosity syndrome (n = 18). Seventy (26.9%) of the 260 plasma exchange procedures were reported with at least one adverse reaction. Centrifugation and filtration techniques had similar rates of adverse reactions (23.9 vs. 31.7%, P = .19). Hypotension was the most reported (n = 21, 8%) and correlates with a low hematocrit before therapy. Most complications were related to allergic reactions to the replacement fluids. Coagulation disorders depended on the type of replacement fluid. The post-exchange fibrinogen level was decreased by 54% [48;66] with albumin 5%, and 4% [-5;17] with plasma frozen within 24 h. Twenty-three (22.8%) of the 101 filtration procedures experienced filter clotting. Filter clotting was associated with a higher volume exchange prescribed when compared to procedures without filter clotting (4600 [4000;5000] ml vs. 3900 [3600;4800] ml, P < .01). Plasma exchange is a relatively safe and generally well-tolerated procedure in the ICU setting. Most adverse events are unpredictable and related to minor allergic reactions. © 2017 Wiley Periodicals, Inc.

Autotransplantation of Mandibular Third Molar with Buccal Cortical Plate to Replace Vertically Fractured Mandibular Second Molar: A Novel Technique.

PubMed

Zufía, Juan; Abella, Francesc; Trebol, Ivan; Gómez-Meda, Ramón

2017-09-01

Tooth replacement often leads to inadequate vertical volume in the recipient site bone when a tooth has been extracted because of a vertical root fracture (VRF). This case report presents the autotransplantation of a mandibular third molar (tooth #32) with the attached buccal cortical plate to replace a mandibular second molar (tooth #31) diagnosed with a VRF. After extraction of tooth #31, the recipient socket was prepared based on the size measured in advance with cone-beam computed tomographic imaging. The precise and calculated osteotomy of the cortical bone of tooth #32 allowed for the exact placement of the donor tooth in the position of tooth #31. The total extraoral time was only 25 minutes. The block was fixed to the recipient socket with an osteosynthesis screw and splinted with a double resin wire for 8 weeks. At the 6-month follow-up, the screw was removed, and the stability of the tooth and the regeneration obtained throughout the vestibular area were confirmed. At the 2-year follow-up, the transplanted tooth was asymptomatic and maintained a normal bone level. Advantages of autotransplantation over dental implants include maintenance of proprioception, possible orthodontic movements, and a relatively low cost. This case report demonstrates that an autotransplantation of a third molar attached to its buccal cortical plate is a viable option to replace teeth with a VRF. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Tumescent and syringe liposculpture: a logical partnership.

PubMed

Hunstad, J P

1995-01-01

Liposuction has been traditionally performed under general anesthesia. Standard instrumentation for the procedure has included blunt-tipped suction cannulae connected to an electric vacuum pump by noncollapsible tubing. A subcutaneous injection of Lidocaine with Epinephrine is routinely employed to minimize blood loss during the procedure. This infiltration has been described as the "wet technique," but it is not a method to supplant general anesthesia. The tumescent technique, a method of infusing very large volumes of dilute lidocaine with epinephrine solutions, has been advocated as a satisfactory means for providing conscious anesthesia for liposuction procedures, avoiding the need for general anesthesia. The syringe technique employs blunt-tipped suction cannulae connected to a syringe. Drawing back the syringe plunger generates the negative pressures needed to remove fat during liposuction and replaces the electric vacuum pump and connecting tubing traditionally used for this procedure. This study evaluates the combined tumescent and syringe techniques for liposuction. One hundred consecutive patients were treated with the tumescent technique as the sole means of anesthesia and the syringe technique as the sole means of performing liposuction. A modified tumescent formula is presented. A comparison of liposuction aspirates using this modified tumescent technique is compared and contrasted to liposuction aspirates obtained using the "dry technique" and the "wet technique." A historical review of the syringe technique and its perceived attributes is also presented. Technical descriptions of the tumescent infusion method, tumescent fluid formulation, and suggested patient sedation and monitoring is presented. Photographic documentation of patients who underwent the combined tumescent and syringe liposculpture treating various body areas is shown. A critical analysis of the limitations of this combined technique is also described noting added time requirements, difficulties with under-correction of deformities, and need for reoperation, methods for determining the "end-point" for the procedure, as well as addressing large-volume liposuction problems. The conclusion reached by this study is that combining the tumescent technique and the syringe technique is a logical partnership. Each method complements the other, allowing liposuction to be performed with considerable advantage over traditional methods. These advantages include eliminating the need for general anesthesia, lessening blood loss and postoperative bruising, greater accuracy, precision, and overall high patient satisfaction.

Fascian.

PubMed

Burres, Steve

2004-05-01

Fascian is preserved particulate fascia derived from the gastrocnemious fascia that extends from the Achilles tendon. Over 50,000 syringes of material have been sold to physicians over the past six years with an impeccable safety record. The material has been used for wrinkles, scars, fat atrophy, diffuse depressions, paralyzed lips and tongues, nasolabial folds, cellulite, and other problems. Solid fascia grafts are routinely replaced with native collagen and a similar effect may be achieved with Fascian, especially after repeat injections. The FDA classifies the material as a tissue product, so injections may be made anywhere in the human body at the physician's discretion. Injections may last from a few months to permanently, depending on the volume of material, location, particle size, skin layer, and technique.

Liquid cooled approaches for high density avionics

NASA Astrophysics Data System (ADS)

Levasseur, Robert

Next-generation aircraft will require avionics that provide greater system performance in a smaller volume, a process that requires highly developed thermal management techniques. To meet this need, a liquid-cooled approach has been developed to replace the conventional air-cooled approach for high-power applications. Liquid-cooled chassis and flow-through modules have been developed to limit junction temperatures to acceptable levels. Liquid cooling also permits emergency operation after loss of coolant for longer time intervals, which is desirable for flight-critical airborne applications. Activity to date has emphasized the development of chassis and modules that support the US Department of Defense's (DoD) two-level maintenance initiative as governed by the Joint Integrated Avionics Working Group (JIAWG).

EPA’s permeable pavement research and the Edison Environmental Center

EPA Science Inventory

A deteriorated parking area on EPA’s Edison Environmental Center needed replacement. The replacement offered an opportunity for the facility managers to reduce the impervious footprint and the reduce stormwater runoff volume. This also provided researchers from the National Risk ...

Ripe Banana Flour as a Source of Antioxidants in Layer and Sponge Cakes.

PubMed

Segundo, Cristina; Román, Laura; Lobo, Manuel; Martinez, Mario M; Gómez, Manuel

2017-12-01

About one-fifth of all bananas harvested become culls that are normally disposed of improperly. However, ripe banana pulp contains significant amounts of fibre and polyphenol compounds as well as a high content of simple sugars (61.06 g/100 g), making it suitable for sucrose replacement in bakery products. This work studied the feasibility of incorporating ripe banana flour (20 and 40% of replacement) in cake formulation. Physical, nutritional and sensory attributes of sponge and layer cakes were evaluated. The inclusion of ripe banana flour generally led to an increased batter consistency that hindered cake expansion, resulting in a slightly lower specific volume and higher hardness. This effect was minimised in layer cakes where differences in volume were only evident with the higher level of replacement. The lower volume and higher hardness contributed to the decline of the acceptability observed in the sensory test. Unlike physical attributes, the banana flour inclusion significantly improved the nutritional properties of the cakes, bringing about an enhancement in dietary fibre, polyphenols and antioxidant capacity (up to a three-fold improvement in antioxidant capacity performance). Therefore, results showed that sugar replacement by ripe banana flour enhanced the nutritional properties of cakes, but attention should be paid to its inclusion level.

Functional characterization of steam jet-cooked buckwheat flour as a fat replacer in cake-baking.

PubMed

Min, Bockki; Lee, Seung Mi; Yoo, Sang-Ho; Inglett, George E; Lee, Suyong

2010-10-01

With rising consumer awareness of obesity, the food industry has a market-driven impetus to develop low-fat or fat-free foods with acceptable taste and texture. Fancy buckwheat flour was thus subjected to steam jet-cooking and the performance of the resulting product in cake-baking was evaluated as a fat replacer. Steam jet-cooking caused structural breakdown and starch gelatinization of buckwheat flour, thus increasing its water hydration properties. In the pasting measurements, steam jet-cooked buckwheat flour exhibited high initial viscosity, while no peak viscosity was observed. Also, the suspensions of steam jet-cooked buckwheat flour exhibited shear-thinning behaviors, which were well characterized by the power law model. When shortening in cakes was replaced with steam jet-cooked buckwheat gels, the specific gravity of cake batters significantly increased, consequently affecting cake volume after baking. However, shortening replacement with steam jet-cooked buckwheat up to 20% by weight appeared to be effective in producing cakes as soft as the control without volume loss. When buckwheat flour was thermomechanically modified by steam jet-cooking, it was successfully incorporated into cake formulations for shortening up to 20% by weight, producing low-fat cakes with comparable volume and textural properties to the control. Copyright © 2010 Society of Chemical Industry.

Toward Increasing Micropore Volume between Hybrid Layered Perovskites with Silsesquioxane Interlayers.

PubMed

Kataoka, Sho; Kamimura, Yoshihiro; Endo, Akira

2018-04-10

Hybrid organic-inorganic layered perovskites are typically nonporous solids. However, the incorporation of silsesquioxanes with a cubic cage structure as interlayer materials creates micropores between the perovskite layers. In this study, we increase in the micropore volume in layered perovskites by replacing a portion of the silsesquioxane interlayers with organic amines. In the proposed method, approximately 20% of the silsesquioxane interlayers can be replaced without changing the layer distance owing to the size of the silsesquioxane. When small amines (e.g., ethylamine) are used in this manner, the micropore volume of the obtained hybrid layered perovskites increases by as much as 44%; when large amines (e.g., phenethylamine) are used, their micropore volume decreases by as much as 43%. Through the variation of amine fraction, the micropore volume can be adjusted in the range. Finally, the magnetic moment measurements reveal that the layered perovskites with mixed interlayers exhibit ferromagnetic ordering at temperature below 20 K, thus indicating that the obtained perovskites maintain their functions as layered perovskites.

Comparative study of methods to measure the density of Cementious powders

PubMed Central

Helsel, Michelle A.; Bentz, Dale

2016-01-01

The accurate measurement of the density of hydraulic cement has an essential role in the determination of concrete mixture proportions. As more supplementary cementitious materials (SCM), such as fly ash, and slag, or cement replacements materials such as limestone and calcium carbonate are used in blended cements, knowledge of the density of each powder or of the blended cement would allow a more accurate calculation of the proportions of a concrete mixture by volume instead of by mass. The current ASTM standard for measuring cement density is the “Test Method for Density of Hydraulic Cements” (ASTM C188-14), which utilizes a liquid displacement method to measure the volume of the cement. This paper will examine advantageous modifications of the current ASTM test, by alcohol substitutions for kerosene. In addition, a gas (helium) pycnometry method is evaluated as a possible alternative to the current standard. The described techniques will be compared to determine the most precise and reproducible method for measuring the density of hydraulic cements and other powders. PMID:27099404

Comparative study of methods to measure the density of Cementious powders.

PubMed

Helsel, Michelle A; Ferraris, Chiara F; Bentz, Dale

2016-11-01

The accurate measurement of the density of hydraulic cement has an essential role in the determination of concrete mixture proportions. As more supplementary cementitious materials (SCM), such as fly ash, and slag, or cement replacements materials such as limestone and calcium carbonate are used in blended cements, knowledge of the density of each powder or of the blended cement would allow a more accurate calculation of the proportions of a concrete mixture by volume instead of by mass. The current ASTM standard for measuring cement density is the "Test Method for Density of Hydraulic Cements" (ASTM C188-14), which utilizes a liquid displacement method to measure the volume of the cement. This paper will examine advantageous modifications of the current ASTM test, by alcohol substitutions for kerosene. In addition, a gas (helium) pycnometry method is evaluated as a possible alternative to the current standard. The described techniques will be compared to determine the most precise and reproducible method for measuring the density of hydraulic cements and other powders.

Novel cardiac magnetic resonance biomarkers: native T1 and extracellular volume myocardial mapping.

PubMed

Cannaò, Paola Maria; Altabella, Luisa; Petrini, Marcello; Alì, Marco; Secchi, Francesco; Sardanelli, Francesco

2016-04-28

Cardiac magnetic resonance (CMR) is a non-invasive diagnostic tool playing a key role in the assessment of cardiac morphology and function as well as in tissue characterization. Late gadolinium enhancement is a fundamental CMR technique for detecting focal or regional abnormalities such as scar tissue, replacement fibrosis, or inflammation using qualitative, semi-quantitative, or quantitative methods, but not allowing for evaluating the whole myocardium in the presence of diffuse disease. The novel T1 mapping approach permits a quantitative assessment of the entire myocardium providing a voxel-by-voxel map of native T1 relaxation time, obtained before the intravenous administration of gadolinium-based contrast material. Combining T1 data obtained before and after contrast injection, it is also possible to calculate the voxel-by-voxel extracellular volume (ECV), resulting in another myocardial parametric map. This article describes technical challenges and clinical perspectives of these two novel CMR biomarkers: myocardial native T1 and ECV mapping.

High-volume fly ash concrete.

DOT National Transportation Integrated Search

2013-06-01

The objective of the proposed study is to design, test, and evaluate high-volume fly ash concrete mixtures. Traditional specifications : limit the amount of fly ash to 40% or less cement replacement. This program attempts to increase the ash content ...

Noninvasive Hemodynamic Measurements During Neurosurgical Procedures in Sitting Position.

PubMed

Schramm, Patrick; Tzanova, Irene; Gööck, Tilman; Hagen, Frank; Schmidtmann, Irene; Engelhard, Kristin; Pestel, Gunther

2017-07-01

Neurosurgical procedures in sitting position need advanced cardiovascular monitoring. Transesophageal echocardiography (TEE) to measure cardiac output (CO)/cardiac index (CI) and stroke volume (SV), and invasive arterial blood pressure measurements for systolic (ABPsys), diastolic (ABPdiast) and mean arterial pressure (MAP) are established monitoring technologies for these kind of procedures. A noninvasive device for continuous monitoring of blood pressure and CO based on a modified Penaz technique (volume-clamp method) was introduced recently. In the present study the noninvasive blood pressure measurements were compared with invasive arterial blood pressure monitoring, and the noninvasive CO monitoring to TEE measurements. Measurements of blood pressure and CO were performed in 35 patients before/after giving a fluid bolus and a change from supine to sitting position, start of surgery, and repositioning from sitting to supine at the end of surgery. Data pairs from the noninvasive device (Nexfin HD) versus arterial line measurements (ABPsys, ABPdiast, MAP) and versus TEE (CO, CI, SV) were compared using Bland-Altman analysis and percentage error. All parameters compared (CO, CI, SV, ABPsys, ABPdiast, MAP) showed a large bias and wide limits of agreement. Percentage error was above 30% for all parameters except ABPsys. The noninvasive device based on a modified Penaz technique cannot replace arterial blood pressure monitoring or TEE in anesthetized patients undergoing neurosurgery in sitting position.

Investigation on the Rheological Behavior of Fly Ash Cement Composites at Paste and Concrete Level

NASA Astrophysics Data System (ADS)

Thiyagarajan, Hemalatha; Mapa, Maitri; Kushwaha, Rakhi

2018-06-01

Towards developing sustainable concrete, nowadays, high volume replacement of cement with fly ash (FA) is more common. Though the replacement of fly ash at 20-30% is widely accepted due to its advantages at both fresh and hardened states, applicability and acceptability of high volume fly ash (HVFA) is not so popular due to some adverse effects on concrete properties. Nowadays to suit various applications, flowing concretes such as self compacting concrete is often used. In such cases, implications of usage of HVFA on fresh properties are required to be investigated. Further, when FA replacement is beyond 40% in cement, it results in the reduction of strength and in order to overcome this drawback, additions such as nano calcium carbonate (CC), lime sludge (LS), carbon nano tubes (CNT) etc. are often incorporated to HVFA concrete. Hence, in this study, firstly, the influence of replacement level of 20-80% FA on rheological property is studied for both cement and concrete. Secondly, the influence of additions such as LS, CC and CNT on rheological parameters are discussed. It is found that the increased FA content improved the flowability in paste as well as in concrete. In paste, the physical properties such as size and shape of fly ash is the reason for increased flowability whereas in concrete, the paste volume contributes dominantly for the flowability rather than the effect due to individual FA particle. Reduced density of FA increases the paste volume in FA concrete thus reducing the interparticle friction by completely coating the coarse aggregate.

PRISM: An open source framework for the interactive design of GPU volume rendering shaders.

PubMed

Drouin, Simon; Collins, D Louis

2018-01-01

Direct volume rendering has become an essential tool to explore and analyse 3D medical images. Despite several advances in the field, it remains a challenge to produce an image that highlights the anatomy of interest, avoids occlusion of important structures, provides an intuitive perception of shape and depth while retaining sufficient contextual information. Although the computer graphics community has proposed several solutions to address specific visualization problems, the medical imaging community still lacks a general volume rendering implementation that can address a wide variety of visualization use cases while avoiding complexity. In this paper, we propose a new open source framework called the Programmable Ray Integration Shading Model, or PRISM, that implements a complete GPU ray-casting solution where critical parts of the ray integration algorithm can be replaced to produce new volume rendering effects. A graphical user interface allows clinical users to easily experiment with pre-existing rendering effect building blocks drawn from an open database. For programmers, the interface enables real-time editing of the code inside the blocks. We show that in its default mode, the PRISM framework produces images very similar to those produced by a widely-adopted direct volume rendering implementation in VTK at comparable frame rates. More importantly, we demonstrate the flexibility of the framework by showing how several volume rendering techniques can be implemented in PRISM with no more than a few lines of code. Finally, we demonstrate the simplicity of our system in a usability study with 5 medical imaging expert subjects who have none or little experience with volume rendering. The PRISM framework has the potential to greatly accelerate development of volume rendering for medical applications by promoting sharing and enabling faster development iterations and easier collaboration between engineers and clinical personnel.

PRISM: An open source framework for the interactive design of GPU volume rendering shaders

PubMed Central

Collins, D. Louis

2018-01-01

Direct volume rendering has become an essential tool to explore and analyse 3D medical images. Despite several advances in the field, it remains a challenge to produce an image that highlights the anatomy of interest, avoids occlusion of important structures, provides an intuitive perception of shape and depth while retaining sufficient contextual information. Although the computer graphics community has proposed several solutions to address specific visualization problems, the medical imaging community still lacks a general volume rendering implementation that can address a wide variety of visualization use cases while avoiding complexity. In this paper, we propose a new open source framework called the Programmable Ray Integration Shading Model, or PRISM, that implements a complete GPU ray-casting solution where critical parts of the ray integration algorithm can be replaced to produce new volume rendering effects. A graphical user interface allows clinical users to easily experiment with pre-existing rendering effect building blocks drawn from an open database. For programmers, the interface enables real-time editing of the code inside the blocks. We show that in its default mode, the PRISM framework produces images very similar to those produced by a widely-adopted direct volume rendering implementation in VTK at comparable frame rates. More importantly, we demonstrate the flexibility of the framework by showing how several volume rendering techniques can be implemented in PRISM with no more than a few lines of code. Finally, we demonstrate the simplicity of our system in a usability study with 5 medical imaging expert subjects who have none or little experience with volume rendering. The PRISM framework has the potential to greatly accelerate development of volume rendering for medical applications by promoting sharing and enabling faster development iterations and easier collaboration between engineers and clinical personnel. PMID:29534069

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

Berkowitz, L.R.; Orringer, E.P.

Swelling hemoglobin CC erythrocytes stimulates a ouabain-insensitive K flux that restores original cell volume. Studies were performed with the K analog, /sup 86/Rb. This volume regulatory pathway was characterized for its anion dependence, sensitivity to loop diuretics, and requirement for Na. The swelling-induced K flux was eliminated if intracellular chloride was replaced by nitrate and both swelling-activated K influx and efflux were partially inhibited by 1 mM furosemide or bumetanide. K influx in swollen hemoglobin CC cells was not diminished when Na in the incubation medium was replaced with choline, indicating Na independence of the swelling-induced flux. Identical experiments withmore » hemoglobin AA cells also demonstrated a swelling-induced increase in K flux, but the magnitude and duration of this increase were considerably less than that seen with hemoglobin CC cells. The increased K flux in hemoglobin AA cells was likewise sensitive to anion replacement and to loop diuretics and did not require the presence of Na. These data indicate that a volume-activated K pathway with similar transport characteristics exists in both hemoglobin CC and AA red cells.« less

Degradation of self-compacting concrete (SCC) due to sulfuric acid attack: Experiment investigation on the effect of high volume fly ash content

NASA Astrophysics Data System (ADS)

Kristiawan, S. A.; Sunarmasto; Tyas, G. P.

2016-02-01

Concrete is susceptible to a variety of chemical attacks. In the sulfuric acid environment, concrete is subjected to a combination of sulfuric and acid attack. This research is aimed to investigate the degradation of self-compacting concrete (SCC) due to sulfuric acid attack based on measurement of compressive strength loss and diameter change. Since the proportion of SCC contains higher cement than that of normal concrete, the vulnerability of this concrete to sulfuric acid attack could be reduced by partial replacement of cement with fly ash at high volume level. The effect of high volume fly ash at 50-70% cement replacement levels on the extent of degradation owing to sulfuric acid will be assessed in this study. It can be shown that an increase in the utilization of fly ash to partially replace cement tends to reduce the degradation as confirmed by less compressive strength loss and diameter change. The effect of fly ash to reduce the degradation of SCC is more pronounced at a later age.

Correlation between central venous pressure and peripheral venous pressure with passive leg raise in patients on mechanical ventilation.

PubMed

Kumar, Dharmendra; Ahmed, Syed Moied; Ali, Shahna; Ray, Utpal; Varshney, Ankur; Doley, Kashmiri

2015-11-01

Central venous pressure (CVP) assesses the volume status of patients. However, this technique is not without complications. We, therefore, measured peripheral venous pressure (PVP) to see whether it can replace CVP. To evaluate the correlation and agreement between CVP and PVP after passive leg raise (PLR) in critically ill patients on mechanical ventilation. Prospective observational study in Intensive Care Unit. Fifty critically ill patients on mechanical ventilation were included in the study. CVP and PVP measurements were taken using a water column manometer. Measurements were taken in the supine position and subsequently after a PLR of 45°. Pearson's correlation and Bland-Altman's analysis. This study showed a fair correlation between CVP and PVP after a PLR of 45° (correlation coefficient, r = 0.479; P = 0.0004) when the CVP was <10 cmH2O. However, the correlation was good when the CVP was >10 cmH2O. Bland-Altman analysis showed 95% limits of agreement to be -2.912-9.472. PVP can replace CVP for guiding fluid therapy in critically ill patients.

Preferential effects of low volume versus high volume replacement with crystalloid fluid in a hemorrhagic shock model in pigs.

PubMed

Ponschab, Martin; Schöchl, Herbert; Keibl, Claudia; Fischer, Henrik; Redl, Heinz; Schlimp, Christoph J

2015-10-06

Fluid resuscitation is a core stone of hemorrhagic shock therapy, and crystalloid fluids seem to be associated with lower mortality compared to colloids. However, as redistribution starts within minutes, it has been suggested to replace blood loss with a minimum of a three-fold amount of crystalloids. The hypothesis was that in comparison to high volume (HV), a lower crystalloid volume (LV) achieves a favorable coagulation profile and exerts sufficient haemodynamics in the acute phase of resuscitation. In 24 anaesthetized pigs, controlled arterial blood loss of 50 % of the estimated blood volume was either (n = 12) replaced with a LV (one-fold) or a HV (three-fold) volume of a balanced, acetated crystalloid solution at room temperature. Hemodynamic parameters, dilution effects and coagulation profile by standard coagulation tests and thromboelastometry at baseline and after resuscitation were determined in both groups. LV resuscitation increased MAP significantly less compared to the HV, 61 ± 7 vs. 82 ± 14 mmHg (p < 0.001) respectively, with no difference between lactate and base excess between groups. Haematocrit after fluid replacement was 0.20 vs. 0.16 (LV vs. HV, p < 0.001), suggesting a grade of blood dilution of 32 vs. 42 % (p < 0.001) compared to baseline values. Compared to LV, HV resulted in decreased core temperature (37.5 ± 0.2 vs. 36.0 ± 0.6 °C, p < 0.001), lower platelet count (318 ± 77 vs. 231 ± 53 K/μL, p < 0.01) and lower plasma fibrinogen levels (205 ± 19 vs. 168 ± 24 mg/dL, p < 0.001). Thromboelastometric measurements showed a significant impairment on viscoelastic clot properties following HV group. While prothrombin time index decreased significantly more in the HV group, activated partial thromboplastin time did not differ between both groups. HV did not result in hyperchloraemic acidosis. Coagulation parameters represented by plasma fibrinogen and ROTEM parameters were also less impaired with LV. With regrad to hematocrit, 60 % of LV remained intracascular , while in HV only 30 % remained in circulation within the first hour of administration. In the acute setting of 50 % controlled blood loss, a one fold LV crystalloid replacement strategy is sufficient to adequately raise blood pressure up to a mean arterial pressure >50 mm Hg. The concept of damage control resuscitation (DCR) with permissive hypotension may be better met by using LV as compared to a three fold HV resuscitation strategy. High volume administration of an acetated balanced crystalloid does not lead to hyperchloraemic acidosis, but may negatively influence clinical parameters, such as higher blood pressure, lower body temperature and impaired coagulation parameters, which could potentially increase bleeding after trauma. Replacement of acute blood loss with just an equal amount of an acetated balanced crystalloid appears to be the preferential treatment strategy in the acute phase after controlled bleeding.

Aids to navigation service force mix 2000 project. Volume 3 : analysis of multi-mission requirements and development of planning factors for the replacement buoy tender fleet

DOT National Transportation Integrated Search

1992-06-01

The Aids to Navigation (ATON) Service Force Mix (SFM) 2000 Project is documented in a Project Overview and three separately bound volumes. This is Volume III. The Project Overview describes the purpose, approach, analysis, and results of the ATON SFM...

Maintenance Resources by Building Use for U.S. Army Installations. Volume 2. Appendices A through H

DTIC Science & Technology

1991-05-01

Installations, Volume II: Appendices A Through H RDTE dated 1980REIMB 1984 6 . AUTHOR(S) Edgar S. Neely and Robert D. Neathammer 7 . PERFORML’JG...Recurring Maintenance Factor 1.10 MRT For Major Cost Tasks and Replacement Tasks Decade 1 2 3 4 6 7 8 9 10 0 .000 .000 .000 .000 .000 .050 .190 .240 .300 .280...Special Condition Multiplier 1.00 Annual Recurring Maintenance Factor .79 MRT For Major Cost Tasks and Replacement Tasks Decade 1 2 3 4 6 7 8 9 10 0

"Replacing" Problem Behavior: An Analysis of Tactical Alternatives

ERIC Educational Resources Information Center

Johnston, J. M.

2006-01-01

A number of textbooks and professional volumes in applied behavior analysis suggest that interventions designed primarily to decrease a problem behavior should routinely be accompanied by efforts to increase the frequency of at least one appropriate behavior. Some sources describe the objective of this tactic as "replacing" the problem behavior.…

High-volume recycled materials for sustainable pavement construction.

DOT National Transportation Integrated Search

2017-05-01

The main objective of this research is to evaluate the feasibility of using high-volume recycled materials for concrete production in rigid pavement. The goal was to replace 50% of the solids with recycled materials and industrial by-products. The pe...

Correction of Large Oro-antral Communications From Previously Failed Implant Treatment: Reconstruction of Hard and Soft Tissues.

PubMed

Petrungaro, Paul S; Gonzalez, Santiago; Villegas, Carlos

2018-02-01

As dental implants become more popular for the treatment of partial and total edentulism and treatment of "terminal dentitions," techniques for the management of the atrophic posterior maxillae continue to evolve. Although dental implants carry a high success rate long term, attention must be given to the growing numbers of revisions or retreatment of cases that have had previous dental implant treatment and/or advanced bone replacement procedures that, due to either poor patient compliance, iatrogenic error, or poor quality of the pre-existing alveolar and/or soft tissues, have led to large osseous defects, possibly with deficient soft-tissue volume. In the posterior maxillae, where the poorest quality of bone in the oral cavity exists, achieving regeneration of the alveolar bone and adequate volume of soft tissue remains a complex procedure. This is made even more difficult when dealing with loss of dental implants previously placed, aggressive bone reduction required in various implant procedures, and/or residual sinus infections precluding proper closure of the oral wound margins. The purpose of this article is to outline a technique for the total closure of large oro-antral communications, with underlying osseous defects greater than 15 mm in width and 30 mm in length, for which multiple previous attempts at closure had failed, to achieve not only the reconstruction of adequate volume and quality of soft tissues in the area of the previous fistula, but also total regeneration of the osseous structures in the area of the large void.

Electronics reliability fracture mechanics. Volume 2: Fracture mechanics

NASA Astrophysics Data System (ADS)

Kallis, J.; Duncan, L.; Buechler, D.; Backes, P.; Sandkulla, D.

1992-05-01

This is the second of two volumes. The other volume (WL-TR-92-3015) is 'Causes of Failures of Shop Replaceable Units and Hybrid Microcircuits.' The objective of the Electronics Reliability Fracture Mechanics (ERFM) program was to develop and demonstrate a life prediction technique for electronic assemblies, when subjected to environmental stresses of vibration and thermal cycling, based upon the mechanical properties of the materials and packaging configurations which make up an electronic system. The application of fracture mechanics to microscale phenomena in electronic assemblies was a pioneering research effort. The small scale made the experiments very difficult; for example, the 1-mil-diameter bond wires in microelectronic devices are 1/3 the diameter of a human hair. A number of issues had to be resolved to determine whether a fracture mechanics modelling approach is correct for the selected failures; specifically, the following two issues had to be resolved: What fraction of the lifetime is spent in crack initiation? Are macro fracture mechanics techniques, used in large structures such as bridges, applicable to the tiny structures in electronic equipment? The following structural failure mechanisms were selected for modelling: bondwire fracture from mechanical cycling; bondwire fracture from thermal (power) cycling; plated through hole (PTH) fracture from thermal cycling. The bondwire fracture test specimens were A1-1 percent Si wires, representative of wires used in the parts in the modules selected for detailed investigation in this program (see Vol. 1 of this report); 1-mil-diameter wires were tested in this program. The PTH test specimens were sections of 14-layer printed wiring boards of the type used.

Metallic artifact mitigation and organ-constrained tissue assignment for Monte Carlo calculations of permanent implant lung brachytherapy

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

Sutherland, J. G. H.; Miksys, N.; Thomson, R. M., E-mail: rthomson@physics.carleton.ca

2014-01-15

Purpose: To investigate methods of generating accurate patient-specific computational phantoms for the Monte Carlo calculation of lung brachytherapy patient dose distributions. Methods: Four metallic artifact mitigation methods are applied to six lung brachytherapy patient computed tomography (CT) images: simple threshold replacement (STR) identifies high CT values in the vicinity of the seeds and replaces them with estimated true values; fan beam virtual sinogram replaces artifact-affected values in a virtual sinogram and performs a filtered back-projection to generate a corrected image; 3D median filter replaces voxel values that differ from the median value in a region of interest surrounding the voxelmore » and then applies a second filter to reduce noise; and a combination of fan beam virtual sinogram and STR. Computational phantoms are generated from artifact-corrected and uncorrected images using several tissue assignment schemes: both lung-contour constrained and unconstrained global schemes are considered. Voxel mass densities are assigned based on voxel CT number or using the nominal tissue mass densities. Dose distributions are calculated using the EGSnrc user-code BrachyDose for{sup 125}I, {sup 103}Pd, and {sup 131}Cs seeds and are compared directly as well as through dose volume histograms and dose metrics for target volumes surrounding surgical sutures. Results: Metallic artifact mitigation techniques vary in ability to reduce artifacts while preserving tissue detail. Notably, images corrected with the fan beam virtual sinogram have reduced artifacts but residual artifacts near sources remain requiring additional use of STR; the 3D median filter removes artifacts but simultaneously removes detail in lung and bone. Doses vary considerably between computational phantoms with the largest differences arising from artifact-affected voxels assigned to bone in the vicinity of the seeds. Consequently, when metallic artifact reduction and constrained tissue assignment within lung contours are employed in generated phantoms, this erroneous assignment is reduced, generally resulting in higher doses. Lung-constrained tissue assignment also results in increased doses in regions of interest due to a reduction in the erroneous assignment of adipose to voxels within lung contours. Differences in dose metrics calculated for different computational phantoms are sensitive to radionuclide photon spectra with the largest differences for{sup 103}Pd seeds and smallest but still considerable differences for {sup 131}Cs seeds. Conclusions: Despite producing differences in CT images, dose metrics calculated using the STR, fan beam + STR, and 3D median filter techniques produce similar dose metrics. Results suggest that the accuracy of dose distributions for permanent implant lung brachytherapy is improved by applying lung-constrained tissue assignment schemes to metallic artifact corrected images.« less

The importance of size-exclusion characteristics of type I collagen in bonding to dentin matrices

PubMed Central

M, Takahashi; M, Nakajima; J, Tagami; DLS, Scheffel; RM, Carvalho; A, Mazzoni; M, Carrilho; A, Tezvergil-Mutluay; L, Breschi; L, Tjäderhane; SS, Jang; FR, Tay; KA, Agee; DH, Pashley

2013-01-01

The mineral phase of dentin is located primarily within collagen fibrils. During development, bone or dentin collagen fibrils are formed first and then water within the fibril is replaced with apatite crystallites. Mineralized collagen contains very little water. During dentin bonding, acid-etching of mineralized dentin solubilizes the mineral crystallites and replaces them with water. During the infiltration phase of dentin bonding, adhesive comonomers are supposed to replace all of the collagen water with adhesive monomers that are then polymerized into copolymers. The authors of a recently published review suggested that dental monomers were too large to enter and displace water from collagen fibrils. If that were true, the endogenous proteases bound to dentin collagen could be responsible for unimpeded collagen degradation that is responsible for the poor durability of resin-dentin bonds. The current work studied the size-exclusion characteristics of dentin collagen, using a gel-filtration-like column chromatography technique, using dentin powder instead of Sephadex. The elution volumes of test molecules, including adhesive monomers, revealed that adhesive monomers smaller than about 1000 Da can freely diffuse into collagen water, while molecules of 10,000 Da begin to be excluded, and bovine serum albumin (66,000 Da) was fully excluded. These results validate the concept that dental monomers can permeate between collagen molecules during infiltration by etch-and-rinse adhesives. PMID:23928333

Dual-beam, second-derivative tunable diode-laser infrared spectroscopy applied to trace-gas measurement

NASA Astrophysics Data System (ADS)

Tallant, D. R.; Jungst, R. G.

1981-04-01

A dual base diode laser spectrometer was constructed using off axis reflective optics. The spectrometer was amplitude modulated for direct absorption measurements or frequency modulated to obtain derivative spectra. The spectrometer had: high throughput; was easy to operate and align; provided good dual beam compensation; and had no evidence of the interference effects that were observed in diode laser spectrometers using refractive optics. Unpurged, using second derivative techniques, the instrument measured 108 parts per million CO (10/cm absorption cell, atmospheric pressure broadened) with good signal/noise. With the replacement of marginal instrumental components, the signal/noise was substantially increased. This instrument was developed to monitor the evolution of decomposition gases in sealed containers of small volume at atmospheric pressure.

DORMAN computer program (study 2.5). Volume 1: Executive summary. [development of data bank for computerized information storage of NASA programs

NASA Technical Reports Server (NTRS)

Stricker, L. T.

1973-01-01

The DORCA Applications study has been directed at development of a data bank management computer program identified as DORMAN. Because of the size of the DORCA data files and the manipulations required on that data to support analyses with the DORCA program, automated data techniques to replace time-consuming manual input generation are required. The Dynamic Operations Requirements and Cost Analysis (DORCA) program was developed for use by NASA in planning future space programs. Both programs are designed for implementation on the UNIVAC 1108 computing system. The purpose of this Executive Summary Report is to define for the NASA management the basic functions of the DORMAN program and its capabilities.

Beam shaping of laser diode radiation by waveguides with arbitrary cladding geometry written with fs-laser radiation.

PubMed

Beckmann, Dennis; Schnitzler, Daniel; Schaefer, Dagmar; Gottmann, Jens; Kelbassa, Ingomar

2011-12-05

Waveguides with arbitrary cross sections are written in the volume of Al(2)O(3)-crystals using tightly focused femtosecond laser radiation. Utilizing a scanning system with large numerical aperture, complex cladding geometries are realized with a precision around 0.5 µm and a scanning speed up to 100 mm/s. Individual beam and mode shaping of laser diode radiation is demonstrated by varying the design of the waveguide cladding. The influence of the writing parameters on the waveguide properties are investigated resulting in a numerical aperture of the waveguides in the range of 0.1. This direct laser writing technique enables optical devices which could possibly replace bulky beam shaping setups with an integrated solution.

Correlation between three-dimensional power Doppler and morphometric measurement of endometrial vascularity at the time of embryo implantation in women with unexplained recurrent miscarriage.

PubMed

Chen, Xiaoyan; Saravelos, Sotirios H; Liu, Yingyu; Huang, Jin; Wang, Chi Chiu; Li, Tin Chiu

2017-06-01

Power Doppler in combination with three-dimensional (3D-PD) ultrasonography has been used as a noninvasive tool to evaluate the vascularity. However, it is unclear whether 3D-PD can accurately reflect endometrial vascularization and replace the invasive endometrial biopsy. This study aims to investigate the correlation between 3D-PD and micro vessel morphometric measurement of endometrial vascularity. Twenty-five women with unexplained recurrent miscarriage were recruited for 3D-PD and endometrial biopsy on precisely day LH + 7. Immunohistochemistry using vWF was employed to identify micro vessels in endometrial biopsy specimens followed by the use of morphometric technique to measure the mean vessel diameter and volume fractions. The vascularization index (VI), flow index (FI) and vascularization flow index (VFI) assessed by 3D-PD were calculated for both the endometrial and sub-endometrial regions. There were no significant correlations between any of the ultrasonographic measurements (endometrial thickness, endometrial volume, endometrial VI/FI/VFI, sub-endometrial volume, sub-endometrial VI/FI/VFI) and morphometric features (number of micro vessel, mean diameter of micro vessel and volume fraction measurement of vessel). This study indicates that endometrial vascularity assessed by 3D-PD could not be used to reflect changes in micro vessels of the endometrium at the time of embryo implantation in women with unexplained recurrent miscarriage.

Effect of preoperative incentive spirometry patient education on patient outcomes in the knee and hip joint replacement population.

PubMed

Bergin, Carole; Speroni, Karen Gabel; Travis, Tom; Bergin, John; Sheridan, Michael J; Kelly, Karen; Daniel, Marlon G

2014-02-01

This study examined the effects of preoperative incentive spirometry (IS) education (POISE) on postoperative outcomes for knee and hip total joint replacement patients. In this prospective study, 140 patients were randomized to Group 1 (POISE intervention = 50 completing) or Group 2 (no intervention = 56 completing) (34 dropped). The Group 1 intervention consisted of formal instruction preoperatively for IS home use, postoperative use, and IS volumes documentation. Group 2 patients received no intervention. Patients recorded postoperative IS volumes, which were used to determine return to baseline volume. One hundred six patients completed the study. Most were Caucasian females averaging 64 years. Although IS return to baseline volume time was not significantly different between groups, POISE patients had fewer postoperative complications, hospital days, and charges. POISE patients ranked the intervention as helpful. Although IS volumes were not significantly different between groups, POISE patients had better outcomes and ranked the intervention as helpful. Copyright © 2014 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

Composite aortic root replacement using the classic or modified Cabrol coronary artery implantation technique.

PubMed

Garlicki, Miroslaw; Roguski, K; Puchniewicz, M; Ehrlich, Marek P

2006-08-01

We report in this study our results with composite aortic root replacement (CVR) using the classic or modified Cabrol coronary implantation technique. From October 2001 to March 2005, 25 patients underwent aortic root replacement. In all cases, the indication for surgery was a degenerative aneurysm with a diameter of more than 6 cm. Seven patients had undergone a previous aortic operation on the ascending aorta. Mean age was 53+/-13 years and 22 patients were male. Mean Euroscore was 5.2+/-2.4. Aortic insufficiency was present in all patients. Two patients had Marfan syndrome. The 30-day mortality was 0%. Two patients required profound hypothermic circulatory arrest. Mean aortic cross-clamp time was 91+/-24 minutes and the mean circulatory arrest time was 24+/-15 minutes. No patients developed a pseudoaneurysm after the operation. We conclude that composite aortic root replacement with the classic or modified Cabrol technique results in a low operative mortality. However, it should be only used when a "button" technique is not feasible.

The effects of platelet apheresis on blood saving and coagulation in bilateral total hip replacement: A prospective study on 60 patients.

PubMed

Qu, Zhijun; Wang, Geng; Xu, Chengshi; Zhang, Dazhi; Qu, Xiangdong; Zhou, Haibin; Ma, Jun

2016-10-01

Preoperative platelet rich plasma (PRP) harvest has been used in cardiopulmonary surgery for more than 10 years. There is no previous study dealing with PRP in bilateral total hip replacement. This study was to investigate the effects of PRP on blood saving and blood coagulation function in patients with bilateral total hip replacement. A prospective, randomized, clinical trial was conducted. Sixty patients were enrolled, including 30 patients undergoing PRP in the PRP group and 30 controls. The surgery time, total transfusion volume, blood loss, allogenic blood transfusion, autologous blood transfusion, urine volume, drainage volume, some blood parameters (including Fibrinogen, D-dimer, Prothrombin time, international normalizedratio, activated partial thromboplastin time, Platelet, Haemoglobin B), thrombelastogram (TEG) and blood-gas parameters were studied in the perioperative stage. The measurement data were analyzed statistically. There was no statistical difference between the two groups in baseline characteristics, surgery time, total transfusion volume, blood loss, autologous blood transfusion, etc. Allogenic blood transfusion in the PRP group was less than the control group with statistical difference (p = 0.024). Fibrinogen in the PRP group was higher than the control group (p = 0.008). Among the TEG indicators, activated clotting time and coagulation time K in the PRP group were less than the control group. Clotting rate and maximum amplitude in the PRP group were higher. The blood-gas parameters presented no statistical difference. The results suggested that PRP probably played a positive role in blood coagulation function as well as blood saving in patients with bilateral total hip replacement. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

Validation of a defibrillation lead ventricular volume measurement compared to three-dimensional echocardiography.

PubMed

Haines, David E; Wong, Wilson; Canby, Robert; Jewell, Coty; Houmsse, Mahmoud; Pederson, David; Sugeng, Lissa; Porterfield, John; Kottam, Anil; Pearce, John; Valvano, Jon; Michalek, Joel; Trevino, Aron; Sagar, Sandeep; Feldman, Marc D

2017-10-01

There is increasing evidence that using frequent invasive measures of pressure in patients with heart failure results in improved outcomes compared to traditional measures. Admittance, a measure of volume derived from preexisting defibrillation leads, is proposed as a new technique to monitor cardiac hemodynamics in patients with an implantable defibrillator. The purpose of this study was to evaluate the accuracy of a new ventricular volume sensor (VVS, CardioVol) compared with 3-dimenssional echocardiography (echo) in patients with an implantable defibrillator. Twenty-two patients referred for generator replacement had their defibrillation lead attached to VVS to determine the level of agreement to a volume measurement standard (echo). Two opposite hemodynamic challenges were sequentially applied to the heart (overdrive pacing and dobutamine administration) to determine whether real changes in hemodynamics could be reliably and repeatedly assessed with VVS. Equivalence of end-diastolic volume (EDV) and stroke volume (SV) determined by both methods was also assessed. EDV and SV were compared using VVS and echo. VVS tracked expected physiologic trends. EDV was modulated -10% by overdrive pacing (14 mL). SV was modulated -13.7% during overdrive pacing (-6 mL) and increased over baseline +14.6% (+8 mL) with dobutamine. VVS and echo mean EDVs were found statistically equivalent, with margin of equivalence 13.8 mL (P <.05). Likewise, mean SVs were found statistically equivalent with margin of equivalence 15.8 mL (P <.05). VVS provides an accurate method for ventricular volume assessment using chronically implanted defibrillator leads and is statistically equivalent to echo determination of mean EDV and SV. Copyright © 2017 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Spontaneous transition of replacive to displacive growth of dolomite in burial dolomitization, and of serpentine in serpentinization

NASA Astrophysics Data System (ADS)

Merino, E.; Canals, A.

2011-12-01

Burial dolostones consist of huge volumes of dolomite that has replaced limestone volume for volume, with patches < 10 meters across of thin, equidistant "zebra" veins that are displacive. Characteristically, the contact between the two dolomite types is, under the microscope, seamless. This has long puzzled carbonate petrologists, who have mistaken the displacive dolomite veins for "void-filling cements" and therefore expect a sharp contact between the two dolomite types. The replacive dolomite forms not by dissolution-precipitation as usually assumed, but by dolomite-growth-driven pressure solution of the host calcite -- if the host is sufficiently viscous, or rigid. The local stress induced by the dolomite growth self-adjusts automatically so as to force the rates of dolomite growth and calcite pressure-solution to be mutually equal at each moment of the replacement. That is why replacement is always isovolumetric. But the dolomite-for-calcite replacement is self-accelerating via Ca2+ (each replacement increment releases Ca2+, which increases the activity product for dolomite and thus the rate of the next replacement increment, and so on), and crystalline carbonates are non-newtonian solids of the softening kind (as shown experimentally, Heard & Raleigh 1972). Thus, when the dolomite-for-calcite replacement becomes fast enough to reduce the local rock viscosity sufficiently, and if aqueous Mg2+ has not run out by then, the replacive growth will inevitably, and seamlessly, transition to displacive growth. This is when incipient zebra veins start to form. Each vein interacts with its neighbors via the induced stress they exert on each other, which leads to a "weeding" feedback that pressure dissolves some veins (the ones that find themselves too close to their neighbors), leaving the surviving ones more equidistant than before. Dolomitic zebra veins, or "rhythmites", are a good example of syntaxial veins. The same process and feedbacks, via Mg2+ instead of via Ca2+, take place in the serpentinization of ultrabasic rocks, leading also to displacive zebra veins of serpentine in seamless contact with the host, replacive serpentine. The origin of the dolomite zebra veins above turns out to have a serendipitous proof. The same feedback that causes the dolomite-for-calcite replacement to self-accelerate exponentially, raises the pore-fluid Ca2+ concentration also exponentially. Consequently, when the rheological replacement-to-displacement transition takes place, the displacive dolomite is growing under such a huge Ca2+ concentration that some Ca2+, even as submicroscopic calcitic slivers, is forced to substitute for Mg2+ in the structure of the growing dolomite, deforming and curving it. This is why the displacive zebra veins always consist of dolomite crystals that are curved, called saddle dolomite. It also explains why some calcite forms right after the dolomite veins stop growing, as a cement and/or back-replacing dolomite.

Esophageal replacement in children: Challenges and long-term outcomes.

PubMed

Soccorso, Giampiero; Parikh, Dakshesh H

2016-01-01

Replacement of a nonexistent or damaged esophagus continues to pose a significant challenge to pediatric surgeons. Various esophageal replacement grafts and techniques have not produced consistently good outcomes to emulate normal esophagus. Therefore, many techniques are still being practiced and recommended with no clear consensus. We present a concise literature review of the currently used techniques and with discussions on the advantages and anticipated morbidity. There are no randomized controlled pediatric studies to compare different types of esophageal replacements. Management and graft choice are based on geographical and personal predilections rather than on any discernible objective data. The biggest series with long-term outcome are reported for gastric transposition and colonic replacement. Comparison of different studies shows no significant difference in early (graft necrosis and anastomotic leaks) or late complications (strictures, poor feeding, gastro-esophageal reflux, tortuosity of the graft, and Barrett's esophagus). The biggest series seem to have lower complications than small series reflecting the decennials experience in their respective centers. Long-term follow-up is recommended following esophageal replacement for the development of late strictures, excessive tortuosity, and Barrett's changes within the graft. Once child overcomes initial morbidity and establishes oral feeding, long-term consequences and complications of pediatric esophageal replacement should be monitored and managed in adult life.

Esophageal replacement in children: Challenges and long-term outcomes

PubMed Central

Soccorso, Giampiero; Parikh, Dakshesh H.

2016-01-01

Replacement of a nonexistent or damaged esophagus continues to pose a significant challenge to pediatric surgeons. Various esophageal replacement grafts and techniques have not produced consistently good outcomes to emulate normal esophagus. Therefore, many techniques are still being practiced and recommended with no clear consensus. We present a concise literature review of the currently used techniques and with discussions on the advantages and anticipated morbidity. There are no randomized controlled pediatric studies to compare different types of esophageal replacements. Management and graft choice are based on geographical and personal predilections rather than on any discernible objective data. The biggest series with long-term outcome are reported for gastric transposition and colonic replacement. Comparison of different studies shows no significant difference in early (graft necrosis and anastomotic leaks) or late complications (strictures, poor feeding, gastro-esophageal reflux, tortuosity of the graft, and Barrett's esophagus). The biggest series seem to have lower complications than small series reflecting the decennials experience in their respective centers. Long-term follow-up is recommended following esophageal replacement for the development of late strictures, excessive tortuosity, and Barrett's changes within the graft. Once child overcomes initial morbidity and establishes oral feeding, long-term consequences and complications of pediatric esophageal replacement should be monitored and managed in adult life. PMID:27365900

40 CFR 1042.605 - Dressing engines already certified to other standards for nonroad or heavy-duty highway engines...

Code of Federal Regulations, 2012 CFR

2012-07-01

... and all related components. (ii) Replacing an original turbocharger, except that small-volume engine manufacturers may replace an original turbocharger on a recreational engine with one that matches the performance of the original turbocharger. (iii) Modify or design the marine engine cooling or aftercooling...

40 CFR 1042.605 - Dressing engines already certified to other standards for nonroad or heavy-duty highway engines...

Code of Federal Regulations, 2011 CFR

2011-07-01

... and all related components. (ii) Replacing an original turbocharger, except that small-volume engine manufacturers may replace an original turbocharger on a recreational engine with one that matches the performance of the original turbocharger. (iii) Modify or design the marine engine cooling or aftercooling...

40 CFR 1042.605 - Dressing engines already certified to other standards for nonroad or heavy-duty highway engines...

Code of Federal Regulations, 2013 CFR

2013-07-01

... and all related components. (ii) Replacing an original turbocharger, except that small-volume engine manufacturers may replace an original turbocharger on a recreational engine with one that matches the performance of the original turbocharger. (iii) Modify or design the marine engine cooling or aftercooling...

40 CFR 1042.605 - Dressing engines already certified to other standards for nonroad or heavy-duty highway engines...

Code of Federal Regulations, 2014 CFR

2014-07-01

... and all related components. (ii) Replacing an original turbocharger, except that small-volume engine manufacturers may replace an original turbocharger on a recreational engine with one that matches the performance of the original turbocharger. (iii) Modify or design the marine engine cooling or aftercooling...

Trends in Hospital Volume and Operative Mortality for High-Risk Surgery

PubMed Central

Finks, Jonathan F.; Osborne, Nicholas H.; Birkmeyer, John D.

2011-01-01

BACKGROUND There were numerous efforts in the United States during the previous decade to concentrate selected surgical procedures in high-volume hospitals. It remains unknown whether referral patterns for high-risk surgery have changed as a result and how operative mortality has been affected. METHODS We used national Medicare data to study patients undergoing one of eight different cancer and cardiovascular operations from 1999 through 2008. For each procedure, we examined trends in hospital volume and market concentration, defined as the proportion of Medicare patients undergoing surgery in the top decile of hospitals by volume per year. We used regression-based techniques to assess the effects of volume and market concentration on mortality over time, adjusting for case mix. RESULTS Median hospital volumes of four cancer resections (lung, esophagus, pancreas, and bladder) and of repair of abdominal aortic aneurysm (AAA) rose substantially. Depending on the procedure, higher hospital volumes were attributable to an increasing number of cases nationwide, an increasing market concentration, or both. Hospital volumes rose slightly for aortic-valve replacement but fell for coronary-artery bypass grafting and carotid endarterectomy. Operative mortality declined for all eight procedures, ranging from a relative decline of 8% for carotid endarterectomy (1.3% mortality in 1999 and 1.2% in 2008) to 36% for AAA repair (4.4% in 1999 and 2.8% in 2008). Higher hospital volumes explained a large portion of the decline in mortality for pancreatectomy (67% of the decline), cystectomy (37%), and esophagectomy (32%), but not for the other procedures. CONCLUSIONS Operative mortality with high-risk surgery fell substantially during the previous decade. Although increased market concentration and hospital volume have contributed to declining mortality with some high-risk cancer operations, declines in mortality with other procedures are largely attributable to other factors. (Funded by the National Institute on Aging.) PMID:21631325

A technique for fast and accurate measurement of hand volumes using Archimedes' principle.

PubMed

Hughes, S; Lau, J

2008-03-01

A new technique for measuring hand volumes using Archimedes principle is described. The technique involves the immersion of a hand in a water container placed on an electronic balance. The volume is given by the change in weight divided by the density of water. This technique was compared with the more conventional technique of immersing an object in a container with an overflow spout and collecting and weighing the volume of overflow water. The hand volume of two subjects was measured. Hand volumes were 494 +/- 6 ml and 312 +/- 7 ml for the immersion method and 476 +/- 14 ml and 302 +/- 8 ml for the overflow method for the two subjects respectively. Using plastic test objects, the mean difference between the actual and measured volume was -0.3% and 2.0% for the immersion and overflow techniques respectively. This study shows that hand volumes can be obtained more quickly than the overflow method. The technique could find an application in clinics where frequent hand volumes are required.

Importance of milk replacer intake and composition in rearing orphan foals

PubMed Central

Cymbaluk, Nadia F.; Smart, Marion E.; Bristol, Frank M.; Pouteaux, Victor A.

1993-01-01

Effects of milk replacer composition and intake on the growth of orphan foals were evaluated. Twenty foals were assigned to four treatments: 1) mare-nursed, 2) commercial foal milk replacer at recommended intakes (standard), 3) commercial foal milk replacer at high intakes (high), and 4) acidified replacer at recommended intakes (acidified). Foals fed milk replacer diets were weaned at 12-24 hours postpartum and fed milk replacer for 50 days. Mare-nursed foals were weaned between 52 and 56 days of age. Foals fed replacer diets gained 12% to 28% less weight than mare-nursed foals up to two weeks of age. However, by four months of age, weights of replacer-fed foals were similar to those of mare-nursed foals and 32 other mare-nursed foals at the farm weaned between three and four months postparium. Foals drank 10 to 12 L/100 kg body weight (BW) in fluid replacer daily over the trial period. During the first week, high intake foals consumed 26% more replacer (p<0.05) than foals fed acidified or standard diets. This higher intake resulted in diarrhea earlier (6-11 days vs 11-22 days) and for a longer time (6.3 days vs 2.5-3.6 days) than in foals fed recommended amounts. Mare-nursed foals developed “foal heat scours” in the second week postpartum. After the first week, foals fed high replacer diet voluntarily consumed the same volume of fluid replacer as foals fed the standard intake. Foals ate less than 1 kg grain mix/100 kg BW daily to one month of age, then increased intake to 1.5-2 kg/ 100 kg BW to weaning. Water intake was 20-40% of daily fluid intake and was correlated (r = 0.85) to dry matter intake. Foals in the high intake group ate less (p<0.05) solid feed and drank less water than foals fed the standard and acidified diets. The foal's stomach capacity appears to limit meal size and thus replacer intake. If recommended feeding intervals are used, replacer intakes by foals are less than 15% BW daily. High volume intakes appeared to prolong diarrhea. Normal growth rates occur when replacer and good-quality feeds are fed concurrently. PMID:17424268

The influence of a balanced volume replacement concept on inflammation, endothelial activation, and kidney integrity in elderly cardiac surgery patients.

PubMed

Boldt, Joachim; Suttner, Stephan; Brosch, Christian; Lehmann, Andreas; Röhm, Kerstin; Mengistu, Andinet

2009-03-01

A balanced fluid replacement strategy appears to be promising for correcting hypovolemia. The benefits of a balanced fluid replacement regimen were studied in elderly cardiac surgery patients. In a randomized clinical trial, 50 patients aged >75 years undergoing cardiac surgery received a balanced 6% HES 130/0.42 plus a balanced crystalloid solution (n = 25) or a non-balanced HES in saline plus saline solution (n = 25) to keep pulmonary capillary wedge pressure/central venous pressure between 12-14 mmHg. Acid-base status, inflammation, endothelial activation (soluble intercellular adhesion molecule-1, kidney integrity (kidney-specific proteins glutathione transferase-alpha; neutrophil gelatinase-associated lipocalin) were studied after induction of anesthesia, 5 h after surgery, 1 and 2 days thereafter. Serum creatinine (sCr) was measured approximately 60 days after discharge. A total of 2,750 +/- 640 mL of balanced and 2,820 +/- 550 mL of unbalanced HES were given until the second POD. Base excess (BE) was significantly reduced in the unbalanced (from +1.21 +/- 0.3 to -4.39 +/- 1.0 mmol L(-1) 5 h after surgery; P < 0.001) and remained unchanged in the balanced group (from 1.04 +/- 0.3 to -0.81 +/- 0.3 mmol L(-1) 5 h after surgery). Evolution of the BE was significantly different. Inflammatory response and endothelial activation were significantly less pronounced in the balanced than the unbalanced group. Concentrations of kidney-specific proteins after surgery indicated less alterations of kidney integrity in the balanced than in the unbalanced group. A total balanced volume replacement strategy including a balanced HES and a balanced crystalloid solution resulted in moderate beneficial effects on acid-base status, inflammation, endothelial activation, and kidney integrity compared to a conventional unbalanced volume replacement regimen.

Initial experience with custom-fit total knee replacement: intra-operative events and long-leg coronal alignment.

PubMed

Spencer, Brian A; Mont, Michael A; McGrath, Mike S; Boyd, Bradley; Mitrick, Michael F

2009-12-01

New technology using magnetic resonance imaging (MRI) allows the surgeon to place total knee replacement components into each patient's pre-arthritic natural alignment. This study evaluated the initial intra-operative experience using this technique. Twenty-one patients had a sagittal MRI of their arthritic knee to determine component placement for a total knee replacement. Cutting guides were machined to control all intra-operative cuts. Intra-operative events were recorded and these knees were compared to a matching cohort of the senior surgeon's previous 30 conventional total knee replacements. Post-operative scanograms were obtained from each patient and coronal alignment was compared to previous studies using conventional and computer-assisted techniques. There were no intra-operative or acute post-operative complications. There were no differences in blood loss and there was a mean decrease in operative time of 14% compared to a cohort of patients with conventional knee replacements. The average deviation from the mechanical axis was 1.2 degrees of varus, which was comparable to previously reported conventional and computer-assisted techniques. Custom-fit total knee replacement appeared to be a safe procedure for uncomplicated cases of osteoarthritis.

Beating heart mitral valve replacement with a bovine pericardial bioprosthesis for treatment of mitral valve dysplasia in a Bull Terrier.

PubMed

Behr, Luc; Chetboul, Valérie; Sampedrano, Carolina Carlos; Vassiliki, Gouni; Pouchelon, Jean-Louis; Laborde, François; Borenstein, Nicolas

2007-04-01

To describe an open, beating heart surgical technique and use of a bovine pericardial prosthetic valve for mitral valve replacement (MVR) in the dog. Clinical case report. Male Bull Terrier (17-month-old, 26 kg) with mitral valve dysplasia and severe regurgitation. A bovine pericardial bioprosthesis was used to replace the mitral valve using an open beating heart surgical technique and cardiopulmonary bypass. Successful MVR was achieved using a beating heart technique. Mitral regurgitation resolved and cardiac performances improved (left ventricular end-diastolic diameter decreased from 57.6 to 48.7 mm, and left atrium/aorta ratio returned to almost normal, from 1.62 to 1.19). Cardiopulmonary by-pass time and total surgical duration were decreased compared with standard cardioplegic techniques. Surgical recovery was uneventful and on echocardiography 6 months later valve function was excellent. Considering the technique advantages (no cardiac arrest, ischemic reperfusion injury, and hypothermia, or the need for aortic dissection and cannulation for administration of cardioplegic solution), short-term mortality and morbidity may be reduced compared with standard cardioplegic techniques. Based on experience in this dog, beating heart mitral valvular replacement is a seemingly safe and viable option for the dog and bovine pericardial prosthesis may provide better long-term survival than mechanical prostheses.

Improved Design of Tunnel Supports : Volume 3 : Finite Element Analysis of the Peachtree Center Station in Atlanta

DOT National Transportation Integrated Search

1980-06-01

Volume 3 contains the application of the three-dimensional (3-D) finite element program, Automatic Dynamic Incremental Nonlinear Analysis (ADINA), which was designed to replace the traditional 2-D plane strain analysis, to a specific location. The lo...

Foundational Performance Analyses of Pressure Gain Combustion Thermodynamic Benefits for Gas Turbines

NASA Technical Reports Server (NTRS)

Paxson, Daniel E.; Kaemming, Thomas A.

2012-01-01

A methodology is described whereby the work extracted by a turbine exposed to the fundamentally nonuniform flowfield from a representative pressure gain combustor (PGC) may be assessed. The method uses an idealized constant volume cycle, often referred to as an Atkinson or Humphrey cycle, to model the PGC. Output from this model is used as input to a scalable turbine efficiency function (i.e., a map), which in turn allows for the calculation of useful work throughout the cycle. Integration over the entire cycle yields mass-averaged work extraction. The unsteady turbine work extraction is compared to steady work extraction calculations based on various averaging techniques for characterizing the combustor exit pressure and temperature. It is found that averages associated with momentum flux (as opposed to entropy or kinetic energy) provide the best match. This result suggests that momentum-based averaging is the most appropriate figure-of-merit to use as a PGC performance metric. Using the mass-averaged work extraction methodology, it is also found that the design turbine pressure ratio for maximum work extraction is significantly higher than that for a turbine fed by a constant pressure combustor with similar inlet conditions and equivalence ratio. Limited results are presented whereby the constant volume cycle is replaced by output from a detonation-based PGC simulation. The results in terms of averaging techniques and design pressure ratio are similar.

Mitochondrial replacement techniques and Mexico's rule of law: on the legality of the first maternal spindle transfer case

PubMed Central

Medina-Arellano, María de Jesús

2017-01-01

Abstract News about the first baby born after a mitochondrial replacement technique (MRT; specifically maternal spindle transfer) broke on September 27, 2016 and, in a matter of hours, went global. Of special interest was the fact that the mitochondrial replacement procedure happened in Mexico. One of the scientists behind this world first was quoted as having said that he and his team went to Mexico to carry out the procedure because, in Mexico, there are no rules. In this paper, we explore Mexico's rule of law in relation to mitochondrial replacement techniques and show that, in fact, certain instances of MRTs are prohibited at the federal level and others are prohibited at the state level. According to our interpretation of the law, the scientists behind this first successful MRT procedure broke federal regulations regarding assisted fertilization research. PMID:28852557

Novel Numerical Approaches to Loop Quantum Cosmology

NASA Astrophysics Data System (ADS)

Diener, Peter

2015-04-01

Loop Quantum Gravity (LQG) is an (as yet incomplete) approach to the quantization of gravity. When applied to symmetry reduced cosmological spacetimes (Loop Quantum Cosmology or LQC) one of the predictions of the theory is that the Big Bang is replaced by a Big Bounce, i.e. a previously existing contracting universe underwent a bounce at finite volume before becoming our expanding universe. The evolution equations of LQC take the form of difference equations (with the discretization given by the theory) that in the large volume limit can be approximated by partial differential equations (PDEs). In this talk I will first discuss some of the unique challenges encountered when trying to numerically solve these difference equations. I will then present some of the novel approaches that have been employed to overcome the challenges. I will here focus primarily on the Chimera scheme that takes advantage of the fact that the LQC difference equations can be approximated by PDEs in the large volume limit. I will finally also briefly discuss some of the results that have been obtained using these numerical techniques by performing simulations in regions of parameter space that were previously unreachable. This work is supported by a grant from the John Templeton Foundation and by NSF grant PHYS1068743.

Data availability and feasibility of various techniques to predict response to volume expansion in critically ill patients

PubMed Central

Lanspa, Michael J.; Briggs, Benjamin J.; Hirshberg, Eliotte L.; Pratt, Cristina M.; Grissom, Colin K.; Brown, Samuel M.

2017-01-01

Objective: The accuracy of various techniques to predict response to volume expansion in shock has been studied, but less well known is how feasible these techniques are in the ICU. Methods: This is a prospective observation single-center study of inpatients from a mixed profile ICU who received volume expansion. At time of volume expansion, we determined whether a particular technique to predict response was feasible, according to rules developed from available literature and nurse assessment. Results: We studied 214 volume expansions in 97 patients. The most feasible technique was central venous pressure (50%), followed by vena cava collapsibility, (47%) passive leg raise (42%), and stroke volume variation (22%). Aortic velocity variation, and pulse pressure variation, and were rarely feasible (1% each). In 37% of volume expansions, no technique that we assessed was feasible. Conclusions: Techniques to predict response to volume expansion are infeasible in many patients in shock. PMID:28971030

Increase in vastus medialis cross-sectional area is associated with reduced pain, cartilage loss, and joint replacement risk in knee osteoarthritis.

PubMed

Wang, Yuanyuan; Wluka, Anita E; Berry, Patricia A; Siew, Terence; Teichtahl, Andrew J; Urquhart, Donna M; Lloyd, David G; Jones, Graeme; Cicuttini, Flavia M

2012-12-01

Although there is evidence for a beneficial effect of increased quadriceps strength on knee symptoms, the effect on knee structure is unclear. We undertook this study to examine the relationship between change in vastus medialis cross-sectional area (CSA) and knee pain, tibial cartilage volume, and risk of knee replacement in subjects with symptomatic knee osteoarthritis (OA). One hundred seventeen subjects with symptomatic knee OA underwent magnetic resonance imaging of the knee at baseline and at 2 and 4.5 years. Vastus medialis CSA was measured at baseline and at 2 years. Tibial cartilage volume was measured at baseline and at 2 and 4.5 years. Knee pain was assessed by the Western Ontario and McMaster Universities Osteoarthritis Index at baseline and at 2 years. The frequency of knee joint replacement over 4 years was determined. Regression coefficients (B) and odds ratios were determined along with 95% confidence intervals (95% CIs). After adjusting for confounders, baseline vastus medialis CSA was inversely associated with current knee pain (r = -0.16, P = 0.04) and with medial tibial cartilage volume loss from baseline to 2 years (B coefficient -10.9 [95% CI -19.5, -2.3]), but not with baseline tibial cartilage volume. In addition, an increase in vastus medialis CSA from baseline to 2 years was associated with reduced knee pain over the same time period (r = 0.24, P = 0.007), reduced medial tibial cartilage loss from 2 to 4.5 years (B coefficient -16.8 [95% CI -28.9, -4.6]), and reduced risk of knee replacement over 4 years (odds ratio 0.61 [95% CI 0.40, 0.94]). In a population of patients with symptomatic knee OA, increased vastus medialis size was associated with reduced knee pain and beneficial structural changes at the knee, suggesting that management of knee pain and optimizing vastus medialis size are important in reducing OA progression and subsequent knee replacement. Copyright © 2012 by the American College of Rheumatology.

Timing of Re-Transfusion Drain Removal Following Total Knee Replacement

PubMed Central

Leeman, MF; Costa, ML; Costello, E; Edwards, D

2006-01-01

INTRODUCTION The use of postoperative drains following total knee replacement (TKR) has recently been modified by the use of re-transfusion drains. The aim of our study was to investigate the optimal time for removal of re-transfusion drains following TKR. PATIENTS AND METHODS The medical records of 66 patients who had a TKR performed between October 2003 and October 2004 were reviewed; blood drained before 6 h and the total volume of blood drained was recorded. RESULTS A total of 56 patients had complete records of postoperative drainage. The mean volume of blood collected in the drain in the first 6 h was 442 ml. The mean total volume of blood in the drain was 595 ml. Therefore, of the blood drained, 78% was available for transfusion. CONCLUSION Re-transfusion drains should be removed after 6 h, when no further re-transfusion is permissible. PMID:16551400

Whole-body fluid distribution in humans during dehydration and recovery, before and after humid-heat acclimation induced using controlled hyperthermia.

PubMed

Patterson, M J; Stocks, J M; Taylor, N A S

2014-04-01

This experiment was designed to test the hypothesis that the plasma volume is not selectively defended during exercise- and heat-induced dehydration following humid-heat acclimation. Eight physically active males were heat acclimated (39.8 °C, relative humidity 59.2%) using 17 days of controlled hyperthermia (core temperature: 38.5 °C). Inter-compartmental fluid losses and movements were tracked (radioisotopes and Evans blue dye) during progressive dehydration (cycling) in these same conditions and also during a resting recovery without fluid replacement (28 °C), before (day 1), during (day 8) and after heat acclimation (day 22). On days 8 and 22, there were significant increases in total body water, interstitial fluid and plasma volume (P < 0.05), but the intracellular compartments did not change (P > 0.05). The baseline plasma volume remained expanded throughout: 43.4 [±2.6 (day 1)], 49.1 [±2.4 (day 8); P < 0.05] and 48.9 mL kg(-1) [±3.0 (day 22); P < 0.05]. During progressive dehydration, plasma reductions of 9.0% (±0.9: day 1), 12.4% (±1.6: day 8) and 13.6% (±1.2: day 22) were observed, with day 8 and 22 losses significantly exceeding day 1 (P < 0.05). During recovery, plasma volume restoration commenced, with the intracellular fluid contribution becoming more pronounced as acclimation progressed. It is concluded that the plasma volume was not defended more vigorously following humid-heat acclimation. Indeed, a greater fluid loss may well underlie the mechanisms for enhancing plasma volume recovery when heat acclimation is induced using the controlled-hyperthermia technique. © 2013 Scandinavian Physiological Society. Published by John Wiley & Sons Ltd.

The Effect on Long-Term Survivorship of Surgeon Preference for Posterior-Stabilized or Minimally Stabilized Total Knee Replacement: An Analysis of 63,416 Prostheses from the Australian Orthopaedic Association National Joint Replacement Registry.

PubMed

Vertullo, Christopher J; Lewis, Peter L; Lorimer, Michelle; Graves, Stephen E

2017-07-05

Controversy still exists as to the optimum management of the posterior cruciate ligament (PCL) in total knee arthroplasty. Surgeons can choose to kinematically substitute the PCL with a posterior-stabilized total knee replacement or alternatively to utilize a cruciate-retaining, also known as minimally stabilized, total knee replacement. Proponents of posterior-stabilized total knee replacement propose that the reported lower survivorship in registries when directly compared with minimally stabilized total knee replacement is due to confounders such as selection bias because of the preferential usage of posterior-stabilized total knee replacement in more complex or severe cases. In this study, we aimed to eliminate these possible confounders by performing an instrumental variable analysis based on surgeon preference to choose either posterior-stabilized or minimally stabilized total knee replacement, rather than the actual prosthesis received. Cumulative percent revision, hazard ratio (HR), and revision diagnosis data were obtained from the Australian Orthopaedic Association National Joint Replacement Registry from September 1, 1999, to December 31, 2014, for 2 cohorts of patients, those treated by high-volume surgeons who preferred minimally stabilized replacements and those treated by high-volume surgeons who preferred posterior-stabilized replacements. All patients had a diagnosis of osteoarthritis and underwent fixed-bearing total knee replacement with patellar resurfacing. At 13 years, the cumulative percent revision was 5.0% (95% confidence interval [CI], 4.0% to 6.2%) for the surgeons who preferred the minimally stabilized replacements compared with 6.0% (95% CI, 4.2% to 8.5%) for the surgeons who preferred the posterior-stabilized replacements. The revision risk for the surgeons who preferred posterior-stabilized replacements was significantly higher for all causes (HR = 1.45 [95% CI, 1.30 to 1.63]; p < 0.001), for loosening or lysis (HR = 1.93 [95% CI, 1.58 to 2.37]; p < 0.001), and for infection (HR = 1.51 [95% CI, 1.25 to 1.82]; p < 0.001). This finding was irrespective of patient age and was evident with cemented fixation and with both cross-linked polyethylene and non-cross-linked polyethylene. However, the higher revision risk was only evident in male patients. There was a 45% higher risk of revision for the patients of surgeons who preferred a posterior-stabilized total knee replacement compared with the patients of surgeons who preferred a minimally stabilized total knee replacement. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Development and application of novelty pretreatment method for the concurrent quantitation of eleven water-soluble B vitamins in ultrafiltrates after renal replacement therapy.

PubMed

Wirkus, Dorota; Jakubus, Aleksandra; Owczuk, Radosław; Stepnowski, Piotr; Paszkiewicz, Monika

2017-02-01

Continous renal replacement therapy (CRRT) is particularly recommended for septic shock patients in intensive care units. The CRRT technique used most frequently is high volume continuous veno-venous haemofiltration. It provides a high rate of clearance of uremic toxins and inflammatory cytokines. However, it should also be taken into account that substances important for homeostasis may be concurrently unintentionally removed. Accordingly, water-soluble vitamins can be removed during continuous renal replacement therapy, and the estimate of the loss is critical to ensure appropriate supplementation. The aim of this work was to develop a simple methodology for a purification step prior to the LC-MS/MS determination of water-soluble vitamins in ultrafiltrate samples. For this purpose, two types of resin and a mix of resins were used as sorbents for the purification step. Moreover, parameters such as the amount of resin and the extraction time were optimized. The LC-MS/MS method was developed and validated for final determination of 11 vitamins. The results demonstrated the high purification capability of DEAE Sephadex resin with recoveries between 65 and 101% for water-soluble vitamins from ultrafiltrate samples. An optimized method was applied to assess the loss of B-group vitamins in patients after 24h of renal replacement therapy. The loss of vitamins B2, B6 pyridoxamine, B6 pyridoxal, B7, B1, and B5 in ultrafiltrates was similar in all patients. In the native ultrafiltrates, vitamins B6 pyridoxine, B9 and B12 were not detected. Copyright © 2016 Elsevier B.V. All rights reserved.

Direct Replacement of Arbitrary Grid-Overlapping by Non-Structured Grid

NASA Technical Reports Server (NTRS)

Kao, Kai-Hsiung; Liou, Meng-Sing

1994-01-01

A new approach that uses nonstructured mesh to replace the arbitrarily overlapped structured regions of embedded grids is presented. The present methodology uses the Chimera composite overlapping mesh system so that the physical domain of the flowfield is subdivided into regions which can accommodate easily-generated grid for complex configuration. In addition, a Delaunay triangulation technique generates nonstructured triangular mesh which wraps over the interconnecting region of embedded grids. It is designed that the present approach, termed DRAGON grid, has three important advantages: eliminating some difficulties of the Chimera scheme, such as the orphan points and/or bad quality of interpolation stencils; making grid communication in a fully conservative way; and implementation into three dimensions is straightforward. A computer code based on a time accurate, finite volume, high resolution scheme for solving the compressible Navier-Stokes equations has been further developed to include both the Chimera overset grid and the nonstructured mesh schemes. For steady state problems, the local time stepping accelerates convergence based on a Courant - Friedrichs - Leury (CFL) number near the local stability limit. Numerical tests on representative steady and unsteady supersonic inviscid flows with strong shock waves are demonstrated.

Use of cryopoor plasma for albumin replacement and continuous antimicrobial infusion for treatment of septic peritonitis in a dog.

PubMed

Ropski, Meaghan K; Guillaumin, Julien; Monnig, Andrea A; Townsend, Katy; McLoughlin, Mary A

2017-05-01

To report the successful management of a dog with septic peritonitis and septic shock secondary to enterectomy dehiscence using novel techniques for identification of intestinal dehiscence and for septic shock treatment. A 5-year-old castrated male Bernese Mountain Dog presented for lethargy 6 days following enterotomy for foreign body obstruction. Septic peritonitis was identified due to dehiscence of the enterotomy site, and resection and anastomosis were performed using a gastrointestinal anastomosis and thoracoabdominal stapling device. Postoperatively the patient experienced severe hypotension, which responded to norepinephrine constant rate infusion (CRI) after failing to improve with fluid therapy or dopamine CRI. Further treatment included antimicrobial CRI and supportive care including careful fluid therapy. Due to low effective circulating volume paired with intersititial fluid overload and large volume abdominal effusion, fluid therapy consisted of a combination of human serum albumin, canine albumin, synthetic colloids, and isotonic crystalloids. Cryopoor plasma (CPP) was used as a source of canine albumin and intravascular volume. On Day 4, food dye was given through a nasogastric tube due to suspicion of dehiscence of the anastomosis site. Dehiscence was confirmed during abdominal exploratory, and a second resection and anastomosis was performed. Abdominal partial closure with vacuum-assisted closure device was performed. Supportive care was continued with CPP CRI and imipenem CRI. Planned relaparotomy to change the vacuum-assisted closure device was performed 48 hours later, with abdominal closure 96 hours after anastomosis. The patient was discharged on Day 15. Recheck 12 months later was normal. This case includes novel techniques such food dye via nasogastric tube to identify anastomosis dehiscence, use of CPP as a source of canine albumin, and antimicrobial CRI in a dog with septic peritonitis. © Veterinary Emergency and Critical Care Society 2017.

Study of boro-tellurite glasses doped with neodymium oxide

NASA Astrophysics Data System (ADS)

Sanjay, Kishore, N.; Sheoran, M. S.; Devi, S.

2018-05-01

Borotellurite glasses doped with Nd2O3 [xB2O3(95-x)TeO25Nd2O3] have been prepared by the standard melt-quenching technique. Amorphous nature of the present system was estimated by XRD patterns. The thermal parameters like glass transition temperature (Tg), crystallization (Tc) and melting (Tm) temperatures have been estimated from differential scanning calorimetry (DSC) traces. Density and molar volume have been determined. It was found that Tg is increased due to increasing number of Te-O bonds were replaced by a number of stronger B-O bonds whereas density was decreased with an increase in B2O3 content is due to the higher degree of cross-bonding between the Boron and non-bridging oxygen ions resulting in a strengthening of glass network.

Rapid Deployment Aortic Replacement (RADAR) Registry in Spain: a protocol.

PubMed

Bautista-Hernandez, Victor; Cal-Purriños, Natalia; Arribas-Leal, Jose M; Carnero-Alcazar, Manuel; Gutierrez-Diez, Jose F; Cuenca-Castillo, Jose J

2017-01-10

Rapid deployment valves (RDV) represent a newly introduced approach to aortic valve replacement which facilitates surgical implantation and minimally invasive techniques, shortens surgical times and shows excellent haemodynamic performance. However, evidence on their safety, efficacy and potential complications is mostly fitted with small-volume and retrospective studies. Moreover, no current guidelines exist. To improve our knowledge on this technology, The Rapid Deployment Aortic Replacement (RADAR) Registry will be established across Spain with the aim of assessing RDV outcomes in the real-world setting. The RADAR Registry is designed as a product registry that would provide information on its use and outcomes in clinical practice. This multicentre, prospective, national effort will initially involve 4 centres in Spain. Any patient undergoing cardiac surgery for aortic valve replacement and receiving an RDV as an isolated operation or in combination with other cardiac procedures may be included. Participation is voluntary. Data collection is equal to information obtained during standard care and is prospectively entered by the participating physicians perioperatively and during subsequent follow-up visits. The primary outcome assessed is in-hospital and up to 5 years of follow-up, prosthetic valve functioning and clinical status. Secondary outcomes are to perform subgroup analysis, to compare outcomes with other existing approaches and to develop future clinical guidelines. The follow-up assessments are timed with routine clinical appointments. Dissociated data will be extracted and collectively analysed. Initial target sample size for the registry is 500 participants entered with complete follow-up information. Different substudies will be implemented within the registry to investigate specific populations undergoing aortic valve replacement. The protocol is approved by all local institutional ethics committees. Findings will be shared by the participant hospitals, policymakers and the academic community to promote quality monitoring and efficient use of this technology. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Digital I and C system upgrade integration technique

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

Huang, H. W.; Shih, C.; Wang, J. R.

2012-07-01

This work developed an integration technique for digital I and C system upgrade, the utility can replace the I and C systems step by step systematically by this method. Inst. of Nuclear Energy Research (INER) developed a digital Instrumentation and Control (I and C) replacement integration technique on the basis of requirement of the three existing nuclear power plants (NPPs), which are Chin-Shan (CS) NPP, Kuo-Sheng (KS) NPP, and Maanshan (MS) NPP, in Taiwan, and also developed the related Critical Digital Review (CDR) Procedure. The digital I and C replacement integration technique includes: (I) Establishment of Nuclear Power Plant Digitalmore » Replacement Integration Guideline, (2) Preliminary Investigation on I and C System Digitalization, (3) Evaluation on I and C System Digitalization, and (4) Establishment of I and C System Digitalization Architectures. These works can be a reference for performing I and C system digital replacement integration of the three existing NPPs of Taiwan Power Company (TPC). A CDR is the review for a critical system digital I and C replacement. The major reference of this procedure is EPRI TR- 1011710 (2005) 'Handbook for Evaluating Critical Digital Equipment and Systems' which was published by the Electric Power Research Inst. (EPRI). With this document, INER developed a TPC-specific CDR procedure. Currently, CDR becomes one of the policies for digital I and C replacement in TPC. The contents of this CDR procedure include: Scope, Responsibility, Operation Procedure, Operation Flow Chart, CDR review items. The CDR review items include the comparison of the design change, Software Verification and Validation (SVandV), Failure Mode and Effects Analysis (FMEA), Evaluation of Diversity and Defense-in-depth (D3), Evaluation of Watchdog Timer, Evaluation of Electromagnetic Compatibility (EMC), Evaluation of Grounding for System/Component, Seismic Evaluation, Witness and Inspection, Lessons Learnt from the Digital I and C Failure Events. A solid review can assure the quality of the digital I and C system replacement. (authors)« less

Learner-Centered Instruction (LCI): Volume IV, The Simulated Maintenance Task Environment (SMTE): A Job Specific Simulator.

ERIC Educational Resources Information Center

Rifkin, Kenneth I.; And Others

The purpose of the simulated maintenance task environment is to provide a means for training and job performance testing of the flight line weapon control systems mechanic/technician for the F-111A aircraft. It provides practice in flight line equipment checkout, troubleshooting, and removal and replacement of line replaceable units in the…

40 CFR 261.35 - Deletion of certain hazardous waste codes following equipment cleaning and replacement.

Code of Federal Regulations, 2010 CFR

2010-07-01

... cleaning and replacement. (a) Wastes from wood preserving processes at plants that do not resume or... parts per trillion (ppt), sample weight of 1000 g, IS spiking level of 1 ppt, final extraction volume of... previously used and the date on which their use ceased in each process at the plant; (3) Formulations...

40 CFR 261.35 - Deletion of certain hazardous waste codes following equipment cleaning and replacement.

Code of Federal Regulations, 2011 CFR

2011-07-01

... cleaning and replacement. (a) Wastes from wood preserving processes at plants that do not resume or... parts per trillion (ppt), sample weight of 1000 g, IS spiking level of 1 ppt, final extraction volume of... previously used and the date on which their use ceased in each process at the plant; (3) Formulations...

Pharmacokinetic analysis of cloxacillin loss in children undergoing major surgery with massive bleeding.

PubMed Central

Levy, M; Egersegi, P; Strong, A; Tessoro, A; Spino, M; Bannatyne, R; Fear, D; Posnick, J C; Koren, G

1990-01-01

To determine the magnitude of cloxacillin loss during surgical procedures involving significant blood loss and high fluid replacement, we compared the pharmacokinetics of cloxacillin in children during craniomaxillofacial surgery with the disposition of the drug in healthy young adult volunteers with intact circulation. Blood loss during craniofacial operations may exceed blood volume, in some cases by as much as three times. Hemodynamic replacement with electrolyte solutions and blood products, which do not contain the drug, further dilute cloxacillin concentrations. In the patients that we studied, mean drug loss was estimated at 71%. Cloxacillin concentrations in serum fell below the lower range of the MIC for Staphylococcus aureus during significant portions of the surgical procedures. Thus, the traditional dosing of cloxacillin during prolonged operations with massive blood loss is inadequate. A more frequent dosing interval or priming of all replacement fluids with the drug may be required to maintain therapeutic levels. Our findings suggest that massive blood loss is likely to have a dramatic effect on the level of any drug with a small distribution volume. If such a drug is essential to the patient's well-being (e.g., antibiotics, antiarrhythmics, and anticonvulsants), it must be replaced promptly. PMID:2393274

Development of an accurate fluid management system for a pediatric continuous renal replacement therapy device

PubMed Central

SANTHANAKRISHNAN, ARVIND; NESTLE, TRENT T.; MOORE, BRIAN L.; YOGANATHAN, AJIT P.; PADEN, MATTHEW L.

2013-01-01

Acute kidney injury is common in critically ill children and renal replacement therapies provide a life saving therapy to a subset of these children. However, there is no Food and Drug Administration approved device to provide pediatric continuous renal replacement therapy (CRRT). Consequently, clinicians adapt approved adult CRRT devices for use in children due to lack of safer alternatives. Complications occur using adult CRRT devices in children due to inaccurate fluid balance (FB) between the volumes of ultrafiltrate (UF) removed and replacement fluid (RF) delivered. We demonstrate the design and validation of a pediatric fluid management system for obtaining accurate instantaneous and cumulative FB. Fluid transport was achieved via multiple novel pulsatile diaphragm pumps. The conservation of volume principle leveraging the physical property of fluid incompressibility along with mechanical coupling via a crankshaft was used for FB. Accuracy testing was conducted in vitro for 8-hour long continuous operation of the coupled UF and RF pumps. The mean cumulative FB error was <1% across filtration flows from 300 mL/hour to 3000 mL/hour. This approach of FB control in a pediatric specific CRRT device would represent a significant accuracy improvement over currently used clinical implementations. PMID:23644618

Experimental Investigation of the Mechanical and Durability Properties of Crumb Rubber Concrete.

PubMed

Liu, Hanbing; Wang, Xianqiang; Jiao, Yubo; Sha, Tao

2016-03-07

Recycling waste tire rubber by incorporating it into concrete has become the preferred solution to dispose of waste tires. In this study, the effect of the volume content of crumb rubber and pretreatment methods on the performances of concrete was evaluated. Firstly, the fine aggregate and mixture were partly replaced by crumb rubber to produce crumb rubber concrete. Secondly, the mechanical and durability properties of crumb rubber concrete with different replacement forms and volume contents had been investigated. Finally, the crumb rubber after pretreatment by six modifiers was introduced into the concrete mixture. Corresponding tests were conducted to verify the effectiveness of pretreatment methods as compared to the concrete containing untreated crumb rubber. It was observed that the mechanical strength of crumb rubber concrete was reduced, while durability was improved with the increasing of crumb rubber content. 20% replacement of fine aggregate and 5% replacement of the total mixture exhibited acceptable properties for practical applications. In addition, the results indicated that the modifiers had a positive impact on the mechanical and durability properties of crumb rubber concrete. It avoided the disadvantage of crumb rubber concrete having lower strength and provides a reference for the production of modified crumb rubber concrete.

Experimental Investigation of the Mechanical and Durability Properties of Crumb Rubber Concrete

PubMed Central

Liu, Hanbing; Wang, Xianqiang; Jiao, Yubo; Sha, Tao

2016-01-01

Recycling waste tire rubber by incorporating it into concrete has become the preferred solution to dispose of waste tires. In this study, the effect of the volume content of crumb rubber and pretreatment methods on the performances of concrete was evaluated. Firstly, the fine aggregate and mixture were partly replaced by crumb rubber to produce crumb rubber concrete. Secondly, the mechanical and durability properties of crumb rubber concrete with different replacement forms and volume contents had been investigated. Finally, the crumb rubber after pretreatment by six modifiers was introduced into the concrete mixture. Corresponding tests were conducted to verify the effectiveness of pretreatment methods as compared to the concrete containing untreated crumb rubber. It was observed that the mechanical strength of crumb rubber concrete was reduced, while durability was improved with the increasing of crumb rubber content. 20% replacement of fine aggregate and 5% replacement of the total mixture exhibited acceptable properties for practical applications. In addition, the results indicated that the modifiers had a positive impact on the mechanical and durability properties of crumb rubber concrete. It avoided the disadvantage of crumb rubber concrete having lower strength and provides a reference for the production of modified crumb rubber concrete. PMID:28773298

Is there resetting of central venous pressure in microgravity?

NASA Technical Reports Server (NTRS)

Convertino, V. A.; Ludwig, D. A.; Elliott, J. J.; Wade, C. E.

2001-01-01

In the early phase of the Space Shuttle program, NASA flight surgeons implemented a fluid-loading countermeasure in which astronauts were instructed to ingest eight 1-g salt tablets with 960 ml of water approximately 2 hours prior to reentry from space. This fluid loading regimen was intended to enhance orthostatic tolerance by replacing circulating plasma volume reduced during the space mission. Unfortunately, fluid loading failed to replace plasma volume in groundbased experiments and has proven minimally effective as a countermeasure against post-spaceflight orthostatic intolerance. In addition to the reduction of plasma volume, central venous pressure (CVP) is reduced during exposure to actual and groundbased analogs of microgravity. In the present study, we hypothesized that the reduction in CVP due to exposure to microgravity represents a resetting of the CVP operating point to a lower threshold. A lower CVP 'setpoint' might explain the failure of fluid loading to restore plasma volume. In order to test this hypothesis, we conducted an investigation in which we administered an acute volume load (stimulus) and measured responses in CVP, plasma volume and renal functions. If our hypothesis is true, we would expect the elevation in CVP induced by saline infusion to return to its pre-infusion levels in both HDT and upright control conditions despite lower vascular volume during HDT. In contrast to previous experiments, our approach is novel in that it provides information on alterations in CVP and vascular volume during HDT that are necessary for interpretation of the proposed CVP operating point resetting hypothesis.

Mitochondrial Replacement Techniques: Divergence in Global Policy.

PubMed

Schandera, Johanna; Mackey, Tim K

2016-07-01

In 2015, the UK became the first country permitting the clinical application of mitochondrial replacement techniques (MRT). Here, we explore how MRT have led to diverging international policy. In response, we recommend focused regulatory efforts coupled with United Nations (UN) leadership to build international consensus on the future of MRT. Copyright © 2016 Elsevier Ltd. All rights reserved.

Characterization of the intragranular water regime within subsurface sediments: Pore volume, surface area, and mass transfer limitations

USGS Publications Warehouse

Hay, M.B.; Stoliker, D.L.; Davis, J.A.; Zachara, J.M.

2011-01-01

Although "intragranular" pore space within grain aggregates, grain fractures, and mineral surface coatings may contain a relatively small fraction of the total porosity within a porous medium, it often contains a significant fraction of the reactive surface area, and can thus strongly affect the transport of sorbing solutes. In this work, we demonstrate a batch experiment procedure using tritiated water as a high-resolution diffusive tracer to characterize the intragranular pore space. The method was tested using uranium-contaminated sediments from the vadose and capillary fringe zones beneath the former 300A process ponds at the Hanford site (Washington). Sediments were contacted with tracers in artificial groundwater, followed by a replacement of bulk solution with tracer-free groundwater and the monitoring of tracer release. From these data, intragranular pore volumes were calculated and mass transfer rates were quantified using a multirate first-order mass transfer model. Tritium-hydrogen exchange on surface hydroxyls was accounted for by conducting additional tracer experiments on sediment that was vacuum dried after reaction. The complementary ("wet" and "dry") techniques allowed for the simultaneous determination of intragranular porosity and surface area using tritium. The Hanford 300A samples exhibited intragranular pore volumes of ???1% of the solid volume and intragranular surface areas of ???20%-35% of the total surface area. Analogous experiments using bromide ion as a tracer yielded very different results, suggesting very little penetration of bromide into the intragranular porosity. Copyright 2011 by the American Geophysical Union.

Characterization of the intragranular water regime within subsurface sediments: pore volume, surface area, and mass transfer limitations

USGS Publications Warehouse

Hay, Michael B.; Stoliker, Deborah L.; Davis, James A.; Zachara, John M.

2011-01-01

Although "intragranular" pore space within grain aggregates, grain fractures, and mineral surface coatings may contain a relatively small fraction of the total porosity within a porous medium, it often contains a significant fraction of the reactive surface area, and can thus strongly affect the transport of sorbing solutes. In this work, we demonstrate a batch experiment procedure using tritiated water as a high-resolution diffusive tracer to characterize the intragranular pore space. The method was tested using uranium-contaminated sediments from the vadose and capillary fringe zones beneath the former 300A process ponds at the Hanford site (Washington). Sediments were contacted with tracers in artificial groundwater, followed by a replacement of bulk solution with tracer-free groundwater and the monitoring of tracer release. From these data, intragranular pore volumes were calculated and mass transfer rates were quantified using a multirate first-order mass transfer model. Tritium-hydrogen exchange on surface hydroxyls was accounted for by conducting additional tracer experiments on sediment that was vacuum dried after reaction. The complementary ("wet" and "dry") techniques allowed for the simultaneous determination of intragranular porosity and surface area using tritium. The Hanford 300A samples exhibited intragranular pore volumes of ~1% of the solid volume and intragranular surface areas of ~20%–35% of the total surface area. Analogous experiments using bromide ion as a tracer yielded very different results, suggesting very little penetration of bromide into the intragranular porosity.

Small-Scale Fabrication of Biomimetic Structures for Periodontal Regeneration

PubMed Central

Green, David W.; Lee, Jung-Seok; Jung, Han-Sung

2016-01-01

The periodontium is the supporting tissues for the tooth organ and is vulnerable to destruction, arising from overpopulating pathogenic bacteria and spirochaetes. The presence of microbes together with host responses can destroy large parts of the periodontium sometimes leading tooth loss. Permanent tissue replacements are made possible with tissue engineering techniques. However, existing periodontal biomaterials cannot promote proper tissue architectures, necessary tissue volumes within the periodontal pocket and a “water-tight” barrier, to become clinically acceptable. New kinds of small-scale engineered biomaterials, with increasing biological complexity are needed to guide proper biomimetic regeneration of periodontal tissues. So the ability to make compound structures with small modules, filled with tissue components, is a promising design strategy for simulating the anatomical complexity of the periodotium attachment complexes along the tooth root and the abutment with the tooth collar. Anatomical structures such as, intima, adventitia, and special compartments such as the epithelial cell rests of Malassez or a stellate reticulum niche need to be engineered from the start of regeneration to produce proper periodontium replacement. It is our contention that the positioning of tissue components at the origin is also necessary to promote self-organizing cell–cell connections, cell–matrix connections. This leads to accelerated, synchronized and well-formed tissue architectures and anatomies. This strategy is a highly effective preparation for tackling periodontitis, periodontium tissue resorption, and to ultimately prevent tooth loss. Furthermore, such biomimetic tissue replacements will tackle problems associated with dental implant support and perimimplantitis. PMID:26903872

Long-Term and Seismic Performance of Concrete-Filled Steel Tube Columns with Conventional and High-Volume SCM Concrete

DOT National Transportation Integrated Search

2012-06-01

Production of Portland Cement for concrete is a major source of CO2 emission. Concrete can be made more sustainable by replacing a large volume of the cement with Supplementary Cementitous Materials (SCMs) such as fly ash and slag. The amount of ceme...

Development of Self-Consolidating High Strength Concrete Incorporating Treated Palm Oil Fuel Ash

PubMed Central

Alsubari, Belal; Shafigh, Payam; Jumaat, Mohd Zamin

2015-01-01

Palm oil fuel ash (POFA) has previously been used as a partial cement replacement in concrete. However, limited research has been undertaken to utilize POFA in high volume in concrete. This paper presents a study on the treatment and utilization of POFA in high volume of up to 50% by weight of cement in self-consolidating high strength concrete (SCHSC). POFA was treated via heat treatment to reduce the content of unburned carbon. Ordinary Portland cement was substituted with 0%, 10%, 20%, 30%, and 50% treated POFA in SCHSC. Tests have been conducted on the fresh properties, such as filling ability, passing ability and segregation resistance, as well as compressive strength, drying shrinkage and acid attack resistance to check the effect of high volume treated POFA on SCHSC. The results revealed that compared to the control concrete mix, the fresh properties, compressive strength, drying shrinkage, and resistance against acid attack have been significantly improved. Conclusively, treated POFA can be used in high volume as a cement replacement to produce SCHSC with an improvement in its properties.

Theoretical Impact of Replacing Whole Cow's Milk by Young-Child Formula on Nutrient Intakes of UK Young Children: Results of a Simulation Study.

PubMed

Eussen, Simone R B M; Pean, Josephine; Olivier, Leanne; Delaere, Fabien; Lluch, Anne

2015-01-01

Research into the role of young-child formulae (YCF) in a child's diet is limited and there is no consensual recommendation on its use. We evaluated the theoretical nutritional impact of replacing the existing practice of consuming cow's milk by YCF. From the UK Diet and Nutrition Survey of Infants and Young Children, whole cow's milk consumers, aged 12-18 months (n = 591) were selected for simulation scenarios. In Scenario 1, we tested the replacement of all whole cow's milk (434 ± 187 ml/day) by a matching volume of YCF, and in Scenario 2, all whole cow's milk was replaced by the on-pack recommended daily intake of 300 ml. Nutrient intakes before and after simulation scenarios were compared and evaluated against nutrient recommendations. Intakes of protein and saturated fatty acids were significantly decreased, whereas essential fatty acid intakes were increased. The prevalence of nutrient inadequacy before simulation was 95.2% for vitamin D and 53.8% for iron. After simulation, inadequacy decreased to 4.9% (Scenario 1) and 0% (Scenario 2) for vitamin D and to 2.7% (Scenario 1) and 1.1% (Scenario 2) for iron. Replacement of habitual cow's milk intake by a matching volume or 300 ml of YCF may lead to nutritional intakes more in line with recommendations in young children. © 2015 S. Karger AG, Basel.

Replacement of eggs with soybean protein isolates and polysaccharides to prepare yellow cakes suitable for vegetarians.

PubMed

Lin, Muyang; Tay, Siang Hong; Yang, Hongshun; Yang, Bao; Li, Hongliang

2017-08-15

To evaluate the feasibility of substituting eggs in yellow cake by a mixture of soybean proteins, plant polysaccharides, and emulsifiers, the batter properties, including specific gravity and viscosity; cake properties, including specific volume, texture, colour, moisture, microstructures, and structural properties of starch and glutens of the replaced cake and traditional cake containing egg, were evaluated. Replacing eggs with a soy protein isolate and 1% mono-, di-glycerides yielded a similar specific volume, specific gravity, firmness and moisture content (1.92 vs. 2.08cm 3 /g, 0.95 vs. 1.03, 319.8 vs. 376.1g, and 28.03% vs. 29.01%, respectively) compared with the traditional cakes baked with eggs. Structurally, this formulation comprised dominant gliadin aggregates in the size range of 100-200nm and glutenin networking structures containing fewer but larger porosities. The results suggest that a mixture of soybean proteins and emulsifier is a promising substitute for eggs in cakes. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Lung and kidney failure. Pathogenesis, interactions, and therapy].

PubMed

John, S; Willam, C

2015-09-01

The lungs and kidneys represent the most often affected organs (acute respiratory distress syndrome, ARDS or kidney failure) in multiple organ failure (MOF) due to shock, trauma, or sepsis with a still unacceptable high mortality for both organ failures. Although the exact pathophysiological mechanisms of MOF are not completely elucidated, it appears that the lungs and kidneys share several pathophysiologic pathways and have the potential to further harm each other (kidney-lung crosstalk). Inflammatory signals in both directions and volume overload with consecutive edema formation in both organs may play a key role in this crosstalk. The organ replacement therapies used in both organ failures have the potential to further injure the other organ (ventilator trauma, dialyte trauma). On the other hand, renal replacement therapy can have positive effects on lung injury by restoring volume and acid-base homeostasis. The new development of "low-flow" extracorporeal CO2 removal on renal replacement therapy platforms may further help to decrease ventilator trauma in the future.

Evolving trends in aortic valve replacement: A statewide experience.

PubMed

Kim, Karen M; Shannon, Francis; Paone, Gaetano; Lall, Shelly; Batra, Sanjay; Boeve, Theodore; DeLucia, Alphonse; Patel, Himanshu J; Theurer, Patricia F; He, Chang; Clark, Melissa J; Sultan, Ibrahim; Deeb, George Michael; Prager, Richard L

2018-06-17

Transcatheter aortic valve replacement (TAVR) is an alternative to surgical aortic valve replacement (SAVR) for the treatment of aortic stenosis in patients at intermediate, high, and extreme risk for mortality from SAVR. We examined recent trends in aortic valve replacement (AVR) in Michigan. The Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative (MSTCVS-QC) database was used to determine the number of SAVR and TAVR cases performed from January 2012 through June 2017. Patients were divided into low, intermediate, high, and extreme risk groups based on STS predicted risk of mortality (PROM). TAVR patients in the MSTCVS-QC database were also matched with those in the Transcatheter Valve Therapy Registry to determine their Heart Team-designated risk category. During the study period 9517 SAVR and 4470 TAVR cases were performed. Total annual AVR volume increased by 40.0% (from 2086 to 2920), with a 13.3% decrease in number of SAVR cases (from 1892 to 1640) and a 560% increase in number of TAVR cases (from 194 to 1280). Greater than 90% of SAVR patients had PROM ≤8%. While >70% of TAVR patients had PROM ≤ 8%, they were mostly designated as high or extreme risk by a Heart Team. During the study period, SAVR volume gradually declined and TAVR volume dramatically increased. This was mostly due to a new group of patients with lower STS PROM who were designated as higher risk by a Heart Team due to characteristics not completely captured by the STS PROM score. © 2018 Wiley Periodicals, Inc.

Relationship of patient volume and service concentration with outcome in geriatric rehabilitation.

PubMed

Holstege, Marije S; Zekveld, Ineke G; Caljouw, Monique A A; Peerenboom, Peter Bob; van Balen, Romke; Gussekloo, Jacobijn; Achterberg, Wilco P

2013-10-01

Although geriatric rehabilitation (GR) is beneficial for restoration of activities and participation after hospitalization of vulnerable older persons, little is known about the optimal organization of care of these postacute facilities. This study examines the relationship of patient volume and service concentration with successful GR (short length of stay and discharge home) in skilled nursing facilities (SNFs). A national multicenter retrospective cohort study. All patients indicated for GR in a Dutch SNF. Nurses filled out digital registration forms from patient records. Patients were studied in 3 predefined diagnostic groups: total joint replacement, traumatic injuries, and stroke. Facility characteristics were obtained by structured telephone interviews with facility managers. Volume was based on the number of discharges in a 3-month period and categorized in low-, medium-, and high-volume facilities. Concentration was defined at the organizational level in which the population consists of 80% or more of 1 or 2 diagnostic groups, with the prerequisite of having a minimum of 10 rehabilitation beds. From 88 facilities, 2269 GR patients (mean age 78.2 years [SD 9.7]; 68.2% female) were included. The median length of stay in the SNF was 45 days (interquartile range 23-81), 57% of the patients were discharged home, and 9.8% died during GR. Of patients with total joint replacement (n = 501), concentration was related to successful rehabilitation (odds ratio 5.7; 95% confidence interval 1.3-24.3; P = .020, adjusted for age and gender); this relationship was not found for patients with traumatic injuries or stroke. Volume showed no relation with successful rehabilitation in any of the 3 diagnostic groups. This study may indicate that concentration in an SNF, as a proxy for specialization, favors successful GR in total joint replacement. This relationship was not found for the traumatic injuries or stroke groups, or for volume. The relation on functional outcome in GR needs further investigation. Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

Surgeon specialization and operative mortality in United States: retrospective analysis

PubMed Central

Dalton, Maurice; Cutler, David M; Birkmeyer, John D; Chandra, Amitabh

2016-01-01

Objective To measure the association between a surgeon’s degree of specialization in a specific procedure and patient mortality. Design Retrospective analysis of Medicare data. Setting US patients aged 66 or older enrolled in traditional fee for service Medicare. Participants 25 152 US surgeons who performed one of eight procedures (carotid endarterectomy, coronary artery bypass grafting, valve replacement, abdominal aortic aneurysm repair, lung resection, cystectomy, pancreatic resection, or esophagectomy) on 695 987 patients in 2008-13. Main outcome measure Relative risk reduction in risk adjusted and volume adjusted 30 day operative mortality between surgeons in the bottom quarter and top quarter of surgeon specialization (defined as the number of times the surgeon performed the specific procedure divided by his/her total operative volume across all procedures). Results For all four cardiovascular procedures and two out of four cancer resections, a surgeon’s degree of specialization was a significant predictor of operative mortality independent of the number of times he or she performed that procedure: carotid endarterectomy (relative risk reduction between bottom and top quarter of surgeons 28%, 95% confidence interval 0% to 48%); coronary artery bypass grafting (15%, 4% to 25%); valve replacement (46%, 37% to 53%); abdominal aortic aneurysm repair (42%, 29% to 53%); lung resection (28%, 5% to 46%); and cystectomy (41%, 8% to 63%). In five procedures (carotid endarterectomy, valve replacement, lung resection, cystectomy, and esophagectomy), the relative risk reduction from surgeon specialization was greater than that from surgeon volume for that specific procedure. Furthermore, surgeon specialization accounted for 9% (coronary artery bypass grafting) to 100% (cystectomy) of the relative risk reduction otherwise attributable to volume in that specific procedure. Conclusion For several common procedures, surgeon specialization was an important predictor of operative mortality independent of volume in that specific procedure. When selecting a surgeon, patients, referring physicians, and administrators assigning operative workload may want to consider a surgeon’s procedure specific volume as well as the degree to which a surgeon specializes in that procedure. PMID:27444190

Accurate mass replacement method for the sediment concentration measurement with a constant volume container

NASA Astrophysics Data System (ADS)

Ban, Yunyun; Chen, Tianqin; Yan, Jun; Lei, Tingwu

2017-04-01

The measurement of sediment concentration in water is of great importance in soil erosion research and soil and water loss monitoring systems. The traditional weighing method has long been the foundation of all the other measuring methods and instrument calibration. The development of a new method to replace the traditional oven-drying method is of interest in research and practice for the quick and efficient measurement of sediment concentration, especially field measurements. A new method is advanced in this study for accurately measuring the sediment concentration based on the accurate measurement of the mass of the sediment-water mixture in the confined constant volume container (CVC). A sediment-laden water sample is put into the CVC to determine its mass before the CVC is filled with water and weighed again for the total mass of the water and sediments in the container. The known volume of the CVC, the mass of sediment-laden water, and sediment particle density are used to calculate the mass of water, which is replaced by sediments, therefore sediment concentration of the sample is calculated. The influence of water temperature was corrected by measuring water density to determine the temperature of water before measurements were conducted. The CVC was used to eliminate the surface tension effect so as to obtain the accurate volume of water and sediment mixture. Experimental results showed that the method was capable of measuring the sediment concentration from 0.5 up to 1200 kg m-3. A good liner relationship existed between the designed and measured sediment concentrations with all the coefficients of determination greater than 0.999 and the averaged relative error less than 0.2%. All of these seem to indicate that the new method is capable of measuring a full range of sediment concentration above 0.5 kg m-3 to replace the traditional oven-drying method as a standard method for evaluating and calibrating other methods.

Cell culture-based tissue engineering as an alternative to bone grafts in implant dentistry: a literature review.

PubMed

Boeckel, Daniel Gonçalves; Shinkai, Rosemary Sadami Arai; Grossi, Márcio Lima; Teixeira, Eduardo Rolim

2012-09-01

Several biomaterials and techniques for bone grafting have been described in the literature for atresic bone tissue replacement caused by edentulism, surgical resectioning, and traumas. A new technique involves tissue engineering, a promising option to replace bone tissue and solve problems associated with morbidity of autogenous grafting. This literature review aims to describe tissue-engineering techniques using ex vivo cell culture as an alternative to repair bone maxillary atresias and discuss the concepts and potentials of bone regeneration through cell culture techniques as an option for restorative maxillofacial surgery.

Experimental study of the replacement of calcite by calcium sulphates

NASA Astrophysics Data System (ADS)

Ruiz-Agudo, E.; Putnis, C. V.; Hövelmann, J.; Álvarez-Lloret, P.; Ibáñez-Velasco, A.; Putnis, A.

2015-05-01

Among the most relevant mineral replacement reactions are those involving sulphates and carbonates, which have important geological and technological implications. Here it is shown experimentally that during the interaction of calcite (CaCO3) cleavage surfaces with sulphate-bearing acidic solutions, calcite is ultimately replaced by gypsum (CaSO4 2H2O) and anhydrite (CaSO4), depending on the reaction temperature. Observations suggest that this occurs most likely via an interface-coupled dissolution-precipitation reaction, in which the substrate is replaced pseudomorphically by the product. At 120 and 200 °C gypsum and/or bassanite (CaSO4·0.5H2O) form as precursor phases for the thermodynamically stable anhydrite. Salinity promotes the formation of less hydrated precursor phases during the replacement of calcite by anhydrite. The reaction stops before equilibrium with respect to calcite is reached and during the course of the reaction most of the bulk solutions are undersaturated with respect to the precipitating phase(s). A mechanism consisting of the dissolution of small amounts of solid in a thin layer of fluid at the mineral-fluid interface and the subsequent precipitation of the product phase from this layer is in agreement with these observations. PHREEQC simulations performed in the framework of this mechanism highlight the relevance of transport and surface reaction kinetics on the volume change associated with the CaCO3-CaSO4 replacement. Under our experimental conditions, this reaction occurs with a positive volume change, which ultimately results in passivation of the unreacted substrate before calcite attains equilibrium with respect to the bulk solution.

High renesting rates in arctic-breeding Dunlin (Calidris alpina): A clutch-removal experiment

USGS Publications Warehouse

Gates, H. River; Lanctot, Richard B.; Powell, Abby N.

2013-01-01

The propensity to replace a clutch is a complex component of avian reproduction and poorly understood. We experimentally removed clutches from an Arctic-breeding shorebird, the Dunlin (Calidris alpina arcticola), during early and late stages of incubation to investigate replacement clutch rates, renesting interval, and mate and site fidelity between nesting attempts. In contrast to other Arctic studies, we documented renesting by radiotracking individuals to find replacement clutches. We also examined clutch size and mean egg volume to document changes in individual females’ investment in initial and replacement clutches. Finally, we examined the influence of adult body mass, clutch volume, dates of clutch initiation and nest loss, and year on the propensity to renest. We found high (82–95%) and moderate (35–50%) rates of renesting for early and late incubation treatments. Renesting intervals averaged 4.7–6.8 days and were not different for clutches removed early or late in incubation. Most pairs remained together for renesting attempts. Larger females were more likely to replace a clutch; female body mass was the most important parameter predicting propensity to renest. Clutches lost later in the season were less likely to be replaced. We present evidence that renesting is more common in Arctic-breeding shorebirds than was previously thought, and suggest that renesting is constrained by energetic and temporal factors as well as mate availability. Obtaining rates of renesting in species breeding at different latitudes will help determine when this behavior is likely to occur; such information is necessary for demographic models that include individual and population-level fecundity estimates.

Satellite Power Systems (SPS) concept definition study. Volume 7: SPS program plan and economic analysis

NASA Technical Reports Server (NTRS)

Hanley, G.

1978-01-01

The economic and programmatic requirements for a recommended SPS solar photovoltaic baseline concept were analyzed. Costs are determined for the DDT&E; initial capital investment (covers initial procurement and emplacement of each SPS plant and equipment); replacement capital investment (capital asset replacement over the SPS operating life); operations and maintenance (expendables, minor maintenance, repair crews); and taxes/insurance.

Association of Nurse-to-Patient Ratio with mortality and preventable complications following aortic valve replacement.

PubMed

Arkin, Nicole; Lee, Peter H U; McDonald, Kathryn; Hernandez-Boussard, Tina

2014-03-01

To examine hospital resources associated with patient outcomes for aortic valve replacement (AVR), including inpatient adverse events and mortality. We used the Nationwide Inpatient Sample to identify AVR procedures from 1998 to 2010 and the American Hospital Association Annual Survey to augment hospital characteristics. Primary outcomes included mortality and the development of adverse events, identified using standardized patient safety indicators (PSI). Patient and hospital characteristics associated with PSI development were evaluated using univariate and multivariate analyses. An estimated 410,157 AVRs at 5009 hospitals were performed in the US between 1998 and 2010. The number of procedures grew annually by 4.72% (p=0.0003) in high volume hospitals, 4.48% in medium volume hospitals (p<0.0001), and 2.03% in low volume hospitals (p=0.154). Mortality was highest in low volume hospitals, 4.70%, decreased from 4.14% to 3.73% in medium and high volume hospitals, respectively (p=0.0002). Rates of PSIs did not vary significantly across volume terciles (p=0.254). Multivariate logistic regression analysis showed low volume hospitals had increased risk of mortality as compared with high volume hospitals (odds ratio [OR]: 1.42; 95% confidence interval [CI]: 1.01 to 2.00), while hospital volume was not associated with adverse events. PSI development was associated with small hospitals as compared with large (OR: 1.63, 95% CI: 1.16 to 2.28) and inversely associated with higher nurse-to-patient ratio (OR: 0.94, 95% CI: 0.90 to 0.99). The volume-outcomes relationship was associated with mortality outcomes but not postoperative complications. We identified structural differences in hospital size, nurses-to-patient ratio, and nursing skill level indicative of high quality outcomes. © 2014 Wiley Periodicals, Inc.

Management of Osseous and Soft-Tissue Ankle Equinus During Total Ankle Replacement.

PubMed

Roukis, Thomas S; Simonson, Devin C

2015-10-01

Obtaining functional alignment of a total ankle replacement, including physiologic sagittal plane range of motion, is paramount for a successful outcome. This article reviews the literature on techniques available for correction of osseous and soft-tissue equinus at the time of index total ankle replacement. These techniques include anterior tibiotalar joint cheilectomy, posterior superficial muscle compartment lengthening, posterior ankle capsule release, and release of the posterior portions of the medial and lateral collateral ligament complexes. The rationale for these procedures and the operative sequence of events for these procedures are presented. Copyright © 2015 Elsevier Inc. All rights reserved.

Performance of an Artificial Multi-observer Deep Neural Network for Fully Automated Segmentation of Polycystic Kidneys.

PubMed

Kline, Timothy L; Korfiatis, Panagiotis; Edwards, Marie E; Blais, Jaime D; Czerwiec, Frank S; Harris, Peter C; King, Bernard F; Torres, Vicente E; Erickson, Bradley J

2017-08-01

Deep learning techniques are being rapidly applied to medical imaging tasks-from organ and lesion segmentation to tissue and tumor classification. These techniques are becoming the leading algorithmic approaches to solve inherently difficult image processing tasks. Currently, the most critical requirement for successful implementation lies in the need for relatively large datasets that can be used for training the deep learning networks. Based on our initial studies of MR imaging examinations of the kidneys of patients affected by polycystic kidney disease (PKD), we have generated a unique database of imaging data and corresponding reference standard segmentations of polycystic kidneys. In the study of PKD, segmentation of the kidneys is needed in order to measure total kidney volume (TKV). Automated methods to segment the kidneys and measure TKV are needed to increase measurement throughput and alleviate the inherent variability of human-derived measurements. We hypothesize that deep learning techniques can be leveraged to perform fast, accurate, reproducible, and fully automated segmentation of polycystic kidneys. Here, we describe a fully automated approach for segmenting PKD kidneys within MR images that simulates a multi-observer approach in order to create an accurate and robust method for the task of segmentation and computation of TKV for PKD patients. A total of 2000 cases were used for training and validation, and 400 cases were used for testing. The multi-observer ensemble method had mean ± SD percent volume difference of 0.68 ± 2.2% compared with the reference standard segmentations. The complete framework performs fully automated segmentation at a level comparable with interobserver variability and could be considered as a replacement for the task of segmentation of PKD kidneys by a human.

Computational imaging of sperm locomotion.

PubMed

Daloglu, Mustafa Ugur; Ozcan, Aydogan

2017-08-01

Not only essential for scientific research, but also in the analysis of male fertility and for animal husbandry, sperm tracking and characterization techniques have been greatly benefiting from computational imaging. Digital image sensors, in combination with optical microscopy tools and powerful computers, have enabled the use of advanced detection and tracking algorithms that automatically map sperm trajectories and calculate various motility parameters across large data sets. Computational techniques are driving the field even further, facilitating the development of unconventional sperm imaging and tracking methods that do not rely on standard optical microscopes and objective lenses, which limit the field of view and volume of the semen sample that can be imaged. As an example, a holographic on-chip sperm imaging platform, only composed of a light-emitting diode and an opto-electronic image sensor, has emerged as a high-throughput, low-cost and portable alternative to lens-based traditional sperm imaging and tracking methods. In this approach, the sample is placed very close to the image sensor chip, which captures lensfree holograms generated by the interference of the background illumination with the light scattered from sperm cells. These holographic patterns are then digitally processed to extract both the amplitude and phase information of the spermatozoa, effectively replacing the microscope objective lens with computation. This platform has further enabled high-throughput 3D imaging of spermatozoa with submicron 3D positioning accuracy in large sample volumes, revealing various rare locomotion patterns. We believe that computational chip-scale sperm imaging and 3D tracking techniques will find numerous opportunities in both sperm related research and commercial applications. © The Authors 2017. Published by Oxford University Press on behalf of Society for the Study of Reproduction. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Reproductive age modulates the impact of focal ischemia on the forebrain as well as the effects of estrogen treatment in female rats

PubMed Central

Selvamani, Amutha; Sohrabji, Farida

2009-01-01

While human observational studies and animal studies report a neuroprotective role for estrogen therapy in stroke, the multicenter placebo-controlled Women's Health Initiative (WHI) study concluded that hormone therapy increased the risk for stroke in postmenopausal women. The present study therefore tested the hypothesis that estrogen replacement would increase the severity of a stroke-like injury in females when this replacement occurs after a prolonged hypoestrogenic period, such as the menopause or reproductive senescence, but not when given to females that were normally cycling immediately prior to the hormone replacement. Two groups of female rats were used: multiparous females with normal but lengthened estrus cycles (mature adults), and older multiparous females currently in a persistent acyclic state (reproductive senescent). Animals were either used intact, or were bilaterally ovariectomized and immediately replaced with a 17β-estradiol pellet or control pellet. Animals were subject to a forelimb placing test (a test for sensorimotor deficit) and thereafter to middle cerebral artery occlusion (MCAo) by stereotaxic injection of the vasoconstrictive peptide endothelin-1, adjacent to the MCA. One week after stroke, behavioral tests were performed again. Cortical and striatal infarct volume, measured from brain slices, was significantly greater in intact reproductive senescent females as compared to intact mature adults. Furthermore, estrogen treatment to ovariectomized mature adult females significantly reduced the cortical infarct volume. Paradoxically, estrogen treatment to ovariectomized reproductive senescent females significantly increased cortical and striatal infarct volumes as compared to control pellet replaced senescent females. Significant post-stroke behavioral deficit was observed in all groups on the side contralateral to the lesion, while senescent females also exhibited deficits on the ipsilateral side, in the cross-midline forelimb placement test. Using an animal model that approximates the natural ovarian aging process, these findings strongly support the hypothesis that the effectiveness of estrogen therapy in protecting brain health may depend critically on the time of initiation with respect to a female's reproductive status. PMID:18829137

Utilizing on-farm best management practices: Managing Nitrate Leaching Using Evapotranspiration Based Irrigation Methods

NASA Astrophysics Data System (ADS)

Zaragosa, I.; Melton, F. S.; Dexter, J.; Post, K.; Haffa, A.; Kortman, S.; Spellenberg, R.; Cahn, M.

2017-12-01

In efforts to provide tools to allow farmers to optimize and quantify water usage and fertilizer applications, University of California Cooperative Extension (UCCE) developed the CropManage irrigation and nitrogen scheduling tool that provides real time evapotranspiration (ETc) based irrigation recommendations and fertilizer recommendations on a per field basis. CropManage incorporates satellite based estimates of fractional cover from web data services from the Satellite Irrigation Management Information Support (SIMS) system developed by NASA Ames Research Center in collaboration with California State University Monterey Bay (CSUMB). In this study, we conducted field trials to quantify the benefits of using these tools to support best management practices (BMPs) for irrigation and nutrient management in strawberries and lettuce in the Salinas Valley, California. We applied two different irrigation treatments based on full replacement (100%) of crop evapotranspiration (ETc), and irrigation at 130% of ETc replacement to approximate irrigation under business as usual irrigation management. Both field studies used a randomized block design with four replicates each. We used CropManage to calculate the 100% and 130% ETc replacement requirements prior to each irrigation event. We collected drainage volume and samples and analyzed them for 8500 to nitrate as (NO3-) concentrations. Experimental results for both strawberries and lettuce showed a significant decrease in the percentage of applied nitrogen leached for the 100% ETc replacement treatment against the 130% ETc replacement treatment. For strawberries, we observed that 24% of applied nitrogen was leached under the 100% ETc replacement treatment, versus 51% of applied nitrogen that was leached under the 130% ETc replacement treatment. For lettuce, we observe that 2% of the applied nitrogen leached bellow the soil profile, versus 6% of the applied nitrogen for the 130%ETc replacement treatment. In both experiments, we observed significant differences in the amount of leached nitrogen, both as in terms of total volume and as a percent of nitrogen applied, with no significant differences in yield.

Compact and high resolution virtual mouse using lens array and light sensor

NASA Astrophysics Data System (ADS)

Qin, Zong; Chang, Yu-Cheng; Su, Yu-Jie; Huang, Yi-Pai; Shieh, Han-Ping David

2016-06-01

Virtual mouse based on IR source, lens array and light sensor was designed and implemented. Optical architecture including lens amount, lens pitch, baseline length, sensor length, lens-sensor gap, focal length etc. was carefully designed to achieve low detective error, high resolution, and simultaneously, compact system volume. System volume is 3.1mm (thickness) × 4.5mm (length) × 2, which is much smaller than that of camera-based device. Relative detective error of 0.41mm and minimum resolution of 26ppi were verified in experiments, so that it can replace conventional touchpad/touchscreen. If system thickness is eased to 20mm, resolution higher than 200ppi can be achieved to replace real mouse.

Structural Extremes in a Cretaceous Dinosaur

PubMed Central

Sereno, Paul C.; Wilson, Jeffrey A.; Witmer, Lawrence M.; Whitlock, John A.; Maga, Abdoulaye; Ide, Oumarou; Rowe, Timothy A.

2007-01-01

Fossils of the Early Cretaceous dinosaur, Nigersaurus taqueti, document for the first time the cranial anatomy of a rebbachisaurid sauropod. Its extreme adaptations for herbivory at ground-level challenge current hypotheses regarding feeding function and feeding strategy among diplodocoids, the larger clade of sauropods that includes Nigersaurus. We used high resolution computed tomography, stereolithography, and standard molding and casting techniques to reassemble the extremely fragile skull. Computed tomography also allowed us to render the first endocast for a sauropod preserving portions of the olfactory bulbs, cerebrum and inner ear, the latter permitting us to establish habitual head posture. To elucidate evidence of tooth wear and tooth replacement rate, we used photographic-casting techniques and crown thin sections, respectively. To reconstruct its 9-meter postcranial skeleton, we combined and size-adjusted multiple partial skeletons. Finally, we used maximum parsimony algorithms on character data to obtain the best estimate of phylogenetic relationships among diplodocoid sauropods. Nigersaurus taqueti shows extreme adaptations for a dinosaurian herbivore including a skull of extremely light construction, tooth batteries located at the distal end of the jaws, tooth replacement as fast as one per month, an expanded muzzle that faces directly toward the ground, and hollow presacral vertebral centra with more air sac space than bone by volume. A cranial endocast provides the first reasonably complete view of a sauropod brain including its small olfactory bulbs and cerebrum. Skeletal and dental evidence suggests that Nigersaurus was a ground-level herbivore that gathered and sliced relatively soft vegetation, the culmination of a low-browsing feeding strategy first established among diplodocoids during the Jurassic. PMID:18030355

Factors influencing the restoration of fluid and electrolyte balance after exercise in the heat.

PubMed Central

Maughan, R J; Leiper, J B; Shirreffs, S M

1997-01-01

Maintenance of fluid balance is a major concern for all athletes competing in events held in hot climates. This paper reviews recent work relating to optimisation of fluid replacement after sweat loss induced by exercising in the heat. Data are taken from studies undertaken in our laboratory. Issues investigated were drink composition, volume consumed, effects of consuming food with a drink, effects of alcohol in rehydration effectiveness, voluntary intake of fluid, and considerations for women related to the menstrual cycle. The results are presented as a series of summaries of experiments, followed by a discussion of the implications. The focus of this review is urine output after ingestion of a drink; fluid excreted in urine counteracts rehydration. Also included are data on the restoration of plasma volume losses. Ingestion of large volumes of plain water will inhibit thirst and will also promote a diuretic response. If effective rehydration is to be maintained for some hours after fluid ingestion, drinks should contain moderately high levels of sodium (perhaps as much as 50-60 mmol/l) and possibly also some potassium to replace losses in the sweat. To surmount ongoing obligatory urine losses, the volume consumed should be greater than the volume of sweat lost. Palatability of drinks is important in stimulating intake and ensuring adequate volume replacement. Where opportunities allow, the electrolytes required may be ingested as solid food consumed with a drink. There are no special concerns for women related to changes in hormone levels associated with the menstrual cycle. Ingestion of carbohydrate-electrolyte drinks in the post-exercise period restores exercise capacity more effectively than plain water. The effects on performance of an uncorrected fluid deficit should persuade all athletes to attempt to remain fully hydrated at all times, and the aim should be to start each bout of exercise in a fluid replete state. This will only be achieved if a volume of fluid in excess of the sweat loss is ingested together with sufficient electrolytes. PMID:9298549

Long-term outcome in dogs undergoing mitral valve repair with suture annuloplasty and chordae tendinae replacement.

PubMed

Mizuno, T; Mizukoshi, T; Uechi, M

2013-02-01

Mitral valve repair under cardiopulmonary bypass was performed in three dogs with clinical signs associated with mitral regurgitation that were not controlled by medication. Mitral valve repair comprised circumferential annuloplasty and chordal replacement with expanded polytetrafluoroethylene. One dog died 2 years after surgery because of severe mitral regurgitation resulting from partial circumferential suture detachment. The others survived for over 5 years, but mild mitral valve stenosis persisted in one. The replaced chordae did not rupture in any dog. Mitral valve repair appears to be an effective treatment for mitral regurgitation in dogs. Chordal replacement with expanded polytetrafluoroethylene is a feasible technique, demonstrating long-term durability in dogs. However, mitral annuloplasty techniques need improvement. © 2012 British Small Animal Veterinary Association.

Electronic Repair Concepts for Long-Duration Spaceflight

NASA Technical Reports Server (NTRS)

Easton, John; Pettegrew, Richard D.; Struk, Peter M.

2007-01-01

Constraints on the mass and volume that can be allocated for electronics spares and repair equipment on long-duration space missions mean that NASA must look at repair strategies beyond the traditional approach, which has been to replace faulty subsystems in a modular form, termed Orbital Replacement Units or Line Replacement Units. Other possible strategies include component and board-level replacement, modular designs that allow reprogramming of less-critical systems to take the place of more critical failed systems, and a blended approach which uses elements of each of these approaches, along with a limited number of Line Replacement Units. This paper presents some of the constraints and considerations that affect the decision on how to approach electronics repair for long duration space missions, and discusses the benefits and limitations of each of the previously mentioned strategies.

Resin embedded multicycle imaging (REMI): a tool to evaluate protein domains.

PubMed

Busse, B L; Bezrukov, L; Blank, P S; Zimmerberg, J

2016-08-08

Protein complexes associated with cellular processes comprise a significant fraction of all biology, but our understanding of their heterogeneous organization remains inadequate, particularly for physiological densities of multiple protein species. Towards resolving this limitation, we here present a new technique based on resin-embedded multicycle imaging (REMI) of proteins in-situ. By stabilizing protein structure and antigenicity in acrylic resins, affinity labels were repeatedly applied, imaged, removed, and replaced. In principle, an arbitrarily large number of proteins of interest may be imaged on the same specimen with subsequent digital overlay. A series of novel preparative methods were developed to address the problem of imaging multiple protein species in areas of the plasma membrane or volumes of cytoplasm of individual cells. For multiplexed examination of antibody staining we used straightforward computational techniques to align sequential images, and super-resolution microscopy was used to further define membrane protein colocalization. We give one example of a fibroblast membrane with eight multiplexed proteins. A simple statistical analysis of this limited membrane proteomic dataset is sufficient to demonstrate the analytical power contributed by additional imaged proteins when studying membrane protein domains.

In vivo imaging of human photoreceptor mosaic with wavefront sensorless adaptive optics optical coherence tomography.

PubMed

Wong, Kevin S K; Jian, Yifan; Cua, Michelle; Bonora, Stefano; Zawadzki, Robert J; Sarunic, Marinko V

2015-02-01

Wavefront sensorless adaptive optics optical coherence tomography (WSAO-OCT) is a novel imaging technique for in vivo high-resolution depth-resolved imaging that mitigates some of the challenges encountered with the use of sensor-based adaptive optics designs. This technique replaces the Hartmann Shack wavefront sensor used to measure aberrations with a depth-resolved image-driven optimization algorithm, with the metric based on the OCT volumes acquired in real-time. The custom-built ultrahigh-speed GPU processing platform and fast modal optimization algorithm presented in this paper was essential in enabling real-time, in vivo imaging of human retinas with wavefront sensorless AO correction. WSAO-OCT is especially advantageous for developing a clinical high-resolution retinal imaging system as it enables the use of a compact, low-cost and robust lens-based adaptive optics design. In this report, we describe our WSAO-OCT system for imaging the human photoreceptor mosaic in vivo. We validated our system performance by imaging the retina at several eccentricities, and demonstrated the improvement in photoreceptor visibility with WSAO compensation.

Temperature and heat flux measurements: Challenges for high temperature aerospace application

NASA Technical Reports Server (NTRS)

Neumann, Richard D.

1992-01-01

The measurement of high temperatures and the influence of heat transfer data is not strictly a problem of either the high temperatures involved or the level of the heating rates to be measured at those high temperatures. It is a problem of duration during which measurements are made and the nature of the materials in which the measurements are made. Thermal measurement techniques for each application must respect and work with the unique features of that application. Six challenges in the development of measurement technology are discussed: (1) to capture the character and localized peak values within highly nonuniform heating regions; (2) to manage large volumes of thermal instrumentation in order to efficiently derive critical information; (3) to accommodate thermal sensors into practical flight structures; (4) to broaden the capabilities of thermal survey techniques to replace discrete gages in flight and on the ground; (5) to provide supporting instrumentation conduits which connect the measurement points to the thermally controlled data acquisition system; and (6) to develop a class of 'vehicle tending' thermal sensors to assure the integrity of flight vehicles in an efficient manner.

Resin embedded multicycle imaging (REMI): a tool to evaluate protein domains

PubMed Central

Busse, B. L.; Bezrukov, L.; Blank, P. S.; Zimmerberg, J.

2016-01-01

Protein complexes associated with cellular processes comprise a significant fraction of all biology, but our understanding of their heterogeneous organization remains inadequate, particularly for physiological densities of multiple protein species. Towards resolving this limitation, we here present a new technique based on resin-embedded multicycle imaging (REMI) of proteins in-situ. By stabilizing protein structure and antigenicity in acrylic resins, affinity labels were repeatedly applied, imaged, removed, and replaced. In principle, an arbitrarily large number of proteins of interest may be imaged on the same specimen with subsequent digital overlay. A series of novel preparative methods were developed to address the problem of imaging multiple protein species in areas of the plasma membrane or volumes of cytoplasm of individual cells. For multiplexed examination of antibody staining we used straightforward computational techniques to align sequential images, and super-resolution microscopy was used to further define membrane protein colocalization. We give one example of a fibroblast membrane with eight multiplexed proteins. A simple statistical analysis of this limited membrane proteomic dataset is sufficient to demonstrate the analytical power contributed by additional imaged proteins when studying membrane protein domains. PMID:27499335

Fluid overload in the ICU: evaluation and management.

PubMed

Claure-Del Granado, Rolando; Mehta, Ravindra L

2016-08-02

Fluid overload is frequently found in acute kidney injury patients in critical care units. Recent studies have shown the relationship of fluid overload with adverse outcomes; hence, manage and optimization of fluid balance becomes a central component of the management of critically ill patients. In critically ill patients, in order to restore cardiac output, systemic blood pressure and renal perfusion an adequate fluid resuscitation is essential. Achieving an appropriate level of volume management requires knowledge of the underlying pathophysiology, evaluation of volume status, and selection of appropriate solution for volume repletion, and maintenance and modulation of the tissue perfusion. Numerous recent studies have established a correlation between fluid overload and mortality in critically ill patients. Fluid overload recognition and assessment requires an accurate documentation of intakes and outputs; yet, there is a wide difference in how it is evaluated, reviewed and utilized. Accurate volume status evaluation is essential for appropriate therapy since errors of volume evaluation can result in either in lack of essential treatment or unnecessary fluid administration, and both scenarios are associated with increased mortality. There are several methods to evaluate fluid status; however, most of the tests currently used are fairly inaccurate. Diuretics, especially loop diuretics, remain a valid therapeutic alternative. Fluid overload refractory to medical therapy requires the application of extracorporeal therapies. In critically ill patients, fluid overload is related to increased mortality and also lead to several complications like pulmonary edema, cardiac failure, delayed wound healing, tissue breakdown, and impaired bowel function. Therefore, the evaluation of volume status is crucial in the early management of critically ill patients. Diuretics are frequently used as an initial therapy; however, due to their limited effectiveness the use of continuous renal replacement techniques are often required for fluid overload treatment. Successful fluid overload treatment depends on precise assessment of individual volume status, understanding the principles of fluid management with ultrafiltration, and clear treatment goals.

[Optimizing primary total hip replacement--a technique to effect saving of manpower].

PubMed

Huber, J F; Rink, M; Broger, I; Zumstein, M; Ruflin, G B

2003-01-01

Development of a standardized surgical technique for total hip replacement thereby saving manpower (one assistant) by using a retractor system. Total hip replacement is performed with the patient in a true lateral position on a tunnel cushion. By means of a direct lateral approach the pelvitrochanteric muscles are partially detached using an omega-shaped cut. The Bookwalter retractor is fixed dorsally on the operating table. The ring is centered keeping the greater trochanter in the middle. The Hohmann retractors are fixed to the ring to sufficiently expose the acetabulum. To insert the femoral stem the ring needs to be opened dorsally and the patient's leg is bent 90 degrees in the hip and the knee over the tunnel cushion. The muscles inserting at the greater trochanter are retracted by a separate Hohmann retractor with weight. In a case control study with matched pairs the patients treated with this technique were compared with those treated in supine position with the transgluteal approach. The number of assistants required and the operating time were assessed. All the hip replacements with the patient in side position were performed with one assistant, in supine position with two assistants. The operating time did not differ significantly (supine position 110 min/side position 112 min). The complication rate in both groups was comparable (one secondary wound healing, one transient ischalgia). The process of total hip replacement can be optimized. The described technique allows to spare one surgical assistant without prolonging the operating time.

Comparative Analysis of 2-D Versus 3-D Ultrasound Estimation of the Fetal Adrenal Gland Volume and Prediction of Preterm Birth

PubMed Central

Turan, Ozhan M.; Turan, Sifa; Buhimschi, Irina A.; Funai, Edmund F.; Campbell, Katherine H.; Bahtiyar, Ozan M.; Harman, Chris R.; Copel, Joshua A.; Baschat, Ahmet A; Buhimschi, Catalin S.

2013-01-01

Objective We aim to test the hypothesis that 2D fetal AGV measurements offer similar volume estimates as volume calculations based on 3D technique Methods Fetal AGV was estimated by 3D ultrasound (VOCAL) in 93 women with signs/symptoms of preterm labor and 73 controls. Fetal AGV was calculated using an ellipsoid formula derived from 2D measurements of the same blocks (0.523× length × width × depth). Comparisons were performed by intra-class correlation coefficient (ICC), coefficient of repeatability, and Bland-Altman method. The cAGV (AGV/fetal weight) was calculated for both methods and compared for prediction of PTB within 7 days. Results Among 168 volumes, there was a significant correlation between 3D and 2D methods (ICC=0.979[95%CI: 0.971-0.984]). The coefficient of repeatability for the 3D was superior to the 2D method (Intra-observer 3D: 30.8, 2D:57.6; inter-observer 3D: 12.2, 2D: 15.6). Based on 2D calculations, a cAGV≥433mm3/kg, was best for prediction of PTB (sensitivity: 75%(95%CI=59-87); specificity: 89%(95%CI=82-94). Sensitivity and specificity for the 3D cAGV (cut-off ≥420mm3/kg) was 85%(95%CI=70-94) and 95%(95%CI=90-98), respectively. In receiver-operating-curve curve analysis, 3D cAGV was superior to 2D cAGV for prediction of PTB (z=1.99, p=0.047). Conclusion 2D volume estimation of fetal adrenal gland using ellipsoid formula cannot replace 3D AGV calculations for prediction of PTB. PMID:22644825

Cosmological singularity resolution from quantum gravity: The emergent-bouncing universe

NASA Astrophysics Data System (ADS)

Alesci, Emanuele; Botta, Gioele; Cianfrani, Francesco; Liberati, Stefano

2017-08-01

Alternative scenarios to the big bang singularity have been subject of intense research for several decades by now. Most popular in this sense have been frameworks were such singularity is replaced by a bounce around some minimal cosmological volume or by some early quantum phase. This latter scenario was devised a long time ago and referred as an "emergent universe" (in the sense that our universe emerged from a constant volume quantum phase). We show here that within an improved framework of canonical quantum gravity (the so-called quantum reduced loop gravity) the Friedmann equations for cosmology are modified in such a way to replace the big bang singularity with a short bounce preceded by a metastable quantum phase in which the volume of the universe oscillates between a series of local maxima and minima. We call this hybrid scenario an "emergent-bouncing universe" since after a pure oscillating quantum phase the classical Friedmann spacetime emerges. Perspective developments and possible tests of this scenario are discussed in the end.

Current and innovative pain management techniques in total knee arthroplasty.

PubMed

Dalury, David F; Lieberman, Jay R; Macdonald, Steven J

2012-01-01

Pain management is a major concern for patients contemplating total knee replacement surgery and is one of the leading causes of dissatisfaction after knee replacement. Substantial progress has been made over the past several years in improving pain control after total knee replacement using multimodal pain control, preemptive analgesia, and periarticular injections.

Single frequency RF powered ECG telemetry system

NASA Technical Reports Server (NTRS)

Ko, W. H.; Hynecek, J.; Homa, J.

1979-01-01

It has been demonstrated that a radio frequency magnetic field can be used to power implanted electronic circuitry for short range telemetry to replace batteries. A substantial reduction in implanted volume can be achieved by using only one RF tank circuit for receiving the RF power and transmitting the telemetered information. A single channel telemetry system of this type, using time sharing techniques, was developed and employed to transmit the ECG signal from Rhesus monkeys in primate chairs. The signal from the implant is received during the period when the RF powering radiation is interrupted. The ECG signal is carried by 20-microsec pulse position modulated pulses, referred to the trailing edge of the RF powering pulse. Satisfactory results have been obtained with this single frequency system. The concept and the design presented may be useful for short-range long-term implant telemetry systems.

Medical Surveillance Monthly Report (MSMR). Volume 15, Number 2, February/March 2008

DTIC Science & Technology

2008-03-01

Surveillance trends: Hyponatremia associated with heat stress and excessive water consumption: the impact of education and a new Army fl uid replacement... Environmental Medicine (USARIEM), Natick, Massachusetts, published new guidelines for fl uid replacement during military training in heat. Th e new...distributions of self-assessed health status as reported on deployment health assesment forms, U.S. Armed Forces, March 2007-February 2008 as “fair” or

Inpatient Rehabilitation Volume and Functional Outcomes in Stroke, Lower Extremity Fracture, and Lower Extremity Joint Replacement

PubMed Central

Graham, James E.; Deutsch, Anne; O’Connell, Ann A.; Karmarkar, Amol M.; Granger, Carl V.; Ottenbacher, Kenneth J.

2013-01-01

Background It is unclear if volume-outcome relationships exist in inpatient rehabilitation. Objectives Assess associations between facility volumes and two patient-centered outcomes in the three most common diagnostic groups in inpatient rehabilitation. Research Design We used hierarchical linear and generalized linear models to analyze administrative assessment data from patients receiving inpatient rehabilitation services for stroke (n=202,423), lower extremity fracture (n=132,194), or lower extremity joint replacement (n=148,068) between 2006 and 2008 in 717 rehabilitation facilities across the U.S. Facilities were assigned to quintiles based on average annual diagnosis-specific patient volumes. Measures Discharge functional status (FIM instrument) and probability of home discharge. Results Facility-level factors accounted for 6–15% of the variance in discharge FIM total scores and 3–5% of the variance in home discharge probability across the 3 diagnostic groups. We used the middle volume quintile (Q3) as the reference group for all analyses and detected small, but statistically significant (p < .01) associations with discharge functional status in all three diagnosis groups. Only the highest volume quintile (Q5) reached statistical significance, displaying higher functional status ratings than Q3 each time. The largest effect was observed in FIM total scores among fracture patients, with only a 3.6-point difference in Q5 and Q3 group means. Volume was not independently related to home discharge. Conclusions Outcome-specific volume effects ranged from small (functional status) to none (home discharge) in all three diagnostic groups. Patients with these conditions can be treated locally rather than at higher-volume regional centers. Further regionalization of inpatient rehabilitation services is not needed for these conditions. PMID:23579350

Inpatient rehabilitation volume and functional outcomes in stroke, lower extremity fracture, and lower extremity joint replacement.

PubMed

Graham, James E; Deutsch, Anne; O'Connell, Ann A; Karmarkar, Amol M; Granger, Carl V; Ottenbacher, Kenneth J

2013-05-01

It is unclear if volume-outcome relationships exist in inpatient rehabilitation. Assess associations between facility volumes and 2 patient-centered outcomes in the 3 most common diagnostic groups in inpatient rehabilitation. We used hierarchical linear and generalized linear models to analyze administrative assessment data from patients receiving inpatient rehabilitation services for stroke (n=202,423), lower extremity fracture (n=132,194), or lower extremity joint replacement (n=148,068) between 2006 and 2008 in 717 rehabilitation facilities across the United States. Facilities were assigned to quintiles based on average annual diagnosis-specific patient volumes. Discharge functional status (FIM instrument) and probability of home discharge. Facility-level factors accounted for 6%-15% of the variance in discharge FIM total scores and 3%-5% of the variance in home discharge probability across the 3 diagnostic groups. We used the middle volume quintile (Q3) as the reference group for all analyses and detected small, but statistically significant (P<0.01) associations with discharge functional status in all 3 diagnosis groups. Only the highest volume quintile (Q5) reached statistical significance, displaying higher functional status ratings than Q3 each time. The largest effect was observed in FIM total scores among fracture patients, with only a 3.6-point difference in Q5 and Q3 group means. Volume was not independently related to home discharge. Outcome-specific volume effects ranged from small (functional status) to none (home discharge) in all 3 diagnostic groups. Patients with these conditions can be treated locally rather than at higher volume regional centers. Further regionalization of inpatient rehabilitation services is not needed for these conditions.

Effect of copolymer latexes on physicomechanical properties of mortar containing high volume fly ash as a replacement material of cement.

PubMed

Negim, El-Sayed; Kozhamzharova, Latipa; Gulzhakhan, Yeligbayeva; Khatib, Jamal; Bekbayeva, Lyazzat; Williams, Craig

2014-01-01

This paper investigates the physicomechanical properties of mortar containing high volume of fly ash (FA) as partial replacement of cement in presence of copolymer latexes. Portland cement (PC) was partially replaced with 0, 10, 20, 30 50, and 60% FA. Copolymer latexes were used based on 2-hydroxyethyl acrylate (2-HEA) and 2-hydroxymethylacrylate (2-HEMA). Testing included workability, setting time, absorption, chemically combined water content, compressive strength, and scanning electron microscopy (SEM). The addition of FA to mortar as replacement of PC affected the physicomechanical properties of mortar. As the content of FA in the concrete increased, the setting times (initial and final) were elongated. The results obtained at 28 days of curing indicate that the maximum properties of mortar occur at around 30% FA. Beyond 30% FA the properties of mortar reduce and at 60% FA the properties of mortar are lower than those of the reference mortar without FA. However, the addition of polymer latexes into mortar containing FA improved most of the physicomechanical properties of mortar at all curing times. Compressive strength, combined water, and workability of mortar containing FA premixed with latexes are higher than those of mortar containing FA without latexes.

Effect of Copolymer Latexes on Physicomechanical Properties of Mortar Containing High Volume Fly Ash as a Replacement Material of Cement

PubMed Central

Kozhamzharova, Latipa; Gulzhakhan, Yeligbayeva; Bekbayeva, Lyazzat; Williams, Craig

2014-01-01

This paper investigates the physicomechanical properties of mortar containing high volume of fly ash (FA) as partial replacement of cement in presence of copolymer latexes. Portland cement (PC) was partially replaced with 0, 10, 20, 30 50, and 60% FA. Copolymer latexes were used based on 2-hydroxyethyl acrylate (2-HEA) and 2-hydroxymethylacrylate (2-HEMA). Testing included workability, setting time, absorption, chemically combined water content, compressive strength, and scanning electron microscopy (SEM). The addition of FA to mortar as replacement of PC affected the physicomechanical properties of mortar. As the content of FA in the concrete increased, the setting times (initial and final) were elongated. The results obtained at 28 days of curing indicate that the maximum properties of mortar occur at around 30% FA. Beyond 30% FA the properties of mortar reduce and at 60% FA the properties of mortar are lower than those of the reference mortar without FA. However, the addition of polymer latexes into mortar containing FA improved most of the physicomechanical properties of mortar at all curing times. Compressive strength, combined water, and workability of mortar containing FA premixed with latexes are higher than those of mortar containing FA without latexes. PMID:25254256

Blob-enhanced reconstruction technique

NASA Astrophysics Data System (ADS)

Castrillo, Giusy; Cafiero, Gioacchino; Discetti, Stefano; Astarita, Tommaso

2016-09-01

A method to enhance the quality of the tomographic reconstruction and, consequently, the 3D velocity measurement accuracy, is presented. The technique is based on integrating information on the objects to be reconstructed within the algebraic reconstruction process. A first guess intensity distribution is produced with a standard algebraic method, then the distribution is rebuilt as a sum of Gaussian blobs, based on location, intensity and size of agglomerates of light intensity surrounding local maxima. The blobs substitution regularizes the particle shape allowing a reduction of the particles discretization errors and of their elongation in the depth direction. The performances of the blob-enhanced reconstruction technique (BERT) are assessed with a 3D synthetic experiment. The results have been compared with those obtained by applying the standard camera simultaneous multiplicative reconstruction technique (CSMART) to the same volume. Several blob-enhanced reconstruction processes, both substituting the blobs at the end of the CSMART algorithm and during the iterations (i.e. using the blob-enhanced reconstruction as predictor for the following iterations), have been tested. The results confirm the enhancement in the velocity measurements accuracy, demonstrating a reduction of the bias error due to the ghost particles. The improvement is more remarkable at the largest tested seeding densities. Additionally, using the blobs distributions as a predictor enables further improvement of the convergence of the reconstruction algorithm, with the improvement being more considerable when substituting the blobs more than once during the process. The BERT process is also applied to multi resolution (MR) CSMART reconstructions, permitting simultaneously to achieve remarkable improvements in the flow field measurements and to benefit from the reduction in computational time due to the MR approach. Finally, BERT is also tested on experimental data, obtaining an increase of the signal-to-noise ratio in the reconstructed flow field and a higher value of the correlation factor in the velocity measurements with respect to the volume to which the particles are not replaced.

The future of rapid bridge deck replacement.

DOT National Transportation Integrated Search

2015-06-01

Replacing aging, deteriorated infrastructure often requires road closures and traffic detours which impose : inconvenience and delay on commerce and members of the motoring public. Accelerated bridge construction : techniques often use precast member...

Does Discontinuing Teriparatide Treatment and Replacing It with Bisphosphonate Maintain the Volume of the Bone Fusion Mass after Lumbar Posterolateral Fusion in Women with Postmenopausal Osteoporosis?

PubMed

Ohtori, Seiji; Orita, Sumihisa; Yamauchi, Kazuyo; Eguchi, Yawara; Aoki, Yasuchika; Nakamura, Junichi; Suzuki, Miyako; Kubota, Gou; Inage, Kazuhide; Shiga, Yasuhiro; Abe, Koki; Fujimoto, Kazuki; Kanamoto, Hirohito; Inoue, Masahiro; Kinoshita, Hideyuki; Furuya, Takeo; Koda, Masao

2017-04-01

Retrospective case series. The purpose of this study was to determine whether discontinuing teriparatide treatment and replacing it with bisphosphonate treatment maintains the volume of the fusion mass after posterolateral fusion (PLF) in women with postmenopausal osteoporosis. Clinical data support the efficacy of parathyroid hormone (PTH) for lumbar PLF. However, the use of PTH is limited to 2 years. We treated 19 women diagnosed with osteoporosis and degenerative spondylolisthesis with teriparatide (20 µg daily subcutaneously). All patients underwent one-level instrumented PLF. Teriparatide was used during 2 months prior to surgery and more than 8 months after surgery. After discontinuing teriparatide treatment, all patients used bisphosphonate (17.5 mg risedronate weekly, oral administration). Area of the fusion mass across the transverse processes at one segment was determined on an anteroposterior radiograph at 1, 2, and 3 years after surgery. We followed 19 patients for 3 years. The average duration of teriparatide treatment was 11.5 months. The bone union rate was 95%. The average area of the bone fusion mass was not significantly different between the right and left sides at 1, 2, or 3 years after surgery ( p >0.05). This study showed that replacing teriparatide treatment with bisphosphonate maintained the bone fusion mass volume after PLF in women with postmenopausal osteoporosis.

Pozzolanic Activity Assessment of LUSI (LUmpur SIdoarjo) Mud in Semi High Volume Pozzolanic Mortar

PubMed Central

Hardjito, Djwantoro; Antoni; Wibowo, Gunadi M.; Christianto, Danny

2012-01-01

LUSI mud obtained from the mud volcano in Sidoarjo, Indonesia, is a viable aluminosilicate material to be utilized as pozzolanic material. LUSI is an abbreviation of the local name of the mud, i.e., Lumpur Sidoarjo, meaning Sidoarjo mud. This paper reports the results of an investigation to assess the pozzolanic activity of LUSI mud, especially in semi high volume pozzolanic mortar. In this case, the amount of mud incorporated is between 30% to 40% of total cementitious material, by mass. The content of SiO2 in the mud is about 30%, whilst the total content of SiO2, Fe2O3 and Al2O3 is more than 70%. Particle size and degree of partial cement replacement by treated LUSI mud affect the compressive strength, the strength activity index (SAI), the rate of pozzolanic activity development, and the workability of mortar incorporating LUSI mud. Manufacturing semi high volume LUSI mud mortar, up to at least 40% cement replacement, is a possibility, especially with a smaller particle size of LUSI mud, less than 63 μm. The use of a larger percentage of cement replacement by LUSI mud does not show any adverse effect on the water demand, as the flow of the fresh mortar increased with the increase of percentage of LUSI mud usage.

Bone density and anisotropy affect periprosthetic cement and bone stresses after anatomical glenoid replacement: A micro finite element analysis.

PubMed

Chevalier, Yan; Santos, Inês; Müller, Peter E; Pietschmann, Matthias F

2016-06-14

Glenoid loosening is still a main complication for shoulder arthroplasty. We hypothesize that cement and bone stresses potentially leading to fixation failure are related not only to glenohumeral conformity, fixation design or eccentric loading, but also to bone volume fraction, cortical thickness and degree of anisotropy in the glenoid. In this study, periprosthetic bone and cement stresses were computed with micro finite element models of the replaced glenoid depicting realistic bone microstructure. These models were used to quantify potential effects of bone microstructural parameters under loading conditions simulating different levels of glenohumeral conformity and eccentric loading simulating glenohumeral instability. Results show that peak cement stresses were achieved near the cement-bone interface in all loading schemes. Higher stresses within trabecular bone tissue and cement mantle were obtained within specimens of lower bone volume fraction and in regions of low anisotropy, increasing with decreasing glenohumeral conformity and reaching their maxima below the keeled design when the load is shifted superiorly. Our analyses confirm the combined influences of eccentric load shifts with reduced bone volume fraction and anisotropy on increasing periprosthetic stresses. They finally suggest that improving fixation of glenoid replacements must reduce internal cement and bone tissue stresses, in particular in glenoids of low bone density and heterogeneity. Copyright © 2016 Elsevier Ltd. All rights reserved.

From picture to porosity of river bed material using Structure-from-Motion with Multi-View-Stereo

NASA Astrophysics Data System (ADS)

Seitz, Lydia; Haas, Christian; Noack, Markus; Wieprecht, Silke

2018-04-01

Common methods for in-situ determination of porosity of river bed material are time- and effort-consuming. Although mathematical predictors can be used for estimation, they do not adequately represent porosities. The objective of this study was to assess a new approach for the determination of porosity of frozen sediment samples. The method is based on volume determination by applying Structure-from-Motion with Multi View Stereo (SfM-MVS) to estimate a 3D volumetric model based on overlapping imagery. The method was applied on artificial sediment mixtures as well as field samples. In addition, the commonly used water replacement method was applied to determine porosities in comparison with the SfM-MVS method. We examined a range of porosities from 0.16 to 0.46 that are representative of the wide range of porosities found in rivers. SfM-MVS performed well in determining volumes of the sediment samples. A very good correlation (r = 0.998, p < 0.0001) was observed between the SfM-MVS and the water replacement method. Results further show that the water replacement method underestimated total sample volumes. A comparison with several mathematical predictors showed that for non-uniform samples the calculated porosity based on the standard deviation performed better than porosities based on the median grain size. None of the predictors were effective at estimating the porosity of the field samples.

Oxygen transport as a structure probe for heterogeneous polymeric systems

NASA Astrophysics Data System (ADS)

Hu, Yushan

Although permeability of small molecules is often measured as an important performance property, deeper analysis of the transport characteristics provides insight into polymer structure, especially if used in combination with other characterization techniques. Transport of small gas molecules senses the permeable amorphous structure and probes the nature of free volume. This work focuses on oxygen transport, supplemented with other methods of physical analysis, as a probe for: (1) the nature of free volume and crystalline morphology in the crystallized glassy state, (2) the nature of free volume and hierarchical structure in liquid crystalline polymers, and (3) the role of dispersed polyamide phase geometry on oxygen barrier properties of poly(ethylene terephthalate) (PET)/polyamide blends. In the first part, the improvement in oxygen-barrier properties of glassy polyesters by crystallization was examined. Examples included poly(ethylene naphthalate) (PEN), and a copolymer based on PET in which 55 mol% terephthalate was replaced with 4,4'-bibenzoate. Explanation of the unexpectedly high solubility of crystallized PEN required a two-phase transport model consisting of an impermeable crystalline phase of constant density and a permeable amorphous phase of variable density. The resulting relationship between oxygen solubility and amorphous phase density was consistent with free volume concepts of gas sorption. In the second part, oxygen barrier properties of liquid crystalline (LC) polyesters based on poly(diethylene glycol 4,4'-bibenzoate) (PDEGBB) were studied. This study extended the 2-phase transport model for oxygen transport of non-LC crystalline polymers to a smectic LCP. It was possible to systematically vary the solid state structure of (PDEGBB) from LC glass to crystallized LC glass. The results were consistent with a liquid crystalline state intermediate between the permeable amorphous glass and the impermeable 3-dimensional crystal. In this interpretation, LC order naturally led to inherently low gas solubility. In the third part, improvement of gas-barrier properties of poly(ethylene terephthalate) (PET) by blending with an aromatic polyamide, either poly(m-xylylene adipamide) (MXD6) or a copolyamide based on MXD6 in which 12 mol% adipamide was replaced with isophthalamide (MXD6-12I), was studied. Aromatic polyamides provided higher barrier than aliphatic polyamides, and unlike aliphatic polyamides, the aromatic polyamides retained high barrier under conditions of high humidity, making them more suitable for beverage packaging applications. (Abstract shortened by UMI.)

RESIDUAL LIMB VOLUME CHANGE: SYSTEMATIC REVIEW OF MEASUREMENT AND MANAGEMENT

PubMed Central

Sanders, JE; Fatone, S

2014-01-01

Management of residual limb volume affects decisions regarding timing of fit of the first prosthesis, when a new prosthetic socket is needed, design of a prosthetic socket, and prescription of accommodation strategies for daily volume fluctuations. The purpose of this systematic review was to assess what is known about measurement and management of residual limb volume change in persons with lower-limb amputation. Publications that met inclusion criteria were grouped into three categories: (I) descriptions of residual limb volume measurement techniques; (II) studies on people with lower-limb amputation investigating the effect of residual limb volume change on clinical care; and (III) studies of residual limb volume management techniques or descriptions of techniques for accommodating or controlling residual limb volume. The review showed that many techniques for the measurement of residual limb volume have been described but clinical use is limited largely because current techniques lack adequate resolution and in-socket measurement capability. Overall, there is limited evidence regarding the management of residual limb volume, and the evidence available focuses primarily on adults with trans-tibial amputation in the early post-operative phase. While we can draw some insights from the available research about residual limb volume measurement and management, further research is required. PMID:22068373

An Assessment of the Red Maple Resource in the Northeastern United States

Treesearch

Delton R., Jr. Alderman; Matthew S. Bumgardner; John E. Baumgras; John E. Baumgras

2005-01-01

The red maple resource in the northeastern United States has exhibited dramatic gains in the past 3 decades in terms of stem numbers and net volume. Growing stock and sawtimber volumes have displayed extraordinary growth compared to other species, and red maple is replacing important market species that have historically been used in the Northeast. The increase in red...

[Minimal provider volume in total knee replacement : an analysis of the external quality assurance program of North Rhine-Westphalia (QS-NRW)].

PubMed

Kostuj, T; Schulze-Raestrup, U; Noack, M; Buckup, K; Smektala, R

2011-05-01

A minimal provider volume for total knee replacement (TKR) was introduced in 2006. Does this lead to an improvenment in quality or not? The records of treatment in the compulsory external quality assurance program of the Land of North Rhine-Westphalia (QS-NRW) were evaluated. A total of 125,324 comparable records from the QS-NRW program were available to determine the appearance of general and surgical complications. In a logistical regression model the risk factors age, gender, ASA classification, comorbidity and duration were taken into account. A significant reduction could only be shown for pneumonia, thrombotic events and lung embolisms as well as vascular injury. In 2006 and 2007 malpositioning of implants was significantly higher and from 2005 to 2008 the number of fractures rose compared to 2004. Deep infections and reoperations did not change significantly during the whole study period. This evaluation could not show an improvement in quality due to the minimal provider volume. Thus the minimal provider volume should not be taken into account as a main criterion to improve quality. Further outcome studies and creating an arthroplasty register in Germany are more useful.

Fixation of Hydroxyapatite-Coated Revision Implants Is Improved by the Surgical Technique of Cracking the Sclerotic Bone Rim

PubMed Central

Elmengaard, Brian; Bechtold, Joan E.; Chen, Xinqian; Søballe, Kjeld

2013-01-01

Revision joint replacement has poorer outcomes that have been associated with poorer mechanical fixation. We investigate a new bone-sparing surgical technique that locally cracks the sclerotic bone rim formed during aseptic loosening. We inserted 16 hydroxyapatite-coated implants bilaterally in the distal femur of eight dogs, using a controlled weight-bearing experimental model that replicates important features of a typical revision setting. At 8 weeks, a control revision procedure and a crack revision procedure were performed on contralateral implants. The crack procedure used a splined tool to perform a systematic local perforation of the sclerotic bone rim of the revision cavity. After 4 weeks, the hydroxyapatite-coated implants were evaluated for mechanical fixation by a push-out test and for tissue distribution by histomorphometry. The cracking revision procedure resulted in significantly improved mechanical fixation, significantly more bone ongrowth and bone volume in the gap, and reduced fibrous tissue compared to the control revision procedure. The study demonstrates that the sclerotic bone rim prevents bone ingrowth and promotes fixation by fibrous tissue. The effect of the cracking technique may be due to improved access to the vascular compartment of the bone. The cracking technique is a simple surgical method that potentially can improve the fixation of revision implants in sclerotic regions important for obtaining the fixation critical for overall implant stability. PMID:19148940

Electrically Driven Liquid Film Boiling Experiment

NASA Technical Reports Server (NTRS)

Didion, Jeffrey R.

2016-01-01

This presentation presents the science background and ground based results that form the basis of the Electrically Driven Liquid Film Boiling Experiment. This is an ISS experiment that is manifested for 2021. Objective: Characterize the effects of gravity on the interaction of electric and flow fields in the presence of phase change specifically pertaining to: a) The effects of microgravity on the electrically generated two-phase flow. b) The effects of microgravity on electrically driven liquid film boiling (includes extreme heat fluxes). Electro-wetting of the boiling section will repel the bubbles away from the heated surface in microgravity environment. Relevance/Impact: Provides phenomenological foundation for the development of electric field based two-phase thermal management systems leveraging EHD, permitting optimization of heat transfer surface area to volume ratios as well as achievement of high heat transfer coefficients thus resulting in system mass and volume savings. EHD replaces buoyancy or flow driven bubble removal from heated surface. Development Approach: Conduct preliminary experiments in low gravity and ground-based facilities to refine technique and obtain preliminary data for model development. ISS environment required to characterize electro-wetting effect on nucleate boiling and CHF in the absence of gravity. Will operate in the FIR - designed for autonomous operation.

A GIS-based methodology for selecting stormwater disconnection opportunities.

PubMed

Moore, S L; Stovin, V R; Wall, M; Ashley, R M

2012-01-01

The purpose of this paper is to introduce a geographic information system (GIS)-based decision support tool that assists the user to select not only areas where (retrofit) sustainable drainage systems (SuDS) could be implemented within a large catchment (>100 ha), but also to allow discrimination between suitable SuDS techniques based on their likely feasibility and effectiveness. The tool is applied to a case study catchment within London, UK, with the aim of increasing receiving water quality by reducing combined sewer overflow (CSO) spill frequency and volume. The key benefit of the tool presented is to allow rapid assessment of the retrofit SuDS potential of large catchments. It is not intended to replace detailed site investigations, but may help to direct attention to sites that have the greatest potential for retrofit SuDS implementation. Preliminary InfoWorks CS modelling of 'global disconnections' within the case study catchment, e.g. the removal of 50% of the total impervious area, showed that CSO spill volume could be reduced by 55 to 78% during a typical year. Using the disconnection hierarchy developed by the authors, the feasibility of retrofit SuDS deployment within the case study catchment is assessed, and the implications discussed.

Continuous blood densitometry - Fluid shifts after graded hemorrhage in animals

NASA Technical Reports Server (NTRS)

Hinghofer-Szalkay, H.

1986-01-01

Rapid fluid shifts in four pigs and two dogs subjected to graded hemorrhage are investigated. Arterial blood density (BD), mean arterial pressure (MAP), central venous pressure (CVP), arterial plasma density (PD), hematocrit (Hct) and erythrocyte density were measured. The apparatus and mechancial oscillator technique for measuring density are described. Fluid shifts between red blood cells and blood plasma and alterations in the whole-body-to-large vessel Hct, F(cell) are studied using two models. The bases of the model calculations are discussed. A decrease in MAP, CVP, and BP is detected at the beginning of hemorrhaging; continued bleeding results in further BD decrease correlating with volume displacement. The data reveal that at 15 ml/kg blood loss the mean PD and BD dropped by 0.99 + or - 0.15 and 2.42 + or 0.26 g/liter, respectively, and the Hct dropped by 2.40 + or 0.47 units. The data reveal that inward-shifted fluid has a higher density than normal ultrafiltrate and/or there is a rise in the F(cell) ratio. It is noted that rapid fluid replacement ranged from 5.8 + or - 0.8 to 10.6 + or - 2.0 percent of the initial plasma volume.

Microstructures and Hardness/Wear Performance of High-Carbon Stellite Alloys Containing Molybdenum

NASA Astrophysics Data System (ADS)

Liu, Rong; Yao, J. H.; Zhang, Q. L.; Yao, M. X.; Collier, Rachel

2015-12-01

Conventional high-carbon Stellite alloys contain a certain amount of tungsten which mainly serves to provide strengthening to the solid solution matrix. These alloys are designed for combating severe wear. High-carbon molybdenum-containing Stellite alloys are newly developed 700 series of Stellite family, with molybdenum replacing tungsten, which are particularly employed in severe wear condition with corrosion also involved. Three high-carbon Stellite alloys, designated as Stellite 706, Stellite 712, and Stellite 720, with different carbon and molybdenum contents, are studied experimentally in this research, focusing on microstructure and phases, hardness, and wear resistance, using SEM/EDX/XRD techniques, a Rockwell hardness tester, and a pin-on-disk tribometer. It is found that both carbon and molybdenum contents influence the microstructures of these alloys significantly. The former determines the volume fraction of carbides in the alloys, and the latter governs the amount of molybdenum-rich carbides precipitated in the alloys. The hardness and wear resistance of these alloys are increased with the carbide volume fraction. However, with the same or similar carbon content, high-carbon CoCrMo Stellite alloys exhibit worse wear resistance than high-carbon CoCrW Stellite alloys.

Cost-effective and rapid concrete repair techniques.

DOT National Transportation Integrated Search

2016-02-08

Concrete is a principal component of many transportation structures. While highly durable, a : variety of processes degrade and damage concrete. Replacement is expensive. Many cases : warrant repair instead of replacement. Since many damage processes...

Severe impingement of lumbar disc replacements increases the functional biological activity of polyethylene wear debris.

PubMed

Baxter, Ryan M; Macdonald, Daniel W; Kurtz, Steven M; Steinbeck, Marla J

2013-06-05

Wear, oxidation, and particularly rim impingement damage of ultra-high molecular weight polyethylene total disc replacement components have been observed following surgical revision. However, neither in vitro testing nor retrieval-based evidence has shown the effect(s) of impingement on the characteristics of polyethylene wear debris. Thus, we sought to determine (1) differences in polyethylene particle size, shape, number, or biological activity that correspond to mild or severe rim impingement and (2) in an analysis of all total disc replacements, regardless of impingement classification, whether there are correlations between the extent of regional damage and the characteristics of polyethylene wear debris. The extent of dome and rim damage was characterized for eleven retrieved polyethylene cores obtained at revision surgery after an average duration of implantation of 9.7 years (range, 4.6 to 16.1 years). Polyethylene wear debris was isolated from periprosthetic tissues with use of nitric acid and was imaged with use of environmental scanning electron microscopy. Subsequently, particle size, shape, number, biological activity, and chronic inflammation scores were determined. Grouping of particles by size ranges that represented high biological relevance (<0.1 to 1-μm particles), intermediate biological relevance (1 to 10-μm particles), and low biological relevance (>10-μm particles) revealed an increased volume fraction of particles in the <0.1 to 1-μm and 1 to 10-μm size ranges in the mild-impingement cohort as compared with the severe-impingement cohort. The increased volume fractions resulted in a higher specific biological activity per unit particle volume in the mild-impingement cohort than in the severe-impingement cohort. However, functional biological activity, which is normalized by particle volume (mm3/g of tissue), was significantly higher in the severe-impingement cohort. This increase was due to a larger volume of particles in all three size ranges. In both cohorts, the functional biological activity correlated with the chronic inflammatory response, and the extent of rim penetration positively correlated with increasing particle size, number, and functional biological activity. The results of this study suggest that severe rim impingement increases the production of biologically relevant particles from motion-preserving lumbar total disc replacement components. Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Severe Impingement of Lumbar Disc Replacements Increases the Functional Biological Activity of Polyethylene Wear Debris

PubMed Central

Baxter, Ryan M.; MacDonald, Daniel W.; Kurtz, Steven M.; Steinbeck, Marla J.

2013-01-01

Background: Wear, oxidation, and particularly rim impingement damage of ultra-high molecular weight polyethylene total disc replacement components have been observed following surgical revision. However, neither in vitro testing nor retrieval-based evidence has shown the effect(s) of impingement on the characteristics of polyethylene wear debris. Thus, we sought to determine (1) differences in polyethylene particle size, shape, number, or biological activity that correspond to mild or severe rim impingement and (2) in an analysis of all total disc replacements, regardless of impingement classification, whether there are correlations between the extent of regional damage and the characteristics of polyethylene wear debris. Methods: The extent of dome and rim damage was characterized for eleven retrieved polyethylene cores obtained at revision surgery after an average duration of implantation of 9.7 years (range, 4.6 to 16.1 years). Polyethylene wear debris was isolated from periprosthetic tissues with use of nitric acid and was imaged with use of environmental scanning electron microscopy. Subsequently, particle size, shape, number, biological activity, and chronic inflammation scores were determined. Results: Grouping of particles by size ranges that represented high biological relevance (<0.1 to 1-μm particles), intermediate biological relevance (1 to 10-μm particles), and low biological relevance (>10-μm particles) revealed an increased volume fraction of particles in the <0.1 to 1-μm and 1 to 10-μm size ranges in the mild-impingement cohort as compared with the severe-impingement cohort. The increased volume fractions resulted in a higher specific biological activity per unit particle volume in the mild-impingement cohort than in the severe-impingement cohort. However, functional biological activity, which is normalized by particle volume (mm3/g of tissue), was significantly higher in the severe-impingement cohort. This increase was due to a larger volume of particles in all three size ranges. In both cohorts, the functional biological activity correlated with the chronic inflammatory response, and the extent of rim penetration positively correlated with increasing particle size, number, and functional biological activity. Conclusions: The results of this study suggest that severe rim impingement increases the production of biologically relevant particles from motion-preserving lumbar total disc replacement components. Level of Evidence: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence. PMID:23780545

Continuous renal replacement therapies: a brief primer for the neurointensivist.

PubMed

Patel, Pritesh; Nandwani, Veena; McCarthy, Paul J; Conrad, Steven A; Keith Scott, L

2010-10-01

Continuous renal replacement therapy (CRRT) is a renal replacement modality that is often used in the ICU setting, including the neuro-ICU. This form of renal replacement therapy has been used classically for acute renal failure in patients with hemodynamic compromise, but is gaining acceptance as a method to control vascular and extra-vascular volume and mediate cytokines in non-renal diseases. Although these uses are briefly discussed, this review concentrates on the different forms of continuous renal replacement, mainly focusing on the technology of convective versus diffusive modalities and briefly on filter technology. There is also discussion on the various anticoagulation regimes used in CRRT including data on performing CRRT without anticoagulation. This review is not meant to be a discussion on the pros and cons of CRRT versus intermittent dialysis, but rather a primer on the technology of CRRT and how this therapy may affect general care of the ICU patient.

SPIDER: Next Generation Chip Scale Imaging Sensor Update

NASA Astrophysics Data System (ADS)

Duncan, A.; Kendrick, R.; Ogden, C.; Wuchenich, D.; Thurman, S.; Su, T.; Lai, W.; Chun, J.; Li, S.; Liu, G.; Yoo, S. J. B.

2016-09-01

The Lockheed Martin Advanced Technology Center (LM ATC) and the University of California at Davis (UC Davis) are developing an electro-optical (EO) imaging sensor called SPIDER (Segmented Planar Imaging Detector for Electro-optical Reconnaissance) that seeks to provide a 10x to 100x size, weight, and power (SWaP) reduction alternative to the traditional bulky optical telescope and focal-plane detector array. The substantial reductions in SWaP would reduce cost and/or provide higher resolution by enabling a larger-aperture imager in a constrained volume. Our SPIDER imager replaces the traditional optical telescope and digital focal plane detector array with a densely packed interferometer array based on emerging photonic integrated circuit (PIC) technologies that samples the object being imaged in the Fourier domain (i.e., spatial frequency domain), and then reconstructs an image. Our approach replaces the large optics and structures required by a conventional telescope with PICs that are accommodated by standard lithographic fabrication techniques (e.g., complementary metal-oxide-semiconductor (CMOS) fabrication). The standard EO payload integration and test process that involves precision alignment and test of optical components to form a diffraction limited telescope is, therefore, replaced by in-process integration and test as part of the PIC fabrication, which substantially reduces associated schedule and cost. This paper provides an overview of performance data on the second-generation PIC for SPIDER developed under the Defense Advanced Research Projects Agency (DARPA)'s SPIDER Zoom research funding. We also update the design description of the SPIDER Zoom imaging sensor and the second-generation PIC (high- and low resolution versions).

Testbed Experiment for SPIDER: A Photonic Integrated Circuit-based Interferometric imaging system

NASA Astrophysics Data System (ADS)

Badham, K.; Duncan, A.; Kendrick, R. L.; Wuchenich, D.; Ogden, C.; Chriqui, G.; Thurman, S. T.; Su, T.; Lai, W.; Chun, J.; Li, S.; Liu, G.; Yoo, S. J. B.

The Lockheed Martin Advanced Technology Center (LM ATC) and the University of California at Davis (UC Davis) are developing an electro-optical (EO) imaging sensor called SPIDER (Segmented Planar Imaging Detector for Electro-optical Reconnaissance) that seeks to provide a 10x to 100x size, weight, and power (SWaP) reduction alternative to the traditional bulky optical telescope and focal-plane detector array. The substantial reductions in SWaP would reduce cost and/or provide higher resolution by enabling a larger-aperture imager in a constrained volume. Our SPIDER imager replaces the traditional optical telescope and digital focal plane detector array with a densely packed interferometer array based on emerging photonic integrated circuit (PIC) technologies that samples the object being imaged in the Fourier domain (i.e., spatial frequency domain), and then reconstructs an image. Our approach replaces the large optics and structures required by a conventional telescope with PICs that are accommodated by standard lithographic fabrication techniques (e.g., complementary metal-oxide-semiconductor (CMOS) fabrication). The standard EO payload integration and test process that involves precision alignment and test of optical components to form a diffraction limited telescope is, therefore, replaced by in-process integration and test as part of the PIC fabrication, which substantially reduces associated schedule and cost. In this paper we describe the photonic integrated circuit design and the testbed used to create the first images of extended scenes. We summarize the image reconstruction steps and present the final images. We also describe our next generation PIC design for a larger (16x area, 4x field of view) image.

40 CFR 94.907 - Engine dressing exemption.

Code of Federal Regulations, 2011 CFR

2011-07-01

... turbocharger, except that small-volume manufacturers of recreational engines may replace an original turbocharger with one that matches the performance of the original turbocharger. (iii) Modify or design the...

40 CFR 94.907 - Engine dressing exemption.

Code of Federal Regulations, 2012 CFR

2012-07-01

... turbocharger, except that small-volume manufacturers of recreational engines may replace an original turbocharger with one that matches the performance of the original turbocharger. (iii) Modify or design the...

40 CFR 94.907 - Engine dressing exemption.

Code of Federal Regulations, 2014 CFR

2014-07-01

... turbocharger, except that small-volume manufacturers of recreational engines may replace an original turbocharger with one that matches the performance of the original turbocharger. (iii) Modify or design the...

Energy density and rate limitations in structural composite supercapacitors

NASA Astrophysics Data System (ADS)

Snyder, J. F.; Gienger, E.; Wetzel, E. D.; Xu, K.

2012-06-01

The weight and volume of conventional energy storage technologies greatly limits their performance in mobile platforms. Traditional research efforts target improvements in energy density to reduce device size and mass. Enabling a device to perform additional functions, such as bearing mechanical load, is an alternative approach as long as the total mass efficiency exceeds that of the individual materials it replaces. Our research focuses on structural composites that function as batteries and supercapacitors. These multifunctional devices could be used to replace conventional structural components, such as vehicle frame elements, to provide significant system-level weight reductions and extend mission times. Our approach is to design structural properties directly into the electrolyte and electrode materials. Solid polymer electrolyte materials bind the system and transfer load to the fibers while conducting ions between the electrodes. Carbon fiber electrodes provide a route towards optimizing both energy storage and load-bearing capabilities, and may also obviate the need for a separate current collector. The components are being integrated using scalable, cost-effective composite processing techniques that are amenable to complex part shapes. Practical considerations of energy density and rate behavior are described here as they relate to materials used. Our results highlight the viability as well as the challenges of this multifunctional approach towards energy storage.

[Plasma exchange in nephrology: Indications and technique].

PubMed

Ridel, Christophe; Kissling, Sébastien; Mesnard, Laurent; Hertig, Alexandre; Rondeau, Éric

2017-02-01

Plasma exchange is a non-selective apheresis technique that can be performed by filtration or centrifugation allowing rapid purification of high molecular weight pathogens. An immunosuppressive treatment is generally associated to reduce the rebound effect of the purified substance. Substitution solutes such as human albumin and macromolecules are needed to compensate for plasma extraction. Compensation by viro-attenuated plasma is reserved solely for the treatment of thrombotic microangiopathies or when there is a risk of bleeding, because this product is very allergenic and expensive. The treatment goal for a plasma exchange session should be between one and one and one-half times the patient's plasma volume estimated at 40 mL/kg body weight. The anticoagulation is best ensured by the citrate. Complications of plasma exchange are quite rare according to the French hemapheresis registry. The level of evidence of efficacy of plasma exchange in nephrology varies from one pathology to another. Main indications of plasma exchange in nephrology are Goodpasture syndrome, antineutrophil cytoplasmic antibody vasculitis when plasma creatinine is greater than 500 μmol/L, and thrombotic microangiopathies. During renal transplantation, plasma exchange may be proposed in the context of human leukocyte antigen (HLA) desensitization protocols or ABO-incompatible graft. After renal transplantation, plasma exchange is indicated as part of the treatment of acute humoral rejection or recurrent focal segmental glomerulosclerosis on the graft. Plasma exchanges are also proposed in the management of cryoglobulinemia or polyarteritis nodosa. Hemodialysis with membranes of very high permeability tends to replace plasma exchange for myeloma nephropathy. The benefit from plasma exchange has not been formally demonstrated for the treatment of severe lupus or antiphospholipid antibody syndrome. There is no indication of plasma exchange in the treatment of scleroderma or nephrogenic systemic fibrosis. More selective apheresis techniques such as immunoadsorption are currently proposed to replace plasma exchange. Copyright © 2016. Published by Elsevier SAS.

Dutasteride reduces prostate size and prostate specific antigen in older hypogonadal men with benign prostatic hyperplasia undergoing testosterone replacement therapy.

PubMed

Page, Stephanie T; Hirano, Lianne; Gilchriest, Janet; Dighe, Manjiri; Amory, John K; Marck, Brett T; Matsumoto, Alvin M

2011-07-01

Benign prostatic hyperplasia and hypogonadism are common disorders in aging men. There is concern that androgen replacement in older men may increase prostate size and symptoms of benign prostatic hyperplasia. We examined whether combining dutasteride, which inhibits testosterone to dihydrotestosterone conversion, with testosterone treatment in older hypogonadal men with benign prostatic hyperplasia reduces androgenic stimulation of the prostate compared to testosterone alone. We conducted a double-blind, placebo controlled trial of 53 men 51 to 82 years old with symptomatic benign prostatic hyperplasia, prostate volume 30 cc or greater and serum total testosterone less than 280 ng/dl (less than 9.7 nmol/l). Subjects were randomized to daily transdermal 1% T gel plus oral placebo or dutasteride for 6 months. Testosterone dosing was adjusted to a serum testosterone of 500 to 1,000 ng/dl. The primary outcomes were prostate volume measured by magnetic resonance imaging, serum prostate specific antigen and androgen levels. A total of 46 subjects completed all procedures. Serum testosterone increased similarly into the mid-normal range in both groups. Serum dihydrotestosterone increased in the testosterone only but decreased in the testosterone plus dutasteride group. In the testosterone plus dutasteride group prostate volume and prostate specific antigen (mean ± SEM) decreased 12% ± 2.5% and 35% ± 5%, respectively, compared to the testosterone only group in which prostate volume and prostate specific antigen increased 7.5% ± 3.3% and 19% ± 7% (p = 0.03 and p = 0.008), respectively, after 6 months of treatment. Prostate symptom scores improved in both groups. Combined treatment with testosterone plus dutasteride reduces prostate volume and prostate specific antigen compared to testosterone only. Coadministration of a 5α-reductase inhibitor with testosterone appears to spare the prostate from androgenic stimulation during testosterone replacement in older, hypogonadal men with symptomatic benign prostatic hyperplasia. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Impact of Transcatheter Technology on Surgical Aortic Valve Replacement Volume, Outcomes, and Cost.

PubMed

Hawkins, Robert B; Downs, Emily A; Johnston, Lily E; Mehaffey, J Hunter; Fonner, Clifford E; Ghanta, Ravi K; Speir, Alan M; Rich, Jeffrey B; Quader, Mohammed A; Yarboro, Leora T; Ailawadi, Gorav

2017-06-01

Transcatheter aortic valve replacement (TAVR) represents a disruptive technology that is rapidly expanding in use. We evaluated the effect on surgical aortic valve replacement (SAVR) patient selection, outcomes, volume, and cost. A total of 11,565 patients who underwent SAVR, with or without coronary artery bypass grafting (2002 to 2015), were evaluated from the Virginia Cardiac Services Quality Initiative database. Patients were stratified by surgical era: pre-TAVR era (2002 to 2008, n = 5,113), early-TAVR era (2009 to 2011, n = 2,709), and commercial-TAVR era (2012 to 2015, n = 3,743). Patient characteristics, outcomes, and resource utilization were analyzed by univariate analyses. Throughout the study period, statewide SAVR volumes increased with median volumes of pre-TAVR: 722 cases/year, early-TAVR: 892 cases/year, and commercial-TAVR: 940 cases/year (p = 0.005). Implementation of TAVR was associated with declining Society of Thoracic Surgeons predicted risk of mortality among SAVR patients (3.7%, 2.6%, and 2.4%; p < 0.0001), despite increasing rates of comorbid disease. The mortality rate was lowest in the current commercial-TAVR era (3.9%, 4.3%, and 3.2%; p = 0.05), and major morbidity decreased throughout the time period (21.2%, 20.5%, and 15.2%; p < 0.0001). The lowest observed-to-expected ratios for both occurred in the commercial-TAVR era (0.9 and 0.9, respectively). Resource utilization increased generally, including total cost increases from $42,835 to $51,923 to $54,710 (p < 0.0001). At present, SAVR volumes have not been affected by the introduction of TAVR. The outcomes for SAVR continue to improve, potentially due to availability of transcatheter options for high-risk patients. Despite rising costs for SAVR, open approaches still provide a significant cost advantage over TAVR. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Measurement of absolute lung volumes by imaging techniques.

PubMed

Clausen, J

1997-10-01

In this paper, the techniques available for estimating total lung capacities from standard chest radiographs in children and infants as well as adults are reviewed. These techniques include manual measurements using ellipsoid and planimetry techniques as well as computerized systems. Techniques are also available for making radiographic lung volume measurements from portable chest radiographs. There are inadequate data in the literature to support recommending one specific technique over another. Though measurements of lung volumes by radiographic, plethysmographic, gas dilution or washout techniques result in remarkably similar mean results when groups of normal subjects are tested, in patients with disease, the results of these different basic measurement techniques can differ significantly. Computed tomographic and magnetic resonance techniques can also be used to measure absolute lung volumes and offer the theoretical advantages that the results in individual subjects are less affected by variances of thoracic shape than are measurements made using conventional chest radiographs.

Comparison of Spectra Optia and COBE Spectra apheresis systems' performances for red blood cell exchange procedures.

PubMed

Kim, Jaehyup; Joseph, Ranjit; Matevosyan, Karen; Sarode, Ravi

2016-12-01

Spectra Optia (Terumo BCT, Lakewood, CO) was FDA approved for red blood cell exchange (RBCx) procedures in January 2014 and is expected to replace COBE spectra (Terumo BCT) very soon in the USA. The performance characteristics of these devices for Isovolemic Hemodilution (IHD-RBCx) procedure were compared in this study. A total of 114 IHD-RBCx procedures from 19 patients were analyzed. For every patient, three procedures on each device with similar pre-procedure hematocrits were compared. Pre and post procedure laboratory parameters compared were hemoglobin S (HbS), hematocrits (Hct), platelet counts and fraction of cells remaining (FCR). Statistical analysis was performed using t-test adjusted by the Holm-Bonferroni method to reduce family-wise error rate. There were no significant differences between these two devices in regards to HbS, Hct, FCR and platelet counts (p = > 0.05). However, rinseback volume (124.2 ± 8.9 ml) and normal saline replacement volume during IHD phase (296.1 ± 97.2 ml) were lower in Spectra Optia as compared to COBE Spectra (337 ± 33.8 ml and 326.6 ± 105.2 ml, p value <0.001 and 0.030 respectively). Spectra Optia had a longer run time (107.1 ± 15.9 min vs 123.8 ± 19.6 min, p value <0.001) overall. Performance characteristics of Spectra Optia for HbS, Hct and FCR were similar to COBE Spectra for IHD-RBCx. IHD-RBCx procedure on Optia required less normal saline replacement volume and rinse back volume but with overall longer procedure run time. Copyright © 2016. Published by Elsevier Ltd.

A bio-telemetric device for measurement of left ventricular pressure-volume loops using the admittance technique in conscious, ambulatory rats.

PubMed

Raghavan, Karthik; Feldman, Marc D; Porterfield, John E; Larson, Erik R; Jenkins, J Travis; Escobedo, Daniel; Pearce, John A; Valvano, Jonathan W

2011-06-01

This paper presents the design, construction and testing of a device to measure pressure-volume loops in the left ventricle of conscious, ambulatory rats. Pressure is measured with a standard sensor, but volume is derived from data collected from a tetrapolar electrode catheter using a novel admittance technique. There are two main advantages of the admittance technique to measure volume. First, the contribution from the adjacent muscle can be instantaneously removed. Second, the admittance technique incorporates the nonlinear relationship between the electric field generated by the catheter and the blood volume. A low power instrument weighing 27 g was designed, which takes pressure-volume loops every 2 min and runs for 24 h. Pressure-volume data are transmitted wirelessly to a base station. The device was first validated on 13 rats with an acute preparation with 2D echocardiography used to measure true volume. From an accuracy standpoint, the admittance technique is superior to both the conductance technique calibrated with hypertonic saline injections, and calibrated with cuvettes. The device was then tested on six rats with 24 h chronic preparation. Stability of animal preparation and careful calibration are important factors affecting the success of the device.

Bio-telemetric device for measurement of left ventricular pressure-volume loops using the admittance technique in conscious, ambulatory rats

PubMed Central

Raghavan, Karthik; Feldman, Marc D; Porterfield, John E; Larson, Erik R; Jenkins, J Travis; Escobedo, Daniel; Pearce, John A

2011-01-01

This paper presents the design, construction and testing of a device to measure pressure volume loops in the left ventricle of conscious, ambulatory rats. Pressure is measured with a standard sensor, but volume is derived from data collected from a tetrapolar electrode catheter using a novel admittance technique. There are two main advantages of the admittance technique to measure volume. First, the contribution from the adjacent muscle can be instantaneously removed. Second, the admittance technique incorporates the nonlinear relationship between the electric field generated by the catheter and the blood volume. A low power instrument weighing 27 g was designed, which takes pressure-volume loops every 2 minutes and runs for 24 hours. Pressure-volume data are transmitted wirelessly to a base station. The device was first validated in thirteen rats with an acute preparation with 2-D echocardiography used to measure true volume. From an accuracy standpoint, the admittance technique is superior to both the conductance technique calibrated with hypertonic saline injections, and calibrated with cuvettes. The device was then tested in six rats with a 24-hour chronic preparation. Stability of the animal preparation and careful calibration are important factors affecting the success of the device. PMID:21606560

75 FR 17861 - 2010 Standard Mail Incentive Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-08

...The Postal Service is revising Mailing Standards of the United States Postal Service, Domestic Mail Manual (DMM[supreg]), to replace existing section 709.2 with new standards for a volume incentive program for mailers of Standard Mail[supreg] letters and flats with mail volume exceeding their individual USPS[supreg]--determined threshold levels. The program period will be from July 1, 2010 through September 30, 2010.

Surgeon specialization and operative mortality in United States: retrospective analysis.

PubMed

Sahni, Nikhil R; Dalton, Maurice; Cutler, David M; Birkmeyer, John D; Chandra, Amitabh

2016-07-21

 To measure the association between a surgeon's degree of specialization in a specific procedure and patient mortality.  Retrospective analysis of Medicare data.  US patients aged 66 or older enrolled in traditional fee for service Medicare.  25 152 US surgeons who performed one of eight procedures (carotid endarterectomy, coronary artery bypass grafting, valve replacement, abdominal aortic aneurysm repair, lung resection, cystectomy, pancreatic resection, or esophagectomy) on 695 987 patients in 2008-13.  Relative risk reduction in risk adjusted and volume adjusted 30 day operative mortality between surgeons in the bottom quarter and top quarter of surgeon specialization (defined as the number of times the surgeon performed the specific procedure divided by his/her total operative volume across all procedures).  For all four cardiovascular procedures and two out of four cancer resections, a surgeon's degree of specialization was a significant predictor of operative mortality independent of the number of times he or she performed that procedure: carotid endarterectomy (relative risk reduction between bottom and top quarter of surgeons 28%, 95% confidence interval 0% to 48%); coronary artery bypass grafting (15%, 4% to 25%); valve replacement (46%, 37% to 53%); abdominal aortic aneurysm repair (42%, 29% to 53%); lung resection (28%, 5% to 46%); and cystectomy (41%, 8% to 63%). In five procedures (carotid endarterectomy, valve replacement, lung resection, cystectomy, and esophagectomy), the relative risk reduction from surgeon specialization was greater than that from surgeon volume for that specific procedure. Furthermore, surgeon specialization accounted for 9% (coronary artery bypass grafting) to 100% (cystectomy) of the relative risk reduction otherwise attributable to volume in that specific procedure.  For several common procedures, surgeon specialization was an important predictor of operative mortality independent of volume in that specific procedure. When selecting a surgeon, patients, referring physicians, and administrators assigning operative workload may want to consider a surgeon's procedure specific volume as well as the degree to which a surgeon specializes in that procedure. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The area-time-integral technique to estimate convective rain volumes over areas applied to satellite data - A preliminary investigation

NASA Technical Reports Server (NTRS)

Doneaud, Andre A.; Miller, James R., Jr.; Johnson, L. Ronald; Vonder Haar, Thomas H.; Laybe, Patrick

1987-01-01

The use of the area-time-integral (ATI) technique, based only on satellite data, to estimate convective rain volume over a moving target is examined. The technique is based on the correlation between the radar echo area coverage integrated over the lifetime of the storm and the radar estimated rain volume. The processing of the GOES and radar data collected in 1981 is described. The radar and satellite parameters for six convective clusters from storm events occurring on June 12 and July 2, 1981 are analyzed and compared in terms of time steps and cluster lifetimes. Rain volume is calculated by first using the regression analysis to generate the regression equation used to obtain the ATI; the ATI versus rain volume relation is then employed to compute rain volume. The data reveal that the ATI technique using satellite data is applicable to the calculation of rain volume.

[Knee arthrodesis performed with intramedullary nailing technique in failed total knee replacement--a preliminary report].

PubMed

Gaździk, Tadeusz Szymon; Kotas-Strzoda, Justyna; Bozek, Marek

2004-01-01

Knee arthrodesis is the method of choice in treatment of failed total knee replacement. It is recommended when revisory total knee replacement is impossible. The authors present 2 cases of knee fusions using intramedullary nails after prosthesis loosening (1 aseptic, 1 septic). In both cases good results were achieved, with no complications observed during convalescence.

Pledget Induced Cardiogenic Shock Following a Minimally Invasive Aortic Valve Replacement.

PubMed

Tedesco, Alexandra E; Tedesco, Victor E

2017-01-01

Within the last decade, minimally invasive valve replacements have become exceedingly popular, and as a result, so has the rise of technology aimed at refining and simplifying these techniques. With new technology, new complications are inevitable. We present a routine Minimally invasive aortic valve replacement through a right anterior minithoracotomy complicated by pledget impaction in a coronary artery.

Novel methods of treating ovarian infertility in older and POF women, testicular infertility, and other human functional diseases.

PubMed

Bukovsky, Antonin

2015-02-25

In vitro maturation (IVM) and in vitro fertilization (IVF) technologies are facing with growing demands of older women to conceive. Although ovarian stem cells (OSCs) of older women are capable of producing in vitro fresh oocyte-like cells (OLCs), such cells cannot respond to IVM and IVF due to the lack of granulosa cells required for their maturation. Follicular renewal is also dependent on support of circulating blood mononuclear cells. They induce intermediary stages of meiosis (metaphase I chromosomal duplication and crossover, anaphase, telophase, and cytokinesis) in newly emerging ovarian germ cells, as for the first time demonstrated here, induce formation of granulosa cells, and stimulate follicular growth and development. A pretreatment of OSC culture with mononuclear cells collected from blood of a young healthy fertile woman may cause differentiation of bipotential OSCs into both developing germ and granulosa cells. A small blood volume replacement may enable treatment of ovarian infertility in vivo. The transferred mononuclear cells may temporarily rejuvenate virtually all tissues, including improvement of the function of endocrine tissues. Formation of new follicles and their development may be sufficient for IVM and IVF. The novel proposed in vitro approaches may be used as a second possibility. Infertility of human males affects almost a half of the infertility cases worldwide. Small blood volume replacement from young healthy fertile men may also be easy approach for the improvement of sperm quality in older or other affected men. In addition, body rejuvenation by small blood volume replacement from young healthy individuals of the same sex could represent a decline of in vitro methodology in favor of in vivo treatment for human functional diseases. Here we propose for the first time that blood mononuclear cells are essential for rejuvenation of those tissues, where immune system components participate in an appropriate division and differentiation of tissue stem cells. If needed, small blood volume replacement from distinct young healthy individuals could be utilized in six month intervals for repair of young altered or aged reproductive and other tissue functions. Systemic and local use of honey bee propolis tincture is an alternative option for functional rejuvenation of some tissues.

Passive potassium transport in low potassium sheep red cells: dependence upon cell volume and chloride.

PubMed Central

Dunham, P B; Ellory, J C

1981-01-01

The major pathway of passive K influx (ouabain-insensitive) was characterized in low-K type (LK) red cells of sheep. 1. Passive K transport in these cells was highly sensitive to variations in cell volume; it increased threefold or more in cells swollen osmotically by 10%, and decreased up to twofold in cells shrunken 5-10%. Active K influx was insensitive to changes in cell volume. Three different methods for varying cell volume osmotically all gave similar results. 2. The volume-sensitive pathway was specific for K in that Na influx did not vary with changes in cell volume. 3. The volume-sensitive K influx was a saturable function of external K concentration. It was slightly inhibited by Na, whereas K influx in shrunken cells was unaffected by Na. 4. Passive K influx was dependent on the major anion in the medium in that replacement of Cl with any of six other anions resulted in a reduction of K influx by 50-80% (replacement of Cl by Br caused an increase in K influx). The activation of K influx by Cl followed sigmoid kinetics. 5. Passive K influx is inhibited by anti-L antibody. The antibody affected only that portion of influx which was Cl-dependent and volume-sensitve. Of the subfractions of the antibody, it is anti-L1 which inhibits passive K transport. 6. Pretreatment of cells with iodoacetamide reduced the sensitivity of K influx to cell volume in that the influx was reduced in swollen IAA-treated cells and increased in shrunken IAA-cells. 7. Intracellular Ca has no role in altering passive K transport in LK sheep cells. Therefore, the major pathway of passive K transport in LK sheep red cells is sensitive to changes in cell volume, specific for K, dependent on Cl, and inhibited by anti-L1 antibody, The minor pathway, observed in shrunken cells, has none of these properties. PMID:6798197

The Ross operation: a 12-year experience.

PubMed

Elkins, R C

1999-09-01

The Ross operation, originally introduced as a scalloped subcoronary implant with an 80% survival and 85% freedom from reoperation, has recently been modified to a root replacement which is now the most utilized implant technique. The mid and late results of this operative technique and comparison of intra-aortic implants and root replacement in a single institution are reported. The records of 328 patients who had a Ross operation at the University of Oklahoma (August 1986 to July 1998) were reviewed to assess operative technique and patient-related factors on survival, autograft valve function, homograft valve function, valve-related complications, and need for reoperation. Operative survival was 95.4% with an actuarial survival of 89% +/- 5% at 8 years. Freedom from replacement of the pulmonary autograft was 94% +/- 3% at 8 years, freedom from reoperation on the pulmonary homograft was 90% +/- 4% at 8 years, and freedom from autograft valve reoperation or dysfunction (3+ autograft valve insufficiency) was 83% +/- 6% at 9 years. The incidence of autograft valve reoperation and late autograft valve dysfunction was decreased by root replacement. Annulus reduction and fixation improved early results in patients with aortic insufficiency and annulus dilatation. Early results have been excellent, as the development of late autograft valve dysfunction or dilatation has been rare. The excellent hemodynamic results with a limited incidence of reoperation and replacement of the autograft valve justify its continued use.

Quantitative CT: technique dependence of volume estimation on pulmonary nodules

NASA Astrophysics Data System (ADS)

Chen, Baiyu; Barnhart, Huiman; Richard, Samuel; Colsher, James; Amurao, Maxwell; Samei, Ehsan

2012-03-01

Current estimation of lung nodule size typically relies on uni- or bi-dimensional techniques. While new three-dimensional volume estimation techniques using MDCT have improved size estimation of nodules with irregular shapes, the effect of acquisition and reconstruction parameters on accuracy (bias) and precision (variance) of the new techniques has not been fully investigated. To characterize the volume estimation performance dependence on these parameters, an anthropomorphic chest phantom containing synthetic nodules was scanned and reconstructed with protocols across various acquisition and reconstruction parameters. Nodule volumes were estimated by a clinical lung analysis software package, LungVCAR. Precision and accuracy of the volume assessment were calculated across the nodules and compared between protocols via a generalized estimating equation analysis. Results showed that the precision and accuracy of nodule volume quantifications were dependent on slice thickness, with different dependences for different nodule characteristics. Other parameters including kVp, pitch, and reconstruction kernel had lower impact. Determining these technique dependences enables better volume quantification via protocol optimization and highlights the importance of consistent imaging parameters in sequential examinations.

Leaving Moderate Tricuspid Valve Regurgitation Alone at the Time of Pulmonary Valve Replacement: A Worthwhile Approach.

PubMed

Kogon, Brian; Mori, Makoto; Alsoufi, Bahaaldin; Kanter, Kirk; Oster, Matt

2015-06-01

Pulmonary valve disruption in patients with tetralogy of Fallot and congenital pulmonary stenosis often results in pulmonary insufficiency, right ventricular dilation, and tricuspid valve regurgitation. Management of functional tricuspid regurgitation at the time of subsequent pulmonary valve replacement remains controversial. Our aims were to (1) analyze tricuspid valve function after pulmonary valve replacement through midterm follow-up and (2) determine the benefits, if any, of concomitant tricuspid annuloplasty. Thirty-five patients with tetralogy of Fallot or congenital pulmonary stenosis were analyzed. All patients had been palliated in childhood by disrupting the pulmonary valve, and all patients had at least moderate tricuspid valve regurgitation at the time of subsequent pulmonary valve replacement. Preoperative and serial postoperative echocardiograms were analyzed. Pulmonary and tricuspid regurgitation, along with right ventricular dilation and dysfunction were scored as 0 (none), 1 (mild), 2 (moderate), and 3 (severe). Right ventricular volume and area were also calculated. Comparisons were made between patients who underwent pulmonary valve replacement alone and those who underwent concomitant tricuspid valve annuloplasty. At 1 month after pulmonary valve replacement, there were significant reductions in pulmonary valve regurgitation (mean 3 vs 0.39, p < 0.0001), tricuspid valve regurgitation (mean 2.33 vs 1.3, p < 0.0001), and in right ventricular dilation, volume, and area. There was no difference in the degree of tricuspid regurgitation 1 month postoperatively between patients who underwent concomitant tricuspid annuloplasty and those who underwent pulmonary valve replacement alone (mean 1.31 vs 1.29, p = 0.81). However, at latest follow-up (mean 7.0 ± 2.8 years), the degree of tricuspid regurgitation was significantly higher in the concomitant annuloplasty group (mean 1.87 vs 1.12, p = 0.005). In patients with at least moderate tricuspid valve regurgitation, significant improvement in tricuspid valve function and right ventricular size occurs in the first postoperative month after pulmonary valve replacement, irrespective of concomitant tricuspid valve annuloplasty. The tricuspid valve appears to function better over the midterm if annuloplasty is not performed. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Minimalist transcatheter aortic valve replacement: The new standard for surgeons and cardiologists using transfemoral access?

PubMed

Jensen, Hanna A; Condado, Jose F; Devireddy, Chandan; Binongo, Jose; Leshnower, Bradley G; Babaliaros, Vasilis; Sarin, Eric L; Lerakis, Stamatios; Guyton, Robert A; Stewart, James P; Syed, Amjadullah Q; Mavromatis, Kreton; Kaebnick, Brian; Rajaei, Mohammad Hossein; Tsai, Lillian L; Rahman, Ayaz; Simone, Amy; Keegan, Patricia; Block, Peter C; Thourani, Vinod H

2015-10-01

A minimalist approach for transcatheter aortic valve replacement (MA-TAVR) utilizing transfemoral access under conscious sedation and transthoracic echocardiography is increasing in popularity. This relatively novel technique may necessitate a learning period to achieve proficiency in performing a successful and safe procedure. This report evaluates our MA-TAVR cohort with specific characterization between our early, midterm, and recent experience. We retrospectively reviewed 151 consecutive patients who underwent MA-TAVR with surgeons and interventionists equally as primary operator at Emory University between May 2012 and July 2014. Our institution had performed 300 TAVR procedures before implementation of MA-TAVR. Patient characteristics and early outcomes were compared using Valve Academic Research Consortium 2 definitions among 3 groups: group 1 included the first 50 patients, group 2 included patients 51 to 100, and group 3 included patients 101 to 151. Median age for all patients was 84 years and similar among groups. The majority of patients were men (56%) and the median ejection fraction for all patients was 55% (interquartile range, 38.0%-60.0%). The majority of patients were high-risk surgical candidates with a median Society of Thoracic Surgeons Predicted Risk of Mortality of 10.0% and similar among groups. The overall major stroke rate was 3.3%, major vascular complications occurred in 3% of patients, and greater-than-mild paravalvular leak rate was 7%. In-hospital mortality and morbidity were similar among all 3 groups. In a high-volume TAVR center, transition to MA-TAVR is feasible with acceptable outcomes and a diminutive procedural learning curve. We advocate for TAVR centers to actively pursue the minimalist technique with equal representation by cardiologists and surgeons. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

End-to-end system test for solid-state microdosemeters.

PubMed

Pisacane, V L; Dolecek, Q E; Malak, H; Dicello, J F

2010-08-01

The gold standard in microdosemeters has been the tissue equivalent proportional counter (TEPC) that utilises a gas cavity. An alternative is the solid-state microdosemeter that replaces the gas with a condensed phase (silicon) detector with microscopic sensitive volumes. Calibrations of gas and solid-state microdosemeters are generally carried out using radiation sources built into the detector that impose restrictions on their handling, transportation and licensing in accordance with the regulations from international, national and local nuclear regulatory bodies. Here a novel method is presented for carrying out a calibration and end-to-end system test of a microdosemeter using low-energy photons as the initiating energy source, thus obviating the need for a regulated ionising radiation source. This technique may be utilised to calibrate both a solid-state microdosemeter and, with modification, a TEPC with the higher average ionisation energy of a gas.

Melt Stirring by Horizontal Crucible Vibration

NASA Technical Reports Server (NTRS)

Wolf, M. F.; Elwell, D.; Feigelson, R. S.

1985-01-01

Horizontal vibration suggested as technique for more effective stirring of melts in crystal-growth apparatus. Vibrational technique may replace accelerated crucible rotation. Potential superiority of vibrational technique shown by preliminary experiments in which ink stirred into water.

Salvage of infected total knee fusion: the last option.

PubMed

Wiedel, Jerome D

2002-11-01

Currently the most common indication for an arthrodesis of the knee is a failed infected total knee prosthesis. Other causes of a failed total knee replacement that might necessitate a knee fusion include aseptic loosening, deficient extensor mechanism, poor soft tissues, and Charcot joint. Techniques available for achieving a knee fusion are external fixation and internal fixation methods. The external fixation compression devices have been the most widely used for knee fusion and have been successful until the indications for fusion changed to mostly failed prosthetic knee replacement. With failed total knee replacement, the problem of severe bone loss became an issue, and the external fixation compression devices, even including the biplane external fixators, have been the least successful method reported for gaining fusion. The Ilizarov technique has been shown to achieve rigid fixation despite this bone loss, and a review of reports are showing high fusion rates using this method. Internal fixation methods including plate fixation and intramedullary nails have had the best success in gaining fusion in the face of this bone loss and have replaced external fixation methods as the technique of choice for knee fusion when severe bone loss is present. A review of the literature and a discussion of different fusion techniques are presented including a discussion of the influence that infection has on the success of fusion.

The Benefit of Modified Rehabilitation and Minimally Invasive Techniques in Total Hip Replacement

PubMed Central

Lilikakis, Anastasios K; Gillespie, Beryl; Villar, Richard N

2008-01-01

INTRODUCTION We wished to assess if an intensive rehabilitation regimen alone, or one combined with modified anaesthetic and surgical techniques, can change the speed of rehabilitation or the length of hospital stay after total hip replacement. PATIENTS AND METHODS We compared 44 patients who had followed a traditional care pathway, with 38 patients who had rehabilitated under a new rehabilitation protocol, with 40 patients who had also received modified, minimally invasive techniques. The speed of rehabilitation was measured in terms of three specific milestones accomplished on the day after surgery. RESULTS We found a statistically significant improvement in the day after surgery each activity was possible. The length of hospital stay was reduced from 6.5 days to 5.4 days to 4.1 days, a difference which was also statistically significant. CONCLUSIONS The data support the view that a new rehabilitation protocol alone can reduce the length of hospital stay and hasten rehabilitation. The combination of modified anaesthetic and minimally invasive surgical techniques with the new rehabilitation regimen can further improve short-term outcome after total hip replacement. PMID:18634739

Mitral valve replacement with preservation of the subvalvular apparatus.

PubMed

Reardon, M J; David, T E

1999-03-01

The introduction of the Starr-Edwards valve allowed complete replacement of diseased left-sided heart valves. With improved cardiopulmonary bypass, myocardial protection, and surgical techniques the mortality rate from aortic valve replacement decreased substantially, whereas the mortality rate from mitral valve replacement remained high, largely because of low cardiac output syndrome. Increasing use of mitral valve repair techniques resulted in a marked decrease in short-term and long-term morbidity and mortality when treating patients with mitral regurgitation. Some believed that this resulted from maintenance of the mitral annular papillary muscle continuity during mitral valve repair. Subsequent experimental and clinical studies have validated the positive short-term and long-term effects of maintaining the integrity of the mitral valve subvalvular apparatus. This article considers the history of the clinical use of preservation of the subvalvular apparatus, the physiologic studies examining this concept, and the clinical data available on its use. It also examines the following: 1) mitral stenosis versus mitral regurgitation and the preservation of the subvalvular apparatus; 2) whether the anterior, posterior, or both areas of the subvalvular apparatus should be preserved; and 3) the surgical techniques for the preservation of the subvalvular apparatus and valve implantation.

Evaluation of mitral valve replacement anchoring in a phantom

NASA Astrophysics Data System (ADS)

McLeod, A. Jonathan; Moore, John; Lang, Pencilla; Bainbridge, Dan; Campbell, Gordon; Jones, Doug L.; Guiraudon, Gerard M.; Peters, Terry M.

2012-02-01

Conventional mitral valve replacement requires a median sternotomy and cardio-pulmonary bypass with aortic crossclamping and is associated with significant mortality and morbidity which could be reduced by performing the procedure off-pump. Replacing the mitral valve in the closed, off-pump, beating heart requires extensive development and validation of surgical and imaging techniques. Image guidance systems and surgical access for off-pump mitral valve replacement have been previously developed, allowing the prosthetic valve to be safely introduced into the left atrium and inserted into the mitral annulus. The major remaining challenge is to design a method of securely anchoring the prosthetic valve inside the beating heart. The development of anchoring techniques has been hampered by the expense and difficulty in conducting large animal studies. In this paper, we demonstrate how prosthetic valve anchoring may be evaluated in a dynamic phantom. The phantom provides a consistent testing environment where pressure measurements and Doppler ultrasound can be used to monitor and assess the valve anchoring procedures, detecting pararvalvular leak when valve anchoring is inadequate. Minimally invasive anchoring techniques may be directly compared to the current gold standard of valves sutured under direct vision, providing a useful tool for the validation of new surgical instruments.

High-volume forced diuresis with matched hydration using the RenalGuard System to prevent contrast-induced nephropathy: A meta-analysis of randomized trials.

PubMed

Shah, Rahman; Wood, Sarah J; Khan, Sajjad A; Chaudhry, Amina; Rehan Khan, M; Morsy, Mohamed S

2017-12-01

Contrast-induced nephropathy (CIN) is a well-recognized complication of coronary angiography that is associated with poor outcomes. Several small randomized controlled trials (RCTs) have recently shown that in patients with chronic kidney disease (CKD), furosemide-induced forced diuresis with matched hydration using the RenalGuard system can prevent its occurrence. However, individual studies have been underpowered and thus cannot show significant differences in major clinical endpoints. Forced diuresis with matched hydration using the RenalGuard system improves clinical outcomes in patients undergoing coronary angiography. Scientific databases and websites were searched for relevant RCTs. The pooled risk ratios were calculated using random-effects models. The primary endpoint was CIN, and the secondary endpoints were major adverse clinical events (MACEs) and the need for renal replacement therapy. Data from 3 trials including 586 patients were analyzed. High-volume forced diuresis with matched hydration using the RenalGuard system decreased risk of CIN by 60% (risk ratio: 0.40, 95% confidence interval: 0.25 to 0.65, P < 0.001), MACE rate by 59%, and the need for renal replacement therapy by 78%, compared with the standard of care. In patients with CKD undergoing coronary angiography, high-volume forced diuresis with matched hydration using the RenalGuard system significantly reduces the risk of CIN, MACE rate, and the need for renal replacement therapy. Larger RCTs with sufficient power are needed to confirm these findings. © 2017 Wiley Periodicals, Inc.

Physical and mechanical properties of mortars containing PET and PC waste aggregates.

PubMed

Hannawi, Kinda; Kamali-Bernard, Siham; Prince, William

2010-11-01

Non-biodegradable plastic aggregates made of polycarbonate (PC) and polyethylene terephthalate (PET) waste are used as partial replacement of natural aggregates in mortar. Various volume fractions of sand 3%, 10%, 20% and 50% are replaced by the same volume of plastic. This paper investigates the physical and mechanical properties of the obtained composites. The main results of this study show the feasibility of the reuse of PC and PET waste aggregates materials as partial volume substitutes for natural aggregates in cementitious materials. Despite of some drawbacks like a decrease in compressive strength, the use of PC and PET waste aggregates presents various advantages. A reduction of the specific weight of the cementitious materials and a significant improvement of their post-peak flexural behaviour are observed. The calculated flexural toughness factors increase significantly with increasing volume fraction of PET and PC-aggregates. Thus, addition of PC and PET plastic aggregates in cementitious materials seems to give good energy absorbing materials which is very interesting for several civil engineering applications like structures subjected to dynamic or impact efforts. The present study has shown quite encouraging results and opened new way for the recycling of PC waste aggregate in cement and concrete composites. Copyright © 2010 Elsevier Ltd. All rights reserved.

Repair vs replacement of direct composite restorations: a survey of teaching and operative techniques in Oceania.

PubMed

Brunton, Paul A; Ghazali, Amna; Tarif, Zahidah H; Loch, Carolina; Lynch, Christopher; Wilson, Nairn; Blum, Igor R

2017-04-01

To evaluate the teaching and operative techniques for the repair and/or replacement of direct resin-based composite restorations (DCRs) in dental schools in Oceania. A 14-item questionnaire was mailed to the heads of operative dentistry in 16 dental schools in Oceania (Australia, New Zealand, Fiji and Papua New Guinea). The survey asked whether the repair of DCRs was taught within the curriculum; the rationale behind the teaching; how techniques were taught, indications for repair, operative techniques, materials used, patient acceptability, expected longevity and recall systems. All 16 schools participated in the study. Thirteen (81%) reported the teaching of composite repairs as an alternative to replacement. Most schools taught the theoretical and practical aspects of repair at a clinical level only. All 13 schools (100%) agreed on tooth substance preservation being the main reason for teaching repair. The main indications for repair were marginal defects (100%), followed by secondary caries (69%). All 13 schools that performed repairs reported high patient acceptability, and considered it a definitive measure. Only three schools (23%) claimed to have a recall system in place following repair of DCRs. Most respondents either did not know or did not answer when asked about the longevity of DCRs. Repair of DCRs seems to be a viable alternative to replacement, which is actively taught within Oceania. Advantages include it being minimally invasive, preserving tooth structure, and time and money saving. However, standardised guidelines need to be developed and further clinical long-term studies need to be carried out. The decision between replacing or repairing a defective composite restoration tends to be based on what clinicians have been taught, tempered by experience and judgement. This study investigated the current status of teaching and operative techniques of repair of direct composite restorations in dental schools in Oceania. Copyright © 2017 Elsevier Ltd. All rights reserved.

An experimental result of estimating an application volume by machine learning techniques.

PubMed

Hasegawa, Tatsuhito; Koshino, Makoto; Kimura, Haruhiko

2015-01-01

In this study, we improved the usability of smartphones by automating a user's operations. We developed an intelligent system using machine learning techniques that periodically detects a user's context on a smartphone. We selected the Android operating system because it has the largest market share and highest flexibility of its development environment. In this paper, we describe an application that automatically adjusts application volume. Adjusting the volume can be easily forgotten because users need to push the volume buttons to alter the volume depending on the given situation. Therefore, we developed an application that automatically adjusts the volume based on learned user settings. Application volume can be set differently from ringtone volume on Android devices, and these volume settings are associated with each specific application including games. Our application records a user's location, the volume setting, the foreground application name and other such attributes as learning data, thereby estimating whether the volume should be adjusted using machine learning techniques via Weka.

Quantitative assessment of paravalvular leakage after transcatheter aortic valve replacement using a patient-specific pulsatile flow model.

PubMed

Tanaka, Yutaka; Saito, Shigeru; Sasuga, Saeko; Takahashi, Azuma; Aoyama, Yusuke; Obama, Kazuto; Umezu, Mitsuo; Iwasaki, Kiyotaka

2018-05-01

Quantitative assessment of post-transcatheter aortic valve replacement (TAVR) aortic regurgitation (AR) remains challenging. We developed patient-specific anatomical models with pulsatile flow circuit and investigated factors associated with AR after TAVR. Based on pre-procedural computed tomography (CT) data of the six patients who underwent transfemoral TAVR using a 23-mm SAPIEN XT, anatomically and mechanically equivalent aortic valve models were developed. Forward flow and heart rate of each patient in two days after TAVR were duplicated under mean aortic pressure of 80mmHg. Paravalvular leakage (PVL) volume in basal and additional conditions was measured for each model using an electromagnetic flow sensor. Incompletely apposed tract between the transcatheter and aortic valves was examined using a micro-CT. PVL volume in each patient-specific model was consistent with each patient's PVL grade, and was affected by hemodynamic conditions. PVL and total regurgitation volume increased with the mean aortic pressure, whereas closing volume did not change. In contrast, closing volume increased proportionately with heart rate, but PVL did not change. The minimal cross-sectional gap had a positive correlation with the PVL volumes (r=0.89, P=0.02). The gap areas typically occurred in the vicinity of the bulky calcified nodules under the native commissure. PVL volume, which could be affected by hemodynamic conditions, was significantly associated with the minimal cross-sectional gap area between the aortic annulus and the stent frame. These data may improve our understanding of the mechanism of the occurrence of post-TAVR PVL. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Simple retrograde cerebral perfusion is as good as complex antegrade cerebral perfusion for hemiarch replacement.

PubMed

Tanaka, Akiko; Estrera, Anthony L

2018-01-01

Cerebral complication is a major concern after aortic arch surgery, which may lead to death. Thus, cerebral protection strategy plays the key role to obtain respectable results in aortic arch repair. Deep hypothermic circulatory arrest was introduced in 1970s to decrease the ischemic insults to the brain. However, safe duration of circulatory arrest time was limited to 30 minutes. The 1990s was the decade of evolution for cerebral protection, in which two adjuncts for deep hypothermic circulatory arrest were introduced: retrograde and antegrade cerebral perfusion (ACP) techniques. These two cerebral perfusion techniques significantly decreased incidence of postoperative neurological dysfunction and mortality after aortic arch surgery. Although there are no large prospective studies that demonstrate which perfusion technique provide better outcomes, multiple retrospective studies implicate that ACP may decrease cerebral complications compared to retrograde cerebral perfusion (RCP) when a long circulatory arrest time is required during aortic arch reconstructions. To date, many surgeons favor ACP over RCP during a complex aortic arch repair, such as total arch replacement and hybrid arch replacement. However, the question is whether the use of ACP is necessary during a short, limited circulatory arrest time, such as hemiarch replacement? There is a paucity of data that proves the advantages of a complex ACP over a simple RCP for a short circulatory arrest time. RCP with deep hypothermic circulatory arrest is the simple, efficient cerebral protection technique with minimal interference to the surgical field-and it potentially allows to flush atheromatous debris out from the arch vessels. Thus, it is the preferred adjunct to deep hypothermic circulatory arrest during hemiarch replacement in our institution.

Simple retrograde cerebral perfusion is as good as complex antegrade cerebral perfusion for hemiarch replacement

PubMed Central

Tanaka, Akiko

2018-01-01

Cerebral complication is a major concern after aortic arch surgery, which may lead to death. Thus, cerebral protection strategy plays the key role to obtain respectable results in aortic arch repair. Deep hypothermic circulatory arrest was introduced in 1970s to decrease the ischemic insults to the brain. However, safe duration of circulatory arrest time was limited to 30 minutes. The 1990s was the decade of evolution for cerebral protection, in which two adjuncts for deep hypothermic circulatory arrest were introduced: retrograde and antegrade cerebral perfusion (ACP) techniques. These two cerebral perfusion techniques significantly decreased incidence of postoperative neurological dysfunction and mortality after aortic arch surgery. Although there are no large prospective studies that demonstrate which perfusion technique provide better outcomes, multiple retrospective studies implicate that ACP may decrease cerebral complications compared to retrograde cerebral perfusion (RCP) when a long circulatory arrest time is required during aortic arch reconstructions. To date, many surgeons favor ACP over RCP during a complex aortic arch repair, such as total arch replacement and hybrid arch replacement. However, the question is whether the use of ACP is necessary during a short, limited circulatory arrest time, such as hemiarch replacement? There is a paucity of data that proves the advantages of a complex ACP over a simple RCP for a short circulatory arrest time. RCP with deep hypothermic circulatory arrest is the simple, efficient cerebral protection technique with minimal interference to the surgical field—and it potentially allows to flush atheromatous debris out from the arch vessels. Thus, it is the preferred adjunct to deep hypothermic circulatory arrest during hemiarch replacement in our institution. PMID:29682460

Transverse joint configuration development and testing for a modular bridge deck replacement system.

DOT National Transportation Integrated Search

2011-03-01

According to the 2009 Report Card for Americas Infrastructure, one in four of the nations bridges are listed as : structurally deficient of functionally obsolete, establishing a dire need for new and innovative repair and replacement : techniqu...

A New CT Reconstruction Technique Using Adaptive Deformation Recovery and Intensity Correction (ADRIC)

PubMed Central

Zhang, You; Ma, Jianhua; Iyengar, Puneeth; Zhong, Yuncheng; Wang, Jing

2017-01-01

Purpose Sequential same-patient CT images may involve deformation-induced and non-deformation-induced voxel intensity changes. An adaptive deformation recovery and intensity correction (ADRIC) technique was developed to improve the CT reconstruction accuracy, and to separate deformation from non-deformation-induced voxel intensity changes between sequential CT images. Materials and Methods ADRIC views the new CT volume as a deformation of a prior high-quality CT volume, but with additional non-deformation-induced voxel intensity changes. ADRIC first applies the 2D-3D deformation technique to recover the deformation field between the prior CT volume and the new, to-be-reconstructed CT volume. Using the deformation-recovered new CT volume, ADRIC further corrects the non-deformation-induced voxel intensity changes with an updated algebraic reconstruction technique (‘ART-dTV’). The resulting intensity-corrected new CT volume is subsequently fed back into the 2D-3D deformation process to further correct the residual deformation errors, which forms an iterative loop. By ADRIC, the deformation field and the non-deformation voxel intensity corrections are optimized separately and alternately to reconstruct the final CT. CT myocardial perfusion imaging scenarios were employed to evaluate the efficacy of ADRIC, using both simulated data of the extended-cardiac-torso (XCAT) digital phantom and experimentally acquired porcine data. The reconstruction accuracy of the ADRIC technique was compared to the technique using ART-dTV alone, and to the technique using 2D-3D deformation alone. The relative error metric and the universal quality index metric are calculated between the images for quantitative analysis. The relative error is defined as the square root of the sum of squared voxel intensity differences between the reconstructed volume and the ‘ground-truth’ volume, normalized by the square root of the sum of squared ‘ground-truth’ voxel intensities. In addition to the XCAT and porcine studies, a physical lung phantom measurement study was also conducted. Water-filled balloons with various shapes/volumes and concentrations of iodinated contrasts were put inside the phantom to simulate both deformations and non-deformation-induced intensity changes for ADRIC reconstruction. The ADRIC-solved deformations and intensity changes from limited-view projections were compared to those of the ‘gold-standard’ volumes reconstructed from fully-sampled projections. Results For the XCAT simulation study, the relative errors of the reconstructed CT volume by the 2D-3D deformation technique, the ART-dTV technique and the ADRIC technique were 14.64%, 19.21% and 11.90% respectively, by using 20 projections for reconstruction. Using 60 projections for reconstruction reduced the relative errors to 12.33%, 11.04% and 7.92% for the three techniques, respectively. For the porcine study, the corresponding results were 13.61%, 8.78%, 6.80% by using 20 projections; and 12.14%, 6.91% and 5.29% by using 60 projections. The ADRIC technique also demonstrated robustness to varying projection exposure levels. For the physical phantom study, the average DICE coefficient between the initial prior balloon volume and the new ‘gold-standard’ balloon volumes was 0.460. ADRIC reconstruction by 21 projections increased the average DICE coefficient to 0.954. Conclusion The ADRIC technique outperformed both the 2D-3D deformation technique and the ART-dTV technique in reconstruction accuracy. The alternately solved deformation field and non-deformation voxel intensity corrections can benefit multiple clinical applications, including tumor tracking, radiotherapy dose accumulation and treatment outcome analysis. PMID:28380247

The Role of New Removable Complete Dentures in Stimulated Salivary Flow and Taste Perception.

PubMed

Tango, Rubens Nisie; Arata, Anelyse; Borges, Alexandre Luiz Souto; Costa, Anna K F; Pereira, Luciano Jose; Kaminagakura, Estela

2018-04-01

To evaluate the effect of replacement of inadequate complete dentures on salivary flow and taste perception in geriatric patients. Thirty-three patients, 13 males and 20 females, with a mean age of 64.4 years were submitted to stimulated and unstimulated salivary flow rate and salivary pH measurements, and sense of taste evaluation. Tests were performed 3 months before complete denture substitution and 3 weeks after denture insertion. The mean for unstimulated saliva (USS) was 2.1 ml before and 2.7 ml after replacement (p = 0.003). The mean volume of stimulated saliva was 6.3 ml before and 8.2 ml after replacement (p = 0.004). The pH mean of USS was 7.8 ± 0.44 before and 8.02 ± 0.41 after replacement (p = 0.005). No statistically significant difference was determined in the sense of taste before and 3 weeks after complete denture replacement. The replacement of inadequate complete dentures increases saliva flow; however, it does not improve taste perception. © 2016 by the American College of Prosthodontists.

Enhanced recovery in total hip replacement: a clinical review.

PubMed

Ibrahim, M S; Twaij, H; Giebaly, D E; Nizam, I; Haddad, F S

2013-12-01

The outcome after total hip replacement has improved with the development of surgical techniques, better pain management and the introduction of enhanced recovery pathways. These pathways require a multidisciplinary team to manage pre-operative education, multimodal pain control and accelerated rehabilitation. The current economic climate and restricted budgets favour brief hospitalisation while minimising costs. This has put considerable pressure on hospitals to combine excellent results, early functional recovery and shorter admissions. In this review we present an evidence-based summary of some common interventions and methods, including pre-operative patient education, pre-emptive analgesia, local infiltration analgesia, pre-operative nutrition, the use of pulsed electromagnetic fields, peri-operative rehabilitation, wound dressings, different surgical techniques, minimally invasive surgery and fast-track joint replacement units.

Accuracy of volume measurement using 3D ultrasound and development of CT-3D US image fusion algorithm for prostate cancer radiotherapy.

PubMed

Baek, Jihye; Huh, Jangyoung; Kim, Myungsoo; Hyun An, So; Oh, Yoonjin; Kim, DongYoung; Chung, Kwangzoo; Cho, Sungho; Lee, Rena

2013-02-01

To evaluate the accuracy of measuring volumes using three-dimensional ultrasound (3D US), and to verify the feasibility of the replacement of CT-MR fusion images with CT-3D US in radiotherapy treatment planning. Phantoms, consisting of water, contrast agent, and agarose, were manufactured. The volume was measured using 3D US, CT, and MR devices. A CT-3D US and MR-3D US image fusion software was developed using the Insight Toolkit library in order to acquire three-dimensional fusion images. The quality of the image fusion was evaluated using metric value and fusion images. Volume measurement, using 3D US, shows a 2.8 ± 1.5% error, 4.4 ± 3.0% error for CT, and 3.1 ± 2.0% error for MR. The results imply that volume measurement using the 3D US devices has a similar accuracy level to that of CT and MR. Three-dimensional image fusion of CT-3D US and MR-3D US was successfully performed using phantom images. Moreover, MR-3D US image fusion was performed using human bladder images. 3D US could be used in the volume measurement of human bladders and prostates. CT-3D US image fusion could be used in monitoring the target position in each fraction of external beam radiation therapy. Moreover, the feasibility of replacing the CT-MR image fusion to the CT-3D US in radiotherapy treatment planning was verified.

Shoulder arthroplasty in osteoarthritis: current concepts in biomechanics and surgical technique

PubMed Central

Merolla, G; Nastrucci, G; Porcellini, G

Shoulder arthroplasty is a technically demanding procedure to restore shoulder function in patients with severe osteoarthritis of the glenohumeral joint. The modern prosthetic system exploit the benefits of modularity and the availibility of additional sizes of the prosthetic components. In this paper we describe the biomechanics of shoulder arthroplasty and the technique for shoulder replacement including total shoulder arthroplasty (TSA) with all-polyethylene and metal-backed glenoid component, humeral head resurfacing and stemless humeral replacement. PMID:24251240

2005 40th Annual Armament Systems: Guns - Ammunition - Rockets - Missiles Conference and Exhibition. Volume 3: Wednesday

DTIC Science & Technology

2005-04-28

Lessons Learned, Mr. David F. Fair, US Army ARDEC Propellant Replacement for the 105-mm M67 Propelling Charge, Ms. Adriana L. Eng, US Army ARDEC Lead...Application of Lessons Learned Mr. David F. Fair, US Army ARDEC Propellant Replacement for the 105-mm Artillery Propelling Charge Ms. Adriana L. Eng...high voltage power supply (several kV and kA ) • Solid state Switching device • Appropriate dimensions en properties of: • Exploding foil • Flyer

Intelligent Advanced Communications IP Telephony Feasibility for the U.S. Navy. Volume 1

DTIC Science & Technology

2007-10-01

Monitors Control and Bearer Designed by the There are no bearing Circuitry Health through Non - manufacture of the circuits to be testing in Selectable... controlled process, only replacing non -tactical end devices at first and then replacing tactical when the sailors and the commanding officers build up...looked at as an alternative to the touch screen in a non -software research . A complete review of development of voice is larger then this test bed can

"Pulmonary valve replacement diminishes the presence of restrictive physiology and reduces atrial volumes": a prospective study in Tetralogy of Fallot patients.

PubMed

Pijuan-Domenech, Antonia; Pineda, Victor; Castro, Miguel Angel; Sureda-Barbosa, Carlos; Ribera, Aida; Cruz, Luz M; Ferreira-Gonzalez, Ignacio; Dos-Subirà, Laura; Subirana-Domènech, Teresa; Garcia-Dorado, David; Casaldàliga-Ferrer, Jaume

2014-11-15

Pulmonary valve replacement (PVR) reduces right ventricular (RV) volumes in the setting of long-term pulmonary regurgitation after Tetralogy of Fallot (ToF) repair; however, little is known of its effect on RV diastolic function. Right atrial volumes may reflect the burden of RV diastolic dysfunction. The objective of this paper is to evaluate the clinical, echocardiographic, biochemical and cardiac magnetic resonance (CMR) variables, focusing particularly on right atrial response and right ventricular diastolic function prior to and after elective PVR in adult patients with ToF. This prospective study was conducted from January 2009 to April 2013 in consecutive patients > 18 years of age who had undergone ToF repair in childhood and were accepted for elective PVR. Twenty patients (mean age: 35 years; 70% men) agreed to enter the study. PVR was performed with a bioporcine prosthesis. Concomitant RV reduction was performed in all cases when technically possible. Pulmonary end-diastolic forward flow (EDFF) decreased significantly from 5.4 ml/m(2) to 0.3 ml/m(2) (p < 0.00001), and right atrial four-chamber echocardiographic measurements and volumes by 25% (p = 0.0024): mean indexed diastolic/systolic atrial volumes prior to surgery were 43 ml/m(2) (SD+/-4.6)/63 ml/m(2) (SD+/-5.5), and dropped to 33 ml/m(2) (SD+/-3)/46 ml/m(2) (SD+/-2.55) post-surgery. All patients presented right ventricular diastolic and systolic volume reductions, with a mean volume reduction of 35% (p < 0.00001). Right ventricular diastolic dysfunction was common in a population of severely dilated RV patients long term after ToF repair. Right ventricular diastolic parameters improved as did right atrial volumes in keeping with the known reduction in RV volumes, after PVR. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Road Construction Safety Audit for Interstate Reconstruction. Volume 2.

DOT National Transportation Integrated Search

1998-10-01

Traffic control alternatives associated with reconstruction projects on a rural interstate have been investigated in this research. Slab replacement projects, milling/resurfacing projects, and traffic controls in the vicinity of interstate ramps were...

Road Construction Safety Audit for Interstate Reconstruction. Volume 1.

DOT National Transportation Integrated Search

1998-10-01

Traffic control alternatives associated with reconstruction projects on a rural interstate have been investigated in this research. Slab replacement projects, milling/resurfacing projects, and traffic controls in the vicinity of interstate ramps were...

An adaptive replacement algorithm for paged-memory computer systems.

NASA Technical Reports Server (NTRS)

Thorington, J. M., Jr.; Irwin, J. D.

1972-01-01

A general class of adaptive replacement schemes for use in paged memories is developed. One such algorithm, called SIM, is simulated using a probability model that generates memory traces, and the results of the simulation of this adaptive scheme are compared with those obtained using the best nonlookahead algorithms. A technique for implementing this type of adaptive replacement algorithm with state of the art digital hardware is also presented.

Effect of TiO2/Al2O3 film coated diamond abrasive particles by sol-gel technique

NASA Astrophysics Data System (ADS)

Hu, Weida; Wan, Long; Liu, Xiaopan; Li, Qiang; Wang, Zhiqi

2011-04-01

The diamond abrasive particles were coated with the TiO2/Al2O3 film by the sol-gel technique. Compared with the uncoated diamonds, the TiO2/Al2O3 film was excellent material for the protection of the diamonds. The results showed that the incipient oxidation temperature of the TiO2/Al2O3 film coated diamonds in air atmosphere was 775 °C, which was higher 175 °C than that of the uncoated diamonds. And the coated diamonds also had better the diamond's single particle compressive strength and the impact toughness than that of uncoated diamonds after sintering at 750 °C. For the vitrified bond grinding wheels, replacing the uncoated diamonds with the TiO2/Al2O3 film coated diamonds, the volume expansion of the grinding wheels decreased from 6.2% to 3.4%, the porosity decreased from 35.7% to 25.7%, the hardness increased from 61.2HRC to 66.5HRC and the grinding ratio of the vitrified bond grinding wheels to carbide alloy (YG8) increased from 11.5 to 19.1.

Brillouin light scattering studies on the mechanical properties of ultrathin, porous low-K dielectric films

NASA Astrophysics Data System (ADS)

Zhou, Wei; Sooryakumar, R.; King, Sean

2010-03-01

Low K dielectrics have predominantly replaced silicon dioxide as the interlayer dielectric material for interconnects in state of the art integrated circuits. To further reduce interconnect resistance-capacitance (RC) delays, additional reductions in the K for these low-K materials is being pursued by the introduction of controlled levels of porosity. The main challenge for porous low-K dielectrics is the substantial reduction in mechanical properties that is accompanied by the increased pore volume content needed to reduce K. We report on the application of the nondestructive Brillouin light scattering technique to monitor and characterize the mechanical properties of these porous films at thicknesses well below 200 nm that are pertinent to present applications. Observation of longitudinal and transverse standing wave acoustic resonances and the dispersion that accompany their transformation into traveling waves with finite in-plane wave vectors provides for the principal elastic constants that completely characterize the mechanical properties of these porous films. The mode amplitudes of the standing waves, their variation within the film, and the calculated Brillouin intensities account for most aspects of the spectra. The resulting elastic constants are compared with corresponding values obtained from other experimental techniques.

Brillouin light scattering studies of the mechanical properties of ultrathin low-k dielectric films

NASA Astrophysics Data System (ADS)

Link, A.; Sooryakumar, R.; Bandhu, R. S.; Antonelli, G. A.

2006-07-01

In an effort to reduce RC time delays that accompany decreasing feature sizes, low-k dielectric films are rapidly emerging as potential replacements for silicon dioxide (SiO2) at the interconnect level in integrated circuits. The main challenge in low-k materials is their substantially weaker mechanical properties that accompany the increasing pore volume content needed to reduce k. We show that Brillouin light scattering is an excellent nondestructive technique to monitor and characterize the mechanical properties of these porous films at thicknesses well below 200nm that are pertinent to present applications. Observation of longitudinal and transverse standing wave acoustic resonances and the dispersion that accompany their transformation into traveling waves with finite in-plane wave vectors provides for a direct measure of the principal elastic constants that completely characterize the mechanical properties of these ultrathin films. The mode amplitudes of the standing waves, their variation within the film, and the calculated Brillouin intensities account for most aspects of the spectra. We further show that the values obtained by this method agree well with other experimental techniques such as nanoindentation and picosecond laser ultrasonics.

Analyzer-based imaging technique in tomography of cartilage and metal implants: a study at the ESRF

PubMed Central

COAN, Paola; MOLLENHAUER, Juergen; WAGNER, Andreas; Muehleman, Carol; BRAVIN, Alberto

2009-01-01

Monitoring the progression of osteoarthritis (OA) and the effects of therapy during clinical trials is still a challenge for present clinical imaging techniques since they present intrinsic limitations and can be sensitive only in case of advanced OA stages. In very severe cases, partial or complete joint replacement surgery is the only solution for reducing pain and restoring the joint functions. Poor imaging quality in practically all medical imaging technologies with respect to joint surfaces and to metal implant imaging calls for the development of new techniques that are sensitive to stages preceding the point of irreversible damage of the cartilage tissue. In this scenario, X-ray phase contrast modalities could play an important role since they can provide improved contrast compared to conventional absorption radiography, with a similar or even reduced tissue radiation dose. In this study, the Analyzer-based imaging (ABI), a technique sensitive to the X-ray refraction and permitting a high scatter rejection, has been successfully applied in-vitro on excised human synovial joints and sheep implants. Pathological and healthy joints as well as metal implants have been imaged in projection and computed tomography ABI mode at high resolution and clinically compatible doses (< 10 mGy). Volume rendering and segmentation permitted visualization of the cartilage from volumetric CT-scans. Results demonstrate that ABI can provide an unequivocal non-invasive diagnosis of the state of disease of the joint and be considered a new tool in orthopaedic research. PMID:18584983

Twenty-year analysis of autologous support of the pulmonary autograft in the Ross procedure.

PubMed

Skillington, Peter D; Mokhles, M Mostafa; Takkenberg, Johanna J M; O'Keefe, Michael; Grigg, Leeanne; Wilson, William; Larobina, Marco; Tatoulis, James

2013-09-01

The Ross procedure is seldom offered to adults less than 60 years of age who require aortic valve replacement except in a few high-volume centers with documented expertise. Inserting the pulmonary autograft as an unsupported root replacement may lead to increasing reoperations on the aortic valve in the second decade. Of 333 patients undergoing the Ross procedure between October 1992 and June 2012, the study group of 310 consecutive patients (mean age ± standard deviation, 39.3±12.7 years (limits 16-63) had the aortic root size adjusted to match the pulmonary autograft, which was inserted as a root replacement, with the aorta closed up around it to provide autologous support. The mean follow-up time was 9.4 years; the actuarial survival was 97% at 16 years; and freedom from the composite of all reoperations on the aortic valve and late echocardiographic-detected aortic regurgitation greater than mild was 95% at 5 years, 94% at 10 years, and 93% at 15 years. Overall freedom from all reoperations on aortic and pulmonary valves was 97% at 5 years, 94% at 10 years, and 93% at 15 years. All results were better for the patients presenting with predominant aortic stenosis (98% freedom at 15 years) than for those with aortic regurgitation (p=0.01). Autologous support of the pulmonary autograft leads to excellent results in the groups presenting with aortic stenosis and mixed aortic stenosis/regurgitation and to good results for those presenting with pure aortic regurgitation. The Ross procedure, using one of the proven, durable techniques available, should be considered for more widespread adoption. Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Right anterior mini-thoracotomy vs. conventional sternotomy for aortic valve replacement: a propensity-matched comparison

PubMed Central

Del Giglio, Mauro; Mikus, Elisa; Micari, Antonio; Calvi, Simone; Tripodi, Alberto; Campo, Gianluca; Maietti, Elisa; Castriota, Fausto; Cremonesi, Alberto

2018-01-01

Background Right anterior mini-thoracotomy (MIAVR) is a promising technique for aortic valve replacement. We aimed at comparing its outcomes with those obtained in a propensity-matched group of patients undergoing sternotomy at our two high-volume centers. Methods Main clinical and operative data of patients undergoing aortic valve replacement between January 2010 and May 2016 were retrospectively collected. A total of 678 patients were treated with a standard full sternotomy approach, while MIAVR was performed in 502. Propensity score matching identified 363 patients per each group. Results In-hospital mortality was not significantly different between the propensity-matched groups (1.7% in MIAVR patients vs. 2.2% in conventional sternotomy patients; P=0.79). No significant difference in the incidence of major post-operative complications was observed. Post-operative ventilation times (median 7, range 5–12 hours in MIAVR patients vs. median 7, range 5–12 in conventional sternotomy patients; P=0.72) were not significantly different between the two groups. Cardiopulmonary bypass time (61.0±21.0 vs. 65.9±24.7 min in conventional sternotomy group; P<0.01) and aortic cross-clamping time (48.3±16.7 vs. 53.2±19.6 min in full sternotomy group; P<0.01) were shorter in MIAVR group. EuroSCORE (OR 1.52, 95% CI, 1.12–2.06; P<0.01) was found to be the only independent predictor of intra-hospital mortality in the whole propensity-matched population. Conclusions Our experience shows that mini-access isolated aortic valve surgery is a reproducible, safe and effective procedure with similar outcomes and no longer operative times compared to conventional sternotomy. PMID:29707310

Properties of Cement Mortar Produced from Mixed Waste Materials with Pozzolanic Characteristics.

PubMed

Yen, Chi-Liang; Tseng, Dyi-Hwa; Wu, Yue-Ze

2012-07-01

Waste materials with pozzolanic characteristics, such as sewage sludge ash (SSA), coal combustion fly ash (FA), and granulated blast furnace slag (GBS), were reused as partial cement replacements for making cement mortar in this study. Experimental results revealed that with dual replacement of cement by SSA and GBS and triple replacement by SSA, FA, and GBS at 50% of total cement replacement, the compressive strength (Sc) of the blended cement mortars at 56 days was 93.7% and 92.9% of the control cement mortar, respectively. GBS had the highest strength activity index value and could produce large amounts of CaO to enhance the pozzolanic activity of SSA/FA and form calcium silicate hydrate gels to fill the capillary pores of the cement mortar. Consequently, the Sc development of cement mortar with GBS replacement was better than that without GBS, and the total pore volume of blended cement mortars with GBS/SSA replacement was less than that with FA/SSA replacement. In the cement mortar with modified SSA and GBS at 70% of total cement replacement, the Sc at 56 days was 92.4% of the control mortar. Modifying the content of calcium in SSA also increased its pozzolanic reaction. CaCl(2) accelerated the pozzolanic activity of SSA better than lime did. Moreover, blending cement mortars with GBS/SSA replacement could generate more monosulfoaluminate to fill capillary pores.

Properties of Cement Mortar Produced from Mixed Waste Materials with Pozzolanic Characteristics

PubMed Central

Yen, Chi-Liang; Tseng, Dyi-Hwa; Wu, Yue-Ze

2012-01-01

Abstract Waste materials with pozzolanic characteristics, such as sewage sludge ash (SSA), coal combustion fly ash (FA), and granulated blast furnace slag (GBS), were reused as partial cement replacements for making cement mortar in this study. Experimental results revealed that with dual replacement of cement by SSA and GBS and triple replacement by SSA, FA, and GBS at 50% of total cement replacement, the compressive strength (Sc) of the blended cement mortars at 56 days was 93.7% and 92.9% of the control cement mortar, respectively. GBS had the highest strength activity index value and could produce large amounts of CaO to enhance the pozzolanic activity of SSA/FA and form calcium silicate hydrate gels to fill the capillary pores of the cement mortar. Consequently, the Sc development of cement mortar with GBS replacement was better than that without GBS, and the total pore volume of blended cement mortars with GBS/SSA replacement was less than that with FA/SSA replacement. In the cement mortar with modified SSA and GBS at 70% of total cement replacement, the Sc at 56 days was 92.4% of the control mortar. Modifying the content of calcium in SSA also increased its pozzolanic reaction. CaCl2 accelerated the pozzolanic activity of SSA better than lime did. Moreover, blending cement mortars with GBS/SSA replacement could generate more monosulfoaluminate to fill capillary pores. PMID:22783062

Measurement of Human Blood and Plasma Volumes

NASA Technical Reports Server (NTRS)

Greenleaf, J. E.; Szalkay, H. G. H.

1987-01-01

Report reviews techniques for measuring blood-plasma volume in humans. Common technique of using radioactive iodine isotope to label plasma albumin involves unwarranted risks from low-level radiation. Report emphasizes techniques using Evans-blue-dye (T-1824) labeling of albumin, hematocrit or hemoglobin/hematocrit measurements, or blood densitometry. In Evans-blue-dye technique, plasma volume determined from decrease in dye concentration occurring after small amount of dye solution injected into circulatory system. Subjection of Evans blue dye to test for carcinogenicity gave negative results.

Flow-gradient patterns in severe aortic stenosis with preserved ejection fraction: clinical characteristics and predictors of survival.

PubMed

Eleid, Mackram F; Sorajja, Paul; Michelena, Hector I; Malouf, Joseph F; Scott, Christopher G; Pellikka, Patricia A

2013-10-15

Among patients with severe aortic stenosis (AS) and preserved ejection fraction, those with low gradient (LG) and reduced stroke volume may have an adverse prognosis. We investigated the prognostic impact of stroke volume using the recently proposed flow-gradient classification. We examined 1704 consecutive patients with severe AS (aortic valve area <1.0 cm(2)) and preserved ejection fraction (≥50%) using 2-dimensional and Doppler echocardiography. Patients were stratified by stroke volume index (<35 mL/m(2) [low flow, LF] versus ≥35 mL/m(2) [normal flow, NF]) and aortic gradient (<40 mm Hg [LG] versus ≥40 mm Hg [high gradient, HG]) into 4 groups: NF/HG, NF/LG, LF/HG, and LF/LG. NF/LG (n=352, 21%), was associated with favorable survival with medical management (2-year estimate, 82% versus 67% in NF/HG; P<0.0001). LF/LG severe AS (n=53, 3%) was characterized by lower ejection fraction, more prevalent atrial fibrillation and heart failure, reduced arterial compliance, and reduced survival (2-year estimate, 60% versus 82% in NF/HG; P<0.001). In multivariable analysis, the LF/LG pattern was the strongest predictor of mortality (hazard ratio, 3.26; 95% confidence interval, 1.71-6.22; P<0.001 versus NF/LG). Aortic valve replacement was associated with a 69% mortality reduction (hazard ratio, 0.31; 95% confidence interval, 0.25-0.39; P<0.0001) in LF/LG and NF/HG, with no survival benefit associated with aortic valve replacement in NF/LG and LF/HG. NF/LG severe AS with preserved ejection fraction exhibits favorable survival with medical management, and the impact of aortic valve replacement on survival was neutral. LF/LG severe AS is characterized by a high prevalence of atrial fibrillation, heart failure, and reduced survival, and aortic valve replacement was associated with improved survival. These findings have implications for the evaluation and subsequent management of AS severity.

Determination of fiber volume in graphite/epoxy materials using computer image analysis

NASA Technical Reports Server (NTRS)

Viens, Michael J.

1990-01-01

The fiber volume of graphite/epoxy specimens was determined by analyzing optical images of cross sectioned specimens using image analysis software. Test specimens were mounted and polished using standard metallographic techniques and examined at 1000 times magnification. Fiber volume determined using the optical imaging agreed well with values determined using the standard acid digestion technique. The results were found to agree within 5 percent over a fiber volume range of 45 to 70 percent. The error observed is believed to arise from fiber volume variations within the graphite/epoxy panels themselves. The determination of ply orientation using image analysis techniques is also addressed.

Use of the Box and Jenkins time series technique in traffic forecasting

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

Nihan, N.L.; Holmesland, K.O.

The use of recently developed time series techniques for short-term traffic volume forecasting is examined. A data set containing monthly volumes on a freeway segment for 1968-76 is used to fit a time series model. The resultant model is used to forecast volumes for 1977. The forecast volumes are then compared with actual volumes in 1977. Time series techniques can be used to develop highly accurate and inexpensive short-term forecasts. The feasibility of using these models to evaluate the effects of policy changes or other outside impacts is considered. (1 diagram, 1 map, 14 references,2 tables)

Anthropometric Source Book. Volume 1: Anthropometry for Designers

DTIC Science & Technology

1978-07-01

diet initiates replacement of the tissue loss incurred in the first day or two of flight. Any further caloric excess or deficit would be superimposed...the Skylab missions, a calorically inadequate basic diet was supplied as a result of the assumption that in-flight requirements were less than those...from one-g to weightlessness conditions or vice versa, any remaining volume changes are probably tissue changes. If a diet is calorically inadequate

[Electroacupuncture intervention combined with general anesthesia for 80 cases of heart valve replacement surgery under cardiopulmonary bypass].

PubMed

Chi, Hao; Zhou, Wen-Xiong; Wu, Yao-Yao; Chen, Tong-Yu; Ge, Wen; Yuan, Lan; Shen, Wei-Dong; Zhou, Jia

2014-02-01

To determine whether electroacupuncture (EA) intervention combined with general anesthesia (GA) strategy can reduce early post-operative morbidity and medical costs in patients undergoing heart valve replacement operation under cardiopulmonary bypass. A total of 160 heart valve replacement surgery patients undergoing cardiopulmonary bypass were randomly divided into GA and EA + GA groups (n = 80 in each group). Patients of the GA group were given with intravenous injection of Fentanyl, Midazolam, Vecuronium Bromide, etc. and routine tracheal intubation. EA (3-4 Hz, 2.0-2.2 mA) was applied to bilateral Zhongfu (LU 1), Chize (LU 5) and Ximen (PC 4) beginning about 20 mm before the surgery in the EA + GA group. Endotracheal intubation was not employed but only prepared as a standby for patients of the EA + GA group. The dosage of narcotic drugs, duration of surgery, duration of aertic blockage, rate of cardiac re-beating, volumes of post-operative blood transfusion, discharge volume, cases of post-operative pulmonary infection, vocal cord injury, and the time of first bed-off, first eating and duration in intensive care unit (IOU) residence. etc. were recorded. The successful rates of heart valve replacement surgery were similar in both GA and EA + GA groups. Compared with the GA group, the dosages of Fentanyl, Midazolam and Vecuronium of the EA + GA group were significantly lower (P < 0.05, P < 0.01), the numbers of patients needing blood-transfusion, antibiotics treatment, and suffering from pulmonary infection were fewer, the time of first bed-off and duration of hospitalizetion and IOU residence were considerably shorter (P < 0.05, P < 0.01) and the total medical cost was obviously lower (P < 0.05) in the EA + GA group. EA combined with general anesthesia strategy for heart valve replacement surgery without endotracheal intubation is safe and can reduce post-operative morbidity and medical costs in patients undergoing heart valve replacement surgery under cardiopulmonary bypass.

Blood volume analysis: a new technique and new clinical interest reinvigorate a classic study.

PubMed

Manzone, Timothy A; Dam, Hung Q; Soltis, Daniel; Sagar, Vidya V

2007-06-01

Blood volume studies using the indicator dilution technique and radioactive tracers have been performed in nuclear medicine departments for over 50 y. A nuclear medicine study is the gold standard for blood volume measurement, but the classic dual-isotope blood volume study is time-consuming and can be prone to technical errors. Moreover, a lack of normal values and a rubric for interpretation made volume status measurement of limited interest to most clinicians other than some hematologists. A new semiautomated system for blood volume analysis is now available and provides highly accurate results for blood volume analysis within only 90 min. The availability of rapid, accurate blood volume analysis has brought about a surge of clinical interest in using blood volume data for clinical management. Blood volume analysis, long a low-volume nuclear medicine study all but abandoned in some laboratories, is poised to enter the clinical mainstream. This article will first present the fundamental principles of fluid balance and the clinical means of volume status assessment. We will then review the indicator dilution technique and how it is used in nuclear medicine blood volume studies. We will present an overview of the new semiautomated blood volume analysis technique, showing how the study is done, how it works, what results are provided, and how those results are interpreted. Finally, we will look at some of the emerging areas in which data from blood volume analysis can improve patient care. The reader will gain an understanding of the principles underlying blood volume assessment, know how current nuclear medicine blood volume analysis studies are performed, and appreciate their potential clinical impact.

Guardrails for use on historic bridges : volume 1--replacement strategies.

DOT National Transportation Integrated Search

2016-11-01

Bridges that are designated historic present a special challenge to bridge engineers whenever rehabilitation work or improvements are : made to the bridges. Federal and state laws protect historically significant bridges, and railings on these bridge...

Ethics of Mitochondrial Replacement Techniques: A Habermasian Perspective.

PubMed

Palacios-González, César

2017-01-01

Jürgen Habermas is regarded as a central bioconservative commentator in the debate on the ethics of human prenatal genetic manipulations. While his main work on this topic, The Future of Human Nature, has been widely examined in regard to his position on prenatal genetic enhancement, his arguments regarding prenatal genetic therapeutic interventions have for the most part been overlooked. In this work I do two things. First, I present the three necessary conditions that Habermas establishes for a prenatal genetic manipulation to be regarded as morally permissible. Second, I examine if mitochondrial replacement techniques meet these necessary conditions. I investigate, specifically, the moral permissibility of employing pronuclear transfer and maternal spindle transfer. I conclude that, according to a Habermasian perspective on prenatal genetic manipulation, maternal spindle transfer (without using a preselected sperm and egg) and pronuclear transfer are morally impermissible. Maternal spindle transfer is, in principle, morally permissible, but only when we have beforehand preselected a sperm and an egg for our reproductive purpose. These findings are relevant for bioconservatives, both for those who hold a Habermasian stance and for those who hold something akin to a Habermasian stance, because they answer the question: what should bioconservatives do regarding mitochondrial replacement techniques? In fact, the answer to this question does not only normatively prescribe what bioconservatives should do in terms of their personal morality, but it also points towards what kind of legislation regulating mitochondrial replacement techniques they should aim at. © 2017 The Authors Bioethics Published by John Wiley & Sons Ltd.

Ethics of Mitochondrial Replacement Techniques: A Habermasian Perspective

PubMed Central

2016-01-01

Abstract Jürgen Habermas is regarded as a central bioconservative commentator in the debate on the ethics of human prenatal genetic manipulations. While his main work on this topic, The Future of Human Nature, has been widely examined in regard to his position on prenatal genetic enhancement, his arguments regarding prenatal genetic therapeutic interventions have for the most part been overlooked. In this work I do two things. First, I present the three necessary conditions that Habermas establishes for a prenatal genetic manipulation to be regarded as morally permissible. Second, I examine if mitochondrial replacement techniques meet these necessary conditions. I investigate, specifically, the moral permissibility of employing pronuclear transfer and maternal spindle transfer. I conclude that, according to a Habermasian perspective on prenatal genetic manipulation, maternal spindle transfer (without using a preselected sperm and egg) and pronuclear transfer are morally impermissible. Maternal spindle transfer is, in principle, morally permissible, but only when we have beforehand preselected a sperm and an egg for our reproductive purpose. These findings are relevant for bioconservatives, both for those who hold a Habermasian stance and for those who hold something akin to a Habermasian stance, because they answer the question: what should bioconservatives do regarding mitochondrial replacement techniques? In fact, the answer to this question does not only normatively prescribe what bioconservatives should do in terms of their personal morality, but it also points towards what kind of legislation regulating mitochondrial replacement techniques they should aim at. PMID:27973714

Polymer structure-property requirements for stereolithographic 3D printing of soft tissue engineering scaffolds.

PubMed

Mondschein, Ryan J; Kanitkar, Akanksha; Williams, Christopher B; Verbridge, Scott S; Long, Timothy E

2017-09-01

This review highlights the synthesis, properties, and advanced applications of synthetic and natural polymers 3D printed using stereolithography for soft tissue engineering applications. Soft tissue scaffolds are of great interest due to the number of musculoskeletal, cardiovascular, and connective tissue injuries and replacements humans face each year. Accurately replacing or repairing these tissues is challenging due to the variation in size, shape, and strength of different types of soft tissue. With advancing processing techniques such as stereolithography, control of scaffold resolution down to the μm scale is achievable along with the ability to customize each fabricated scaffold to match the targeted replacement tissue. Matching the advanced manufacturing technique to polymer properties as well as maintaining the proper chemical, biological, and mechanical properties for tissue replacement is extremely challenging. This review discusses the design of polymers with tailored structure, architecture, and functionality for stereolithography, while maintaining chemical, biological, and mechanical properties to mimic a broad range of soft tissue types. Copyright © 2017 Elsevier Ltd. All rights reserved.

Comparison of two-dimensional fast spin echo T2 weighted sequences and three-dimensional volume isotropic T2 weighted fast spin echo (VISTA) MRI in the evaluation of triangular fibrocartilage of the wrist.

PubMed

Park, Hee Jin; Lee, So Yeon; Kang, Kyung A; Kim, Eun Young; Shin, Hun Kyu; Park, Se Jin; Park, Jai Hyung; Kim, Eugene

2018-04-01

To compare image quality of three-dimensional volume isotropic T 2 weighted fast spin echo (3D VISTA) and two-dimensional (2D) T 2 weighted images (T2WI) for evaluation of triangular fibrocartilage (TFC) and to investigate whether 3D VISTA can replace 2D T 2 WI in evaluating TFC injury. This retrospective study included 69 patients who received wrist MRIs using both 2D T 2 WI and 3D VISTA techniques for assessment of wrist pathology, including TFC injury. Two radiologists measured the signal-to-noise ratio (SNR) and the contrast-to-noise ratio (CNR) of the two sequences. The anatomical identification score and diagnostic performance were independently assessed by two interpreters. The diagnostic abilities of 3D VISTA and 2D T 2 WI were analysed by sensitivity, specificity and accuracy for diagnosing TFC injury using surgically or clinically confirmed diagnostic reference standards. 17 cases (25%) were classified as having TFC injury. 2 cases (12%) were diagnosed surgically, and 15 cases (88%) were diagnosed by physical examination. 52 cases (75%) were diagnosed as having intact TFC. 8 of these cases (15%) were surgically confirmed, while the others were diagnosed by physical examination and clinical findings. The 3D VISTA images had significantly higher SNR and CNR values for the TFC than 2D T 2 WI images. The scores of 3D VISTA's total length, full width and sharpness were similar to those of 2D T 2 WI. We were unable to find a significant difference between 3D VISTA and 2D T 2 WI in the ability to diagnose TFC injury. 3D VISTA image quality is similar to that of 2D T 2 WI for TFC evaluation and is also excellent for tissue contrast. 3D VISTA can replace 2D images in TFC injury assessment. Advances in knowledge: 3D VISTA image quality is similar to that of 2D T 2 WI for TFC evaluation and is also excellent for tissue contrast. 3D VISTA can replace 2D images in TFC injury assessment.

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

Chang, Chiou-Shiung, E-mail: et000417@gmail.com; Department of Radiation Oncology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan; Hwang, Jing-Min

Stereotactic radiosurgery (SRS) is a well-established technique that is replacing whole-brain irradiation in the treatment of intracranial lesions, which leads to better preservation of brain functions, and therefore a better quality of life for the patient. There are several available forms of linear accelerator (LINAC)–based SRS, and the goal of the present study is to identify which of these techniques is best (as evaluated by dosimetric outcomes statistically) when the target is located adjacent to brainstem. We collected the records of 17 patients with lesions close to the brainstem who had previously been treated with single-fraction radiosurgery. In all, 5more » different lesion catalogs were collected, and the patients were divided into 2 distance groups—1 consisting of 7 patients with a target-to-brainstem distance of less than 0.5 cm, and the other of 10 patients with a target-to-brainstem distance of ≥ 0.5 and < 1 cm. Comparison was then made among the following 3 types of LINAC-based radiosurgery: dynamic conformal arcs (DCA), intensity-modulated radiosurgery (IMRS), and volumetric modulated arc radiotherapy (VMAT). All techniques included multiple noncoplanar beams or arcs with or without intensity-modulated delivery. The volume of gross tumor volume (GTV) ranged from 0.2 cm{sup 3} to 21.9 cm{sup 3}. Regarding the dose homogeneity index (HI{sub ICRU}) and conformity index (CI{sub ICRU}) were without significant difference between techniques statistically. However, the average CI{sub ICRU} = 1.09 ± 0.56 achieved by VMAT was the best of the 3 techniques. Moreover, notable improvement in gradient index (GI) was observed when VMAT was used (0.74 ± 0.13), and this result was significantly better than those achieved by the 2 other techniques (p < 0.05). For V{sub 4} {sub Gy} of brainstem, both VMAT (2.5%) and IMRS (2.7%) were significantly lower than DCA (4.9%), both at the p < 0.05 level. Regarding V{sub 2} {sub Gy} of normal brain, VMAT plans had attained 6.4 ± 5%; this was significantly better (p < 0.05) than either DCA or IMRS plans, at 9.2 ± 7% and 8.2 ± 6%, respectively. Owing to the multiple arc or beam planning designs of IMRS and VMAT, both of these techniques required higher MU delivery than DCA, with the averages being twice as high (p < 0.05). If linear accelerator is only 1 modality can to establish for SRS treatment. Based on statistical evidence retrospectively, we recommend VMAT as the optimal technique for delivering treatment to tumors adjacent to brainstem.« less

Efficacy of the Stonehenge Technique for Minimally Invasive Aortic Valve Replacement via Right Infraaxillary Thoracotomy.

PubMed

Yamazaki, Masataka; Kin, Hajime; Kitamoto, Shohei; Yamanaka, Shota; Nishida, Hidefumi; Nishigawa, Kosaku; Takanashi, Shuichiro

2017-02-20

Minimally invasive cardiac surgeries for aortic valve replacement (AVR) are still a technical challenge for surgeons because these procedures are undertaken through small incisions and deep surgical fields. Although AVR via vertical infraaxillary thoracotomy can be a cosmetically superior option, a disadvantage of this approach is the distance between the thoracotomy incision and the ascending aorta. Therefore, we devised a technique to perform all manipulations using the fingertips without the aid of a knot pusher or long-shafted surgical instruments. This was achieved by particular placement of several retracted sutures to the right chest wall. We named placement of these sutures the "Stonehenge technique." In conclusion, AVR via vertical infraaxillary thoracotomy with our Stonehenge technique can be safely and simply performed with superior cosmetic advantages.

Application of single-shot spiral scanning for volume localization.

PubMed

Ra, J B; Rim, C Y; Cho, Z H

1991-02-01

A new technique using a spiral scan single-shot RF pulse for localized volume selection has been developed and its experimental results are presented. This technique employs an additional radial-gradient coil in conjunction with the oscillating gradients for the spiral scan to localize the 3D volume. The short selection time in this technique minimizes both signal contamination from unwanted regions and signal attenuation due to T2 decay. We provide both the theoretical background of the technique and the experimental results obtained from a phantom as well as a human volunteer. The proposed method appears simple and accurate in localizing a volume which would be used as either fast imaging or localized spectroscopy.

Determination of gas volume trapped in a closed fluid system

NASA Technical Reports Server (NTRS)

Hunter, W. F.; Jolley, J. E.

1971-01-01

Technique involves extracting known volume of fluid and measuring system before and after extraction, volume of entrapped gas is then computed. Formula derived from ideal gas laws is basis of this method. Technique is applicable to thermodynamic cycles and hydraulic systems.

Feasibility study of sucrose and fat replacement using inulin and rebaudioside A in cake formulations.

PubMed

Majzoobi, Mahsa; Mohammadi, Mahshid; Mesbahi, Gholamreza; Farahnaky, Asgar

2018-02-20

Cake is a popular food around the world, however, it is considered as unhealthy due to its high fat and sucrose content. To satisfy customers' demand for a low fat and sucrose cake, in this research both sucrose and fat content of the cake were reduced by using rebaudioside A (Reb A; as a natural sucrose replacer) and inulin (as a natural fat replacer) at 0%, 25%, 50%, 75%, and 100%. The water content of different formulation was adjusted to obtain a constant batter viscosity similar to the control (3,757 cP). By reducing sucrose and fat content up to 50%, water activity increased and the cakes became more asymmetrical. However, other physical properties including baking weight loss, height, volume, crust color, and texture were similar to those of the control. Higher levels of replacement (75% and 100%) resulted in remarkable loss of different quality attributes. These samples showed higher water activity and baking loss, lower volume, harder texture, darker color, and highly asymmetrical shape. Thus, successful reduction of both fat and sucrose in cakes is possible by using inulin and Reb A at replacement levels no more than 50%. Customers' demand for healthy and yet tasty and high-quality foods is increasing around the world. Therefore, finding applicable and safe methods to produce such products is of great interest in the food manufacturing to satisfy customers. Health conscious customers avoid consumption of cakes because it contains high sucrose and fat content. Many studies have been performed to reduce either fat or sucrose content, while a few studies are available to show the reduction of both fat and sucrose in the same product. This study indicates the results of an applicable method to reduce fat and sucrose content of cakes simultaneously. Using rebaudioside A (as a natural sucrose replacer) and inulin (as a natural fat replacer) up to 50% of sucrose and fat content of cakes were reduced and the resulting cake had very similar physical properties to the control. © 2018 Wiley Periodicals, Inc.

Percutaneous transluminal alcohol septal myocardial ablation after aortic valve replacement

NASA Technical Reports Server (NTRS)

Sitges, M.; Kapadia, S.; Rubin, D. N.; Thomas, J. D.; Tuzcu, M. E.; Lever, H. M.

2001-01-01

When left ventricular outflow tract obstruction develops after aortic valve replacement, few treatment choices have been available until now. We present a patient with prior aortic valve replacement who developed left ventricle outflow tract obstruction that was successfully treated with a percutaneous transcoronary myocardial septal alcohol ablation. This technique is a useful tool for the treatment of obstructive hypertrophic cardiomyopathy, especially in those patients with prior heart surgery. Copyright 2001 Wiley-Liss, Inc.

Aortic valve replacement in a dialysis-dependent Jehovah's Witness: successful use of a minicircuit, microplegia, and multimodality blood conservation technique

PubMed Central

Sutton, Steve W.; Marcel, Randy

2007-01-01

We present the first reported case of an aortic valve replacement operation without blood transfusion in a 62-year-old Jehovah's Witness with dialysis-dependent chronic renal failure, severe anemia, severe aortic stenosis, and symptomatic angina with minimal exertion after an accident in which she suffered fractures of both her right arm and leg. She underwent successful valve replacement surgery after preoperative stabilization of her fractures and high-dose erythropoietin and iron supplement therapy preoperatively and postoperatively. The intraoperative blood conservation technique included a novel approach with a miniature cardiopulmonary bypass circuit and microplegia with limited hemodilution. High-risk valve surgery in patients who are Jehovah's Witnesses can be successful with a carefully planned multimodality blood conservation strategy. PMID:17256040

Recent advances and future directions in the management of knee osteoarthritis: Can biological joint reconstruction replace joint arthroplasty and when?

PubMed Central

Paschos, Nikolaos K

2015-01-01

In this article, a concise description of the recent advances in the field of osteoarthritis management is presented. The main focus is to highlight the most promising techniques that emerge in both biological joint replacement and artificial joint arthroplasty. A critical view of high quality evidence regarding outcome and safety profile of these techniques is presented. The potential role of kinematically aligned total knee replacement, navigation, and robotic-assisted surgery is outlined. A critical description of both primary and stem cell-based therapies, the cell homing theory, the use of biologic factors and recent advancements in tissue engineering and regenerative medicine is provided. Based on the current evidence, some thoughts on a realistic approach towards answering these questions are attempted. PMID:26495242

Breast volume assessment: comparing five different techniques.

PubMed

Bulstrode, N; Bellamy, E; Shrotria, S

2001-04-01

Breast volume assessment is not routinely performed pre-operatively because as yet there is no accepted technique. There have been a variety of methods published, but this is the first study to compare these techniques. We compared volume measurements obtained from mammograms (previously compared to mastectomy specimens) with estimates of volume obtained from four other techniques: thermoplastic moulding, magnetic resonance imaging, Archimedes principle and anatomical measurements. We also assessed the acceptability of each method to the patient. Measurements were performed on 10 women, which produced results for 20 breasts. We were able to calculate regression lines between volume measurements obtained from mammography to the other four methods: (1) magnetic resonance imaging (MRI), 379+(0.75 MRI) [r=0.48], (2) Thermoplastic moulding, 132+(1.46 Thermoplastic moulding) [r=0.82], (3) Anatomical measurements, 168+(1.55 Anatomical measurements) [r=0.83]. (4) Archimedes principle, 359+(0.6 Archimedes principle) [r=0.61] all units in cc. The regression curves for the different techniques are variable and it is difficult to reliably compare results. A standard method of volume measurement should be used when comparing volumes before and after intervention or between individual patients, and it is unreliable to compare volume measurements using different methods. Calculating the breast volume from mammography has previously been compared to mastectomy samples and shown to be reasonably accurate. However we feel thermoplastic moulding shows promise and should be further investigated as it gives not only a volume assessment but a three-dimensional impression of the breast shape, which may be valuable in assessing cosmesis following breast-conserving-surgery.

Seagrass metabolism across a productivity gradient using the eddy covariance, Eulerian control volume, and biomass addition techniques

NASA Astrophysics Data System (ADS)

Long, Matthew H.; Berg, Peter; Falter, James L.

2015-05-01

The net ecosystem metabolism of the seagrass Thalassia testudinum was studied across a nutrient and productivity gradient in Florida Bay, Florida, using the Eulerian control volume, eddy covariance, and biomass addition techniques. In situ oxygen fluxes were determined by a triangular Eulerian control volume with sides 250 m long and by eddy covariance instrumentation at its center. The biomass addition technique evaluated the aboveground seagrass productivity through the net biomass added. The spatial and temporal resolutions, accuracies, and applicability of each method were compared. The eddy covariance technique better resolved the short-term flux rates and the productivity gradient across the bay, which was consistent with the long-term measurements from the biomass addition technique. The net primary production rates from the biomass addition technique, which were expected to show greater autotrophy due to the exclusion of sediment metabolism and belowground production, were 71, 53, and 30 mmol carbon m-2 d-1 at 3 sites across the bay. The net ecosystem metabolism was 35, 25, and 11 mmol oxygen m-2 d-1 from the eddy covariance technique and 10, -103, and 14 mmol oxygen m-2 d-1 from the Eulerian control volume across the same sites, respectively. The low-flow conditions in the shallow bays allowed for periodic stratification and long residence times within the Eulerian control volume that likely reduced its precision. Overall, the eddy covariance technique had the highest temporal resolution while producing accurate long-term flux rates that surpassed the capabilities of the biomass addition and Eulerian control volume techniques in these shallow coastal bays.

Methodological issues concerning the application of reliable laser particle sizing in soils

NASA Astrophysics Data System (ADS)

de Mascellis, R.; Impagliazzo, A.; Basile, A.; Minieri, L.; Orefice, N.; Terribile, F.

2009-04-01

During the past decade, the evolution of technologies has enabled laser diffraction (LD) to become a much widespread means of particle size distribution (PSD), replacing sedimentation and sieve analysis in many scientific fields mainly due to its advantages of versatility, fast measurement and high reproducibility. Despite such developments of the last decade, the soil scientist community has been quite reluctant to replace the good old sedimentation techniques (ST); possibly because of (i) the large complexity of the soil matrix inducing different types of artefacts (aggregates, deflocculating dynamics, etc.), (ii) the difficulties in relating LD results with results obtained through sedimentation techniques and (iii) the limited size range of most LD equipments. More recently LD granulometry is slowly gaining appreciation in soil science also because of some innovations including an enlarged size dynamic range (0,01-2000 m) and the ability to implement more powerful algorithms (e.g. Mie theory). Furthermore, LD PSD can be successfully used in the application of physically based pedo-transfer functions (i.e., Arya and Paris model) for investigations of soil hydraulic properties, due to the direct determination of PSD in terms of volume percentage rather than in terms of mass percentage, thus eliminating the need to adopt the rough approximation of a single value for soil particle density in the prediction process. Most of the recent LD work performed in soil science deals with the comparison with sedimentation techniques and show the general overestimation of the silt fraction following a general underestimation of the clay fraction; these well known results must be related with the different physical principles behind the two techniques. Despite these efforts, it is indeed surprising that little if any work is devoted to more basic methodological issues related to the high sensitivity of LD to the quantity and the quality of the soil samples. Our work aims to both analyse and to suggest technical solutions to address the following key methodological problems: (i) sample representativeness due to the very small amount of soil sample required by LD (e.g. 0,2 g) as compared to ST (e.g. 40 g for densimetry); (ii) PSD reading variability caused by the large number of instantaneous reading on a very small volume of the solution, (iii) the varying soil mineralogy that in turn produce varying refractive indexes affecting PSD results, (iv) the determination of the mass density of the soil samples to compare results with those obtained from ST. Our results, referring to many different soil types (Vertisols, Regosols, Andosols, Calcisols, Luvisols) show that the listed major technical problems can be successfully addressed by the following set of solutions: (i) adequate subsampling in both solid and liquid phases (including a setup of a dilution system); (ii) preliminary study of the PSD variability to reasonably increase the number of readings per each sample; (iii, iv) preliminary sensitivity analysis of both refractive indexes and mass density in accordance to the specific soil mineralogy.

A field test of cut-off importance sampling for bole volume

Treesearch

Jeffrey H. Gove; Harry T. Valentine; Michael J. Holmes

2000-01-01

Cut-off importance sampling has recently been introduced as a technique for estimating bole volume to some point below the tree tip, termed the cut-off point. A field test of this technique was conducted on a small population of eastern white pine trees using dendrometry as the standard for volume estimation. Results showed that the differences in volume estimates...

Incidence of cardiovascular complications in knee arthroplasty patients before and after implementation of a ropivacaine local infiltration analgesia protocol: A retrospective study.

PubMed

Lameijer, Joost R C; Verboom, Frederik; Grefkens, Joost; Jansen, Joris

2016-10-01

Local infiltration analgesia (LIA) during total knee arthroplasty has been shown to give statistically significant reduction in post-operative pain. The effects of using high volumes of ropivacaine combined with adrenaline as LIA on cardiovascular parameters in knee replacement have not been described before. The objective of this study was to investigate the cardiovascular safety of ropivacaine as part of high volume local infiltration analgesia (LIA) in total knee replacement surgery. This is a retrospective observational comparative cohort study conducted in two independent cohorts, one treated without and one treated with a local infiltration analgesia protocol, containing a total of 744 patients with a mean age of 68years (42 to 89) and 68years (21 to 88) respectively with a follow-up of 12months. No statistical difference in bradycardia during surgery, post-operative cardiovascular complications, and mortality was found after use of LIA. A statistically significant lower incidence of hypotension was found in the LIA group (P<0.01). This result has to be interpreted with care, due to the use of adrenaline in the LIA mixture, which could mask possible hypotension. No statistical difference was found in the occurrence of hypertension or tachycardia, despite the addition of adrenaline to the LIA mixture. No difference in mortality was found between the two groups (P=0.11). These results show safe use of high volume ropivacaine with adrenaline as local infiltration analgesia during total knee replacement surgery. Copyright © 2016 Elsevier B.V. All rights reserved.

Anterior Myocardial Territory May Replace the Heart as Organ at Risk in Intensity-Modulated Radiotherapy for Left-Sided Breast Cancer

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

Tan Wenyong; Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan; Liu Dong

Purpose: We investigated whether the heart could be replaced by the anterior myocardial territory (AMT) as the organ at risk (OAR) in intensity-modulated radiotherapy (IMRT) of the breast for patients with left-sided breast cancer. Methods and Materials: Twenty-three patients with left-sided breast cancer who received postoperative radiation after breast-conserving surgery were studied. For each patient, we generated five IMRT plans including heart (H), left ventricle (LV), AMT, LV+AMT, and H+LV as the primary OARs, respectively, except both lungs and right breast, which corresponded to IMRT(H), IMRT(LV), IMRT(AMT), IMRT(LV+AMT), and IMRT(H+LV). For the planning target volumes and OARs, the parameters ofmore » dose-volume histograms were compared. Results: The homogeneity index, conformity index, and coverage index were not compromised significantly in IMRT(AMT), IMRT(LV) and IMRT(LV+ AMT), respectively, when compared with IMRT(H). The mean dose to the heart, LV, and AMT decreased 5.3-21.5% (p < 0.05), 19.9-29.5% (p < 0.05), and 13.3-24.5% (p < 0.05), respectively. Similarly, the low (e.g., V5%), middle (e.g., V20%), and high (e.g., V30%) dose-volume of the heart, LV, and AMT decreased with different levels. The mean dose and V10% of the right lung increased by 9.2% (p < 0.05) and 27.6% (p < 0.05), respectively, in IMRT(LV), and the mean dose and V5% of the right breast decreased significantly in IMRT(AMT) and IMRT(LV+AMT). IMRT(AMT) was the preferred plan and was then compared with IMRT(H+LV); the majority of dose-volume histogram parameters of OARs including the heart, LV, AMT, both lungs, and the right breast were not statistically different. However, the low dose-volume of LV increased and the middle dose-volume decreased significantly (p < 0.05) in IMRT(AMT). Also, those of the right lung (V10%, V15%) and right breast (V5%, V10%) decreased significantly (p < 0.05). Conclusions: The AMT may replace the heart as the OAR in left-sided breast IMRT after breast-conserving surgery to decrease the radiation dose to the heart.« less

Patch enlargement of the aortic and mitral valve rings with aortic and mitral double valve replacement. Experimental study.

PubMed

Manouguian, S; Abu-Aishah, N; Neitzel, J

1979-09-01

The experimental results of patch enlargement of the aortic and mitral valve rings with aortic and mitral double valve replacement are reported. The operative technique of this new surgical method is described and the indications are discussed.

Cardiac autotransplantation for the treatment of permanent atrial fibrillation combined with mitral valve disease.

PubMed

Troise, Giovanni; Brunelli, Federico; Cirillo, Marco; Amaducci, Andrea; Mhagna, Zen; Tomba, Margherita Dalla; Tasca, Giordano; Quaini, Eugenio

2003-01-01

The results of current surgical options for the treatment of permanent atrial fibrillation associated with mitral valve surgery are widely different, particularly for extremely dilated left atria. The aim of this study is to assess the efficacy of cardiac autotransplantation in restoring a normal sinus rhythm via a consistent reduction in the left atrium volume associated with a complete isolation of the pulmonary veins. From April 2000 to April 2002, 28 patients (men/women, 5/23) underwent cardiac autotransplantation for the treatment of mitral disease and concomitant permanent atrial fibrillation (>1 year). A modified surgical technique derived from bicaval heart transplantation procedures maintained the connection of the right atrium with the inferior vena cava in all but 3 cases. In 2 patients, the mitral valve was repaired, and it was replaced in 26 patients. Associated procedures were 6 aortic valve replacements, 2 tricuspid valve annuloplasties, and 2 coronary revascularizations. No hospital deaths were recorded, but 1 patient died of pneumonia 3 months postoperatively. At a mean follow-up period of 17.2 +/- 6.7 months (range, 6-30 months), 24 patients (88.9%) were in sinus rhythm, and 3 (11.1%) were in atrial fibrillation. The Santa Cruz Score was 0 for 3 patients, 2 for 1 patient, and 4 for the remaining 23 patients (85.2%). The mean left atrial diameter decreased from 65.4 +/- 17.1 mm (range, 50-130 mm) before the operation to 48.4 +/- 5.6 mm (range, 37-78 mm) postoperatively (P <.001), and the mean left atrial volume decreased from 119 +/- 70.5 mL (range, 60-426 mL) to 69.1 +/- 35.1 mL (range, 31-226 mL) (P <.0001). Cardiac autotransplantation is a safe and effective surgical option for the treatment of permanent atrial fibrillation in patients with long-lasting mitral valve disease and severe enlargement of the left atrium.

Enhanced freight sketch planning tool for assessing multimodal investment strategies.

DOT National Transportation Integrated Search

2006-09-01

In recent years, there have been dramatic changes in the volume and movement of freight within the : US and internationally. Traditional distribution systems have been replaced by just-in-time driven : processes and freight transportation patterns ha...

Performance evaluation of roundabouts for traffic delay and crash reductions in Oxford, MS.

DOT National Transportation Integrated Search

2011-06-30

Due to increased traffic volume, congestion, and capacity limitations, two roundabouts have been constructed on South Lamar : Boulevard ramp intersections with MS Highway 6 in Oxford, MS. Roundabouts replaced the existing signalized intersection : on...

Design, construction and testing of the Neal Bridge in Pittsfield, Maine.

DOT National Transportation Integrated Search

2009-10-01

Highway bridges in the US are quickly becoming deficient due to increasing traffic volumes, rapid : deterioration, extended service life, and increasing load requirements. Repair or replacement of deficient : structures is expensive, time and labor i...

A single-gradient junction technique to replace multiple-junction shifts for craniospinal irradiation treatment

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

Hadley, Austin; Ding, George X., E-mail: george.ding@vanderbilt.edu

2014-01-01

Craniospinal irradiation (CSI) requires abutting fields at the cervical spine. Junction shifts are conventionally used to prevent setup error–induced overdosage/underdosage from occurring at the same location. This study compared the dosimetric differences at the cranial-spinal junction between a single-gradient junction technique and conventional multiple-junction shifts and evaluated the effect of setup errors on the dose distributions between both techniques for a treatment course and single fraction. Conventionally, 2 lateral brain fields and a posterior spine field(s) are used for CSI with weekly 1-cm junction shifts. We retrospectively replanned 4 CSI patients using a single-gradient junction between the lateral brain fieldsmore » and the posterior spine field. The fields were extended to allow a minimum 3-cm field overlap. The dose gradient at the junction was achieved using dose painting and intensity-modulated radiation therapy planning. The effect of positioning setup errors on the dose distributions for both techniques was simulated by applying shifts of ± 3 and 5 mm. The resulting cervical spine doses across the field junction for both techniques were calculated and compared. Dose profiles were obtained for both a single fraction and entire treatment course to include the effects of the conventional weekly junction shifts. Compared with the conventional technique, the gradient-dose technique resulted in higher dose uniformity and conformity to the target volumes, lower organ at risk (OAR) mean and maximum doses, and diminished hot spots from systematic positioning errors over the course of treatment. Single-fraction hot and cold spots were improved for the gradient-dose technique. The single-gradient junction technique provides improved conformity, dose uniformity, diminished hot spots, lower OAR mean and maximum dose, and one plan for the entire treatment course, which reduces the potential human error associated with conventional 4-shifted plans.« less

Anodizing And Sealing Aluminum In Nonchromated Solutions

NASA Technical Reports Server (NTRS)

Emmons, John R.; Kallenborn, Kelli J.

1995-01-01

Improved process for anodizing and sealing aluminum involves use of 5 volume percent sulfuric acid in water as anodizing solution, and 1.5 to 2.0 volume percent nickel acetate in water as sealing solution. Replaces process in which sulfuric acid used at concentrations of 10 to 20 percent. Improved process yields thinner coats offering resistance to corrosion, fatigue life, and alloy-to-alloy consistency equal to or superior to those of anodized coats produced with chromated solutions.

Very Low Intravenous Contrast Volume Protocol for Computed Tomography Angiography Providing Comprehensive Cardiac and Vascular Assessment Prior to Transcatheter Aortic Valve Replacement in Patients with Chronic Kidney Disease

PubMed Central

Pulerwitz, Todd C.; Khalique, Omar K.; Nazif, Tamim N.; Rozenshtein, Anna; Pearson, Gregory D.N.; Hahn, Rebecca T.; Vahl, Torsten P.; Kodali, Susheel K.; George, Isaac; Leon, Martin B.; D'Souza, Belinda; Po, Ming Jack; Einstein, Andrew J.

2016-01-01

Background Transcatheter aortic valve replacement (TAVR) is a lifesaving procedure for many patients high risk for surgical aortic valve replacement. The prevalence of chronic kidney disease (CKD) is high in this population, and thus a very low contrast volume (VLCV) computed tomography angiography (CTA) protocol providing comprehensive cardiac and vascular imaging would be valuable. Methods 52 patients with severe, symptomatic aortic valve disease, undergoing pre-TAVR CTA assessment from 2013-4 at Columbia University Medical Center were studied, including all 26 patients with CKD (eGFR<30mL/min) who underwent a novel VLCV protocol (20mL of iohexol at 2.5mL/s), and 26 standard-contrast-volume (SCV) protocol patients. Using a 320-slice volumetric scanner, the protocol included ECG-gated volume scanning of the aortic root followed by medium-pitch helical vascular scanning through the femoral arteries. Two experienced cardiologists performed aortic annulus and root measurements. Vascular image quality was assessed by two radiologists using a 4-point scale. Results VLCV patients had mean(±SD) age 86±6.5, BMI 23.9±3.4 kg/m2 with 54% men; SCV patients age 83±8.8, BMI 28.7±5.3 kg/m2, 65% men. There was excellent intra- and inter-observer agreement for annular and root measurements, and excellent agreement with 3D-transesophageal echocardiographic measurements. Both radiologists found diagnostic-quality vascular imaging in 96% of VLCV and 100% of SCV cases, with excellent inter-observer agreement. Conclusions This study is the first of its kind to report the feasibility and reproducibility of measurements for a VLCV protocol for comprehensive pre-TAVR CTA. There was excellent agreement of cardiac measurements and almost all studies were diagnostic quality for vascular access assessment. PMID:27061253

Balloon-Assisted Occlusion of the Internal Iliac Arteries in Patients with Placenta Accreta/Percreta

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

Bodner, Leonard J.; Nosher, John L.; Gribbin, Christopher

2006-06-15

Background. Placenta accreta/percreta is a leading cause of third trimester hemorrhage and postpartum maternal death. The current treatment for third trimester hemorrhage due to placenta accreta/percreta is cesarean hysterectomy, which may be complicated by large volume blood loss. Purpose. To determine what role, if any, prophylactic temporary balloon occlusion and transcatheter embolization of the anterior division of the internal iliac arteries plays in the management of patients with placenta accreta/percreta. Methods. The records of 28 consecutive patients with a diagnosis of placenta accreta/percreta were retrospectively reviewed. Patients were divided into two groups. Six patients underwent prophylactic temporary balloon occlusion, followedmore » by cesarean section, transcatheter embolization of the anterior division of the internal iliac arteries and cesarean hysterectomy (n = 5) or uterine curettage (n = 1). Twenty-two patients underwent cesarean hysterectomy without endovascular intervention. The following parameters were compared in the two groups: patient age, gravidity, parity, gestational age at delivery, days in the intensive care unit after delivery, total hospital days, volume of transfused blood products, volume of fluid replacement intraoperatively, operating room time, estimated blood loss, and postoperative morbidity and mortality. Results. Patients in the embolization group had more frequent episodes of third trimester bleeding requiring admission and bedrest prior to delivery (16.7 days vs. 2.9 days), resulting in significantly more hospitalization time in the embolization group (23 days vs. 8.8 days) and delivery at an earlier gestational age than in those in the surgical group (32.5 weeks). There was no statistical difference in mean estimated blood loss, volume of replaced blood products, fluid replacement needs, operating room time or postoperative recovery time. Conclusion. Our findings do not support the contention that in patients with placenta accreta/percreta, prophylactic temporary balloon occlusion and embolization prior to hysterectomy diminishes intraoperative blood loss.« less

Implementation of transcatheter aortic valve replacement in California: Influence on aortic valve surgery.

PubMed

Maximus, Steven; Milliken, Jeffrey C; Danielsen, Beate; Shemin, Richard; Khan, Junaid; Carey, Joseph S

2018-04-01

Transcatheter aortic valve replacement (TAVR) procedures were introduced in 2011. Initially, procedures were limited to patients who were not surgical candidates, but subsequently high-risk surgical candidates were considered for TAVR. The influence on aortic valve surgery in California is unknown. The California Office of Statewide Health Planning and Development hospitalized patient discharge database was queried for the years 2009 through 2014. isolated surgical aortic valve and aortic valve/coronary artery bypass graft (SAVR) and TAVR procedures were identified by International Classification of Diseases-9th revision clinical modification procedure codes. Seven TAVR programs were introduced in 2011, 12 in 2012, 3 in 2013, and 6 in 2014. SAVR procedure volumes were compared from the 2 years before institution with SAVR volumes during the year(s) after institution of the TAVR program in these 28 hospitals. Overall, surgical volumes increased during the first, second, and third years after implementation of TAVR procedures. Among 7 hospitals with 4-year programs, surgical volumes increased to a maximum of 15.5% during the third year, then began to decrease. The hospital performing the largest number of TAVR procedures showed a marked decrease in SAVR volume by the fourth year, suggesting a shift of SAVR candidates to TAVR. Among all hospitals with 4-year programs, TAVR exceeded SAVR procedures by the fourth year. In California overall, SAVR increased during 2011 through 2013, due primarily to increasing volume of isolated SAVR procedures. Statewide, isolated SAVR increased from a yearly average of 3111 procedures during 2009-2010 to 3592 (+15.5%) in 2013, then decreased slightly in 2014. SAVR plus coronary artery bypass graft procedures decreased during the same time period. After implementation of TAVR, hospital SAVR volumes increased moderately, then began to decrease by the fourth year, when TAVR volume exceeded SAVR. Surgical candidates may be identified during evaluation for TAVR, resulting in increased SAVR volume. Increasing SAVR volume may also be related to improved patient and provider awareness of aortic valve disease. Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Sex, Aging, and Preexisting Cerebral Ischemic Disease in Patients With Aortic Stenosis

PubMed Central

Wang, Ping; Acker, Michael A.; Bilello, Michel; Melhem, Elias R.; Stambrook, Elizabeth; Ratcliffe, Sarah J.; Floyd, Thomas F.

2011-01-01

Background Patients undergoing cardiac surgery have a high frequency of preexisting cerebral ischemic lesions, the presence of which appears to predict cognitive sequelae. Patients undergoing aortic valve replacement for aortic stenosis (AS) incur an exceptionally high risk for perioperative cerebral ischemia. The extreme risk in this subgroup may arise from the preexisting burden of cerebral ischemic disease. We tested the hypotheses that increasing age, female sex, coronary artery disease, and the severity of AS are predictive of the severity of preexisting cerebral ischemic lesions. Methods A total of 95 subjects were included in this study. Subjects were imaged on 1.5 Tesla magnetic resonance imaging scanners to obtain multimodal image sets which were used for the automatic segmentation of cerebral lesion volume. The dependence of lesion volume upon age, sex, coronary artery disease, and the severity of AS were tested. Results The results demonstrate a strong correlation between aging, female sex, and white matter and ischemia-like lesion volume in patients with aortic stenosis. Conclusions Women and those of advanced age presenting for aortic valve replacement for AS may incur a particularly high risk for postoperative neurologic sequelae due to an exceptional preexisting burden of cerebral ischemic disease. PMID:20868818

Efficacy of the Greater Occipital Nerve Block for Cervicogenic Headache: Comparing Classical and Subcompartmental Techniques.

PubMed

Lauretti, Gabriela R; Corrêa, Selma W R O; Mattos, Anita L

2015-09-01

The aim of the study was to compare the efficacy of the greater occipital nerve (GON) block using the classical technique and different volumes of injectate with the subcompartmental technique for the treatment of cervicogenic headache (CH). Thirty patients acted as his/her own control. All patients were submitted to the GON block by the classical technique with 10 mg dexamethasone, plus 40 mg lidocaine (5 mL volume). Patients were randomly allocated into 1 of 3 groups (n = 10) when pain VAS was > 3 cm. Each group was submitted to a GON subcompartmental technique (10 mg dexamethasone + 40 mg lidocaine + nonionic iodine contrast + saline) under fluoroscopy using either 5, 10, or 15 mL final volume. Analgesia and quality of life were evaluated. The classical GON technique resulted in 2 weeks of analgesia and less rescue analgesic consumption, compared to 24 weeks after the subcompartmental technique (P < 0.01). Quality of life improved at 2 and 24 weeks after the classical and the suboccipital techniques, respectively (P < 0.05). The data revealed that groups were similar regarding analgesia when compared to volume of injection (P > 0.05). While the classical technique for GON block resulted in only 2 weeks of analgesia, the subcompartmental technique resulted in at least 24 weeks of analgesia, being 5 mL volume sufficient for the performance of the block under fluoroscopy. © 2014 World Institute of Pain.

Prioritization Methodology for Chemical Replacement

NASA Technical Reports Server (NTRS)

Cruit, W.; Schutzenhofer, S.; Goldberg, B.; Everhart, K.

1993-01-01

This project serves to define an appropriate methodology for effective prioritization of efforts required to develop replacement technologies mandated by imposed and forecast legislation. The methodology used is a semiquantitative approach derived from quality function deployment techniques (QFD Matrix). This methodology aims to weigh the full environmental, cost, safety, reliability, and programmatic implications of replacement technology development to allow appropriate identification of viable candidates and programmatic alternatives. The results are being implemented as a guideline for consideration for current NASA propulsion systems.

Improvement in the assessment of wear of total knee replacements using coordinate-measuring machine techniques.

PubMed

Blunt, L A; Bills, P J; Jiang, X-Q; Chakrabarty, G

2008-04-01

Total joint replacement is one of the most common elective surgical procedures performed worldwide, with an estimate of 1.5x 10(6) operations performed annually. Currently joint replacements are expected to function for 10-15 years; however, with an increase in life expectancy, and a greater call for knee replacement due to increased activity levels, there is a requirement to improve their function to offer longer-term improved quality of life for patients. Wear analysis of total joint replacements has long been an important means in determining failure mechanisms and improving longevity of these devices. The effectiveness of the coordinate-measuring machine (CMM) technique for assessing volumetric material loss during simulated life testing of a replacement knee joint has been proved previously by the present authors. The purpose of the current work is to present an improvement to this method for situations where no pre-wear data are available. To validate the method, simulator tests were run and gravimetric measurements taken throughout the test, such that the components measured had a known wear value. The implications of the results are then discussed in terms of assessment of joint functionality and development of standardized CMM-based product standards. The method was then expanded to allow assessment of clinically retrieved bearings so as to ascertain a measure of true clinical wear.

Graded replacement of maize grain with molassed sugar beet pulp modulated ruminal microbial community and fermentation profile in vitro.

PubMed

Münnich, Matthias; Khol-Parisini, Annabella; Klevenhusen, Fenja; Metzler-Zebeli, Barbara U; Zebeli, Qendrim

2018-02-01

Molassed sugar beet pulp (Bp) is a viable alternative to grains in cattle nutrition for reducing human edible energy input. Yet little is known about the effects of high inclusion rates of Bp on rumen microbiota. This study used an in vitro approach and the quantitative polymerase chain reaction technique to establish the effects of a graded replacement of maize grain (MG) by Bp on the ruminal microbial community, fermentation profile and nutrient degradation. Six different amounts of Bp (0-400 g kg -1 ), which replaced MG in the diet, were tested using the in vitro semi-continuous rumen simulation technique. The increased inclusion of Bp resulted in greater dietary content and degradation of neutral detergent fibre (P < 0.01). Further, Bp feeding enhanced (P < 0.01) the abundance of genus Prevotella and shifted (P < 0.01) the short-chain fatty acid patterns in favour of acetate and propionate and at the expense of butyrate. A total replacement of MG with Bp resulted in an increased daily methane production (P < 0.01). Results suggest positive effects of the replacement of MG by Bp especially in terms of stimulating ruminal acetate and propionate fermentation. However, high replacement rates of Bp resulted in lowered utilization of ammonia and higher ruminal methane production. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

The preliminary exploration of 64-slice volume computed tomography in the accurate measurement of pleural effusion.

PubMed

Guo, Zhi-Jun; Lin, Qiang; Liu, Hai-Tao; Lu, Jun-Ying; Zeng, Yan-Hong; Meng, Fan-Jie; Cao, Bin; Zi, Xue-Rong; Han, Shu-Ming; Zhang, Yu-Huan

2013-09-01

Using computed tomography (CT) to rapidly and accurately quantify pleural effusion volume benefits medical and scientific research. However, the precise volume of pleural effusions still involves many challenges and currently does not have a recognized accurate measuring. To explore the feasibility of using 64-slice CT volume-rendering technology to accurately measure pleural fluid volume and to then analyze the correlation between the volume of the free pleural effusion and the different diameters of the pleural effusion. The 64-slice CT volume-rendering technique was used to measure and analyze three parts. First, the fluid volume of a self-made thoracic model was measured and compared with the actual injected volume. Second, the pleural effusion volume was measured before and after pleural fluid drainage in 25 patients, and the volume reduction was compared with the actual volume of the liquid extract. Finally, the free pleural effusion volume was measured in 26 patients to analyze the correlation between it and the diameter of the effusion, which was then used to calculate the regression equation. After using the 64-slice CT volume-rendering technique to measure the fluid volume of the self-made thoracic model, the results were compared with the actual injection volume. No significant differences were found, P = 0.836. For the 25 patients with drained pleural effusions, the comparison of the reduction volume with the actual volume of the liquid extract revealed no significant differences, P = 0.989. The following linear regression equation was used to compare the pleural effusion volume (V) (measured by the CT volume-rendering technique) with the pleural effusion greatest depth (d): V = 158.16 × d - 116.01 (r = 0.91, P = 0.000). The following linear regression was used to compare the volume with the product of the pleural effusion diameters (l × h × d): V = 0.56 × (l × h × d) + 39.44 (r = 0.92, P = 0.000). The 64-slice CT volume-rendering technique can accurately measure the volume in pleural effusion patients, and a linear regression equation can be used to estimate the volume of the free pleural effusion.

Volume and contact surface area analysis of bony tunnels in single and double bundle anterior cruciate ligament reconstruction using autograft tendons: in vivo three-dimensional imaging analysis.

PubMed

Yang, Jae-Hyuk; Chang, Minho; Kwak, Dai-Soon; Wang, Joon Ho

2014-09-01

Regarding reconstruction surgery of the anterior cruciate ligament (ACL), there is still a debate whether to perform a single bundle (SB) or double bundle (DB) reconstruction. The purpose of this study was to analyze and compare the volume and surface area of femoral and tibial tunnels during transtibial SB versus transportal DB ACL reconstruction. A consecutive series of 26 patients who underwent trantibial SB ACL reconstruction and 27 patients with transportal DB ACL reconstruction using hamstring autograft from January 2010 to October 2010 were included in this study. Three-dimensional computed tomography (3D-CT) was taken within one week after operation. The CT bone images were segmented with use of Mimics software v14.0. The obtained digital images were then imported in the commercial package Geomagic Studio v10.0 and SketchUp Pro v8.0 for processing. The femoral and tibial tunnel lengths, diameters, volumes and surface areas were evaluated. A comparison between the two groups was performed using the independent-samples t-test. A p-value less than the significance value of 5% (p < 0.05) was considered statistically significant. Regarding femur tunnels, a significant difference was not found between the tunnel volume for SB technique (1,496.51 ± 396.72 mm(3)) and the total tunnel volume for DB technique (1,593.81 ± 469.42 mm(3); p = 0.366). However, the total surface area for femoral tunnels was larger in DB technique (919.65 ± 201.79 mm(2)) compared to SB technique (810.02 ± 117.98 mm(2); p = 0.004). For tibia tunnels, there was a significant difference between tunnel volume for the SB technique (2,070.43 ± 565.07 mm(3)) and the total tunnel volume for the DB technique (2,681.93 ± 668.09 mm(3); p ≤ 0.001). The tibial tunnel surface area for the SB technique (958.84 ± 147.50 mm(2)) was smaller than the total tunnel surface area for the DB technique (1,493.31 ± 220.79 mm(2); p ≤ 0.001). Although the total femoral tunnel volume was similar between two techniques, the total surface area was larger in the DB technique. For the tibia, both total tunnel volume and the surface area were larger in DB technique.

21 CFR 888.5 - Resurfacing technique.

Code of Federal Regulations, 2014 CFR

2014-04-01

... techniques, certain joint prostheses require far less bone resection than other devices intended to repair or replace the same joint. The amount of bone resection may or may not affect the safety and effectiveness of...

21 CFR 888.5 - Resurfacing technique.

Code of Federal Regulations, 2011 CFR

2011-04-01

... techniques, certain joint prostheses require far less bone resection than other devices intended to repair or replace the same joint. The amount of bone resection may or may not affect the safety and effectiveness of...

21 CFR 888.5 - Resurfacing technique.

Code of Federal Regulations, 2013 CFR

2013-04-01

... techniques, certain joint prostheses require far less bone resection than other devices intended to repair or replace the same joint. The amount of bone resection may or may not affect the safety and effectiveness of...

21 CFR 888.5 - Resurfacing technique.

Code of Federal Regulations, 2010 CFR

2010-04-01

... techniques, certain joint prostheses require far less bone resection than other devices intended to repair or replace the same joint. The amount of bone resection may or may not affect the safety and effectiveness of...

21 CFR 888.5 - Resurfacing technique.

Code of Federal Regulations, 2012 CFR

2012-04-01

... techniques, certain joint prostheses require far less bone resection than other devices intended to repair or replace the same joint. The amount of bone resection may or may not affect the safety and effectiveness of...

Navigation-assisted versus conventional total knee replacement: no difference in patient-reported outcome measures (PROMs) at 1 and 2 years.

PubMed

Singisetti, Kiran; Muthumayandi, Karthikeyan; Abual-Rub, Zaid; Weir, David

2015-11-01

Navigation technique for total knee replacement has been shown to improve accuracy of prosthesis alignment in several studies. The purpose was to compare the patient-reported outcome measures in primary total knee replacement (TKR) using navigation versus conventional surgical technique at 1- and 2-year follow-up. A retrospective review of prospectively collected patient-reported outcome data for 351 consecutively performed primary TKR was included in the study. The study group (N = 113) included patients who had Triathlon TKR using articular surface mounted (ASM Stryker) navigation technique and control group (N = 238) included patients who had Triathlon TKR using conventional jig. In addition to the WOMAC (Western Ontario and McMaster University Osteoarthritis Index) and SF-36 (Medical Outcomes Trust Short Form-36), a short self-report questionnaire evaluating the level of satisfaction, quality of life and whether patients would undergo knee replacement again. WOMAC: no significant difference between the groups was noted in mean WOMAC pain, function and stiffness scores at 1- and 2-year follow-up. SF-36: no significant difference between the groups was seen except in the physical function component of score at 1 year (p = 0.019). Navigation group mean 56.78 (CI 51.06-62.5) versus conventional group mean 48.34 (44.68-52.01) but this difference was not observed at 2-year follow-up. The overall patient-reported outcome scores improved after total knee replacement but appear to be comparable in both groups at 1- and 2-year follow-up.

Efficacy of the Stonehenge Technique for Minimally Invasive Aortic Valve Replacement via Right Infraaxillary Thoracotomy

PubMed Central

Kin, Hajime; Kitamoto, Shohei; Yamanaka, Shota; Nishida, Hidefumi; Nishigawa, Kosaku; Takanashi, Shuichiro

2017-01-01

Minimally invasive cardiac surgeries for aortic valve replacement (AVR) are still a technical challenge for surgeons because these procedures are undertaken through small incisions and deep surgical fields. Although AVR via vertical infraaxillary thoracotomy can be a cosmetically superior option, a disadvantage of this approach is the distance between the thoracotomy incision and the ascending aorta. Therefore, we devised a technique to perform all manipulations using the fingertips without the aid of a knot pusher or long-shafted surgical instruments. This was achieved by particular placement of several retracted sutures to the right chest wall. We named placement of these sutures the “Stonehenge technique.” In conclusion, AVR via vertical infraaxillary thoracotomy with our Stonehenge technique can be safely and simply performed with superior cosmetic advantages. PMID:28123153

Sentinel Lymph Node Biopsy in Endometrial Cancer: a New Standard of Care?

PubMed

Sullivan, Stephanie A; Rossi, Emma C

2017-09-18

Lymph node status is one of the most important factors in determining prognosis and the need for adjuvant treatment in endometrial cancer (EMCA). Unfortunately, full lymphadenectomy bears significant surgical and postoperative risks. The majority of patients with clinical stage I disease will not have metastatic disease; thus, a full lymphadenectomy only increases morbidity in this population of patients. The use of the sentinel lymph node (SLN) biopsy has emerged as an alternative to complete lymphadenectomy in EMCA. By removing the highest yield lymph nodes, the SLN biopsy has the same diagnostic ability as lymphadenectomy while minimizing morbidity. The sensitivity of sentinel lymph node identification with robotic fluorescence imaging for detecting metastatic endometrial and cervical cancer (FIRES) trial published this year is the largest prospective, multi-institution trial investigating the accuracy of the SLN biopsy for endometrial and cervical cancer. Results of this trial found an excellent sensitivity (97.2%) and false negative rate (3%) with the technique. The conclusions from the FIRES trial and those of a recent meta-analysis are that SLN biopsy has an acceptable diagnostic accuracy in detecting lymphatic metastases, and can replace lymphadenectomy for this diagnostic purpose. There remains controversy surrounding the SLN biopsy in high-risk disease and the use of adjuvant therapy in the setting of low volume disease detected with ultrastaging. Current data suggests that the technique is accurate in high-risk disease and that the increased detection of metastasis helps guide adjuvant therapy such that oncologic outcomes are likely not affected by forgoing a full lymphadenectomy. Further prospective study is needed to investigate the impact of low volume metastatic disease on oncologic outcomes and the need for adjuvant therapy in these patients.

Management of traumatic hemothorax by closed thoracic drainage using a central venous catheter

PubMed Central

Yi, Jian-hua; Liu, Hua-bo; Zhang, Mao; Wu, Jun-song; Yang, Jian-xin; Chen, Jin-ming; Xu, Shan-xiang; Wang, Jian-an

2012-01-01

Objective: To evaluate the efficacy and safety of the treatment of traumatic hemothorax by closed pleural drainage using a central venous catheter (CVC), compared with using a conventional chest tube. Methods: A prospective controlled study with the Ethics Committee approval was undertaken. A total of 407 patients with traumatic hemothorax were involved and they were randomly assigned to undergo closed pleural drainage with CVCs (n=214) or conventional chest tubes (n=193). The Seldinger technique was used for drainage by CVC, and the conventional technique for drainage by chest tube. If the residual volume of the hemothorax was less than 200 ml after the daily volume of drainage decreased to below 100 ml for two consecutive days, the treatment was considered successful. The correlative data of efficacy and safety between the two groups were analyzed using t or chi-squared tests with SPSS 13.0. A P value of less than 0.05 was taken as indicating statistical significance. Results: Compared with the chest tube group, the operation time, fraction of analgesic treatment, time of surgical wound healing, and infection rate of surgical wounds were significantly decreased (P<0.05) in the CVC group. There were no significant differences between the two groups in the success rate of treatment and the incidence of serious complications (P>0.05), or in the mean catheter/tube indwelling time and mean medical costs of patients treated successfully (P>0.05). Conclusions: Management of medium or large traumatic hemothoraxes by closed thoracic drainage using CVC is minimally invasive and as effective as using a conventional large-bore chest tube. Its complications can be prevented and it has the potential to replace the large-bore chest tube. PMID:22205619

Microstructure and hydrogenation properties of a melt-spun non-stoichiometric Zr-based Laves phase alloy

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

Zhang, Tiebang, E-mail: tiebangzhang@nwpu.edu.cn; Zhang, Yunlong; Li, Jinshan

2016-01-15

Alloy with composition of Zr{sub 0.9}Ti{sub 0.1}V{sub 1.7} off normal stoichiometric proportion is selected to investigate the effect of defects introduced by non-stoichiometry on hydrogenation kinetics of Zr–Ti–V Laves phase alloys. Microstructure and phase constituent of melt-spun ribbons have been investigated in this work. The activation process, hydrogenation kinetics, thermodynamics characteristics and hydride phase constituent of as-cast alloy and melt-spun ribbons are also compared. Comparing with the as-cast alloy, the dominant Laves phase ZrV{sub 2} is preserved, V-BCC phase is reduced and α-Zr phase is replaced by a small amount of Zr{sub 3}V{sub 3}O phase in melt-spun ribbons. Melt-spun ribbonsmore » exhibit easy activation and fast initial hydrogen absorption on account of the increased specific surface area. However, the decrease in unit cell volume of the dominant phase leads to the decrease in hydrogen absorption capacity. Melt-spinning technique raises the equilibrium pressure and decreases the stability of hydride due to the decrease of unit cell volume and the elimination of α-Zr phase, respectively. Melt-spun ribbons with fine grains show improved hydrogen absorption kinetics comparing with that of the as-cast alloy. Meanwhile, the prevalent micro twins observed within melt-spun ribbons are believed to account for the improved hydrogen absorption kinetics. - Highlights: • Role of defects on hydrogenation kinetics of Zr-based alloys is proposed. • Microstructure and hydrogenation properties of as-cast/melt-spun alloy are compared. • Melt-spinning technique improves the hydrogenation kinetics of Zr{sub 0.9}Ti{sub 0.1}V{sub 1.7} alloy. • Refined grains and twin defects account for improved hydrogen absorption kinetics.« less

Free Volume Considerations in Thermoplastic and Thermosetting Resins

NASA Technical Reports Server (NTRS)

Landel, R. F.; Gupta, A.; Moacanin, J.; Hong, D.; Tsay, F. D.; Chen, S.; Chung, S.; Fedors, R. F.; Cigmecioglu, M.

1984-01-01

The direct measurement of physical aging and of the volume changes which go on during the course of this aging is discussed. Data on PMMA showing its physical aging as measured by its stress relaxation response and the accompanying volume changes are presented. An indication of how one can measure the free volume both directly from the volume change itself and relatively directly via a new technique is given. The application of this new technique (electron spin resonance spectroscopy) to other polymer systems is demonstrated.

Superior Prognostic Value of Cumulative Intracranial Tumor Volume Relative to Largest Intracranial Tumor Volume for Stereotactic Radiosurgery-Treated Brain Metastasis Patients.

PubMed

Hirshman, Brian R; Wilson, Bayard; Ali, Mir Amaan; Proudfoot, James A; Koiso, Takao; Nagano, Osamu; Carter, Bob S; Serizawa, Toru; Yamamoto, Masaaki; Chen, Clark C

2018-04-01

Two intracranial tumor volume variables have been shown to prognosticate survival of stereotactic-radiosurgery-treated brain metastasis patients: the largest intracranial tumor volume (LITV) and the cumulative intracranial tumor volume (CITV). To determine whether the prognostic value of the Scored Index for Radiosurgery (SIR) model can be improved by replacing one of its components-LITV-with CITV. We compared LITV and CITV in terms of their survival prognostication using a series of multivariable models that included known components of the SIR: age, Karnofsky Performance Score, status of extracranial disease, and the number of brain metastases. Models were compared using established statistical measures, including the net reclassification improvement (NRI > 0) and integrated discrimination improvement (IDI). The analysis was performed in 2 independent cohorts, each consisting of ∼3000 patients. In both cohorts, CITV was shown to be independently predictive of patient survival. Replacement of LITV with CITV in the SIR model improved the model's ability to predict 1-yr survival. In the first cohort, the CITV model showed an NRI > 0 improvement of 0.2574 (95% confidence interval [CI] 0.1890-0.3257) and IDI of 0.0088 (95% CI 0.0057-0.0119) relative to the LITV model. In the second cohort, the CITV model showed a NRI > 0 of 0.2604 (95% CI 0.1796-0.3411) and IDI of 0.0051 (95% CI 0.0029-0.0073) relative to the LITV model. After accounting for covariates within the SIR model, CITV offers superior prognostic value relative to LITV for stereotactic radiosurgery-treated brain metastasis patients.

Optimizing the restoration and maintenance of fluid balance after exercise-induced dehydration.

PubMed

Evans, Gethin H; James, Lewis J; Shirreffs, Susan M; Maughan, Ronald J

2017-04-01

Hypohydration, or a body water deficit, is a common occurrence in athletes and recreational exercisers following the completion of an exercise session. For those who will undertake a further exercise session that day, it is important to replace water losses to avoid beginning the next exercise session hypohydrated and the potential detrimental effects on performance that this may lead to. The aim of this review is to provide an overview of the research related to factors that may affect postexercise rehydration. Research in this area has focused on the volume of fluid to be ingested, the rate of fluid ingestion, and fluid composition. Volume replacement during recovery should exceed that lost during exercise to allow for ongoing water loss; however, ingestion of large volumes of plain water results in a prompt diuresis, effectively preventing longer-term maintenance of water balance. Addition of sodium to a rehydration solution is beneficial for maintenance of fluid balance due to its effect on extracellular fluid osmolality and volume. The addition of macronutrients such as carbohydrate and protein can promote maintenance of hydration by influencing absorption and distribution of ingested water, which in turn effects extracellular fluid osmolality and volume. Alcohol is commonly consumed in the postexercise period and may influence postexercise rehydration, as will the coingestion of food. Future research in this area should focus on providing information related to optimal rates of fluid ingestion, advisable solutions to ingest during different duration recovery periods, and confirmation of mechanistic explanations for the observations outlined. Copyright © 2017 the American Physiological Society.

One Stage Conversion of an Infected Fused Knee to Total Knee Replacement - A Surgical Challenge

PubMed Central

Ravikumar, Mukartihal; Kendoff, Daniel; Citak, Mustafa; Luck, Stefan; Gehrke, Thorsten; Zahar, Akos

2013-01-01

Background and Purpose: Two-stage revision arthroplasty is a common technique for the treatment of infected total knee replacement. Few reports have addressed the conversion of a fused knee into a total knee replacement. However, there is no case reported of converting an infected fused knee into a hinge knee using a one-stage procedure. Methods: We report on a 51-year old male patient with an infected fused knee after multiple surgeries. Results and Interpretation: A one-stage conversion of septic fused knee into total knee arthroplasty by a rotational hinge prosthesis was performed. The case highlights that with profound preoperative assessment, meticulous surgical technique, combined antibiotic treatment and the right implant, one-stage revision in a surgical challenge may have a role as a treatment option with good functional outcome. PMID:23526706

[Minimally invasive approaches to hip and knee joints for total joint replacement].

PubMed

Rittmeister, M; König, D P; Eysel, P; Kerschbaumer, F

2004-11-01

The manuscript features the different minimally invasive approaches to the hip for joint replacement. These include medial, anterior, anterolateral, and posterior approaches. The concept of minimally invasive hip arthroplasty makes sense if it is an integral part of a larger concept to lower postoperative morbidity. Besides minimal soft tissue trauma, this concept involves preoperative patient education, preemptive analgesia, and postoperative physiotherapy. It is our belief that minimal incision techniques for the hip are not suited for all patients and all surgeons. The different minimally invasive approaches to the knee joint for implantation of a knee arthroplasty are described and discussed. There have been no studies published yet that fulfill EBM criteria. The data so far show that minimally invasive approaches and implantation techniques for total knee replacements lead to quicker rehabilitation of patients.

Soot volume fraction fields in unsteady axis-symmetric flames by continuous laser extinction technique.

PubMed

Kashif, Muhammad; Bonnety, Jérôme; Guibert, Philippe; Morin, Céline; Legros, Guillaume

2012-12-17

A Laser Extinction Method has been set up to provide two-dimensional soot volume fraction field time history at a tunable frequency up to 70 Hz inside an axis-symmetric diffusion flame experiencing slow unsteady phenomena preserving the symmetry. The use of a continuous wave laser as the light source enables this repetition rate, which is an incremental advance in the laser extinction technique. The technique is shown to allow a fine description of the soot volume fraction field in a flickering flame exhibiting a 12.6 Hz flickering phenomenon. Within this range of repetition rate, the technique and its subsequent post-processing require neither any method for time-domain reconstruction nor any correction for energy intrusion. Possibly complemented by such a reconstruction method, the technique should support further soot volume fraction database in oscillating flames that exhibit characteristic times relevant to the current efforts in the validation of soot processes modeling.

Performance of composite sand cement brick containing recycle concrete aggregate and waste polyethylene terephthalate with different mix design ratio

NASA Astrophysics Data System (ADS)

Azmi, N. B.; Khalid, F. S.; Irwan, J. M.; Mazenan, P. N.; Zahir, Z.; Shahidan, S.

2018-04-01

This study is focuses to the performance of composite sand cement brick containing recycle concrete aggregate and waste polyethylene terephthalate. The objective is to determine the mechanical properties such as compressive strength and water absorption of composite brick containing recycled concrete aggregate and polyethylene terephthalate waste and to determine the optimum mix ratio of bricks containing recycled concrete aggregate and polyethylene terephthalate waste. The bricks specimens were prepared by using 100% natural sand, they were then replaced by RCA at 25%, 50% and 75% with proportions of PET consists of 1.0%, 1.5%, 2.0% and 2.5% by weight of natural sand. Based on the results of compressive strength, it indicates that the replacement of RCA shows an increasing strength as the strength starts to increase from 25% to 50% for both mix design ratio. The strength for RCA 75% volume of replacement started to decrease as the volume of PET increase. However, the result of water absorption with 50% RCA and 1.0% PET show less permeable compared to control brick at both mix design ratio. Thus, one would expect the density of brick decrease and the water absorption to increase as the RCA and PET content is increased.

Effects of a high milk intake during the pre-weaning period on nutrient metabolism and growth rate in Japanese Black cattle.

PubMed

Matsubara, Atsuko; Takahashi, Hideyuki; Saito, Akira; Nomura, Aoi; Sithyphone, Khounsaknalath; Mcmahon, Christopher D; Fujino, Ryoichi; Shiotsuka, Yuji; Etoh, Tetsuji; Furuse, Mitsuhiro; Gotoh, Takafumi

2016-09-01

This study aimed to determine the effects of feeding an increased volume of high-fat milk during the early post-natal life on metabolite concentrations in the blood, the expression of key genes regulating intermediary metabolism in the skeletal muscles, and the rate of growth of Japanese Black cattle. All calves were fed a high-fat milk replacer (crude protein, 26%; crude fat, 25.5%; total dissolved nitrogen, 116%). Control calves (n = 4) were nursed with 500 g milk replacer until 3 months of age, whereas calves in the experimental group (n = 4) were nursed with 1800 g milk replacer until 3 months, and then the volume was gradually reduced until 5 months. Body weight was significantly higher in the experimental group than in the control group at 7 months. Plasma glucose concentrations were significantly lower in the experimental group. Expression of glucose-transporter-4 messenger RNA (mRNA) was lower, whereas that of glucose transporter 1, cluster of differentiation 36, and carnitine palmitoyltransferase-1b mRNA was significantly higher in the Longissimus thoracis of the experimental group. Nutritional status during early post-natal life appears to strongly influence the growth rate and glucose and lipid metabolism in Japanese Black cattle. © 2015 Japanese Society of Animal Science.

Pulmonary stenosis and pulmonary regurgitation: both ends of the spectrum in residual hemodynamic impairment after tetralogy of Fallot repair.

PubMed

Yoo, Byung Won; Park, Han Ki

2013-06-01

Repair of tetralogy of Fallot (TOF) has shown excellent outcomes. However it leaves varying degrees of residual hemodynamic impairment, with severe pulmonary stenosis (PS) and free pulmonary regurgitation (PR) at both ends of the spectrum. Since the 1980s, studies evaluating late outcomes after TOF repair revealed the adverse impacts of residual chronic PR on RV volume and function; thus, a turnaround of operational strategies has occurred from aggressive RV outflow tract (RVOT) reconstruction for complete relief of RVOT obstruction to conservative RVOT reconstruction for limiting PR. This transformation has raised the question of how much residual PS after conservative RVOT reconstruction is acceptable. Besides, as pulmonary valve replacement (PVR) increases in patients with RV deterioration from residual PR, there is concern regarding when it should be performed. Regarding residual PS, several studies revealed that PS in addition to PR was associated with less PR and a small RV volume. This suggests that PS combined with PR makes RV diastolic property to protect against dilatation through RV hypertrophy and supports conservative RVOT enlargement despite residual PS. Also, several studies have revealed the pre-PVR threshold of RV parameters for the normalization of RV volume and function after PVR, and based on these results, the indications for PVR have been revised. Although there is no established strategy, better understanding of RV mechanics, development of new surgical and interventional techniques, and evidence for the effect of PVR on RV reverse remodeling and its late outcome will aid us to optimize the management of TOF.

Automatic detection of the inner ears in head CT images using deep convolutional neural networks

NASA Astrophysics Data System (ADS)

Zhang, Dongqing; Noble, Jack H.; Dawant, Benoit M.

2018-03-01

Cochlear implants (CIs) use electrode arrays that are surgically inserted into the cochlea to stimulate nerve endings to replace the natural electro-mechanical transduction mechanism and restore hearing for patients with profound hearing loss. Post-operatively, the CI needs to be programmed. Traditionally, this is done by an audiologist who is blind to the positions of the electrodes relative to the cochlea and relies on the patient's subjective response to stimuli. This is a trial-and-error process that can be frustratingly long (dozens of programming sessions are not unusual). To assist audiologists, we have proposed what we call IGCIP for image-guided cochlear implant programming. In IGCIP, we use image processing algorithms to segment the intra-cochlear anatomy in pre-operative CT images and to localize the electrode arrays in post-operative CTs. We have shown that programming strategies informed by image-derived information significantly improve hearing outcomes for both adults and pediatric populations. We are now aiming at deploying these techniques clinically, which requires full automation. One challenge we face is the lack of standard image acquisition protocols. The content of the image volumes we need to process thus varies greatly and visual inspection and labelling is currently required to initialize processing pipelines. In this work we propose a deep learning-based approach to automatically detect if a head CT volume contains two ears, one ear, or no ear. Our approach has been tested on a data set that contains over 2,000 CT volumes from 153 patients and we achieve an overall 95.97% classification accuracy.

Erosion resistance of arc-sprayed coatings to iron ore at 25 and 315 °C

NASA Astrophysics Data System (ADS)

Dallaire, S.; Levert, H.; Legoux, J.-G.

2001-06-01

Iron ore pellets are sintered and reduced in large continuous industrial oil-fired furnaces. From the furnace, powerful fans extract large volumes of hot gas. Being exposed to gas-borne iron ore particles and temperatures ranging between 125 and 328 °C, fan components are rapidly eroded. Extensive part repair or replacement is required for maintaining a profitable operation. The arc spraying technique has been suggested for repair provided it could produce erosion-resistant coatings. Conventional and cored wires (1.6 mm diameter) were arc sprayed using various spray parameters to produce 250 to 300 µm thick coatings. Arc-sprayed coatings and reference specimens were erosion tested at 25 and 315 °C and impact angles of 25 and 90° in a laboratory gas-blast erosion rig. This device was designed to impact materials with coarse (32 to 300 µm) iron ore particles at a speed of 100 m/s. The coating volume loss due to erosion was measured with a laser profilometer built by National Research Council Canada several years ago. Few arc-sprayed coatings exhibited erosion resistance comparable with structural steel at low impact angles. Erosion of arc-sprayed coatings and reference specimens dramatically increases at 315 °C for both 25° and 90° impact angles. Erosion-enhanced oxidation was found to be responsible for the increase in volume loss above room temperature. Though arc spraying can be appropriate for on-site repair, the development of more erosion-resistant coatings is required for intermediate temperatures.

Liposuction: Anaesthesia challenges

PubMed Central

Sood, Jayashree; Jayaraman, Lakshmi; Sethi, Nitin

2011-01-01

Liposuction is one of the most popular treatment modalities in aesthetic surgery with certain unique anaesthetic considerations. Liposuction is often performed as an office procedure. There are four main types of liposuction techniques based on the volume of infiltration or wetting solution injected, viz dry, wet, superwet, and tumescent technique. The tumescent technique is one of the most common liposuction techniques in which large volumes of dilute local anaesthetic (wetting solution) are injected into the fat to facilitate anaesthesia and decrease blood loss. The amount of lignocaine injected may be very large, approximately 35-55 mg/kg, raising concerns regarding local anaesthetic toxicity. Liposuction can be of two types according to the volume of solution aspirated: High volume (>4,000 ml aspirated) or low volume (<4,000 ml aspirated). While small volume liposuction may be done under local/monitored anaesthesia care, large-volume liposuction requires general anaesthesia. As a large volume of wetting solution is injected into the subcutaneous tissue, the intraoperative fluid management has to be carefully titrated along with haemodynamic monitoring and temperature control. Assessment of blood loss is difficult, as it is mixed with the aspirated fat. Since most obese patients opt for liposuction as a quick method to lose weight, all concerns related to obesity need to be addressed in a preoperative evaluation. PMID:21808392

Evaluation of anesthetic technique on surgical site infections (SSIs) at a single institution.

PubMed

Curry, Craig S; Smith, Kahsi A; Allyn, John W

2014-12-01

To determine whether the previously published relationship between anesthetic technique and rate of surgical site infections (SSIs) was influenced by institution specific effects. Retrospective Review of Quality Assurance and Hospital Epidemiology databases. Metropolitan medical center. The records of 7,751 patients who underwent knee or hip joint replacement from 2004 to 2010 were analyzed. Data regarding anesthetic technique, age, ASA status, gender, postoperative temperature, duration of anesthesia and type of surgery were from the department of anesthesiology quality assurance database and SSI cases were identified from the department of epidemiology database. The impact of anesthetic technique and other variables was assessed using bivariate and multivariate techniques. There was no association of anesthetic technique on the rate of SSI. Duration of anesthesia and ASA status were associated with effects on the rate of SSI. The impact of anesthetic technique on SSI following hip and knee replacement surgery may be site specific and using locally gathered quality data may assist in assessing specific institutional impact. Copyright © 2014 Elsevier Inc. All rights reserved.

Physical Limitations in Lithography for Microelectronics.

ERIC Educational Resources Information Center

Flavin, P. G.

1981-01-01

Describes techniques being used in the production of microelectronics kits which have replaced traditional optical lithography, including contact and optical projection printing, and X-ray and electron beam lithography. Also includes limitations of each technique described. (SK)

Prioritization methodology for chemical replacement

NASA Technical Reports Server (NTRS)

Goldberg, Ben; Cruit, Wendy; Schutzenhofer, Scott

1995-01-01

This methodology serves to define a system for effective prioritization of efforts required to develop replacement technologies mandated by imposed and forecast legislation. The methodology used is a semi quantitative approach derived from quality function deployment techniques (QFD Matrix). QFD is a conceptual map that provides a method of transforming customer wants and needs into quantitative engineering terms. This methodology aims to weight the full environmental, cost, safety, reliability, and programmatic implications of replacement technology development to allow appropriate identification of viable candidates and programmatic alternatives.

'Emerging technologies for the changing global market' - Prioritization methodology for chemical replacement

NASA Technical Reports Server (NTRS)

Cruit, Wendy; Schutzenhofer, Scott; Goldberg, Ben; Everhart, Kurt

1993-01-01

This project served to define an appropriate methodology for effective prioritization of technology efforts required to develop replacement technologies mandated by imposed and forecast legislation. The methodology used is a semiquantitative approach derived from quality function deployment techniques (QFD Matrix). This methodology aims to weight the full environmental, cost, safety, reliability, and programmatic implications of replacement technology development to allow appropriate identification of viable candidates and programmatic alternatives. The results will be implemented as a guideline for consideration for current NASA propulsion systems.

Reoperations on the pulmonary autograft and pulmonary homograft after the Ross procedure: An update on the German Dutch Ross Registry.

PubMed

Charitos, Efstratios I; Takkenberg, Johanna J M; Hanke, Thorsten; Gorski, Armin; Botha, Cornelius; Franke, Ulrich; Dodge-Khatami, Ali; Hoerer, Juergen; Lange, Rudiger; Moritz, Anton; Ferrari-Kuehne, Katharina; Hetzer, Roland; Huebler, Michael; Bogers, Ad J J C; Stierle, Ulrich; Sievers, Hans-Hinrich; Hemmer, Wolfgang

2012-10-01

Reinterventions after the Ross procedure are a concern for patients and treating physicians. The scope of the present report was to provide an update on the reinterventions observed in the large patient population of the German-Dutch Ross Registry. From 1988 to 2011, 2023 patients (age, 39.05 ± 16.5 years; male patients, 1502; adults, 1642) underwent a Ross procedure in 13 centers. The mean follow-up was 7.1 ± 4.6 years (range, 0-22 years; 13,168 patient-years). In the adult population, 120 autograft reinterventions in 113 patients (1.03%/patient-year) and 76 homograft reinterventions in 67 patients (0.65%/patient-year) and, in the pediatric population, 14 autograft reinterventions in 13 patients (0.91%/patient-year) and 42 homograft reinterventions in 31 patients (2.72%/patient-year) were observed. Of the autograft and homograft reinterventions, 17.9% and 21.2% were performed because of endocarditis, respectively. The subcoronary technique in the adult population resulted in significantly superior autograft durability (freedom from autograft reintervention: 97% at 10 years and 91% at 12 years; P < .001). The root replacement technique without root reinforcement (hazard ratio, 2.4; 95% confidence interval, 1.4-4.1) and the presence of pure aortic insufficiency preoperatively (hazard ratio, 2.3; 95% confidence interval, 1.5-3.5) were statistically significant predictors for a shorter time to reoperation. The center volume had a significant influence on the long-term results. The freedom from homograft reoperation for the adults and pediatric population was 97% and 87% at 5 years and 93% and 79% at 12 years, respectively (P < .001), with younger recipient and donor age being significant predictors of a shorter time to homograft reoperation. The autograft principle remains a valid option for young patients requiring aortic valve replacement. The risk of reoperation depends largely on the surgical technique used and the preoperative hemodynamics. Center experience and expertise also influence the long-term results. Adequate endocarditis prophylaxis might further reduce the need for reoperation. Copyright © 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

The volume of the human knee joint.

PubMed

Matziolis, Georg; Roehner, Eric; Windisch, Christoph; Wagner, Andreas

2015-10-01

Despite its clinical relevance, particularly in septic knee surgery, the volume of the human knee joint has not been established to date. Therefore, the objective of this study was to determine knee joint volume and whether or not it is dependent on sex or body height. Sixty-one consecutive patients (joints) who were due to undergo endoprosthetic joint replacement were enrolled in this prospective study. During the operation, the joint volume was determined by injecting saline solution until a pressure of 200 mmHg was achieved in the joint. The average volume of all knee joints was 131 ± 53 (40-290) ml. The volume was not found to be dependent on sex, but it was dependent on the patients' height (R = 0.312, p = 0.014). This enabled an estimation of the joint volume according to V = 1.6 height - 135. The considerable inter-individual variance of the knee joint volume would suggest that it should be determined or at least estimated according to body height if the joint volume has consequences for the diagnostics or therapy of knee disorders.

Dosimetric Comparison of Bone Marrow-Sparing Intensity-Modulated Radiotherapy Versus Conventional Techniques for Treatment of Cervical Cancer

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

Mell, Loren K.; Tiryaki, Hanifi; Ahn, Kang-Hyun

2008-08-01

Purpose: To compare bone marrow-sparing intensity-modulated pelvic radiotherapy (BMS-IMRT) with conventional (four-field box and anteroposterior-posteroanterior [AP-PA]) techniques in the treatment of cervical cancer. Methods and Materials: The data from 7 cervical cancer patients treated with concurrent chemotherapy and IMRT without BMS were analyzed and compared with data using four-field box and AP-PA techniques. All plans were normalized to cover the planning target volume with the 99% isodose line. The clinical target volume consisted of the pelvic and presacral lymph nodes, uterus and cervix, upper vagina, and parametrial tissue. Normal tissues included bowel, bladder, and pelvic bone marrow (PBM), which comprisedmore » the lumbosacral spine and ilium and the ischium, pubis, and proximal femora (lower pelvis bone marrow). Dose-volume histograms for the planning target volume and normal tissues were compared for BMS-IMRT vs. four-field box and AP-PA plans. Results: BMS-IMRT was superior to the four-field box technique in reducing the dose to the PBM, small bowel, rectum, and bladder. Compared with AP-PA plans, BMS-IMRT reduced the PBM volume receiving a dose >16.4 Gy. BMS-IMRT reduced the volume of ilium, lower pelvis bone marrow, and bowel receiving a dose >27.7, >18.7, and >21.1 Gy, respectively, but increased dose below these thresholds compared with the AP-PA plans. BMS-IMRT reduced the volume of lumbosacral spine bone marrow, rectum, small bowel, and bladder at all dose levels in all 7 patients. Conclusion: BMS-IMRT reduced irradiation of PBM compared with the four-field box technique. Compared with the AP-PA technique, BMS-IMRT reduced lumbosacral spine bone marrow irradiation and reduced the volume of PBM irradiated to high doses. Therefore BMS-IMRT might reduce acute hematologic toxicity compared with conventional techniques.« less

Prevalence of Total Hip and Knee Replacement in the United States.

PubMed

Maradit Kremers, Hilal; Larson, Dirk R; Crowson, Cynthia S; Kremers, Walter K; Washington, Raynard E; Steiner, Claudia A; Jiranek, William A; Berry, Daniel J

2015-09-02

Descriptive epidemiology of total joint replacement procedures is limited to annual procedure volumes (incidence). The prevalence of the growing number of individuals living with a total hip or total knee replacement is currently unknown. Our objective was to estimate the prevalence of total hip and total knee replacement in the United States. Prevalence was estimated using the counting method by combining historical incidence data from the National Hospital Discharge Survey and the Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases from 1969 to 2010 with general population census and mortality counts. We accounted for relative differences in mortality rates between those who have had total hip or knee replacement and the general population. The 2010 prevalence of total hip and total knee replacement in the total U.S. population was 0.83% and 1.52%, respectively. Prevalence was higher among women than among men and increased with age, reaching 5.26% for total hip replacement and 10.38% for total knee replacement at eighty years. These estimates corresponded to 2.5 million individuals (1.4 million women and 1.1 million men) with total hip replacement and 4.7 million individuals (3.0 million women and 1.7 million men) with total knee replacement in 2010. Secular trends indicated a substantial rise in prevalence over time and a shift to younger ages. Around 7 million Americans are living with a hip or knee replacement, and consequently, in most cases, are mobile, despite advanced arthritis. These numbers underscore the substantial public health impact of total hip and knee arthroplasties. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

Rain Volume Estimation over Areas Using Satellite and Radar Data

NASA Technical Reports Server (NTRS)

Doneaud, A. A.; Miller, J. R., Jr.; Johnson, L. R.; Vonderhaar, T. H.; Laybe, P.

1984-01-01

The application of satellite data to a recently developed radar technique used to estimate convective rain volumes over areas on a dry environment (the northern Great Plains) is discussed. The area time integral technique (ATI) provides a means of estimating total rain volumes over fixed and floating target areas of the order of 1,000 to 100,000 km(2) for clusters lasting 40 min. The basis of the method is the existence of a strong correlation between the area coverage integrated over the lifetime of the storm (ATI) and the rain volume. One key element in this technique is that it does not require the consideration of the structure of the radar intensities inside the area coverage to generate rain volumes, but only considers the rain event per se. This fact might reduce or eliminate some sources of error in applying the technique to satellite data. The second key element is that the ATI once determined can be converted to total rain volume by using a constant factor (average rain rate) for a given locale.

Hip arthroplasty today and tomorrow.

PubMed

Amstutz, H C

1987-12-01

Acrylic-fixed total hip and surface replacement arthroplasty have been very effective in affording immediate relief of pain and providing improved function. Complications have been reduced by improvements in design, materials, and especially technique. They are now very low in the elderly, and the stem type acrylic-fixed design remains the procedure of choice. The failure rates in youthful patients and those with bone-stock deficiencies have been high in both THR and surface types, although the latter had the advantage of preserving femoral stock. On the femoral side, the new "macro" femoral designs from Europe and "micro" femoral porous designs have shown promise, but thigh pain, incomplete and difficult to predict bone ingrowth patterns, coupled with removal problems have influenced design and technique changes. Both press-fit stem types and porous surface replacements have produced promising initial results with less potential downside risks. On the acetabular side, both the cementless hemispherical with screw-type adjuvant fixation, or the chamfered cylinder designs, used primarily with the UCLA porous surface replacements, but also with stem-type devices, appear to achieve best short-term results, while the entire variety of screw rings are disappointing. The future will bring further refinements in technique and specific indications for certain types of replacement stem in specific types of bone stock deficiencies. The all ceramic-ceramic and ceramic-polyethylene bearings show promise of reducing wear and, hence, should improve longevity of implant fixation.

Macromolecular powder diffraction : structure solution via molecular.

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

Doebbler, J.; Von Dreele, R.; X-Ray Science Division

Macromolecular powder diffraction is a burgeoning technique for protein structure solution - ideally suited for cases where no suitable single crystals are available. Over the past seven years, pioneering work by Von Dreele et al. [1,2] and Margiolaki et al. [3,4] has demonstrated the viability of this approach for several protein structures. Among these initial powder studies, molecular replacement solutions of insulin and turkey lysozyme into alternate space groups were accomplished. Pressing the technique further, Margiolaki et al. [5] executed the first molecular replacement of an unknown protein structure: the SH3 domain of ponsin, using data from a multianalyzer diffractometer.more » To demonstrate that cross-species molecular replacement using image plate data is also possible, we present the solution of hen egg white lysozyme using the 60% identical human lysozyme (PDB code: 1LZ1) as the search model. Due to the high incidence of overlaps in powder patterns, especially in more complex structures, we have used extracted intensities from five data sets taken at different salt concentrations in a multi-pattern Pawley refinement. The use of image plates severely increases the overlap problem due to lower detector resolution, but radiation damage effects are minimized with shorter exposure times and the fact that the entire pattern is obtained in a single exposure. This image plate solution establishes the robustness of powder molecular replacement resulting from different data collection techniques.« less

Modified Nance palatal arch appliance for anterior tooth replacement.

PubMed

Sethi, Ntasha; Shanthraj, Srinivas L; Muraleedharan, Manju; Mallikarjuna, Rachappa

2013-06-07

The following case report presents a new and an innovative technique for the postextraction replacement of maxillary central incisors using the natural teeth as pontics. The novel appliance fabricated fully satisfied the demands of the adolescent patient for a fixed prosthetic, while fulfilling the aesthetic and functional requirements presented by the case.

Modified Nance palatal arch appliance for anterior tooth replacement

PubMed Central

Sethi, Ntasha; Shanthraj, Srinivas L; Muraleedharan, Manju; Mallikarjuna, Rachappa

2013-01-01

The following case report presents a new and an innovative technique for the postextraction replacement of maxillary central incisors using the natural teeth as pontics. The novel appliance fabricated fully satisfied the demands of the adolescent patient for a fixed prosthetic, while fulfilling the aesthetic and functional requirements presented by the case. PMID:23749860

Development of flexible pavement database for local calibration of MEPDG : volume 1.

DOT National Transportation Integrated Search

2011-06-01

The new mechanistic-empirical pavement design guide (MEPDG), based on the National Cooperative Highway : Research Program (NCHRP) study 1-37A, replaces the widely used but more empirical 1993 AASHTO Guide : for Design of Pavement Structures. The MEPD...

Low water stream crossings in Iowa : a selection and design guide.

DOT National Transportation Integrated Search

2003-02-01

Most Iowa counties maintain low volume roads with at least one bridge or culvert that is structurally : deficient or obsolete. In some counties the percentage of deficient drainage structures may be as : high as 62%. Replacement with structures of si...

Outcomes of Inpatients With and Without Sickle Cell Disease After High-Volume Surgical Procedures

PubMed Central

Dinan, Michaela A.; Chou, Chia-Hung; Hammill, Bradley G.; Graham, Felicia L.; Schulman, Kevin A.; Telen, Marilyn J.; Reed, Shelby D.

2009-01-01

In this study, we examined differences in inpatient costs, length of stay, and in-hospital mortality between hospitalizations for patients with and without sickle cell disease (SCD) undergoing high-volume surgical procedures. We used Clinical Classification Software (CCS) codes to identify discharges in the 2002–2005 Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project for patients who had undergone either cholecystectomy or hip replacement. We limited the non-SCD cohort to hospitals where patients with SCD had undergone the same procedure. We compared inpatient outcomes using summary statistics and generalized linear regression analysis to adjust for patient, hospital, and procedural characteristics. Overall, the median age of surgical patients with SCD was more than 3 decades less than the median age of patients without SCD undergoing the same procedure. In recognition of the age disparity, we limited the analyses to patients aged 18 to 64 years. Nonetheless, patients with SCD undergoing cholecystectomy or hip replacement were 12.1 and 14.4 years younger, had inpatient stays that were 73% and 82% longer, and incurred costs that were 46% and 40% higher per discharge than patients without SCD, respectively. Inpatient mortality for these procedures was low, approximately 0.6% for cholecystectomy and 0.2% for hip replacement, and did not differ significantly between patients with and without SCD. Multivariable regression analyses revealed that higher inpatient costs among patients with SCD were primarily attributable to longer hospital stays. Patients with SCD who underwent cholecystectomy or hip replacement required more health care resources than patients without SCD. PMID:19787790

Experimentally induced hyperchloremic and DL-lactic acidosis in calves: an attempt to study the effects of oral rehydration on acid-base status.

PubMed

Schwedhelm, L; Kirchner, D; Klaus, B; Bachmann, L

2013-04-01

Many diarrheic calves suffer from metabolic acidosis, which is commonly treated by oral rehydration therapy. Oral rehydration solutions can be prepared in water, milk, or milk replacer. Therefore, the aim of the study was to verify dietary effects of water- or milk replacer-based oral rehydration solutions on parameters of acid-base balance in calves with experimentally induced hyperchloremic and dl-lactate acidosis. In 12 calves, hyperchloremic or dl-lactate acidosis was induced by HCl or dl-lactic acid infusions according to protocols outlined in previous literature. Immediately after induction, the calves were fed with milk replacer or water- or milk replacer-based oral rehydration solutions, or remained fasting, respectively. Blood samples were taken to monitor acid-base status over an experimental period of 4h. Using the protocols, all calves revealed a manifest hyperchloremic or dl-lactate acidosis. Because of high infusion volumes, plasma volume was expanded and effects of feeding regimens on blood parameters were rare. Unexpected clinical aberrations occurred after repeated induction of dl-lactate acidosis: all calves developed a thrombophlebitis of the jugular vein, whereas HCl infusion had no effect on endothelium. Induction of acidosis via infusion is not suitable to study dietary effects. A protocol to induce acidosis and dehydration simultaneously is required to duplicate the metabolic conditions of diarrheic calves. In further investigations, attention should be focused on effects of d-lactate or its metabolites on endothelial tissue. Copyright © 2013 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Esophageal tissue engineering: Current status and perspectives.

PubMed

Poghosyan, T; Catry, J; Luong-Nguyen, M; Bruneval, P; Domet, T; Arakelian, L; Sfeir, R; Michaud, L; Vanneaux, V; Gottrand, F; Larghero, J; Cattan, P

2016-02-01

Tissue engineering, which consists of the combination and in vivo implantation of elements required for tissue remodeling toward a specific organ phenotype, could be an alternative for classical techniques of esophageal replacement. The current hybrid approach entails creation of an esophageal substitute composed of an acellular matrix and autologous epithelial and muscle cells provides the most successful results. Current research is based on the use of mesenchymal stem cells, whose potential for differentiation and proangioogenic, immune-modulator and anti-inflammatory properties are important assets. In the near future, esophageal substitutes could be constructed from acellular "intelligent matrices" that contain the molecules necessary for tissue regeneration; this should allow circumvention of the implantation step and still obtain standardized in vivo biological responses. At present, tissue engineering applications to esophageal replacement are limited to enlargement plasties with absorbable, non-cellular matrices. Nevertheless, the application of existing clinical techniques for replacement of other organs by tissue engineering in combination with a multiplication of translational research protocols for esophageal replacement in large animals should soon pave the way for health agencies to authorize clinical trials. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Procedural Experience for Transcatheter Aortic Valve Replacement and Relation to Outcomes: The STS/ACC TVT Registry.

PubMed

Carroll, John D; Vemulapalli, Sreekanth; Dai, Dadi; Matsouaka, Roland; Blackstone, Eugene; Edwards, Fred; Masoudi, Frederick A; Mack, Michael; Peterson, Eric D; Holmes, David; Rumsfeld, John S; Tuzcu, E Murat; Grover, Frederick

2017-07-04

Transcatheter aortic valve replacement (TAVR) has been introduced into U.S. clinical practice with efforts to optimize outcomes and minimize the learning curve. The goal of this study was to assess the degree to which increasing experience during the introduction of this procedure, separated from other outcome determinants including patient and procedural characteristics, is associated with outcomes. The authors evaluated the association of hospital TAVR volume and patient outcomes for TAVR by using data from 42,988 commercial procedures conducted at 395 hospitals submitting to the Transcatheter Valve Therapy Registry from 2011 through 2015. Outcomes assessed included adjusted and unadjusted in-hospital major adverse events. Increasing site volume was associated with lower in-hospital risk-adjusted outcomes, including mortality (p < 0.02), vascular complications (p < 0.003), and bleeding (p < 0.001) but was not associated with stroke (p = 0.14). From the first case to the 400th case in the volume-outcome model, risk-adjusted adverse outcomes declined, including mortality (3.57% to 2.15%), bleeding (9.56% to 5.08%), vascular complications (6.11% to 4.20%), and stroke (2.03% to 1.66%). Vascular and bleeding volume-outcome associations were nonlinear with a higher risk of adverse outcomes in the first 100 cases. An association of procedure volume with risk-adjusted outcomes was also seen in the subgroup having transfemoral access. The initial adoption of TAVR into practice in the United States showed that increasing experience was associated with better outcomes. This association, whether deemed a prolonged learning curve or a manifestation of a volume-outcome relationship, suggested that concentrating experience in higher volume heart valve centers might be a means of improving outcomes. (STS/ACC Transcatheter Valve Therapy Registry [TVT Registry]; NCT01737528). Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Ulf Fernström (1915-1985) and his Contributions to the Development of Artificial Disc Replacements.

PubMed

Fisahn, Christian; Burgess, Brittni; Iwanaga, Joe; Chapman, Jens R; Oskouian, Rod J; Tubbs, R Shane

2017-02-01

Artificial disc replacements, which serve the function of separating vertebrae to allow for proper spinal alignment, can help treat debilitating low back pain in patients who have failed other conservative methods of treatment. A Swedish surgeon, Ulf Fernström, was the pioneer of artificial disc replacement, and his contribution in the form of Fernström balls dramatically altered spinal surgery and technique by showing the proper technique and implant that should be used for areas requiring motion in many planes. Ulf Fernström created his artificial disc inspired by the movement of the hip and knee joints. His implants attempted to restore disc spacing and articulation in patients who had failed conservative measures of treatment. Fernström balls were the first implants of their kind and represent the first attempt at artificial disc replacement. However, many surgeons and researchers questioned Fernström balls, claiming that their lack of elastic properties could damage patients. Of the wide range of implants on the market for the intervertebral disc space, all designs and applications of products stem from the initial discovery made by Fernström, thus making him a pioneer in disc replacement. Copyright © 2016 Elsevier Inc. All rights reserved.

The effect of body mass and sex on the accuracy of respiratory magnetometers for measurement of end-expiratory lung volumes.

PubMed

Avraam, Joanne; Bourke, Rosie; Trinder, John; Nicholas, Christian L; Brazzale, Danny; O'Donoghue, Fergal J; Rochford, Peter D; Jordan, Amy S

2016-11-01

Respiratory magnetometers are increasingly being used in sleep studies to measure changes in end-expiratory lung volume (EELV), including in obese obstructive sleep apnea patients. Despite this, the accuracy of magnetometers has not been confirmed in obese patients nor compared between sexes. Thus we compared spirometer-measured and magnetometer-estimated lung volume and tidal volume changes during voluntary end-expiratory lung volume changes of 1.5, 1, and 0.5 l above and 0.5 l below functional respiratory capacity in supine normal-weight [body mass index (BMI) < 25 kg/m] and healthy obese (BMI > 30 kg/m) men and women. Two different magnetometer calibration techniques proposed by Banzett et al. [Banzett RB, Mahan ST, Garner DM, Brughera A, Loring SH. J Appl Physiol (1985) 79: 2169-2176, 1995] and Sackner et al. [Sackner MA, Watson H, Belsito AS, Feinerman D, Suarez M, Gonzalez G, Bizousky F, Krieger B. J Appl Physiol (1985) 66: 410-420, 1989] were assessed. Across all groups and target volumes, magnetometers overestimated spirometer-measured EELV by ~65 ml (<0.001) with no difference between techniques (0.07). The Banzett method overestimated the spirometer EELV change in normal-weight women for all target volumes except +0.5 l, whereas no differences between mass or sex groups were observed for the Sackner technique. The variability of breath-to-breath measures of EELV was significantly higher for obese compared with nonobese subjects and was higher for the Sackner than Banzett technique. On the other hand, for tidal volume, both calibration techniques underestimated spirometer measurements (<0.001), with the underestimation being more marked for the Banzett than Sackner technique (0.03), in obese than normal weight (<0.001) and in men than in women (0.003). These results indicate that both body mass and sex affect the accuracy of respiratory magnetometers in measuring EELV and tidal volume. Copyright © 2016 the American Physiological Society.

Measurement of lung volumes from supine portable chest radiographs.

PubMed

Ries, A L; Clausen, J L; Friedman, P J

1979-12-01

Lung volumes in supine nonambulatory patients are physiological parameters often difficult to measure with current techniques (plethysmograph, gas dilution). Existing radiographic methods for measuring lung volumes require standard upright chest radiographs. Accordingly, in 31 normal supine adults, we determined helium-dilution functional residual and total lung capacities and measured planimetric lung field areas (LFA) from corresponding portable anteroposterior and lateral radiographs. Low radiation dose methods, which delivered less than 10% of that from standard portable X-ray technique, were utilized. Correlation between lung volume and radiographic LFA was highly significant (r = 0.96, SEE = 10.6%). Multiple-step regressions using height and chest diameter correction factors reduced variance, but weight and radiographic magnification factors did not. In 17 additional subjects studied for validation, the regression equations accurately predicted radiographic lung volume. Thus, this technique can provide accurate and rapid measurement of lung volume in studies involving supine patients.

Information Processing Techniques Program. Volume II. Communications- Adaptive Internetting

DTIC Science & Technology

1977-09-30

LABORATORY INFORMATION PROCESSING TECHNIQUES PROGRAM VOLUME II: COMMUNICATIONS-ADAPTIVE INTERNETTING I SEMIANNUAL TECHNICAL SUMMARY REPORT TO THE...MASSACHUSETTS ABSTRACT This repori describes work performed on the Communications-Adaptive Internetting program sponsored by the Information ... information processing techniques network speech terminal communicatlons-adaptive internetting 04 links digital voice communications time-varying

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

PubMed

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

2013-09-01

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

Molecular tools for carotenogenesis analysis in the zygomycete Mucor circinelloides.

PubMed

Torres-Martínez, Santiago; Ruiz-Vázquez, Rosa M; Garre, Victoriano; López-García, Sergio; Navarro, Eusebio; Vila, Ana

2012-01-01

The carotene producer fungus Mucor circinelloides is the zygomycete more amenable to genetic manipulations by using molecular tools. Since the initial development of an effective procedure of genetic transformation, more than two decades ago, the availability of new molecular approaches such as gene replacement techniques and gene expression inactivation by RNA silencing, in addition to the sequencing of its genome, has made Mucor a valuable organism for the study of a number of processes. Here we describe in detail the main techniques and methods currently used to manipulate M. circinelloides, including transformation, gene replacement, gene silencing, RNAi, and immunoprecipitation.

Duplication methods for replacement of broken orthoses.

PubMed

Bradbury, R L; Gastwirth, B W; O'Connor, K J; Bloom, J

1988-04-01

The methods presented for replacement of broken orthoses have proved very effective (Fig. 9). In more than 5 years of employing such duplication techniques, we have found patient satisfaction in the product to be commensurate with that for their originally prescribed devices. The techniques presented are not the only methods by which orthoses can be duplicated. We recognize that the clinician should refabricate the same orthosis only when the cause of breakage has been determined to be material fatigue or stress. Should the patient's weight, foot structure, or activities have changed, new orthoses should be fabricated with those factors in mind.

Defining the Role of Free Flaps in Partial Breast Reconstruction.

PubMed

Smith, Mark L; Molina, Bianca J; Dayan, Erez; Jablonka, Eric M; Okwali, Michelle; Kim, Julie N; Dayan, Joseph H

2018-03-01

 Free flaps have a well-established role in breast reconstruction after mastectomy; however, their role in partial breast reconstruction remains poorly defined. We reviewed our experience with partial breast reconstruction to better understand indications for free tissue transfer.  A retrospective review was performed of all patients undergoing partial breast reconstruction at our center between February 2009 and October 2015. We evaluated the characteristics of patients who underwent volume displacement procedures versus volume replacement procedures and free versus pedicled flap reconstruction.  There were 78 partial breast reconstructions, with 52 reductions/tissue rearrangements (displacement group) and 26 flaps (replacement group). Bra cup size and body mass index (BMI) were significantly smaller in the replacement group. Fifteen pedicled and 11 free flaps were performed. Most pedicled flaps (80.0%) were used for lateral or upper pole defects. Most free flaps (72.7%) were used for medial and inferior defects or when there was inadequate donor tissue for a pedicled flap. Complications included hematoma, cellulitis, and one aborted pedicled flap.  Free and pedicled flaps are useful for partial breast reconstruction, particularly in breast cancer patients with small breasts undergoing breast-conserving treatment (BCT). Flap selection depends on defect size, location, and donor tissue availability. Medial defects are difficult to reconstruct using pedicled flaps due to arc of rotation and intervening breast tissue. Free tissue transfer can overcome these obstacles. Confirming negative margins before flap reconstruction ensures harvest of adequate volume and avoids later re-operation. Judicious use of free flaps for oncoplastic reconstruction expands the possibility for breast conservation. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Application of volume rendering technique (VRT) for musculoskeletal imaging.

PubMed

Darecki, Rafał

2002-10-30

A review of the applications of volume rendering technique in musculoskeletal three-dimensional imaging from CT data. General features, potential and indications for applying the method are presented.

Designs for surge immunity in critical electronic facilities

NASA Technical Reports Server (NTRS)

Roberts, Edward F., Jr.

1991-01-01

In recent years, Federal Aviation Administration (FAA) embarked on a program replacing older tube type electronic equipment with newer solid state equipment. This replacement program dramatically increased the susceptibility of the FAA's facilities to lightning related damages. The proposal is presented of techniques which may be employed to lessen the susceptibility of new FAA electronic facility designs to failures resulting from lightning related surges and transients as well as direct strikes. The general concept espoused is one of a consistent system approach employing both perimeter and internal protection. It compares the technique presently employed to reduce electronic noise with other techniques which reduce noise while lowering susceptibility to lightning related damage. It is anticipated that these techniques will be employed in the design of an Air Traffic Control Tower in a high isokeraunic area. This facility would be subjected to rigorous monitoring over a multi-year period to provide quantitative data hopefully supporting the advantage of this design.

Systems-Level Synthetic Biology for Advanced Biofuel Production

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

Ruffing, Anne; Jensen, Travis J.; Strickland, Lucas Marshall

2015-03-01

Cyanobacteria have been shown to be capable of producing a variety of advanced biofuels; however, product yields remain well below those necessary for large scale production. New genetic tools and high throughput metabolic engineering techniques are needed to optimize cyanobacterial metabolisms for enhanced biofuel production. Towards this goal, this project advances the development of a multiple promoter replacement technique for systems-level optimization of gene expression in a model cyanobacterial host: Synechococcus sp. PCC 7002. To realize this multiple-target approach, key capabilities were developed, including a high throughput detection method for advanced biofuels, enhanced transformation efficiency, and genetic tools for Synechococcusmore » sp. PCC 7002. Moreover, several additional obstacles were identified for realization of this multiple promoter replacement technique. The techniques and tools developed in this project will help to enable future efforts in the advancement of cyanobacterial biofuels.« less

Retrofitting existing chemical scrubbers to biotrickling filters for H2S emission control

PubMed Central

Gabriel, David; Deshusses, Marc A.

2003-01-01

Biological treatment is a promising alternative to conventional air-pollution control methods, but thus far biotreatment processes for odor control have always required much larger reactor volumes than chemical scrubbers. We converted an existing full-scale chemical scrubber to a biological trickling filter and showed that effective treatment of hydrogen sulfide (H2S) in the converted scrubber was possible even at gas contact times as low as 1.6 s. That is 8–20 times shorter than previous biotrickling filtration reports and comparable to usual contact times in chemical scrubbers. Significant removal of reduced sulfur compounds, ammonia, and volatile organic compounds present in traces in the air was also observed. Continuous operation for >8 months showed stable performance and robust behavior for H2S treatment, with pollutant-removal performance comparable to that achieved by using a chemical scrubber. Our study demonstrates that biotrickling filters can replace chemical scrubbers and be a safer, more economical technique for odor control. PMID:12740445

Retrofitting existing chemical scrubbers to biotrickling filters for H2S emission control.

PubMed

Gabriel, David; Deshusses, Marc A

2003-05-27

Biological treatment is a promising alternative to conventional air-pollution control methods, but thus far biotreatment processes for odor control have always required much larger reactor volumes than chemical scrubbers. We converted an existing full-scale chemical scrubber to a biological trickling filter and showed that effective treatment of hydrogen sulfide (H2S) in the converted scrubber was possible even at gas contact times as low as 1.6 s. That is 8-20 times shorter than previous biotrickling filtration reports and comparable to usual contact times in chemical scrubbers. Significant removal of reduced sulfur compounds, ammonia, and volatile organic compounds present in traces in the air was also observed. Continuous operation for >8 months showed stable performance and robust behavior for H2S treatment, with pollutant-removal performance comparable to that achieved by using a chemical scrubber. Our study demonstrates that biotrickling filters can replace chemical scrubbers and be a safer, more economical technique for odor control.

Kinect2 - respiratory movement detection study.

PubMed

Rihana, Sandy; Younes, Elie; Visvikis, Dimitris; Fayad, Hadi

2016-08-01

Radiotherapy is one of the main cancer treatments. It consists in irradiating tumor cells to destroy them while sparing healthy tissue. The treatment is planned based on Computed Tomography (CT) and is delivered over fractions during several days. One of the main challenges is replacing patient in the same position every day to irradiate the tumor volume while sparing healthy tissues. Many patient positioning techniques are available. They are both invasive and not accurate performed using tattooed marker on the patient's skin aligned with a laser system calibrated in the treatment room or irradiating using X-ray. Currently systems such as Vision RT use two Time of Flight cameras. Time of Flight cameras have the advantage of having a very fast acquisition rate allows the real time monitoring of patient movement and patient repositioning. The purpose of this work is to test the Microsoft Kinect2 camera for potential use for patient positioning and respiration trigging. This type of Time of Flight camera is non-invasive and costless which facilitate its transfer to clinical practice.

Lattice design and expected performance of the Muon Ionization Cooling Experiment demonstration of ionization cooling

NASA Astrophysics Data System (ADS)

Bogomilov, M.; Tsenov, R.; Vankova-Kirilova, G.; Song, Y.; Tang, J.; Li, Z.; Bertoni, R.; Bonesini, M.; Chignoli, F.; Mazza, R.; Palladino, V.; de Bari, A.; Cecchet, G.; Orestano, D.; Tortora, L.; Kuno, Y.; Ishimoto, S.; Filthaut, F.; Jokovic, D.; Maletic, D.; Savic, M.; Hansen, O. M.; Ramberger, S.; Vretenar, M.; Asfandiyarov, R.; Blondel, A.; Drielsma, F.; Karadzhov, Y.; Charnley, G.; Collomb, N.; Dumbell, K.; Gallagher, A.; Grant, A.; Griffiths, S.; Hartnett, T.; Martlew, B.; Moss, A.; Muir, A.; Mullacrane, I.; Oates, A.; Owens, P.; Stokes, G.; Warburton, P.; White, C.; Adams, D.; Anderson, R. J.; Barclay, P.; Bayliss, V.; Boehm, J.; Bradshaw, T. W.; Courthold, M.; Francis, V.; Fry, L.; Hayler, T.; Hills, M.; Lintern, A.; Macwaters, C.; Nichols, A.; Preece, R.; Ricciardi, S.; Rogers, C.; Stanley, T.; Tarrant, J.; Tucker, M.; Wilson, A.; Watson, S.; Bayes, R.; Nugent, J. C.; Soler, F. J. P.; Gamet, R.; Barber, G.; Blackmore, V. J.; Colling, D.; Dobbs, A.; Dornan, P.; Hunt, C.; Kurup, A.; Lagrange, J.-B.; Long, K.; Martyniak, J.; Middleton, S.; Pasternak, J.; Uchida, M. A.; Cobb, J. H.; Lau, W.; Booth, C. N.; Hodgson, P.; Langlands, J.; Overton, E.; Robinson, M.; Smith, P. J.; Wilbur, S.; Dick, A. J.; Ronald, K.; Whyte, C. G.; Young, A. R.; Boyd, S.; Franchini, P.; Greis, J. R.; Pidcott, C.; Taylor, I.; Gardener, R. B. S.; Kyberd, P.; Nebrensky, J. J.; Palmer, M.; Witte, H.; Bross, A. D.; Bowring, D.; Liu, A.; Neuffer, D.; Popovic, M.; Rubinov, P.; DeMello, A.; Gourlay, S.; Li, D.; Prestemon, S.; Virostek, S.; Freemire, B.; Hanlet, P.; Kaplan, D. M.; Mohayai, T. A.; Rajaram, D.; Snopok, P.; Suezaki, V.; Torun, Y.; Onel, Y.; Cremaldi, L. M.; Sanders, D. A.; Summers, D. J.; Hanson, G. G.; Heidt, C.; MICE Collaboration

2017-06-01

Muon beams of low emittance provide the basis for the intense, well-characterized neutrino beams necessary to elucidate the physics of flavor at a neutrino factory and to provide lepton-antilepton collisions at energies of up to several TeV at a muon collider. The international Muon Ionization Cooling Experiment (MICE) aims to demonstrate ionization cooling, the technique by which it is proposed to reduce the phase-space volume occupied by the muon beam at such facilities. In an ionization-cooling channel, the muon beam passes through a material in which it loses energy. The energy lost is then replaced using rf cavities. The combined effect of energy loss and reacceleration is to reduce the transverse emittance of the beam (transverse cooling). A major revision of the scope of the project was carried out over the summer of 2014. The revised experiment can deliver a demonstration of ionization cooling. The design of the cooling demonstration experiment will be described together with its predicted cooling performance.

Electro-hydrodynamic printing of drugs onto edible substrates

NASA Astrophysics Data System (ADS)

Shen, Yueyang; Elele, Ezinwa; Palle, Prashanth; Khusid, Boris; Basaran, Osman; McGough, Patrick T.; Collins, Robert T.

2009-11-01

While most existing drugs are manufactured as tablets using powder processing techniques, there is growing interest in printing drops containing pharmaceutical actives on edible substrates. We have developed a drop-on-demand (DOD) printing method appropriate for either replacing existing manufacturing platforms or enabling personalized medicine that overcomes the various critical challenges facing current DOD technologies. To eliminate adverse effects of electro-chemical reactions at the fluid-electrode interface, the fluid is infused into an electrically insulating nozzle to form a pendant drop that serves as a floating electrode capacitively coupled to external electrodes. A liquid bridge is formed and broken as the voltage applied at the electrode is varied in time. This gentle method for drop deposition has been demonstrated to operate with fluids spanning over three orders of magnitude in viscosity and conductivity. The proposed method has the potential for the evolving field of pharmaceutical and biomedical applications requiring the deposition of fluids at the exact locations with high volume accuracy.

3D Fast Spin Echo T2-weighted Contrast for Imaging the Female Cervix

NASA Astrophysics Data System (ADS)

Vargas Sanchez, Andrea Fernanda

Magnetic Resonance Imaging (MRI) with T2-weighted contrast is the preferred modality for treatment planning and monitoring of cervical cancer. Current clinical protocols image the volume of interest multiple times with two dimensional (2D) T2-weighted MRI techniques. It is of interest to replace these multiple 2D acquisitions with a single three dimensional (3D) MRI acquisition to save time. However, at present the image contrast of standard 3D MRI does not distinguish cervical healthy tissue from cancerous tissue. The purpose of this thesis is to better understand the underlying factors that govern the contrast of 3D MRI and exploit this understanding via sequence modifications to improve the contrast. Numerical simulations are developed to predict observed contrast alterations and to propose an improvement. Improvements of image contrast are shown in simulation and with healthy volunteers. Reported results are only preliminary but a promising start to establish definitively 3D MRI for cervical cancer applications.

Triple modifier effect on physical, optical and structural properties of boro tellurite zinc lithium glasses

NASA Astrophysics Data System (ADS)

Naresh, P.; Srinivasu, D.; Narsimlu, N.; Ch. Srinivas, Kavitha, B.; Deshpandhe, Uday; Kumar, K. Siva

2018-05-01

To investigate physical, optical and structural properties of glass samples of the Quaternary system (60-x)B2O3-xTeO2-10ZnO-30Li2O with x=0,5,10,15, and 20 mol% were prepared by conventional melt quenching technique. XRD confirmed the amorphous nature of all samples. Physical parameters like density, molar volume, Oxygen packing density and etc. calculated. Density of glass samples increased with the increase of TeO2 concentration due to the replacement of lighter B2O3 with heavier TeO2. Optical properties has studied with the help of UV-Visible spectra. Cut off wavelength is increases whereas Eopt and Urbache energies is decreased except intermediate mole fraction of TeO2 at which the triple modifier effect can be observed. Fourier Transform Infrared spectroscopy reveals that the network consists of TeO3 and TeO6 structural units along with BO3 and BO4 units.

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

Bogomilov, M.; Tsenov, R.; Vankova-Kirilova, G.

Muon beams of low emittance provide the basis for the intense, well-characterized neutrino beams necessary to elucidate the physics of flavor at a neutrino factory and to provide lepton-antilepton collisions at energies of up to several TeV at a muon collider. The international Muon Ionization Cooling Experiment (MICE) aims to demonstrate ionization cooling, the technique by which it is proposed to reduce the phase-space volume occupied by the muon beam at such facilities. In an ionization-cooling channel, the muon beam passes through a material in which it loses energy. The energy lost is then replaced using rf cavities. The combinedmore » effect of energy loss and reacceleration is to reduce the transverse emittance of the beam (transverse cooling). A major revision of the scope of the project was carried out over the summer of 2014. The revised experiment can deliver a demonstration of ionization cooling. The design of the cooling demonstration experiment will be described together with its predicted cooling performance.« less

Direct Growth of Graphene Film on Germanium Substrate

PubMed Central

Wang, Gang; Zhang, Miao; Zhu, Yun; Ding, Guqiao; Jiang, Da; Guo, Qinglei; Liu, Su; Xie, Xiaoming; Chu, Paul K.; Di, Zengfeng; Wang, Xi

2013-01-01

Graphene has been predicted to play a role in post-silicon electronics due to the extraordinary carrier mobility. Chemical vapor deposition of graphene on transition metals has been considered as a major step towards commercial realization of graphene. However, fabrication based on transition metals involves an inevitable transfer step which can be as complicated as the deposition of graphene itself. By ambient-pressure chemical vapor deposition, we demonstrate large-scale and uniform depositon of high-quality graphene directly on a Ge substrate which is wafer scale and has been considered to replace conventional Si for the next generation of high-performance metal-oxide-semiconductor field-effect transistors (MOSFETs). The immiscible Ge-C system under equilibrium conditions dictates graphene depositon on Ge via a self-limiting and surface-mediated process rather than a precipitation process as observed from other metals with high carbon solubility. Our technique is compatible with modern microelectronics technology thus allowing integration with high-volume production of complementary metal-oxide-semiconductors (CMOS). PMID:23955352

Deep patch technique for landslide repair. Final report

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

Helwany, B.M.

1994-10-01

The report describes the laboratory testing of the `USFS deep patch` technique and a CTI modification of this technique for repairing landslides with geosynthetic reinforcement. The technique involves replacing sections of roadway lost due to landslides on top of a geosynthetically-reinforced embankment. The CTI modification involves replacing the reinforced slope with a geosynthetically-reinforced retaining wall with a truncated base. Both techniques rely on the cantilevering ability of the reinforced mass to limit the load on the foundation with a high slide potential. The tests with road base showed that (1) both the USFS and CTI repair reduced effectively the adversemore » effects of local landsliding on the highway pavement by preventing crack propagation; (2) the USFS repair increased the stability of the repaired slope, which was in progressive failure, by reducing the stresses exerted on it; and (3) the CTI repair produced substantially greater stresses on its foundation due to the truncated base of the reinforced mass.« less

Bone Replacement Materials and Techniques Used for Achieving Vertical Alveolar Bone Augmentation

PubMed Central

Sheikh, Zeeshan; Sima, Corneliu; Glogauer, Michael

2015-01-01

Alveolar bone augmentation in vertical dimension remains the holy grail of periodontal tissue engineering. Successful dental implant placement for restoration of edentulous sites depends on the quality and quantity of alveolar bone available in all spatial dimensions. There are several surgical techniques used alone or in combination with natural or synthetic graft materials to achieve vertical alveolar bone augmentation. While continuously improving surgical techniques combined with the use of auto- or allografts provide the most predictable clinical outcomes, their success often depends on the status of recipient tissues. The morbidity associated with donor sites for auto-grafts makes these techniques less appealing to both patients and clinicians. New developments in material sciences offer a range of synthetic replacements for natural grafts to address the shortcoming of a second surgical site and relatively high resorption rates. This narrative review focuses on existing techniques, natural tissues and synthetic biomaterials commonly used to achieve vertical bone height gain in order to successfully restore edentulous ridges with implant-supported prostheses.

An optimized posterior axillary boost technique in radiation therapy to supraclavicular and axillary lymph nodes: A comparative study

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

Hernandez, Victor, E-mail: vhernandezmasgrau@gmail.com; Arenas, Meritxell; Müller, Katrin

2013-01-01

To assess the advantages of an optimized posterior axillary (AX) boost technique for the irradiation of supraclavicular (SC) and AX lymph nodes. Five techniques for the treatment of SC and levels I, II, and III AX lymph nodes were evaluated for 10 patients selected at random: a direct anterior field (AP); an anterior to posterior parallel pair (AP-PA); an anterior field with a posterior axillary boost (PAB); an anterior field with an anterior axillary boost (AAB); and an optimized PAB technique (OptPAB). The target coverage, hot spots, irradiated volume, and dose to organs at risk were evaluated and a statisticalmore » analysis comparison was performed. The AP technique delivered insufficient dose to the deeper AX nodes. The AP-PA technique produced larger irradiated volumes and higher mean lung doses than the other techniques. The PAB and AAB techniques originated excessive hot spots in most of the cases. The OptPAB technique produced moderate hot spots while maintaining a similar planning target volume (PTV) coverage, irradiated volume, and dose to organs at risk. This optimized technique combines the advantages of the PAB and AP-PA techniques, with moderate hot spots, sufficient target coverage, and adequate sparing of normal tissues. The presented technique is simple, fast, and easy to implement in routine clinical practice and is superior to the techniques historically used for the treatment of SC and AX lymph nodes.« less

Mineral Replacement Reactions as a Precursor to Strain Localisation: an (HR-)EBSD approach

NASA Astrophysics Data System (ADS)

Gardner, J.; Wheeler, J.; Wallis, D.; Hansen, L. N.; Mariani, E.

2017-12-01

Much remains to be learned about the links between metamorphism and deformation. Our work investigates the behaviour of fluid-mediated mineral replacement reaction products when exposed to subsequent shear stresses. We focus on albite from a metagabbro that has experienced metamorphism and subsequent deformation at greenschist facies, resulting in a reduction in grain size and associated strain localisation. EBSD maps show that prior to grain size reduction, product grains are highly distorted, yet they formed, and subsequently deformed, at temperatures at which extensive dislocation creep is unlikely. The Weighted Burgers Vector can be used to quantitatively describe the types of Burgers vectors present in geometrically necessary dislocation (GND) populations derived from 2-D EBSD map data. Application of this technique to the distorted product grains reveals the prominence of, among others, dislocations with apparent [010] Burgers vectors. This supports (with some caveats) the idea that dislocation creep is not responsible for the observed lattice distortion, as there are no known slip systems in plagioclase with a [010] Burgers vector. Distortion in a replacement microstructure has also been attributed to the presence of nanoscale product grains, which share very similar, but not identical, orientations due to topotactic nucleation from adjacent sites on the same substrate. As a precipitate, the product grains should be expected to be largely free of elastic strain. However, high angular resolution EBSD results demonstrate that product grains contain both elastic strains (> 10-3) and residual stresses (several hundred MPa), as well as GND densities on the order of 1014-1015 m-2. Thus we suggest the observed distortion (elastic strain plus rotations) in the lattice is produced during the mineral replacement reaction by a lattice mismatch and volume change between parent and product. Stored strain energy then provides a driving force for recovery and recrystallization. Recrystallization produces smaller grains with high angle boundaries, reducing the strength of, and allowing deformation to localise in, the albite phase. Grain size reduction in turn facilitates shear deformation to high strains by a grain size sensitive mechanism (fluid-assisted diffusion creep).

Analysis of the results of replacement of large bone defects in the patients who underwent segmental bone resection for tumor

NASA Astrophysics Data System (ADS)

Anastasieva, E. A.; Voropaeva, A. A.; Sadovoy, M. A.; Kirilova, I. A.

2017-09-01

The problem of large bone defects replacement, formed after segmental bone resections, remains an actual issue of modern orthopedics. It is known that the autograft is the most acceptable material for the replacement of bone tissue; however, due to its small volume and physical properties, it has limited usage. Our goal is to analyze the results of the experiments and studies on replacement of large bone defects after resection of the bone tumor. The problem is justified by the complicated osteoconduction and osteointegration; because it is proved that the reconstruction of the microcirculatory bloodstream is difficult in the presence of damage more than 4 cm2. It was revealed that using of allograft in combination with additional components is comparable in effectiveness, including long-term period, with autograft usage. It is promising to combine plastic allogenous material, capable of reconstructing defects of various configuration intraoperatively, with the necessary chemotherapy with controlled desorption to maintain effective concentration of drug.

Utilization of Oleogels as a Replacement for Solid Fat in Aerated Baked Goods: Physicochemical, Rheological, and Tomographic Characterization.

PubMed

Kim, Joo Young; Lim, Jeongtaek; Lee, JaeHwan; Hwang, Hong-Sik; Lee, Suyong

2017-02-01

Canola oil-carnauba wax oleogels were evaluated as a replacement for shortening in a baked cake system. The use of oleogels produced cake batters with a lower pseudoplastic property and also contributed to their viscous nature. The shortening replacement with oleogels at up to 50% was effective in maintaining the ability to hold air cells into the cake batters. The volume of cakes had an overall tendency to decrease with increasing shortening replacement with oleogels, leading to increased cake firmness. The tomographic analysis demonstrated that the total porosity and fragmentation index were reduced in the oleogel cakes, showing a more connected solid structure. The levels of saturated fatty acids in the cakes containing oleogels were significantly reduced to 13.3%, compared to the control with shortening (74.2%). As a result, the use of oleogels for shortening up to 25% produced cakes with lower levels of saturated fatty acids without quality loss. © 2016 Institute of Food Technologists®.

Improved memory loading techniques for the TSRV display system

NASA Technical Reports Server (NTRS)

Easley, W. C.; Lynn, W. A.; Mcluer, D. G.

1986-01-01

A recent upgrade of the TSRV research flight system at NASA Langley Research Center retained the original monochrome display system. However, the display memory loading equipment was replaced requiring design and development of new methods of performing this task. This paper describes the new techniques developed to load memory in the display system. An outdated paper tape method for loading the BOOTSTRAP control program was replaced by EPROM storage of the characters contained on the tape. Rather than move a tape past an optical reader, a counter was implemented which steps sequentially through EPROM addresses and presents the same data to the loader circuitry. A cumbersome cassette tape method for loading the applications software was replaced with a floppy disk method using a microprocessor terminal installed as part of the upgrade. The cassette memory image was transferred to disk and a specific software loader was written for the terminal which duplicates the function of the cassette loader.

Flushing Time

EPA Science Inventory

The flushing time of an estuary is generally defined as the turnover time of fresh water in the estuary, that is, the time required to replace the fresh water contained in the estuary with freshwater inflow. Thus, the flushing time of an estuary is the ratio of the volume of fres...

Exsanguination Shock: The Next Frontier in Prevention of Battlefield Mortality

DTIC Science & Technology

2011-07-01

and various forms of organ support such as extracorporeal membrane oxygenation/continuous renal replacement therapy.19–23 Given this population of...patient died as a result of near exsanguina- tion but expired with adequate circulating blood volume and indicators of improving physiology

Serum replacement with a growth factor-free synthetic substance in culture medium contributes to effective establishment of mouse embryonic stem cells of various origins.

PubMed

Lee, Seung Tae; Oh, Se Woong; Kim, Dae Yong; Han, Jae Yong; Moon, Shin Yong; Lim, Jeong Mook

2006-10-01

To evaluate whether serum replacement with growth factor-free synthetic substances contributed to the effective establishment of embryonic stem (ES) cells. Randomized, prospective model study. Gamete and stem cell biotechnology laboratory at Seoul National University in Korea. F1 (C57BL6 x DBA2) mice. Blastocysts of different origins were cultured in serum-replaced media. Embryonic stem cell establishment. Eight batches of ES cells were established from colony-forming inner cell mass cells after the replacement of fetal bovine serum (FBS) with synthetic knockout serum replacement (KSR) in mkDMEM. The established cells were positive for ES cell markers and formed both embryoid bodies in vitro and teratomas in vivo, but the established cell batches and control (transformed) ES cells responded differently to the culture media. Higher levels of cell viability were detected after the replacement with the 75:25 FBS-KSR mixture than with any other mixtures, and a gradual decrease in viability was detected as the KSR volume ratio was increased. The 75:25 FBS-KSR mixture-containing medium supported ES cell establishment of outbred ICR, F1, and F2 of C57BL6/DBA2; F1 parthenogenetic and ES cell-complemented tetraploid blastocysts; and single ES-cell cultures. A serum-replaced medium could be used for effective ES-cell establishment of various origins.

The effect of operating conditions on the performance of soil slurry-SBRs.

PubMed

Cassidy, D P; Irvine, R L

2001-01-01

Biological treatment of a silty clay loam with aged diesel fuel contamination was conducted in 8 L Soil Slurry-Sequencing Batch Reactors (SS-SBRs). The purpose was to monitor slurry conditions and evaluate reactor performance for varying solids concentration (5%, 25%, 40%, 50%), mixing speed (300 rpm, 700 rpm, 1200 rpm), retention time (8 d, 10 d, 20 d), and volume replaced per cycle (10%, 50%, 90%). Diesel fuel was measured in slurry and in filtered aqueous samples. Oxygen uptake rate (OUR) was monitored. Aggregate size was measured with sieve analyses. Biosurfactant production was quantified with surface tension measurements. Increasing solids concentration and decreasing mixing speed resulted in increased aggregate size, which in turn increased effluent diesel fuel concentrations. Diesel fuel removal was unaffected by retention time and volume replaced per cycle. Biosurfactant production occurred with all operating strategies. Foam thickness was related to surfactant concentration and mixing speed. OUR, surfactant concentration, and foam thickness increased with increasing diesel fuel added per cycle.

Three-dimensional conformal simultaneously integrated boost technique for breast-conserving radiotherapy.

PubMed

van der Laan, Hans Paul; Dolsma, Wil V; Maduro, John H; Korevaar, Erik W; Hollander, Miranda; Langendijk, Johannes A

2007-07-15

To compare the target coverage and normal tissue dose with the simultaneously integrated boost (SIB) and the sequential boost technique in breast cancer, and to evaluate the incidence of acute skin toxicity in patients treated with the SIB technique. Thirty patients with early-stage left-sided breast cancer underwent breast-conserving radiotherapy using the SIB technique. The breast and boost planning target volumes (PTVs) were treated simultaneously (i.e., for each fraction, the breast and boost PTVs received 1.81 Gy and 2.3 Gy, respectively). Three-dimensional conformal beams with wedges were shaped and weighted using forward planning. Dose-volume histograms of the PTVs and organs at risk with the SIB technique, 28 x (1.81 + 0.49 Gy), were compared with those for the sequential boost technique, 25 x 2 Gy + 8 x 2 Gy. Acute skin toxicity was evaluated for 90 patients treated with the SIB technique according to Common Terminology Criteria for Adverse Events, version 3.0. PTV coverage was adequate with both techniques. With SIB, more efficiently shaped boost beams resulted in smaller irradiated volumes. The mean volume receiving > or =107% of the breast dose was reduced by 20%, the mean volume outside the boost PTV receiving > or =95% of the boost dose was reduced by 54%, and the mean heart and lung dose were reduced by 10%. Of the evaluated patients, 32.2% had Grade 2 or worse toxicity. The SIB technique is proposed for standard use in breast-conserving radiotherapy because of its dose-limiting capabilities, easy implementation, reduced number of treatment fractions, and relatively low incidence of acute skin toxicity.

Volumization of the Brow at the Time of Blepharoplasty: Treating the Eyebrow Fat Pad as an Independent Unit.

PubMed

Vrcek, Ivan; Chou, Eva; Somogyi, Marie; Shore, John W

Loss of volume in the sub-brow fat pad with associated descent of the eyebrow is a common anatomical finding resulting in both functional and aesthetic consequences. A variety of techniques have been described to address brow position at the time of blepharoplasty. To our knowledge, none of these techniques treat the sub-brow fat pad as an isolated unit. Doing so enables the surgeon to stabilize and volumize the brow without resultant tension on the blepharoplasty wound. The authors describe a technique for addressing volume loss in the eyebrow with associated brow descent that treats the sub-brow fat pad as an isolated unit. A retrospective review of all patients undergoing brow ptosis repair by a single surgeon (J.W.S.) over an 11-month period was performed. Eighteen patients and 33 brows underwent the technique described. Patients were followed for an average of 11 weeks (range: 4 weeks to 20 weeks). All patients preoperatively displayed both visually significant dermatochalasis and brow descent below the orbital rim. Evaluation of pre- and postoperative photos demonstrates successful volumization of the brow with skin redraping without focal dimpling or undue tension on the eyelid wound. Performing a dissection that allows the sub-brow fat pad to be elevated in isolation from the overlying orbicularis and underlying periosteum allows for volumization and of the brow without compromising closure. This technique is a safe and effective means of volumizing the brow and treating secondary brow descent.

An Error-Reduction Algorithm to Improve Lidar Turbulence Estimates for Wind Energy

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

Newman, Jennifer F.; Clifton, Andrew

2016-08-01

Currently, cup anemometers on meteorological (met) towers are used to measure wind speeds and turbulence intensity to make decisions about wind turbine class and site suitability. However, as modern turbine hub heights increase and wind energy expands to complex and remote sites, it becomes more difficult and costly to install met towers at potential sites. As a result, remote sensing devices (e.g., lidars) are now commonly used by wind farm managers and researchers to estimate the flow field at heights spanned by a turbine. While lidars can accurately estimate mean wind speeds and wind directions, there is still a largemore » amount of uncertainty surrounding the measurement of turbulence with lidars. This uncertainty in lidar turbulence measurements is one of the key roadblocks that must be overcome in order to replace met towers with lidars for wind energy applications. In this talk, a model for reducing errors in lidar turbulence estimates is presented. Techniques for reducing errors from instrument noise, volume averaging, and variance contamination are combined in the model to produce a corrected value of the turbulence intensity (TI), a commonly used parameter in wind energy. In the next step of the model, machine learning techniques are used to further decrease the error in lidar TI estimates.« less

Characterization of cardiac flow in heart disease patients by computational fluid dynamics and 4D flow MRI

NASA Astrophysics Data System (ADS)

Lantz, Jonas; Gupta, Vikas; Henriksson, Lilian; Karlsson, Matts; Persson, Ander; Carhall, Carljohan; Ebbers, Tino

2017-11-01

In this study, cardiac blood flow was simulated using Computational Fluid Dynamics and compared to in vivo flow measurements by 4D Flow MRI. In total, nine patients with various heart diseases were studied. Geometry and heart wall motion for the simulations were obtained from clinical CT measurements, with 0.3x0.3x0.3 mm spatial resolution and 20 time frames covering one heartbeat. The CFD simulations included pulmonary veins, left atrium and ventricle, mitral and aortic valve, and ascending aorta. Mesh sizes were on the order of 6-16 million cells, depending on the size of the heart, in order to resolve both papillary muscles and trabeculae. The computed flow field agreed visually very well with 4D Flow MRI, with characteristic vortices and flow structures seen in both techniques. Regression analysis showed that peak flow rate as well as stroke volume had an excellent agreement for the two techniques. We demonstrated the feasibility, and more importantly, fidelity of cardiac flow simulations by comparing CFD results to in vivo measurements. Both qualitative and quantitative results agreed well with the 4D Flow MRI measurements. Also, the developed simulation methodology enables ``what if'' scenarios, such as optimization of valve replacement and other surgical procedures. Funded by the Wallenberg Foundation.

A new adaptive mesh refinement strategy for numerically solving evolutionary PDE's

NASA Astrophysics Data System (ADS)

Burgarelli, Denise; Kischinhevsky, Mauricio; Biezuner, Rodney Josue

2006-11-01

A graph-based implementation of quadtree meshes for dealing with adaptive mesh refinement (AMR) in the numerical solution of evolutionary partial differential equations is discussed using finite volume methods. The technique displays a plug-in feature that allows replacement of a group of cells in any region of interest for another one with arbitrary refinement, and with only local changes occurring in the data structure. The data structure is also specially designed to minimize the number of operations needed in the AMR. Implementation of the new scheme allows flexibility in the levels of refinement of adjacent regions. Moreover, storage requirements and computational cost compare competitively with mesh refinement schemes based on hierarchical trees. Low storage is achieved for only the children nodes are stored when a refinement takes place. These nodes become part of a graph structure, thus motivating the denomination autonomous leaves graph (ALG) for the new scheme. Neighbors can then be reached without accessing their parent nodes. Additionally, linear-system solvers based on the minimization of functionals can be easily employed. ALG was not conceived with any particular problem or geometry in mind and can thus be applied to the study of several phenomena. Some test problems are used to illustrate the effectiveness of the technique.

Use of a novel drainage flow servo-controlled CPB for mitral valve replacement in a Jehovah's Witness.

PubMed

Niimi, Yoshinari; Murata, Seiichiro; Mitou, Yumi; Ohno, Yusuke

2018-03-01

We developed a novel open cardiopulmonary bypass (CPB) system, a drainage flow servo-controlled CPB system (DS-CPB), in which rotational speed of the main roller pump is servo-controlled to generate the same amount of flow as the systemic venous drainage. It was designed to safely decrease the priming volume while maintaining a constant reservoir level, even during fluctuations of the drainage flow. We report a successful use of a novel DS-CPB system in an elderly Jehovah's Witness patient with dehydration who underwent mitral valve replacement.

Physician Reaction to Price Changes: An Episode-of-Care Analysis

PubMed Central

Lee, A. James; Mitchell, Janet B.

1994-01-01

Physicians may respond to fee reductions in a variety of ways. This episode-of-care analysis examines the impact of surgical fee reductions (mandated by the Omnibus Budget Reconciliation Acts [OBRAs] of 1986-87) on the overall pattern and cost of health care services provided in association with the surgical procedure itself. The study focuses on six procedure groups: cataract extractions; total hip replacement; total knee replacement; coronary artery bypass graft (CABG) surgery; upper gastrointestinal (GI) endoscopy; and prostatectomy. Only two of these procedures give significant evidence for the existence of a service volume offset to the fee reductions. PMID:10172299

Lipid production of Chlorella vulgaris cultured in artificial wastewater medium.

PubMed

Feng, Yujie; Li, Chao; Zhang, Dawei

2011-01-01

Chlorella vulgaris was used to study algal lipid production with wastewater treatment. Artificial wastewater was used to cultivate C. vulgaris in a column aeration photobioreactor (CAP) under batch and semi-continuous cultivation with various daily culture replacements (0.5l-1.5l per 2l reactor). The cell density was decreased from 0.89 g/l with the daily replacement of 0.5l to 0.28 g/l with 1.5l replacement. However, C. vulgaris culture achieved the highest lipid content (42%, average value of the phase) and the lipid productivity (147 mg/ld(-1)) with daily replacement of 1.0 l. And then the nutrient removal efficiency were 86% (COD), 97% (NH(4)(+)) and 96% (TP), respectively. Analyses of energy efficiency showed that the net energy ratio (NER) for lipid production with daily replacement of 1.0 l (1.25) was higher than the other volume replacement protocols. And cost analyses showed that the algal biomass can be competitive with petroleum at US$ 63.97 per barrel with the potential credit for wastewater treatment. According to the above results, it is concluded that the present research will lead to an economical technology of algal lipid production. Copyright © 2010 Elsevier Ltd. All rights reserved.

Arthrodesis of the knee after failed knee replacement.

PubMed

Wade, P J; Denham, R A

1984-05-01

Arthrodesis of the knee is sometimes needed for failed total knee replacement, but fusion can be difficult to obtain. We describe a method of arthrodesis that uses the simple, inexpensive, Portsmouth external fixator. Bony union was obtained in all six patients treated with this technique. These results are compared with those obtained by other methods of arthrodesis.

[Total hip arthroplasty through anterior "minimal invasive" approach].

PubMed

Moerenhout, Kevin G; Cherix, Stéphane; Rüdiger, Hannes A

2012-12-19

Total hip replacement has seen a tremendous development and has become one of the most successful surgical interventions in orthopaedics. While during the first decades of development of total hip arthroplasty the fixation of the implant into the bone was the main concern, the focus has shifted towards surgical technique and soft tissue handling. In order to avoid permanent soft tissue damage, muscular dysfunction and concerns in regards to cosmetics, minimal invasive and anatomic approaches have been developed. We here provide a short overview on various methods of total hip replacements and we describe our technique through a minimal invasive direct anterior approach. While muscle and nerve damage is minimal, this technique allows for a rapid rehabilitation and is associated with an excellent functional outcome and a minimal risk for dislocation.

Piper sarmentosum enhances fracture healing in ovariectomized osteoporotic rats: a radiological study.

PubMed

Estai, Mohamed Abdalla; Suhaimi, Farihah Haji; Das, Srijit; Fadzilah, Fazalina Mohd; Alhabshi, Sharifah Majedah Idrus; Shuid, Ahmad Nazrun; Soelaiman, Ima-Nirwana

2011-01-01

Osteoporotic fractures are common during osteoporotic states. Piper sarmentosum extract is known to possess antioxidant and anti-inflammatory properties. To observe the radiological changes in fracture calluses following administration of a Piper sarmentosum extract during an estrogen-deficient state. A total of 24 female Sprague-Dawley rats (200-250 g) were randomly divided into 4 groups: (i) the sham-operated group; (ii) the ovariectomized-control group; (iii) the ovariectomized + estrogen-replacement therapy (ovariectomized-control + estrogen replacement therapy) group, which was supplemented with estrogen (100 μg/kg/day); and (iv) the ovariectomized + Piper sarmentosum (ovariectomized + Piper sarmentosum) group, which was supplemented with a water-based Piper sarmentosum extract (125 mg/kg). Six weeks after an ovariectomy, the right femora were fractured at the mid-diaphysis, and a K-wire was inserted. Each group of rats received their respective treatment for 6 weeks. Following sacrifice, the right femora were subjected to radiological assessment. The mean axial callus volume was significantly higher in the ovariectomized-control group (68.2 ± 11.74 mm³) than in the sham-operated, estrogen-replacement-therapy and Piper sarmentosum groups (20.4 ± 4.05, 22.4 ± 4.14 and 17.5 ± 3.68 mm³, respectively). The median callus scores for the sham-operated, estrogen-replacement-therapy and Piper sarmentosum groups had median (range, minimum - maximum value) as 1.0 (0 - 2), 1.0 (1 - 2) and 1.0 (1 - 2), respectively, which were significantly lower than the ovariectomized-control group score of 2.0 (2 - 3). The median fracture scores for the sham-operated, estrogen-replacement-therapy and Piper sarmentosum groups were 3.0 (3 - 4), 3.0 (2 - 3) and 3.0 (2 - 3), respectively, which were significantly higher than the ovariectomized-control group score of 2.0 (1 - 2) (p<0.05). The Piper sarmentosum extract improved fracture healing, as assessed by the reduced callus volumes and reduced callus scores. This extract is beneficial for fractures in osteoporotic states.

Hardware implementation of hierarchical volume subdivision-based elastic registration.

PubMed

Dandekar, Omkar; Walimbe, Vivek; Shekhar, Raj

2006-01-01

Real-time, elastic and fully automated 3D image registration is critical to the efficiency and effectiveness of many image-guided diagnostic and treatment procedures relying on multimodality image fusion or serial image comparison. True, real-time performance will make many 3D image registration-based techniques clinically viable. Hierarchical volume subdivision-based image registration techniques are inherently faster than most elastic registration techniques, e.g. free-form deformation (FFD)-based techniques, and are more amenable for achieving real-time performance through hardware acceleration. Our group has previously reported an FPGA-based architecture for accelerating FFD-based image registration. In this article we show how our existing architecture can be adapted to support hierarchical volume subdivision-based image registration. A proof-of-concept implementation of the architecture achieved speedups of 100 for elastic registration against an optimized software implementation on a 3.2 GHz Pentium III Xeon workstation. Due to inherent parallel nature of the hierarchical volume subdivision-based image registration techniques further speedup can be achieved by using several computing modules in parallel.

Anatomic and Pathologic Variability During Radiotherapy for a Hybrid Active Breath-Hold Gating Technique

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

Glide-Hurst, Carri K.; Gopan, Ellen; Department of Radiation Oncology Wayne State University, Detroit, MI

2010-07-01

Purpose: To evaluate intra- and interfraction variability of tumor and lung volume and position using a hybrid active breath-hold gating technique. Methods and Materials: A total of 159 repeat normal inspiration active breath-hold CTs were acquired weekly during radiotherapy for 9 lung cancer patients (12-21 scans per patient). A physician delineated the gross tumor volume (GTV), lungs, and spinal cord on the first breath-hold CT, and contours were propagated semiautomatically. Intra- and interfraction variability of tumor and lung position and volume were evaluated. Tumor centroid and border variability were quantified. Results: On average, intrafraction variability of lung and GTV centroidmore » position was <2.0 mm. Interfraction population variability was 3.6-6.7 mm (systematic) and 3.1-3.9 mm (random) for the GTV centroid and 1.0-3.3 mm (systematic) and 1.5-2.6 mm (random) for the lungs. Tumor volume regressed 44.6% {+-} 23.2%. Gross tumor volume border variability was patient specific and demonstrated anisotropic shape change in some subjects. Interfraction GTV positional variability was associated with tumor volume regression and contralateral lung volume (p < 0.05). Inter-breath-hold reproducibility was unaffected by time point in the treatment course (p > 0.1). Increases in free-breathing tidal volume were associated with increases in breath-hold ipsilateral lung volume (p < 0.05). Conclusions: The breath-hold technique was reproducible within 2 mm during each fraction. Interfraction variability of GTV position and shape was substantial because of tumor volume and breath-hold lung volume change during therapy. These results support the feasibility of a hybrid breath-hold gating technique and suggest that online image guidance would be beneficial.« less

SRB Environment Evaluation and Analysis. Volume 2: RSRB Joint Filling Test/Analysis Improvements

NASA Technical Reports Server (NTRS)

Knox, E. C.; Woods, G. Hamilton

1991-01-01

Following the Challenger accident a very comprehensive solid rocket booster (SRB) redesign program was initiated. One objective of the program was to develop expertise at NASA/MSFC in the techniques for analyzing the flow of hot gases in the SRB joints. Several test programs were undertaken to provide a data base of joint performance with manufactured defects in the joints to allow hot gases to fill the joints. This data base was used also to develop the analytical techniques. Some of the test programs were Joint Environment Simulator (JES), Nozzle Joint Environment Simulator (NJES), Transient Pressure Test Article (TPTA), and Seventy-Pound Charge (SPC). In 1988 the TPTA test hardware was moved from the Utah site to MSFC and several RSRM tests were scheduled, to be followed by tests for the ASRM program. REMTECH Inc. supported these activities with pretest estimates of the flow conditions in the test joints, and post-test analysis and evaluation of the measurements. During this support REMTECH identified deficiencies in the gas-measurement instrumentation that existed in the TPTA hardware, made recommendations for its replacement, and identified improvements to the analytical tools used in the test support. Only one test was completed under the TPTA RSRM test program, and those scheduled for the ASRM were rescheduled to a time after the expiration of this contract. The attention of this effort was directed toward improvements in the analytical techniques in preparation for when the ASRM program begins.

3D Model of Surfactant Replacement Therapy

NASA Astrophysics Data System (ADS)

Grotberg, James; Tai, Cheng-Feng; Filoche, Marcel

2015-11-01

Surfactant Replacement Therapy (SRT) involves instillation of a liquid-surfactant mixture directly into the lung airway tree. Though successful in neonatal applications, its use in adults had early success followed by failure. We present the first mathematical model of 3D SRT where a liquid plug propagates through the tree from forced inspiration. In two separate modeling steps, the plug first deposits a coating film on the airway wall which subtracts from its volume, a ``coating cost''. Then the plug splits unevenly at the airway bifurcation due to gravity. The steps are repeated until a plug ruptures or reaches the tree endpoint alveoli/acinus. The model generates 3D images of the resulting acinar distribution and calculates two global indexes, efficiency and homogeneity. Simulating published literature, the earlier successful adult SRT studies show comparatively good index values, while the later failed studies do not. Those unsuccessful studies used smaller dose volumes with higher concentration mixtures, apparently assuming a well mixed compartment. The model shows that adult lungs are not well mixed in SRT due to the coating cost and gravity effects. Returning to the higher dose volume protocols could save many thousands of lives annually in the US. Supported by NIH Grants HL85156, HL84370 and Agence Nationale de la Recherche, ANR no. 2010-BLAN-1119-05.

Growth and atrophy of neurons labeled at their birth in a song nucleus of the zebra finch

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

Konishi, M.; Akutagawa, E.

1990-05-01

The robust nucleus of the archistriatum (RA) is one of the forebrain nuclei that control song production in birds. In the zebra finch (Poephila guttata), this nucleus contains more and larger neurons in the male than in the female. A single injection of tritiated thymidine into the egg on the 6th or 7th day of incubation resulted in labeling of many RA neurons with tritium. The size of tritium-labeled neurons and the tissue volume containing them did not differ between the sexes at 15 days after hatching. In the adult brain, tritium-labeled neurons and the tissue volume containing them weremore » much larger in the male than in the female. Also, tritium-labeled RA neurons were large in females which received an implant of estrogen immediately after hatching. The gender differences in the neuron size and nuclear volume of the zebra finch RA are, therefore, due not to the replacement of old neurons by new ones during development but to the growth and atrophy of neurons born before hatching. Similarly, the masculinizing effects of estrogen on the female RA are due not to neuronal replacement but to the prevention of atrophy and promotion of growth in preexisting neurons.« less

Effect of alloying elements and heat treatment on the fracture toughness of Ti-Al-Nb alloys

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

Kamat, S.V.; Gogia, A.K.; Banerjee, D.

The fracture toughness and toughening mechanisms of Ti{sub 3}Al based alloy compositions covering a large range of Nb, small variations in Al and quaternary substitutions of Nb have been studied in a variety of heat treated conditions designed to vary the volume fractions of the constituents phases. It was found that the B2 phase of these alloys failed by cleavage in a coarse grained condition but in a ductile manner when fine grained. A higher Nb and a lower Al content improved the cleavage fracture stress of the B2 phase while replacement of a part of Nb and a lowermore » Al content improved the cleavage fracture stress of the B2 phase while replacement of a part of Nb with Mo or Ta had no significant effect. Heat treatments which result in a two phase microstructure ({alpha}{sub 2} + {beta}/B2) exhibited a trend of increasing fracture toughness with increasing volume fraction of {beta}/B2 up to about 60--80 volume fraction of {beta}/B2. This behavior was largely explained by quantifying the role of crack tip blunting. The effect of alloying elements on fracture toughness in two phase microstructures was similar to that observed in the coarse grained B2 condition.« less

Development of construction materials using nano-silica and aggregates recycled from construction and demolition waste.

PubMed

Mukharjee, Bibhuti Bhusan; Barai, Sudhirkumar V

2015-06-01

The present work addresses the development of novel construction materials utilising commercial grade nano-silica and recycled aggregates retrieved from construction and demolition waste. For this, experimental work has been carried out to examine the influence of nano-silica and recycled aggregates on compressive strength, modulus of elasticity, water absorption, density and volume of voids of concrete. Fully natural and recycled aggregate concrete mixes are designed by replacing cement with three levels (0.75%, 1.5% and 3%) of nano-silica. The results of the present investigation depict that improvement in early days compressive strength is achieved with the incorporation of nano-silica in addition to the restoration of reduction in compressive strength of recycled aggregate concrete mixes caused owing to the replacement of natural aggregates by recycled aggregates. Moreover, the increase in water absorption and volume of voids with a reduction of bulk density was detected with the incorporation of recycled aggregates in place of natural aggregates. However, enhancement in density and reduction in water absorption and volume of voids of recycled aggregate concrete resulted from the addition of nano-silica. In addition, the results of the study reveal that nano-silica has no significant effect on elastic modulus of concrete. © The Author(s) 2015.

Volumetric Analysis of Alveolar Bone Defect Using Three-Dimensional-Printed Models Versus Computer-Aided Engineering.

PubMed

Du, Fengzhou; Li, Binghang; Yin, Ningbei; Cao, Yilin; Wang, Yongqian

2017-03-01

Knowing the volume of a graft is essential in repairing alveolar bone defects. This study investigates the 2 advanced preoperative volume measurement methods: three-dimensional (3D) printing and computer-aided engineering (CAE). Ten unilateral alveolar cleft patients were enrolled in this study. Their computed tomographic data were sent to 3D printing and CAE software. A simulated graft was used on the 3D-printed model, and the graft volume was measured by water displacement. The volume calculated by CAE software used mirror-reverses technique. The authors compared the actual volumes of the simulated grafts with the CAE software-derived volumes. The average volume of the simulated bone grafts by 3D-printed models was 1.52 mL, higher than the mean volume of 1.47 calculated by CAE software. The difference between the 2 volumes was from -0.18 to 0.42 mL. The paired Student t test showed no statistically significant difference between the volumes derived from the 2 methods. This study demonstrated that the mirror-reversed technique by CAE software is as accurate as the simulated operation on 3D-printed models in unilateral alveolar cleft patients. These findings further validate the use of 3D printing and CAE technique in alveolar defect repairing.

Acquired tracheoesophageal fistula due to high intracuff pressure.

PubMed

Hameed, Akmal A; Mohamed, Hasan; Al-Mansoori, Motasem

2008-01-01

High-compliance endotracheal tube cuffs are used to prevent gas leak and also pulmonary aspiration in mechanically ventilated patients. However, the use of the usual cuff inflation volumes may cause tracheal damage and lead to tracheoesophageal fistula.Tracheostomy tube cuffs seal against the tracheal wall and prevent leakage of air around the tube, assuring that the tidal volume is delivered to the lungs. In the past, high-pressure cuffs were used, but these contributed to tracheal injury and have been replaced by high-volume, low-pressure cuffs. For long-term applications, some newer tubes have low-profile (tight to shaft) cuffs that facilitate the tracheostomy tube changes by eliminating the lip that forms when standard cuffs are deflated.

Separation of toxic metal ions, hydrophilic hydrocarbons, hydrophobic fuel and halogenated hydrocarbons and recovery of ethanol from a process stream

DOEpatents

Kansa, Edward J.; Anderson, Brian L.; Wijesinghe, Ananda M.; Viani, Brian E.

1999-01-01

This invention provides a process to tremendously reduce the bulk volume of contaminants obtained from an effluent stream produced subsurface remediation. The chemicals used for the subsurface remediation are reclaimed for recycling to the remediation process. Additional reductions in contaminant bulk volume are achieved by the ultra-violet light destruction of halogenated hydrocarbons, and the complete oxidation of hydrophobic fuel hydrocarbons and hydrophilic hydrocarbons. The contaminated bulk volume will arise primarily from the disposal of the toxic metal ions. The entire process is modular, so if there are any technological breakthroughs in one or more of the component process modules, such modules can be readily replaced.

Archimedes Revisited: A Faster, Better, Cheaper Method of Accurately Measuring the Volume of Small Objects

ERIC Educational Resources Information Center

Hughes, Stephen W.

2005-01-01

A little-known method of measuring the volume of small objects based on Archimedes' principle is described, which involves suspending an object in a water-filled container placed on electronic scales. The suspension technique is a variation on the hydrostatic weighing technique used for measuring volume. The suspension method was compared with two…

SU-E-T-178: Clinical Feasibility of Multi-Leaf Collimator Based Dynamic Wedge

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

Jeong, C; Kwak, J; Ahn, S

2015-06-15

Purpose: A multi-leaf collimator (MLC) based dynamic wedge (MDW), which provide similar dose profile of physical wedge (PW) along x-jaw direction while significant monitor unit (MU) reduction, was developed and investigated for clinical use. Methods: A novel technique was used to create the wedge profile using MLC. A modification was applied to the DICOM-RT format file of the plan made with the PW to replace PW with MDW. The Varian enhanced dynamic wedge profile was used to produce MLC sequence, while the MU of the wedged field was recalculated using PW factor and fluence map. The profiles for all possiblemore » MDWs to substitute PWs were verified in 6/15 MV x-ray irradiations. New plans with MDWs were compared with the original plans in 5 rectal, 5 RT breast and 5 liver cases. Results: The wedge profile of the MDW fields were well matched with those of PWs inside the fields while less scatter than PW out of the fields. For plan comparisons of the clinical cases no significant dose discrepancy was observed between MDW plan and PW’s with the dose volume histograms. The maximum and mean doses in PTVs are agreed within 1.0%. The Result of OARs of MDW plans are slightly improved in the maximum doses (3.22 ∼ 150.4 cGy) and the mean doses (17.18 ∼ 85.52 cGy) on average for all cases while the prescribed doses are 45 Gy for rectal cases, 40 or 45 Gy for liver cases and 50 Gy for breast cases. The MUs of the fields which replace PW with MDW are reduced to 68% of those of PW. Conclusion: We developed a novel dynamic wedge technique with MLC that shows clinical advantage compared to PW.« less

A new model of reaction-driven cracking: fluid volume consumption and tensile failure during serpentinization

NASA Astrophysics Data System (ADS)

Eichenbaum-Pikser, J. M.; Spiegelman, M. W.; Kelemen, P. B.; Wilson, C. R.

2013-12-01

Reactive fluid flow plays an important role in a wide range of geodynamic processes, such as melt migration, formation of hydrous minerals on fault surfaces, and chemical weathering. These processes are governed by the complex coupling between fluid transport, reaction, and solid deformation. Reaction-driven cracking is a potentially critical feedback mechanism, by which volume change associated with chemical reaction drives fracture in the surrounding rock. It has been proposed to play a role in both serpentinization and carbonation of peridotite, motivating consideration of its application to mineral carbon sequestration. Previous studies of reactive cracking have focused on the increase in solid volume, and as such, have considered failure in compression. However, if the consumption of fluid is considered in the overall volume budget, the reaction can be net volume reducing, potentially leading to failure in tension. To explore these problems, we have formulated and solved a 2-D model of coupled porous flow, reaction kinetics, and elastic deformation using the finite element model assembler TerraFERMA (Wilson et al, G3 2013 submitted). The model is applied to the serpentinization of peridotite, which can be reasonably approximated as the transfer of a single reactive component (H2O) between fluid and solid phases, making it a simple test case to explore the process. The behavior of the system is controlled by the competition between the rate of volume consumption by the reaction, and the rate of volume replacement by fluid transport, as characterized by a nondimensional parameter χ, which depends on permeability, reaction rate, and the bulk modulus of the solid. Large values of χ correspond to fast fluid transport relative to reaction rate, resulting in a low stress, volume replacing regime. At smaller values of χ, fluid transport cannot keep up with the reaction, resulting in pore fluid under-pressure and tensile solid stresses. For the range of χ relevant to the serpentinization of peridotite, these stresses can reach hundreds of MPa, exceeding the tensile strength of peridotite.

Meniscal tears, repairs and replacement: their relevance to osteoarthritis of the knee.

PubMed

McDermott, Ian

2011-04-01

The menisci of the knee are important load sharers and shock absorbers in the joint. Meniscal tears are common, and whenever possible meniscal tears should be surgically repaired. Meniscectomy leads to a significant increased risk of osteoarthritis, and various options now exist for replacing missing menisci, including the use of meniscal scaffolds or the replacement of the entire meniscus by meniscal allograft transplantation. The field of meniscal surgery continues to develop apace, and the future may lie in growing new menisci by tissue engineering techniques.

FDOT Protocol for Condition Assessment of Steel Strands in Post-tensioned Segmental Concrete Bridges : Volume II

DOT National Transportation Integrated Search

2012-06-01

Post-tensioned bridges require a detailed inspection of their post-tensioning systems since damage in : these systems is not evident and can result in costly repairs/replacements, loss of integrity and reduction : in safety of the bridge. Different n...

Alterations in microbiota structure and neurobehavior in zebrafish following developmental exposure to estrogenic compounds

EPA Science Inventory

Exposure to Bisphenol A (BPA), a high-production volume chemical and widespread environmental contaminant, has been associated with adverse endocrine and neurodevelopmental effects. Growing public concern over the safety of BPA has resulted in swift replacement with a suite of al...

The use of cone penetration testing to investigate sand fill subsidence at cross-drain locations: final report : Volume I.

DOT National Transportation Integrated Search

1984-03-01

During construction of Interstate I-10 between Baton Rouge and LaPlace, Louisiana, highly organic swamp deposits were excavated and replaced with hydraulically pumped river sand. Recently, excessive settlement was encountered at numerous cross-drain ...

Volume reduction of hot cell plastic wastes

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

Dykes, F W; Henscheid, J P; Lewis, L C

1989-09-19

The disposal of radioactively-contaminated solid wastes has become a national crisis. In such circumstances, it is imperative that this waste be reduced to minimum volume and be packaged to prevent pollution of the environment. The majority of the solid waste generated at the hot cell under consideration is plastic lab ware. Cutting this waste into small pieces with a hot wire technique reduced the volume 66%. Melting the waste, although more time consuming, reduced the volume 90%. The hot wire technique can also be used to cut up damaged master slave manipulator boots, greatly reducing their disposal volume.

Computation Techniques for the Volume of a Tetrahedron

ERIC Educational Resources Information Center

Srinivasan, V. K.

2010-01-01

The purpose of this article is to discuss specific techniques for the computation of the volume of a tetrahedron. A few of them are taught in the undergraduate multivariable calculus courses. Few of them are found in text books on coordinate geometry and synthetic solid geometry. This article gathers many of these techniques so as to constitute a…

Properties of fresh and hardened sustainable concrete due to the use of palm oil fuel ash as cement replacement

NASA Astrophysics Data System (ADS)

Hamada, Hussein M.; Jokhio, Gul Ahmed; Mat Yahaya, Fadzil; Humada, Ali M.

2018-04-01

Palm oil fuel ash (POFA) is a by-product resulting from the combustion of palm oil waste such as palm oil shell and empty fruit bunches to generate electricity in the palm oil mills. Considerable quantities of POFA thus generated, accumulate in the open fields and landfills, which causes atmospheric pollution in the form of generating toxic gases. Firstly, to protect the environment; and secondly, having excellent properties for this purpose; POFA can be and has been used as partial cement replacement in concrete preparation. Therefore, this paper compiles the results obtained from previous studies that address the properties of concrete containing POFA as cement replacement in fresh and hardened states. The results indicate that there is a great potential to using POFA as cement replacement because of its ability to improve compressive strength, reduce hydration heat of cement mortar and positively affect other fresh and hardened concrete properties. The paper recommends that conducting further studies to exploit high volume of POFA along with other additives as cement replacement while maintaining high quality of concrete can help minimize CO2 emissions due to concrete.

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

Harris, Victoria A.; Staffurth, John; Naismith, Olivia

Purpose: The purpose of this study was to establish reproducible guidelines for delineating the clinical target volume (CTV) of the pelvic lymph nodes (LN) by combining the freehand Royal Marsden Hospital (RMH) and Radiation Therapy Oncology Group (RTOG) vascular expansion techniques. Methods and Materials: Seven patients with prostate cancer underwent standard planning computed tomography scanning. Four different CTVs (RMH, RTOG, modified RTOG, and Prostate and pelvIs Versus prOsTate Alone treatment for Locally advanced prostate cancer [PIVOTAL] trial) were created for each patient, and 6 different bowel expansion margins (BEM) were created to assess bowel avoidance by the CTV. The resulting CTVsmore » were compared visually and by using Jaccard conformity indices. The volume of overlap between bowel and planning target volume (PTV) was measured to aid selection of an appropriate BEM to enable maximal LN yet minimal normal tissue coverage. Results: In total, 84 nodal contours were evaluated. LN coverage was similar in all groups, with all of the vascular-expansion techniques (RTOG, modified RTOG, and PIVOTAL), resulting in larger CTVs than that of the RMH technique (mean volumes: 287.3 cm{sup 3}, 326.7 cm{sup 3}, 310.3 cm{sup 3}, and 256.7 cm{sup 3}, respectively). Mean volumes of bowel within the modified RTOG PTV were 19.5 cm{sup 3} (with 0 mm BEM), 17.4 cm{sup 3} (1-mm BEM), 10.8 cm{sup 3} (2-mm BEM), 6.9 cm{sup 3} (3-mm BEM), 5.0 cm{sup 3} (4-mm BEM), and 1.4 cm{sup 3} (5-mm BEM) in comparison with an overlap of 9.2 cm{sup 3} seen using the RMH technique. Evaluation of conformity between LN-CTVs from each technique revealed similar volumes and coverage. Conclusions: Vascular expansion techniques result in larger LN-CTVs than the freehand RMH technique. Because the RMH technique is supported by phase 1 and 2 trial safety data, we proposed modifications to the RTOG technique, including the addition of a 3-mm BEM, which resulted in LN-CTV coverage similar to that of the RMH technique, with reduction in bowel and planning target volume overlap. On the basis of these findings, recommended guidelines including a detailed pelvic LN contouring atlas have been produced and implemented in the PIVOTAL trial.« less

Application of response surface techniques to helicopter rotor blade optimization procedure

NASA Technical Reports Server (NTRS)

Henderson, Joseph Lynn; Walsh, Joanne L.; Young, Katherine C.

1995-01-01

In multidisciplinary optimization problems, response surface techniques can be used to replace the complex analyses that define the objective function and/or constraints with simple functions, typically polynomials. In this work a response surface is applied to the design optimization of a helicopter rotor blade. In previous work, this problem has been formulated with a multilevel approach. Here, the response surface takes advantage of this decomposition and is used to replace the lower level, a structural optimization of the blade. Problems that were encountered and important considerations in applying the response surface are discussed. Preliminary results are also presented that illustrate the benefits of using the response surface.

Locomotor exercise in weightlessness

NASA Technical Reports Server (NTRS)

Thornton, W.; Whitmore, H.

1991-01-01

The requirements for exercise in space by means of locomotion are established and addressed with prototype treadmills for use during long-duration spaceflight. The adaptation of the human body to microgravity is described in terms of 1-G locomotor biomechanics, the effects of reduced activity, and effective activity-replacement techniques. The treadmill is introduced as a complement to other techniques of force replacement with reference given to the angle required for exercise. A motor-driven unit is proposed that can operate at a variety of controlled speeds and equivalent grades. The treadmills permit locomotor exercise as required for long-duration space travel to sustain locomotor and cardiorespiratory capacity at a level consistent with postflight needs.

Temporary bypass for superior vena cava reconstruction with Anthron bypass tubeTM

PubMed Central

Yamasaki, Naoya; Tsuchiya, Tomoshi; Miyazaki, Takuro; Kamohara, Ryotaro; Hatachi, Go; Nagayasu, Takeshi

2017-01-01

Total superior vena cava (SVC) clamping for SVC replacement or repair can be used in thoracic surgery. A bypass technique is an option to avoid hemodynamic instability and cerebral venous hypertension and hypoperfusion. The present report describes a venous bypass technique using Anthron bypass tubeTM for total SVC clamping. Indications for this procedure include the need for a temporary bypass between the brachiocephalic vein and atrium for complete tumor resection. This procedure allows the surgeons sufficient time to complete replacement of SVC or partial resection of SVC without adverse effects. Further, it is a relatively simple procedure requiring minimal time. PMID:28840027

A study of the use of linear programming techniques to improve the performance in design optimization problems

NASA Technical Reports Server (NTRS)

Young, Katherine C.; Sobieszczanski-Sobieski, Jaroslaw

1988-01-01

This project has two objectives. The first is to determine whether linear programming techniques can improve performance when handling design optimization problems with a large number of design variables and constraints relative to the feasible directions algorithm. The second purpose is to determine whether using the Kreisselmeier-Steinhauser (KS) function to replace the constraints with one constraint will reduce the cost of total optimization. Comparisons are made using solutions obtained with linear and non-linear methods. The results indicate that there is no cost saving using the linear method or in using the KS function to replace constraints.

A technique of fusion for failed total replacement of the ankle: tibio-allograft-calcaneal fusion with a locked retrograde intramedullary nail.

PubMed

Thomason, K; Eyres, K S

2008-07-01

Salvage of a failed total ankle replacement is technically challenging and although a revision procedure may be desirable, a large amount of bone loss or infection may preclude this. Arthrodesis can be difficult to achieve and is usually associated with considerable shortening of the limb. We describe a technique for restoring talar height using an allograft from the femoral head compressed by an intramedullary nail. Three patients with aseptic loosening were treated successfully by this method with excellent symptomatic relief at a mean follow-up of 32 months (13 to 50).

Outcomes of De Vega versus biodegradable ring annuloplasty in the surgical treatment of tricuspid regurgitation (mid-term results).

PubMed

Basel, Halil; Aydin, Unal; Kutlu, Hakan; Dostbil, Aysenur; Karadag, Melike; Odabasi, Dolunay; Aydin, Cemalettin

2010-08-01

The aim of this study was to compare De Vega semicircular annuloplasty and a new biodegradable ring annuloplasty technique in patients requiring surgical intervention for tricuspid valve disease with concomitant disease of the mitral valve. Between January 2004 and May 2008, 129 consecutive patients underwent annuloplasty procedures to correct tricuspid valve regurgitation during a concomitant mitral valve operation requiring replacement. Additionally, 24 patients underwent aortic valve replacement (AVR), 11 underwent coronary artery bypass grafting (CABG), 5 underwent AVR plus CABG, 3 underwent mitral valve replacement plus atrial septal defect (ASD) closure, and 2 underwent ASD closure. The patients in this study were assigned to 2 groups: Kalangos ring annuloplasty was performed in 67 patients (group 1), and De Vega semicircular annuloplasty was performed in the remaining 62 patients (group 2). Both tricuspid valve repair techniques produced a low rate of complications; however, the number of patients who developed residual tricuspid regurgitation was significantly lower in group 1. The biodegradable ring annuloplasty technique may be used easily and safely in moderate and severe cases of tricuspid regurgitation; however, larger clinical series are necessary to confirm our promising results.

Steel slag: a waste industrial by-product as an alternative sustainable green building material in construction applications--an attempt for solid waste management.

PubMed

Pofale, Arun D; Nadeem, Mohammed

2012-01-01

This investigation explores the possibility of utilizing granular slag as an alternative to fine aggregate (natural sand) in construction applications like masonry and plastering. Construction industry utilizes large volume of fine aggregate in all the applications which has resulted into shortage of good quality naturally available fine aggregate. Use of granular slag serves two fold purposes, i.e. waste utilisation as well as alternative eco-friendly green building material for construction. The investigation highlights comparative study of properties with partial and full replacement of fine aggregate (natural sand) by granular slag in cement mortar applications (masonry and plastering). For this purpose, cement mortar mix proportions from 1:3, 1:4, 1:5 & 1:6 by volume were selected for 0, 25, 50, 75 & 100% replacement levels with w/c ratios of 0.60, 0.65, 0.70 & 0.72 respectively. Based on the study results, it could be inferred that replacement of natural sand with granular slag from 25 to 75% increased the packing density of mortar which resulted into reduced w/c ratio, increased strength properties of all mortar mixes. Hence, it could be recommended that the granular slag could be effectively utilized as fine aggregate in masonry and plastering applications in place of conventional cement mortar mixes using natural sand.

Effect of various Portland cement paste compositions on early-age strain

NASA Astrophysics Data System (ADS)

Guzzetta, Alana G.

Early-age strain in paste, mortar, and concrete mixtures was investigated using a new method where the specimen shape was a cone frustum. Strain of the specimen from both the horizontal and vertical directions was captured by height change measurement. The volumetric strain was then calculated as a function of the height change and was plotted versus time. A correlation was found between the slopes of the volumetric strain curve resulting from this test method and the initial setting time of the tested material. An initial evaluation of the repeatability of this innovative test method was conducted. The early-age strain effects of aggregate volume, shrinkage reducing admixture, water-cementitious ratio (w/cm), and partial cement replacement with supplementary cementitious materials were tested and individually compared. From these comparisons, it was observed that ambient temperature, bleed water development, and rheological properties had a significant impact on the volumetric strain results. Data showed increased strain as aggregate volume was reduced and as the w/cm was changed from 0.25 up to 0.50. The addition of shrinkage reducing admixture generally caused an increase in the 36-hour volumetric strain value. In most of the mixtures, cement replacement with 20% fly ash or 10% metakaolin reduced the measured volumetric strain when the w/cm was 0.30. Replacement of cement with 10% silica fume caused an insignificant change in volumetric strain results.

Tissue Integration of a Volume-Stable Collagen Matrix in an Experimental Soft Tissue Augmentation Model.

PubMed

Ferrantino, Luca; Bosshardt, Dieter; Nevins, Myron; Santoro, Giacomo; Simion, Massimo; Kim, David

Reducing the need for a connective tissue graft by using an efficacious biomaterial is an important task for dental professionals and patients. This experimental study aimed to test the soft tissue response to a volume-stable new collagen matrix. The device demonstrated good stability during six different time points ranging from 0 to 90 days of healing with no alteration of the wound-healing processes. The 90-day histologic specimen demonstrates eventual replacement of most of the matrix with new connective tissue fibers.

Heavy Lift Helicopter Flight Control System. Volume III. Automatic Flight Control System Development and Feasibility Demonstration

DTIC Science & Technology

1977-09-01

vdI1 SCCLRITY CLASSIFICATIOlN OF THIS PAGE(When DMae ffnifod) Block 20 (Cont): ------ AFCS control laws are examined. Associated documents are: Volume I...both the HII gain and LO gain outputs. Both were traced to defective components. In the former, the HII gain output amplifier AR4 was replaced and in...the latter, a relay in the relay module was defective . 613 S. . ......-. . . 6.2.2.4 ExcessivC Time Lag During the BARO altitude hold evaluation, the

Episode-of-Care Characteristics and Costs for Hip and Knee Replacement Surgery in Hospitals Belonging to the High Value Healthcare Collaborative Compared With Similar Hospitals in the Same Health Care Markets.

PubMed

Weeks, William B; Schoellkopf, William J; Ballard, David J; Kaplan, Gary S; James, Brent; Weinstein, James N

2017-06-01

To inform consumers and restrain health care cost growth, efforts to promote transparency and to reimburse for care episodes are accelerating in the United States. To compare characteristics and costs of 30-day episode of care for hip and knee replacement occurring in High Value Healthcare Collaborative (HVHC)-member hospitals to those occurring in like non-HVHC-member hospitals in the same 15 health care markets before interventions by HVHC members to improve health care value for those interventions. This is a retrospective analysis of fee-for-service Medicare data from 2012 and 2013. For hip arthroplasty, 4030 HVHC-member and 7572 non-HVHC-member, and for knee arthroplasty, 6542 HVHC-member and 13,900 non-HVHC-member fee-for-service Medicare patients aged 65 and older. Volumes, patient demographics, hospital stay characteristics, and acute and postacute care standardized costs for a 30-day episode of care. HVHC-member hospitals differed from similar non-HVHC-member hospitals in the same health care markets when considering volumes of surgeries, patient demographics, Charlson scores, and patient distance to care during the index admission. There was little variation in acute care costs of hip or knee replacement surgery across health care markets; however, there was substantial variation in postacute care costs across those same markets. We saw less variation in postacute care costs within markets than across markets. Regression analyses showed that HVHC-member status was not associated with shorter lengths of stay, different complication rates, or lower total or postacute care costs for hip or knee replacement. Health care regions appear to be a more important predictor of episode costs of care than HVHC status.

Differential patterns of replacement and reactive fibrosis in pressure and volume overload are related to the propensity for ischaemia and involve resistin

PubMed Central

Chemaly, Elie R; Kang, Soojeong; Zhang, Shihong; McCollum, LaTronya; Chen, Jiqiu; Bénard, Ludovic; Purushothaman, K-Raman; Hajjar, Roger J; Lebeche, Djamel

2013-01-01

Pathological left ventricle (LV) hypertrophy (LVH) results in reactive and replacement fibrosis. Volume overload LVH (VOH) is less profibrotic than pressure overload LVH (POH). Studies attribute subendocardial fibrosis in POH to ischaemia, and reduced fibrosis in VOH to collagen degradation favouring dilatation. However, the mechanical origin of the relative lack of fibrosis in VOH is incompletely understood. We hypothesized that reduced ischaemia propensity in VOH compared to POH accounted for the reduced replacement fibrosis, along with reduced reactive fibrosis. Rats with POH (ascending aortic banding) evolved into either compensated-concentric POH (POH-CLVH) or dilated cardiomyopathy (POH-DCM); they were compared to VOH (aorta–caval fistula). We quantified LV fibrosis, structural and haemodynamic factors of ischaemia propensity, and the activation of profibrotic pathways. Fibrosis in POH-DCM was severe, subendocardial and subepicardial, in contrast with subendocardial fibrosis in POH-CLVH and nearly no fibrosis in VOH. The propensity for ischaemia was more important in POH versus VOH, explaining different patterns of replacement fibrosis. LV collagen synthesis and maturation, and matrix metalloproteinase-2 expression, were more important in POH. The angiotensin II-transforming growth-factor β axis was enhanced in POH, and connective tissue growth factor (CTGF) was overexpressed in all types of LVH. LV resistin expression was markedly elevated in POH, mildly elevated in VOH and independently reflected chronic ischaemic injury after myocardial infarction. In vitro, resistin is induced by angiotensin II and induces CTGF in cardiomyocytes. Based on these findings, we conclude that a reduced ischaemia propensity and attenuated upstream reactive fibrotic pathways account for the attenuated fibrosis in VOH versus POH. PMID:24018949

Switch to restoration therapy in a testosterone treated central hypogonadism with erythrocytosis.

PubMed

Cangiano, B; Cacciatore, C; Persani, L; Bonomi, M

2017-01-01

We describe a case of severe erythrocytosis caused by testosterone replacement therapy in a 66-year-old man affected with hypogonadotropic hypogonadism (HH) determining osteoporosis, resolved by switching to restoration therapy with clomiphene citrate. The patient complained fatigue, loss of libido and defective erections and a spontaneous vertebral fracture despite bisphosphonate therapy and vitamin D supplementation. The examinations proved isolated HH and he was therefore treated with testosterone gel with regression of specific manifestations but elevated hemoglobin and hematocrit values. Therefore, it was decided to switch to a restoration therapy with clomiphene citrate 25 mg/die, which resulted in the resolution of symptoms without evident side effects. In a couple of months, the patient showed normalization of testosterone levels and increment of testicular volume. Since secondary hypogonadism is the consequence of an insufficient stimulation of the gonads by hypothalamic-pituitary axis, therapeutic approaches aimed to restore endogenous testosterone production should be considered in alternative to testosterone replacement, particularly if side effects intervene. Among these strategies, clomiphene citrate seems to have a high efficacy and safety profile also in the elderly with isolated HH and no evident pituitary lesion. Hypogonadism should always be assessed in patients with severe loss in BMD and undergo appropriate medical treatment.In hypogonadotropic hypogonadism, more approaches are available other than testosterone replacement therapy alone.In patients with severe late-onset central hypogonadism presenting with erythrocytosis even at low doses of replacement therapy, restoration therapy with clomiphene could prove to be an effective solution, particularly in patients with a reversible disruption of GNRH/gonadotropin functions.Clomiphene citrate increases gonadotropin levels and testicular volume and should therefore be considered in hypogonadal men who wish to remain fertile.

Kinetics of methane hydrate replacement with carbon dioxide and nitrogen gas mixture using in situ NMR spectroscopy.

PubMed

Cha, Minjun; Shin, Kyuchul; Lee, Huen; Moudrakovski, Igor L; Ripmeester, John A; Seo, Yutaek

2015-02-03

In this study, the kinetics of methane replacement with carbon dioxide and nitrogen gas in methane gas hydrate prepared in porous silica gel matrices has been studied by in situ (1)H and (13)C NMR spectroscopy. The replacement process was monitored by in situ (1)H NMR spectra, where about 42 mol % of the methane in the hydrate cages was replaced in 65 h. Large amounts of free water were not observed during the replacement process, indicating a spontaneous replacement reaction upon exposing methane hydrate to carbon dioxide and nitrogen gas mixture. From in situ (13)C NMR spectra, we confirmed that the replacement ratio was slightly higher in small cages, but due to the composition of structure I hydrate, the amount of methane evolved from the large cages was larger than that of the small cages. Compositional analysis of vapor and hydrate phases was also carried out after the replacement reaction ceased. Notably, the composition changes in hydrate phases after the replacement reaction would be affected by the difference in the chemical potential between the vapor phase and hydrate surface rather than a pore size effect. These results suggest that the replacement technique provides methane recovery as well as stabilization of the resulting carbon dioxide hydrate phase without melting.

A technique for sampling low shrub vegetation, by crown volume classes

Treesearch

Jay R. Bentley; Donald W. Seegrist; David A. Blakeman

1970-01-01

The effects of herbicides or other cultural treatments of low shrubs can be sampled by a new technique using crown volume as the key variable. Low shrubs were grouped in 12 crown volume classes with index values based on height times surface area of crown. The number of plants, by species, in each class is counted on quadrats. Many quadrats are needed for highly...

Aortic valve replacement for papillary fibroelastoma.

PubMed

Arikan, Ali Ahmet; Omay, Oğuz; Aydın, Fatih; Kanko, Muhip; Gür, Sibel; Derviş, Emir; Yılmaz, Cansu Eda; Müezzinoğlu, Bahar

2017-06-01

Surgery is indicated for symptomatic patients with papillary fibroelastomas (PFE) on the aortic valve. The valve is commonly spared during tumor excision. Rarely, aortic valve replacement (AVR) is needed. We present a case requiring AVR for an aortic valve PFE and review the literature to determine the risk factors for failure of aortic valve-sparing techniques in patients with PFE. © 2017 Wiley Periodicals, Inc.

SU-E-J-12: A New Stereological Method for Tumor Volume Evaluation for Esophageal Cancer

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

Feng, Y; Tianjin Medical University Cancer Institute and Hospital; East Carolina University

2014-06-01

Purpose: Stereological method used to obtain three dimensional quantitative information from two dimensional images is a widely used tool in the study of cells and pathology. But the feasibility of the method for quantitative evaluation of volumes with 3D image data sets for radiotherapy clinical application has not been explored. On the other hand, a quick, easy-to-use and reliable method is highly desired in image-guided-radiotherapy(IGRT) for tumor volume measurement for the assessment of response to treatment. To meet this need, a stereological method for evaluating tumor volumes for esophageal cancer is presented in this abstract. Methods: The stereology method wasmore » optimized by selecting the appropriate grid point distances and sample types. 7 patients with esophageal cancer were selected retrospectively for this study, each having pre and post treatment computed tomography (CT) scans. Stereological measurements were performed for evaluating the gross tumor volume (GTV) changes after radiotherapy and the results was compared with the ones by planimetric measurements. Two independent observers evaluated the reproducibility for volume measurement using the new stereological technique. Results: The intraobserver variation in the GTV volume estimation was 3.42±1.68cm3 (the Wilcoxon matched-pairs test Resultwas Z=−1.726,P=0.084>0.05); the interobserver variation in the GTV volume estimation was 22.40±7.23 cm3 (Z=−3.296,P=0.083>0.05), which showed the consistency in GTV volume calculation with the new method for the same and different users. The agreement level between the results from the two techniques was also evaluated. Difference between the measured GTVs was 20.10±5.35 cm3 (Z=−3.101,P=0.089>0.05). Variation of the measurement results using the two techniques was low and clinically acceptable. Conclusion: The good agreement between stereological and planimetric techniques proves the reliability of the stereological tumor volume estimations. The optimized stereological technique described in this abstract may provide a quick, unbiased and reproducible tool for tumor volume estimation for treatment response assessment. Supported by NSFC (#81041107, #81171342 and #31000784)« less

Very low intravenous contrast volume protocol for computed tomography angiography providing comprehensive cardiac and vascular assessment prior to transcatheter aortic valve replacement in patients with chronic kidney disease.

PubMed

Pulerwitz, Todd C; Khalique, Omar K; Nazif, Tamim N; Rozenshtein, Anna; Pearson, Gregory D N; Hahn, Rebecca T; Vahl, Torsten P; Kodali, Susheel K; George, Isaac; Leon, Martin B; D'Souza, Belinda; Po, Ming Jack; Einstein, Andrew J

2016-01-01

Transcatheter aortic valve replacement (TAVR) is a lifesaving procedure for many patients high risk for surgical aortic valve replacement. The prevalence of chronic kidney disease (CKD) is high in this population, and thus a very low contrast volume (VLCV) computed tomography angiography (CTA) protocol providing comprehensive cardiac and vascular imaging would be valuable. 52 patients with severe, symptomatic aortic valve disease, undergoing pre-TAVR CTA assessment from 2013-4 at Columbia University Medical Center were studied, including all 26 patients with CKD (eGFR<30 mL/min) who underwent a novel VLCV protocol (20 mL of iohexol at 2.5 mL/s), and 26 standard-contrast-volume (SCV) protocol patients. Using a 320-slice volumetric scanner, the protocol included ECG-gated volume scanning of the aortic root followed by medium-pitch helical vascular scanning through the femoral arteries. Two experienced cardiologists performed aortic annulus and root measurements. Vascular image quality was assessed by two radiologists using a 4-point scale. VLCV patients had mean (±SD) age 86 ± 6.5, BMI 23.9 ± 3.4 kg/m(2) with 54% men; SCV patients age 83 ± 8.8, BMI 28.7 ± 5.3 kg/m(2), 65% men. There was excellent intra- and inter-observer agreement for annular and root measurements, and excellent agreement with 3D-transesophageal echocardiographic measurements. Both radiologists found diagnostic-quality vascular imaging in 96% of VLCV and 100% of SCV cases, with excellent inter-observer agreement. This study is the first of its kind to report the feasibility and reproducibility of measurements for a VLCV protocol for comprehensive pre-TAVR CTA. There was excellent agreement of cardiac measurements and almost all studies were diagnostic quality for vascular access assessment. Copyright © 2016 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

Army Sustainment. Volume 42, Issue 5, September-October 2010

DTIC Science & Technology

2010-10-01

pollution ...creating power plants. Busi- ness prac tices that lead to increased vehicle traffic use more gasoline and create more exhaust pollution . Trash must be...replacing bottled water, which has been a prime target for environmentalists. At least one company offers a compostable plastic water bottle that

Pragmatics: Teaching Natural Conversation

ERIC Educational Resources Information Center

Houck, Noel R., Ed.; Tatsuki, Donna H., Ed.

2011-01-01

This volume offers teachers in the ESL/EFL classroom some of the first published materials for guiding learners past grammar into authentic-sounding (conventional) utterances and sequences, replacing the scripted unnatural or stilted dialogue provided in textbooks. Teachers will find a range of pedagogical activities to put to immediate use in the…

Condition assessment and methods of abatement of prestressed concrete box-beam deterioration, phase II : volume 1.

DOT National Transportation Integrated Search

2009-04-13

Side-by-side box-beam bridge constitutes approximately 17 percent of bridges built or replaced annually on : public roads and there is a renewed thrust to use this bridge type for rapid construction under the Highway for : LIFE program. Further, fail...

Bioaccumulation and Effects of the Alternative Flame Retardant, Bis(2-ethylhexyl) tetrabromophthalate (TBPH), in Atlantic killifish, Fundulus heteroclitus

EPA Science Inventory

Bis(2-ethylhexyl) tetrabromophthalate (TBPH), is a high production volume chemical classified as an alternative flame retardant (FR), which replaces legacy FRs withdrawn from US markets dues to health and environmental concerns. This study provides experimental data on the bioacc...

Condition assessment and methods of abatement of prestressed concrete box-beam deterioration, phase II : volume 2.

DOT National Transportation Integrated Search

2009-04-13

Side-by-side box-beam bridge constitutes approximately 17 percent of bridges built or replaced annually on public roads and there is a renewed thrust to use this bridge type for rapid construction under the Highway for LIFE program. Further, failure ...

Channel bed degradation in major Oklahoma streams volume IV of V : Canadian River.

DOT National Transportation Integrated Search

2007-12-01

The purpose of this research is to analyze the flowline data and relate it to the degradation of the : river bed at bridge locations in the river. This information may then be used to replace or rehabilitate those : bridges that experienced severe de...

Use of High-Volume Reclaimed Asphalt Pavement (RAP) for Asphalt Pavement Rehabilitation Due to Increased Highway Truck Traffic from Freight Transportation

DOT National Transportation Integrated Search

2012-06-01

A recent rise in asphalt binder prices has led state agencies and contractors to use higher quantities of Reclaimed : Asphalt Pavement (RAP). Besides being economic, sustainable, and environmentally friendly, RAP can be replaced : for a portion of ag...

The Last Book: The Delivery of Future Content.

ERIC Educational Resources Information Center

Lim, Edward

This paper discusses the future of the printed book. The first section considers factors contributing to predictions of its eventual demise and replacement by electronic versions, the increasing volume of digitized material, superior characteristics of digital publications, and the development of technologies that will allow the e-book to become…

40 CFR 63.3110 - What notifications must I submit?

Code of Federal Regulations, 2011 CFR

2011-07-01

... elect to include the surface coating of new other motor vehicle bodies, body parts for new other motor vehicles, parts for new other motor vehicles, or aftermarket repair or replacement parts for other motor... volume of applied coating solids from: (i) The combined primer-surfacer, topcoat, final repair, glass...

Channel bed degradation in major Oklahoma streams volume III of IV North Canadian River.

DOT National Transportation Integrated Search

2007-12-01

The purpose of this research is to analyze the flowline data and relate it to the degradation of the river bed at bridge locations in the river. This information may then be used to replace or rehabilitate those bridges that experienced severe degrad...

Channel bed degradation in major Oklahoma Streams volume I of IV : Arkansas River.

DOT National Transportation Integrated Search

2007-12-01

The purpose of this research is to analyze the flowline data and relate it to the degradation of the : river bed at bridge locations in the river. This information may then be used to replace or rehabilitate : those bridges that experienced severe de...

Channel bed degradation in major Oklahoma streams volume V of V : Washita River.

DOT National Transportation Integrated Search

2007-12-01

The purpose of this research is to analyze the flowline data and relate it to the degradation of the river : bed at bridge locations in the river. This information may then be used to replace or rehabilitate those : bridges that experienced severe de...

Power loss and right ventricular efficiency in patients after tetralogy of Fallot repair with pulmonary insufficiency: clinical implications.

PubMed

Fogel, Mark A; Sundareswaran, Kartik S; de Zelicourt, Diane; Dasi, Lakshmi P; Pawlowski, Tom; Rome, Jack; Yoganathan, Ajit P

2012-06-01

To quantify right ventricular output power and efficiency and correlate these to ventricular function in patients with repaired tetralogy of Fallot. This might aid in determining the optimal timing for pulmonary valve replacement. We reviewed the cardiac catheterization and magnetic resonance imaging data of 13 patients with tetralogy of Fallot (age, 22 ± 17 years). Using pressure and flow measurements in the main pulmonary artery, cardiac output and regurgitation fraction, right ventricular (RV) power output, loss, and efficiency were calculated. The RV function was evaluated using cardiac magnetic resonance imaging. The RV systolic power was 1.08 ± 0.62 W, with 20.3% ± 8.6% power loss owing to 41% ± 14% pulmonary regurgitation (efficiency, 79.7% ± 8.6%; 0.84 ± 0.73 W), resulting in a net cardiac output of 4.24 ± 1.82 L/min. Power loss correlated significantly with the indexed RV end-diastolic and end-systolic volume (R = 0.78, P = .002 and R = 0.69, P = .009, respectively). The normalized RV power output had a significant negative correlation with RV end-diastolic and end-systolic volumes (both R = -0.87, P = .002 and R = -0.68, P = .023, respectively). A rapid decrease occurred in the RV power capacity with an increasing RV volume, with the curve flattening out at an indexed RV end-diastolic and end-systolic volume threshold of 139 mL/m(2) and 75 mL/m(2), respectively. Significant power loss is present in patients with repaired tetralogy of Fallot and pulmonary regurgitation. A rapid decrease in efficiency occurs with increasing RV volume, suggesting that pulmonary valve replacement should be done before the critical value of 139 mL/m(2) and 75 mL/m(2) for the RV end-diastolic and end-systolic volume, respectively, to preserve RV function. Copyright © 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Accurate GM atrophy quantification in MS using lesion-filling with co-registered 2D lesion masks☆

PubMed Central

Popescu, V.; Ran, N.C.G.; Barkhof, F.; Chard, D.T.; Wheeler-Kingshott, C.A.; Vrenken, H.

2014-01-01

Background In multiple sclerosis (MS), brain atrophy quantification is affected by white matter lesions. LEAP and FSL-lesion_filling, replace lesion voxels with white matter intensities; however, they require precise lesion identification on 3DT1-images. Aim To determine whether 2DT2 lesion masks co-registered to 3DT1 images, yield grey and white matter volumes comparable to precise lesion masks. Methods 2DT2 lesion masks were linearly co-registered to 20 3DT1-images of MS patients, with nearest-neighbor (NNI), and tri-linear interpolation. As gold-standard, lesion masks were manually outlined on 3DT1-images. LEAP and FSL-lesion_filling were applied with each lesion mask. Grey (GM) and white matter (WM) volumes were quantified with FSL-FAST, and deep gray matter (DGM) volumes using FSL-FIRST. Volumes were compared between lesion mask types using paired Wilcoxon tests. Results Lesion-filling with gold-standard lesion masks compared to native images reduced GM overestimation by 1.93 mL (p < .001) for LEAP, and 1.21 mL (p = .002) for FSL-lesion_filling. Similar effects were achieved with NNI lesion masks from 2DT2. Global WM underestimation was not significantly influenced. GM and WM volumes from NNI, did not differ significantly from gold-standard. GM segmentation differed between lesion masks in the lesion area, and also elsewhere. Using the gold-standard, FSL-FAST quantified as GM on average 0.4% of the lesion area with LEAP and 24.5% with FSL-lesion_filling. Lesion-filling did not influence DGM volumes from FSL-FIRST. Discussion These results demonstrate that for global GM volumetry, precise lesion masks on 3DT1 images can be replaced by co-registered 2DT2 lesion masks. This makes lesion-filling a feasible method for GM atrophy measurements in MS. PMID:24567908

Feasibility of single-beat full-volume capture real-time three-dimensional echocardiography and auto-contouring algorithm for quantification of left ventricular volume: validation with cardiac magnetic resonance imaging.

PubMed

Chang, Sung-A; Lee, Sang-Chol; Kim, Eun-Young; Hahm, Seung-Hee; Jang, Shin Yi; Park, Sung-Ji; Choi, Jin-Oh; Park, Seung Woo; Choe, Yeon Hyeon; Oh, Jae K

2011-08-01

With recent developments in echocardiographic technology, a new system using real-time three-dimensional echocardiography (RT3DE) that allows single-beat acquisition of the entire volume of the left ventricle and incorporates algorithms for automated border detection has been introduced. Provided that these techniques are acceptably reliable, three-dimensional echocardiography may be much more useful for clinical practice. The aim of this study was to evaluate the feasibility and accuracy of left ventricular (LV) volume measurements by RT3DE using the single-beat full-volume capture technique. One hundred nine consecutive patients scheduled for cardiac magnetic resonance imaging and RT3DE using the single-beat full-volume capture technique on the same day were recruited. LV end-systolic volume, end-diastolic volume, and ejection fraction were measured using an auto-contouring algorithm from data acquired on RT3DE. The data were compared with the same measurements obtained using cardiac magnetic resonance imaging. Volume measurements on RT3DE with single-beat full-volume capture were feasible in 84% of patients. Both interobserver and intraobserver variability of three-dimensional measurements of end-systolic and end-diastolic volumes showed excellent agreement. Pearson's correlation analysis showed a close correlation of end-systolic and end-diastolic volumes between RT3DE and cardiac magnetic resonance imaging (r = 0.94 and r = 0.91, respectively, P < .0001 for both). Bland-Altman analysis showed reasonable limits of agreement. After application of the auto-contouring algorithm, the rate of successful auto-contouring (cases requiring minimal manual corrections) was <50%. RT3DE using single-beat full-volume capture is an easy and reliable technique to assess LV volume and systolic function in clinical practice. However, the image quality and low frame rate still limit its application for dilated left ventricles, and the automated volume analysis program needs more development to make it clinically efficacious. Copyright © 2011 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved.

2D to 3D fusion of echocardiography and cardiac CT for TAVR and TAVI image guidance.

PubMed

Khalil, Azira; Faisal, Amir; Lai, Khin Wee; Ng, Siew Cheok; Liew, Yih Miin

2017-08-01

This study proposed a registration framework to fuse 2D echocardiography images of the aortic valve with preoperative cardiac CT volume. The registration facilitates the fusion of CT and echocardiography to aid the diagnosis of aortic valve diseases and provide surgical guidance during transcatheter aortic valve replacement and implantation. The image registration framework consists of two major steps: temporal synchronization and spatial registration. Temporal synchronization allows time stamping of echocardiography time series data to identify frames that are at similar cardiac phase as the CT volume. Spatial registration is an intensity-based normalized mutual information method applied with pattern search optimization algorithm to produce an interpolated cardiac CT image that matches the echocardiography image. Our proposed registration method has been applied on the short-axis "Mercedes Benz" sign view of the aortic valve and long-axis parasternal view of echocardiography images from ten patients. The accuracy of our fully automated registration method was 0.81 ± 0.08 and 1.30 ± 0.13 mm in terms of Dice coefficient and Hausdorff distance for short-axis aortic valve view registration, whereas for long-axis parasternal view registration it was 0.79 ± 0.02 and 1.19 ± 0.11 mm, respectively. This accuracy is comparable to gold standard manual registration by expert. There was no significant difference in aortic annulus diameter measurement between the automatically and manually registered CT images. Without the use of optical tracking, we have shown the applicability of this technique for effective fusion of echocardiography with preoperative CT volume to potentially facilitate catheter-based surgery.

The natural history of Becker expandable breast implants: a single-center 10-year experience.

PubMed

Sindali, Katia; Davis, Marcus; Mughal, Maleeha; Orkar, Kusu S

2013-09-01

Use of Becker expandable breast implants in single-stage breast surgery is a well-established technique; however, replacement with fixed-volume implants is common. The authors sought to analyze the long-term natural history of these implants over a wide range of surgical indications. A retrospective review of 330 consecutive patients who underwent 384 Becker expander breast reconstructions over a 10-year period in a dedicated plastic surgery unit was undertaken. Implant indication, Becker type, volume and site, complications, expander lifespan, and explant reasons were assessed. Two hundred twenty-eight patients (267 implants) and 102 patients (117 implants) underwent implantation for congenital deformities and breast cancer reconstruction, respectively. One hundred eighty-seven (48 percent) were explanted at a median period of 13.0 months (range, 9.0 to 26.0 months), 149 (39 percent) for aesthetic reasons and 38 (10 percent) for complications. Complication rates were higher in breast cancer reconstruction compared with congenital patients (19.6 percent versus 7.9 percent; p = 0.002), driven by an increased rate of wound complications (13.7 percent versus 4.4 percent; p = 0.003). Cancer-related surgery and advancing age were the only predictors of complication risk. The overall Becker expander retention rate was 24.9 percent and 46.8 percent at 150 months in the cancer reconstruction and congenital groups, respectively. Forty-seven percent of Becker implants were retained long term after congenital corrective surgery; only 25 percent were retained after postmastectomy reconstruction. Poor aesthetics was driving the exchange for fixed-volume implants, indicating that after breast cancer reconstruction, Becker expanders were being used as part of a two-stage reconstructive strategy.

Accurate Characterization of the Pore Volume in Microporous Crystalline Materials

PubMed Central

2017-01-01

Pore volume is one of the main properties for the characterization of microporous crystals. It is experimentally measurable, and it can also be obtained from the refined unit cell by a number of computational techniques. In this work, we assess the accuracy and the discrepancies between the different computational methods which are commonly used for this purpose, i.e, geometric, helium, and probe center pore volumes, by studying a database of more than 5000 frameworks. We developed a new technique to fully characterize the internal void of a microporous material and to compute the probe-accessible and -occupiable pore volume. We show that, unlike the other definitions of pore volume, the occupiable pore volume can be directly related to the experimentally measured pore volumes from nitrogen isotherms. PMID:28636815

Accurate Characterization of the Pore Volume in Microporous Crystalline Materials

DOE PAGES

Ongari, Daniele; Boyd, Peter G.; Barthel, Senja; ...

2017-06-21

Pore volume is one of the main properties for the characterization of microporous crystals. It is experimentally measurable, and it can also be obtained from the refined unit cell by a number of computational techniques. In this work, we assess the accuracy and the discrepancies between the different computational methods which are commonly used for this purpose, i.e, geometric, helium, and probe center pore volumes, by studying a database of more than 5000 frameworks. We developed a new technique to fully characterize the internal void of a microporous material and to compute the probe-accessible and -occupiable pore volume. Lasty, wemore » show that, unlike the other definitions of pore volume, the occupiable pore volume can be directly related to the experimentally measured pore volumes from nitrogen isotherms.« less

An operator calculus for surface and volume modeling

NASA Technical Reports Server (NTRS)

Gordon, W. J.

1984-01-01

The mathematical techniques which form the foundation for most of the surface and volume modeling techniques used in practice are briefly described. An outline of what may be termed an operator calculus for the approximation and interpolation of functions of more than one independent variable is presented. By considering the linear operators associated with bivariate and multivariate interpolation/approximation schemes, it is shown how they can be compounded by operator multiplication and Boolean addition to obtain a distributive lattice of approximation operators. It is then demonstrated via specific examples how this operator calculus leads to practical techniques for sculptured surface and volume modeling.

Automatic transfer function generation for volume rendering of high-resolution x-ray 3D digital mammography images

NASA Astrophysics Data System (ADS)

Alyassin, Abdal M.

2002-05-01

3D Digital mammography (3DDM) is a new technology that provides high resolution X-ray breast tomographic data. Like any other tomographic medical imaging modalities, viewing a stack of tomographic images may require time especially if the images are of large matrix size. In addition, it may cause difficulty to conceptually construct 3D breast structures. Therefore, there is a need to readily visualize the data in 3D. However, one of the issues that hinder the usage of volume rendering (VR) is finding an automatic way to generate transfer functions that efficiently map the important diagnostic information in the data. We have developed a method that randomly samples the volume. Based on the mean and the standard deviation of these samples, the technique determines the lower limit and upper limit of a piecewise linear ramp transfer function. We have volume rendered several 3DDM data using this technique and compared visually the outcome with the result from a conventional automatic technique. The transfer function generated through the proposed technique provided superior VR images over the conventional technique. Furthermore, the improvement in the reproducibility of the transfer function correlated with the number of samples taken from the volume at the expense of the processing time.

Apico-Aortic Conduit for severe aortic stenosis: Technique, applications, and systematic review

PubMed Central

Elmistekawy, Elsayed; Lapierre, Harry; Mesana, Thierry; Ruel, Marc

2010-01-01

Patients referred for aortic valve replacement are often elderly and may have increased surgical risk associated with ascending aortic calcification, left ventricular dysfunction, presence of coronary artery disease, previous surgery, and/or presence of several co-morbidities. Some of these patients may not be considered candidates for conventional surgery because of their high risk profile. While transcatheter aortic valve replacement constitutes a widely accepted alternative, some patients may not be eligible for this modality due to anatomic factors. Apico-Aortic Conduit (AAC) insertion (aortic valve bypass surgery) constitutes a possible option in those patients. Apico-Aortic Conduit is not a new technique, as it has been used for decades in both pediatric and adult populations. However, there is a resurging interest in this technique due to the expanding scope of elderly patients being considered for the treatment of aortic stenosis. Herein, we describe our surgical technique and provide a systematic review of recent publications on AAC insertion, reporting that there is continued use and several modifications of this technique, such as performing it through a small thoracotomy without the use of the cardiopulmonary bypass. PMID:23960619

Complementary role of cardiac CT in the assessment of aortic valve replacement dysfunction

PubMed Central

Moss, Alastair J; Dweck, Marc R; Dreisbach, John G; Williams, Michelle C; Mak, Sze Mun; Cartlidge, Timothy; Nicol, Edward D; Morgan-Hughes, Gareth J

2016-01-01

Aortic valve replacement is the second most common cardiothoracic procedure in the UK. With an ageing population, there are an increasing number of patients with prosthetic valves that require follow-up. Imaging of prosthetic valves is challenging with conventional echocardiographic techniques making early detection of valve dysfunction or complications difficult. CT has recently emerged as a complementary approach offering excellent spatial resolution and the ability to identify a range of aortic valve replacement complications including structural valve dysfunction, thrombus development, pannus formation and prosthetic valve infective endocarditis. This review discusses each and how CT might be incorporated into a multimodal cardiovascular imaging pathway for the assessment of aortic valve replacements and in guiding clinical management. PMID:27843568

Arc Length Based Grid Distribution For Surface and Volume Grids

NASA Technical Reports Server (NTRS)

Mastin, C. Wayne

1996-01-01

Techniques are presented for distributing grid points on parametric surfaces and in volumes according to a specified distribution of arc length. Interpolation techniques are introduced which permit a given distribution of grid points on the edges of a three-dimensional grid block to be propagated through the surface and volume grids. Examples demonstrate how these methods can be used to improve the quality of grids generated by transfinite interpolation.

Merchandising Techniques and Libraries.

ERIC Educational Resources Information Center

Green, Sylvie A.

1981-01-01

Proposes that libraries employ modern booksellers' merchandising techniques to improve circulation of library materials. Using displays in various ways, the methods and reasons for weeding out books, replacing worn book jackets, and selecting new books are discussed. Suggestions for learning how to market and 11 references are provided. (RBF)

Diagnosis of deep endometriosis: clinical examination, ultrasonography, magnetic resonance imaging, and other techniques.

PubMed

Bazot, Marc; Daraï, Emile

2017-12-01

The aim of the present review was to evaluate the contribution of clinical examination and imaging techniques, mainly transvaginal sonography and magnetic resonance imaging (MRI) to diagnose deep infiltrating (DE) locations using prisma statement recommendations. Clinical examination has a relative low sensitivity and specificity to diagnose DE. Independently of DE locations, for all transvaginal sonography techniques a pooled sensitivity and specificity of 79% and 94% are observed approaching criteria for a triage test. Whatever the protocol and MRI devices, the pooled sensitivity and specificity for pelvic endometriosis diagnosis were 94% and 77%, respectively. For rectosigmoid endometriosis, pooled sensitivity and specificity of MRI were 92% and 96%, respectively fulfilling criteria of replacement test. In conclusion, advances in imaging techniques offer high sensitivity and specificity to diagnose DE with at least triage value and for rectosigmoid endometriosis replacement value imposing a revision of the concept of laparoscopy as the gold standard. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Comparison of MRI segmentation techniques for measuring liver cyst volumes in autosomal dominant polycystic kidney disease.

PubMed

Farooq, Zerwa; Behzadi, Ashkan Heshmatzadeh; Blumenfeld, Jon D; Zhao, Yize; Prince, Martin R

To compare MRI segmentation methods for measuring liver cyst volumes in autosomal dominant polycystic kidney disease (ADPKD). Liver cyst volumes in 42 ADPKD patients were measured using region growing, thresholding and cyst diameter techniques. Manual segmentation was the reference standard. Root mean square deviation was 113, 155, and 500 for cyst diameter, thresholding and region growing respectively. Thresholding error for cyst volumes below 500ml was 550% vs 17% for cyst volumes above 500ml (p<0.001). For measuring volume of a small number of cysts, cyst diameter and manual segmentation methods are recommended. For severe disease with numerous, large hepatic cysts, thresholding is an acceptable alternative. Copyright © 2017 Elsevier Inc. All rights reserved.

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

Ongari, Daniele; Boyd, Peter G.; Barthel, Senja

Pore volume is one of the main properties for the characterization of microporous crystals. It is experimentally measurable, and it can also be obtained from the refined unit cell by a number of computational techniques. In this work, we assess the accuracy and the discrepancies between the different computational methods which are commonly used for this purpose, i.e, geometric, helium, and probe center pore volumes, by studying a database of more than 5000 frameworks. We developed a new technique to fully characterize the internal void of a microporous material and to compute the probe-accessible and -occupiable pore volume. Lasty, wemore » show that, unlike the other definitions of pore volume, the occupiable pore volume can be directly related to the experimentally measured pore volumes from nitrogen isotherms.« less

Determination of Probe Volume Dimensions in Coherent Measurement Techniques

NASA Technical Reports Server (NTRS)

Tedder, Sarah A.; Weikl, Markus C.; Seeger, Thomas; Leipertz, Alfred

2008-01-01

When investigating combustion phenomena with pump-probe techniques, the spatial resolution is given by the overlapping region of the laser beams and thus defines the probe volume size. The size of this probe volume becomes important when the length scales of interest are on the same order or smaller. In this work, we present a new approach to measure the probe volume in three dimensions (3-D), which can be used to determine the probe volume length, diameter, and shape. The optical arrangement and data evaluation are demonstrated for a dual-pump dual-broadband coherent anti-Stokes Raman scattering (CARS) setup which is used for combustion diagnostics. This new approach offers a simple, quick alternative with more capabilities than formerly used probe volume measurement methods.

A review of techniques for visualising soft tissue microstructure deformation and quantifying strain Ex Vivo.

PubMed

Disney, C M; Lee, P D; Hoyland, J A; Sherratt, M J; Bay, B K

2018-04-14

Many biological tissues have a complex hierarchical structure allowing them to function under demanding physiological loading conditions. Structural changes caused by ageing or disease can lead to loss of mechanical function. Therefore, it is necessary to characterise tissue structure to understand normal tissue function and the progression of disease. Ideally intact native tissues should be imaged in 3D and under physiological loading conditions. The current published in situ imaging methodologies demonstrate a compromise between imaging limitations and maintaining the samples native mechanical function. This review gives an overview of in situ imaging techniques used to visualise microstructural deformation of soft tissue, including three case studies of different tissues (tendon, intervertebral disc and artery). Some of the imaging techniques restricted analysis to observational mechanics or discrete strain measurement from invasive markers. Full-field local surface strain measurement has been achieved using digital image correlation. Volumetric strain fields have successfully been quantified from in situ X-ray microtomography (micro-CT) studies of bone using digital volume correlation but not in soft tissue due to low X-ray transmission contrast. With the latest developments in micro-CT showing in-line phase contrast capability to resolve native soft tissue microstructure, there is potential for future soft tissue mechanics research where 3D local strain can be quantified. These methods will provide information on the local 3D micromechanical environment experienced by cells in healthy, aged and diseased tissues. It is hoped that future applications of in situ imaging techniques will impact positively on the design and testing of potential tissue replacements or regenerative therapies. © 2018 The Authors Journal of Microscopy © 2018 Royal Microscopical Society.

Influence of Waste Tyre Crumb Rubber on Compressive Strength, Static Modulus of Elasticity and Flexural Strength of Concrete

NASA Astrophysics Data System (ADS)

Haridharan, M. K.; Bharathi Murugan, R.; Natarajan, C.; Muthukannan, M.

2017-07-01

In this paper, the experimental investigations was carried out to find the compressive strength, static modulus of elasticity and flexural strength of concrete mixtures, in which natural sand was partially replaced with Waste Tyre Crumb Rubber (WTCR). River sand was replaced with five different percentages (5%, 10%, 15%, 20% and 25%) of WTCR by volume. The main objective of the experimental investigation is to find the relationship between static modulus of elasticity and flexural strength with compressive strength of concrete with WTCR. The experimentally obtainedstatic modulus of elasticity and flexural strength results comparing with the theoretical values (various country codes recommendations).

Conservative treatment of an ankylosed tooth after delayed replantation: a case report.

PubMed

Díaz, Jaime Andrés; Sandoval, Hector Paulo; Pineda, Patricia Irene; Junod, Pablo Antonio

2007-10-01

An 8-year-old boy sustained avulsion of his upper right maxillary central incisor and lateral luxation of his upper left maxillary incisors. Subsequently, the upper right maxillary central incisor developed replacement resorption, and both upper left maxillary incisors developed pulpal canal obliteration. In the ankylosed tooth, decoronation procedure was performed, and in the 44-month follow-up period the involved alveolar site showed vertical apposition of bone and continuing replacement resorption. Decoronation is a surgical procedure that allows preservation of the bone volume for the future, avoiding aesthetic disturbances and more aggressive treatments in cases where other therapeutic alternatives are not feasible.

High volumes fly ash engineered cementitious composites with cost-effective PVA fiber

NASA Astrophysics Data System (ADS)

Yu, Dianyou; Xu, Zhichao; Liu, Yingchun

2018-03-01

A feasibility study of engineered cementitous composites (ECC) using the cost-effective PVA fiber (CEPVA-ECC) was developed based on the micromechanical design theory in order to reduce the cost of ECC. Different amounts of fly ash replacement (up to 83% replacement of cement) was utilized in CEPVA-ECC. The CEPVA-ECC using much cheaper Chinese domestic PVA fiber (1/4˜1/6 price of the imported fiber) maintained the tensile ductility characteristics (4%˜5%) with a moderate compressive strength (30˜40MPa). Moreover, the crack width was reduced with an increase of the fly ash amount.

F/FB-111 Avionics Test Station and Component Specialist/Technician. Automatic Test Stations Manual and Electronic Warfare Test Stations. Training Requirements Analysis (451X6). Volume 2

DTIC Science & Technology

1991-11-01

F-111D RADAR SST TASK NOTES: SST IS LOCATED ONLY AT CANNON AFB, NM. IT CONSISTS OF AN MRU , EPU, LVPS, MFG, DDPU, ARS RACK, AND TRANSMITTER. THE SST...VOTES: SST IS LOCATED ONLY AT CANNON AFB, NM. IT CONSISTS OF AN MRU , EPU, LVPS, MFG, DDPU, ARS RACK, AND TRANSMITTER. THE SST WILL BE REPLACED BY DTS...NOTES: SST IS LOCATED ONLY AT CANNON AFB, NM. IT CONSISTS OF AN MRU , EPU, LVPS, MFG, DDPU, ARS RACK, AND TRANSMITTER. THE SST WILL BE REPLACED BY DTS

A perfluorochemical loss/restoration (L/R) system for tidal liquid ventilation.

PubMed

Libros, R; Philips, C M; Wolfson, M R; Shaffer, T H

2000-01-01

Tidal liquid ventilation is the transport of dissolved respiratory gases via volume exchange of perfluorochemical (PFC) liquid to and from the PFC-filled lung. All gas-liquid surface tension is eliminated, increasing compliance and providing lung protection due to lower inflation pressures. Tidal liquid ventilation is achieved by cycling fluid from a reservoir to and from the lung by a ventilator. Current approaches are microprocessor-based with feedback control. During inspiration, warmed oxygenated PFC liquid is pumped from a fluid reservoir/gas exchanger into the lung. PFC fluid is conserved by condensing (60-80% efficiency) vapor in the expired gas. A feedback-control system was developed to automatically replace PFC lost due to condenser inefficiency. This loss/restoration (L/R) system consists of a PFC-vapor thermal detector (+/- 2.5%), pneumatics, amplifiers, a gas flow detector (+/- 1%), a PFC pump (+/- 5%), and a controller. Gravimetric studies of perflubron loss from a flask due to evaporation were compared with experimental L/R results and found to be within +/- 1.4%. In addition, when L/R studies were conducted with a previously reported liquid ventilation system over a four-hour period, the L/R system maintained system perflubron volume to within +/- 1% of prime volume and 11.5% of replacement volume, and the difference between experimental PFC loss and that of the L/R system was 1.8 mL/hr. These studies suggest that the PFC L/R system may have significant economic (appropriate dosing for PFC loss) as well as physiologic (maintenance of PFC inventory in the lungs and liquid ventilator) impact on liquid ventilation procedures.

Separation of toxic metal ions, hydrophilic hydrocarbons, hydrophobic fuel and halogenated hydrocarbons and recovery of ethanol from a process stream

DOEpatents

Kansa, E.J.; Anderson, B.L.; Wijesinghe, A.M.; Viani, B.E.

1999-05-25

This invention provides a process to tremendously reduce the bulk volume of contaminants obtained from an effluent stream produced subsurface remediation. The chemicals used for the subsurface remediation are reclaimed for recycling to the remediation process. Additional reductions in contaminant bulk volume are achieved by the ultra-violet light destruction of halogenated hydrocarbons, and the complete oxidation of hydrophobic fuel hydrocarbons and hydrophilic hydrocarbons. The contaminated bulk volume will arise primarily from the disposal of the toxic metal ions. The entire process is modular, so if there are any technological breakthroughs in one or more of the component process modules, such modules can be readily replaced. 3 figs.

Re-do aortic root replacement after an allograft aortic root replacement.

PubMed

Vrtik, Marian; Tesar, Peter J

2009-10-01

Structural degeneration of allograft aortic root is a global process. In addition to valvular degeneration, the allograft wall calcification poses a risk of systemic calcific embolization and late phase anastomotic aneurysm formation and rupture (anecdotal). Furthermore, the valve annulus is often small, and the tissues are rigid making the implantation of an adequately sized prosthesis within the allograft wall difficult. To avoid these issues, we routinely perform re-do aortic root replacement with either a mechanical valve conduit or bio-root composite graft. The technique has been successfully used in 22 consecutive patients with no operative mortality and minimal morbidity.

Amphibole and hercynite spinel in Shergotty and Zagami Magmatic water, depth of crystallization, and metasomatism

NASA Technical Reports Server (NTRS)

Treiman, A. H.

1985-01-01

Amphibole and spinel occur in the Shergotty and Zagami meteorites only in magmatic inclusions in pigeonite. The trapped magma is essentially identical to the parental magmas for Shergotty and Zagami. The amphibole is a kaersutite with minimal halogen content; by inference, it must have been hydrous. If so, the Shergotty and Zagami melts contained at least 0.2 wt pct H2O and were probably H2O-undersaturated. Pressures in excess of 1 kilobar seem necessary for the formation of amphibole. Spinel replaces magnetite in the inclusions, and olivine replaces magnetite elsewhere in the meteorites. To stabilize spinel, the melt in the inclusions must have become enriched in Al during fractionation, possibly because the small volume of the inclusions made nucleation of plagioclase unlikely. Pervasive replacement of magnetite through reduction reactions suggests that Shergotty and Zagami interacted with hydrogen-rich fluids during their cooling.

A case of rhabdomyolysis after kidney transplantation successfully managed with intensive continuous dialysis.

PubMed

Shahbazov, Rauf; Fox, Michael; Alejo, Jennifer L; Anjum, Malik A; Azari, Feredun; Doyle, Alden; Agarwal, Avinash; Brayman, Kenneth L

2018-04-01

Rhabdomyolysis is characterized by muscle cell death which can result in acute kidney injury from pigment nephropathy. We present a patient who developed rhabdomyolysis immediately after deceased donor kidney transplantation surgery and was managed with continuous renal replacement therapy that resulted in successful salvage of the kidney allograft. Patients who develop acute kidney failure requiring renal replacement therapy generally have a poor prognosis. It is worth noting that while continuous veno-venous hemofiltration (CVVHF) offers greater volume support and continuous clearance compared to hemodialysis (HD), recent studies have demonstrated no clinically significant improvement in clinical outcome between the two. Perhaps CVVHF is a better modality compared to HD in this setting to prevent further insult from pigment nephropathy to an allograft. A combination of early diagnosis and intensive continuous renal replacement therapy can be used for allograft salvage in a patient with rhabdomyolysis in the immediate post-kidney transplant period.

Properties of lightweight aggregate concrete prepared with PVC granules derived from scraped PVC pipes.

PubMed

Kou, S C; Lee, G; Poon, C S; Lai, W L

2009-02-01

This paper aims to investigate the fresh and hardened properties of lightweight aggregate concretes that are prepared with the use of recycled plastic waste sourced from scraped PVC pipes to replace river sand as fine aggregates. A number of laboratory prepared concrete mixes were tested, in which river sand was partially replaced by PVC plastic waste granules in percentages of 0%, 5%, 15%, 30% and 45% by volume. Two major findings are identified. The positive side shows that the concrete prepared with a partial replacement by PVC was lighter (lower density), was more ductile (greater Poisson's ratios and reduced modulus of elasticity), and had lower drying shrinkage and higher resistance to chloride ion penetration. The negative side reveals that the workability, compressive strength and tensile splitting strength of the concretes were reduced. The results gathered would form a part of useful information for recycling PVC plastic waste in lightweight concrete mixes.

Reconstruction of the replaced right hepatic artery at the time of pancreaticoduodenectomy.

PubMed

Allendorf, John D; Bellemare, Sarah

2009-03-01

The arterial anatomy supplying the liver is highly variable. One of the most common variants is a completely replaced right hepatic artery which is seen in about 11% of the population. Interruption of arterial flow to the right hepatic artery at the time of pancreaticoduodenectomy has been associated with biliary fistula and the consequent complications, as well as stenosis of the biliary enteric anastomosis. Malignancies of the posterior aspect of the head of the pancreas can encase a replaced right hepatic artery without involvement of other vascular structures. In this situation, it is possible to resect and reconstruct the replaced right hepatic artery to maintain oxygen delivery to the biliary enteric anastomosis. Herein we describe a technique to reconstruct a replaced right hepatic artery following resection of the vessel en bloc with the tumor during a pancreaticoduodenectomy, using inflow from the gastroduodenal artery.

Intracranial MRA: single volume vs. multiple thin slab 3D time-of-flight acquisition.

PubMed

Davis, W L; Warnock, S H; Harnsberger, H R; Parker, D L; Chen, C X

1993-01-01

Single volume three-dimensional (3D) time-of-flight (TOF) MR angiography is the most commonly used noninvasive method for evaluating the intracranial vasculature. The sensitivity of this technique to signal loss from flow saturation limits its utility. A recently developed multislab 3D TOF technique, MOTSA, is less affected by flow saturation and would therefore be expected to yield improved vessel visualization. To study this hypothesis, intracranial MR angiograms were obtained on 10 volunteers using three techniques: MOTSA, single volume 3D TOF using a standard 4.9 ms TE (3D TOFA), and single volume 3D TOF using a 6.8 ms TE (3D TOFB). All three sets of axial source images and maximum intensity projection (MIP) images were reviewed. Each exam was evaluated for the number of intracranial vessels visualized. A total of 502 vessel segments were studied with each technique. With use of the MIP images, 86% of selected vessels were visualized with MOTSA, 64% with 3D TOFA (TE = 4.9 ms), and 67% with TOFB (TE = 6.8 ms). Similarly, with the axial source images, 91% of selected vessels were visualized with MOTSA, 77% with 3D TOFA (TE = 4.9 ms), and 82% with 3D TOFB (TE = 6.8 ms). There is improved visualization of selected intracranial vessels in normal volunteers with MOTSA as compared with single volume 3D TOF. These improvements are believed to be primarily a result of decreased sensitivity to flow saturation seen with the MOTSA technique. No difference in overall vessel visualization was noted for the two single volume 3D TOF techniques.

High-efficiency genome editing and allele replacement in prototrophic and wild strains of Saccharomyces.

PubMed

Alexander, William G; Doering, Drew T; Hittinger, Chris Todd

2014-11-01

Current genome editing techniques available for Saccharomyces yeast species rely on auxotrophic markers, limiting their use in wild and industrial strains and species. Taking advantage of the ancient loss of thymidine kinase in the fungal kingdom, we have developed the herpes simplex virus thymidine kinase gene as a selectable and counterselectable marker that forms the core of novel genome engineering tools called the H: aploid E: ngineering and R: eplacement P: rotocol (HERP) cassettes. Here we show that these cassettes allow a researcher to rapidly generate heterogeneous populations of cells with thousands of independent chromosomal allele replacements using mixed PCR products. We further show that the high efficiency of this approach enables the simultaneous replacement of both alleles in diploid cells. Using these new techniques, many of the most powerful yeast genetic manipulation strategies are now available in wild, industrial, and other prototrophic strains from across the diverse Saccharomyces genus. Copyright © 2014 by the Genetics Society of America.

A microprocessor application to a strapdown laser gyro navigator

NASA Technical Reports Server (NTRS)

Giardina, C.; Luxford, E.

1980-01-01

The replacement of analog circuit control loops for laser gyros (path length control, cross axis temperature compensation loops, dither servo and current regulators) with digital filters residing in microcomputers is addressed. In addition to the control loops, a discussion is given on applying the microprocessor hardware to compensation for coning and skulling motion where simple algorithms are processed at high speeds to compensate component output data (digital pulses) for linear and angular vibration motions. Highlights are given on the methodology and system approaches used in replacing differential equations describing the analog system in terms of the mechanized difference equations of the microprocessor. Standard one for one frequency domain techniques are employed in replacing analog transfer functions by their transform counterparts. Direct digital design techniques are also discussed along with their associated benefits. Time and memory loading analyses are also summarized, as well as signal and microprocessor architecture. Trade offs in algorithm, mechanization, time/memory loading, accuracy, and microprocessor architecture are also given.