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Sample records for ad4bp includes severe

  1. Expression analysis and localization of wt1, ad4bp/sf-1 and gata4 in the testis of catfish, Clarias batrachus: Impact of wt1-esiRNA silencing.

    Murugananthkumar, Raju; Senthilkumaran, Balasubramanian

    2016-08-15

    In teleosts, a comprehensive role or interaction of wt1, ad4bp/sf-1 and gata4 genes in relation to gonadal development and/or recrudescence was never attempted. Present study aimed to identify the involvement of these genes during testicular development of catfish, Clarias batrachus. Dominant expression of wt1 and gata4 was observed in developing and adult testis, while ad4bp/sf-1 showed steady expression. Localization of these genes in adult testis revealed their presence in spermatogonia, spermatocytes and interstitial/Leydig cells. Significant high expression during pre-spawning and spawning phases, and upregulated levels of these genes after hCG induction authenticated gonadotropic regulation. Transient silencing of wt1-esiRNA displayed decrease in wt1 expression, which further downregulated the expression of ad4bp/sf-1 and gata4, and certain steroidogenic enzyme genes related to androgen production. These results suggest that wt1 might target ad4bp/sf-1 and gata4 expression, and also have regulatory influence either indirectly or directly on the steroidogenic enzyme genes of catfish. PMID:27173028

  2. Studies on some Australian pottiaceous mosses : including several nomina nuda

    Sollman, Philip

    2000-01-01

    Barbula propingua C. Muell. is Tortula antarctica (Hampe) Wils. in Hook. f.; Barbula vesiculosa C. Muell. is Tortula papillosa Wils.; Tortula chlorotricha Broth. & Geheeb is Barbula crinita K. F. Schultz; Barbula chrysopus C. Muell. is Didymodon torquatus (Tayl.) Catcheside. Furthermore, comments are given on several nomina nuda.

  3. Studies on several Australian pottiaceous mosses : including some nomina nuda

    Sollman, Philip

    2001-01-01

    Barbula geminata C. Muell. is Barbula crinita K.F. Schultz; Barbula austroruralis C. Muell. is Tortula antarctica (Hampe) Wils. in Hook. f.; Hymenostomum olivaceum C. Muell. ex Geheeb is Weissia controversa Hedw.; Hymenostomum sullivanii C. Muell. ex Geheeb is Weissia patula (Knight) A.J. Fife. Furthermore, comments are given on several nomina nuda.

  4. In vitro susceptibility of Coxiella burnetii to antibiotics, including several quinolones.

    Yeaman, M R; Mitscher, L A; Baca, O G

    1987-01-01

    Antibiotic susceptibility testing of the rickettsial Q fever agent Coxiella burnetii was performed by using persistently infected L929 fibroblast cells. The efficacies of a variety of antibiotics with different metabolic targets were tested and compared. The most effective antibiotics in bringing about the elimination of the parasite from infected cells included several quinolone compounds and rifampin. Of the quinolone compounds tested, difloxacin (A-56619) was the most effective, followed b...

  5. Modeling of in-vessel fission product release including fuel morphology effects for severe accident analyses

    A new in-vessel fission product release model has been developed and implemented to perform best-estimate calculations of realistic source terms including fuel morphology effects. The proposed bulk mass transfer correlation determines the product of fission product release and equiaxed grain size as a function of the inverse fuel temperature. The model accounts for the fuel-cladding interaction over the temperature range between 770 K and 3000 K in the steam environment. A separate driver has been developed for the in-vessel thermal hydraulic and fission product behavior models that were developed by the Department of Energy for the Modular Accident Analysis Package (MAAP). Calculational results of these models have been compared to the results of the Power Burst Facility Severe Fuel Damage tests. The code predictions utilizing the mass transfer correlation agreed with the experimentally determined fractional release rates during the course of the heatup, power hold, and cooldown phases of the high temperature transients. Compared to such conventional literature correlations as the steam oxidation model and the NUREG-0956 correlation, the mass transfer correlation resulted in lower and less rapid releases in closer agreement with the on-line and grab sample data from the Severe Fuel Damage tests. The proposed mass transfer correlation can be applied for best-estimate calculations of fission products release from the UO2 fuel in both nominal and severe accident conditions. 15 refs., 10 figs., 2 tabs

  6. A Call to Include Severe Combined Immunodeficiency in Newborn Screening Program

    Raz Somech

    2014-01-01

    Full Text Available Quantification of the T cell receptor excision circles (TRECs has recently emerged as a useful non-invasive clinical and research tool to investigate thymic activity. It allows the identification of T cell production by the thymus. Quantification of TREC copies has recently been implemented as the preferred test to screen neonates with severe combined immunodeficiency (SCID or significant lymphopenia. Neonatal genetic screening for SCID is highly important in countries with high rates of consanguinous marriages, such as Israel, and can be used for early diagnosis, enabling prompt therapeutic intervention that will save lives and improve the outcome of these patients. TREC measurement is also applicable in clinical settings where T cell immunity is involved, including any T cell immunodeficiencies, HIV infection, the aging process, autoimmune diseases, and immune reconstitution after bone marrow transplantation.

  7. Modelling of Water Cooled Fuel Including Design Basis and Severe Accidents. Proceedings of a Technical Meeting

    The demands on nuclear fuel have recently been increasing, and include transient regimes, higher discharge burnup and longer fuel cycles. This has resulted in an increase of loads on fuel and core internals. In order to satisfy these demands while ensuring compliance with safety criteria, new national and international programmes have been launched and advanced modelling codes are being developed. The Fukushima Daiichi accident has particularly demonstrated the need for adequate analysis of all aspects of fuel performance to prevent a failure and also to predict fuel behaviour were an accident to occur.This publication presents the Proceedings of the Technical Meeting on Modelling of Water Cooled Fuel Including Design Basis and Severe Accidents, which was hosted by the Nuclear Power Institute of China (NPIC) in Chengdu, China, following the recommendation made in 2013 at the IAEA Technical Working Group on Fuel Performance and Technology. This recommendation was in agreement with IAEA mid-term initiatives, linked to the post-Fukushima IAEA Nuclear Safety Action Plan, as well as the forthcoming Coordinated Research Project (CRP) on Fuel Modelling in Accident Conditions. At the technical meeting in Chengdu, major areas and physical phenomena, as well as types of code and experiment to be studied and used in the CRP, were discussed. The technical meeting provided a forum for international experts to review the state of the art of code development for modelling fuel performance of nuclear fuel for water cooled reactors with regard to steady state and transient conditions, and for design basis and early phases of severe accidents, including experimental support for code validation. A round table discussion focused on the needs and perspectives on fuel modelling in accident conditions. This meeting was the ninth in a series of IAEA meetings, which reflects Member States’ continuing interest in nuclear fuel issues. The previous meetings were held in 1980 (jointly with

  8. Perfluorooctanesulfonate and related fluorochemicals in several organisms including humans from Italy

    Corsolini, S. [Siena Univ. (Italy); Kannan, K. [New York State Univ., Albany, NY (United States)

    2004-09-15

    Perfluorooctane sulfonate (PFOS) is a persistent organic pollutant, extremely resistant to environmental degradation and is ubiquitous in the environment. Traditional monitoring studies for persistent chemicals failed to identify this contaminant for a long time because of its unique physicochemical properties and its tendency to bind to proteins instead of accumulating in fatty tissues. PFOS is known to be toxic in laboratory animals (rats, mice, monkeys) at levels close to the range already found in organisms and people. PFOS has been commercially produced by an electrochemical fluorination process for over 40 years. Perfluorooctane sulfonylfluoride (POSF; C{sub 8}F{sub 17}SO{sub 2}F) is used as a building block for further reactions that produce several other sulfonated fluorinated compounds, including perfluorooctane sulfonate (C{sub 8}F{sub 17}SO{sub 3}{sup -}) and other precursor molecules such as n-ethyl or n-methyl perfluorooctanesulfonamidoethanol. POSF-based fluorochemicals have been used in a wide variety of industrial and consumer products, including protective coatings for carpets and apparel, paper coatings, insecticide formulations, and surfactants. These compounds repel water and oil, reduce surface tension, catalyze oligomerization and polymerization, and maintain their properties under extreme conditions. Depending upon the specific functional derivatization or the degree of polymerization, POSF-based chemicals may degrade or metabolize to PFOS, which is known to be the final metabolite of POSF-based fluorochemicals. PFOS is stable, chemically inert, and non-reactive and has the potential to bioaccumulate. It has been found in polar bears from the Arctic, albatross and other fish-eating water birds in the mid-Pacific, and aquatic organisms11 and people world-wide. PFOS and other perfluorinated chemicals such as perfluorooctanesulfonamide (PFOSA), perfluorohexanesulfonate (PFHxS), and perfluorooctanoate (PFOA) have been detected in human blood. In

  9. An interesting case that included visual hallucinations in a patient with severe hypomagnesaemia and hypocalcaemia

    Wilkinson, Andrea

    2011-01-01

    A 57-year-old man presenting with profound visual hallucinations was found to have severe hypomagnesaemia and hypocalcaemia with a normal level of parathyroid hormone (PTH). Magnesium is essential to the release of PTH so the suspected pathophysiology was thought to be: low Mg → inappropriately low PTH → low Ca. He commenced supplementation and his symptoms resolved. Causes of hypomagnesaemia are discussed.

  10. Investigation of patients with atypical or severe hyperandrogenaemia including androgen-secreting ovarian teratoma.

    Dennedy, Michael Conall

    2012-02-01

    Approximately 7% of women of reproductive age manifest polycystic ovary syndrome (PCOS) and <0.5% have other causes of hyperandrogenism including congenital adrenal hyperplasia (CAH), androgen-secreting tumour of an ovary or an adrenal gland, Cushing\\'s syndrome or hyperthecosis. The presence of features atypical of PCOS should prompt more extensive evaluation than that usually undertaken. Features atypical of PCOS include the onset of symptoms outside the decade of 15-25 years, rapid progression of symptoms, the development of virilization and a serum testosterone concentration in excess of twice the upper limit of the reference range. Ethnic background, family history and specific clinical findings, e.g. Cushingoid appearance, may inform a focused investigation. Otherwise, patients should have measurement of 17-hydroxyprogesterone (17-OHP) under basal conditions ideally in the early morning, and if abnormal, they should have measurement of 17-OHP one hour after the administration of synthetic ACTH, 250 microg i.v., to screen for CAH, which is present in approximately 2% of hyperandrogenic patients. The overnight cortisol suppression test employing 1 mg dexamethasone at midnight is a sensitive test for Cushing\\'s syndrome. Coronal tomographic (CT) scanning of the adrenals and transvaginal ultrasonography of the ovaries are the investigations of choice when screening for tumours in these organs. Less frequently required is catheterization and sampling from both adrenal and ovarian veins, which is a technically demanding procedure with potential complications which may provide definitive diagnostic information not available from other investigations. Illustrative case reports highlight some complexities in the investigation of hyperandrogenic patients presenting with features atypical of PCOS and include only the ninth case report of an androgen-secreting ovarian teratoma.

  11. Development of several data bases related to reactor safety research including probabilistic safety assessment and incident analysis at JAERI

    Presented are several databases developed at JAERI for reactor safety research including probabilistic safety assessment and incident analysis. First described are the recent developments of the databases such as 1) the component failure rate database, 2) the OECD/NEA/IRS information retrieval system, 3) the nuclear power plant database and so on. Then several issues are discussed referring mostly to the operation of the database (data input and transcoding) and to the retrieval and utilization of the information. Finally, emphasis is given to the increasing role which artifitial intelligence techniques such as natural language treatment and expert systems may play in improving the future capabilities of the databases. (author)

  12. Public status toward radiation and irradiated potatoes at 'Youngster's Science Festival' in several cities including Tokyo, Osaka, and Hiroshima, Japan

    'Youngster's Science Festival' has been held in several big cities in various districts in Japan for the purpose of induction of young students' interests in science and scientific experiments. On the basis of the survey results from the participants of the 'Radiation Fair' in Osaka, Japan, which was presented at the last IMRP, we expanded the area of survey and distributed questionnaires to the visitors of the above event to inquire their status toward radiation and irradiated products including irradiated potatoes. The survey results indicated the same trends as that of the 'Radiation Fair' survey. That is, more than half of the older visitors (16 years old and upward) indicated that they recognized the word of 'radiation' when they were at elementary school and the most significant sources of this information were school lessons and the mass media. We will discuss the relationship between consumer's image toward radiation and the description of radiation related topic in school textbooks. (author)

  13. Including severe accidents in the design basis of nuclear power plants: An organizational factors perspective after the Fukushima accident

    Highlights: • The Fukushima accident was man-made and not caused by natural phenomena. • Vulnerabilities were known by regulator and licensee but measures were not taken. • There was lack of independence and transparency of the regulatory body. • Laws and regulations have not been updated to international standards. • Organizational failures have played an important role in the Fukushima accident. - Abstract: The Fukushima accident was clearly an accident made by humans and not caused by natural phenomena as was initially thought. Vulnerabilities were known by both regulators and operator but they postponed measures. The emergency plan was not effective in protecting the public, because the involved parties were not sufficiently prepared to make the right decisions. The shortcomings and faults mentioned above resulted from the lack of independence and transparency of the regulatory body. Even laws and regulations, and technical standards, have not been upgraded to international standards. Regulators have not defined requirements and left for the operator to decide what would be more appropriate. In this aspect, there was clearly a lack of independence between these bodies and operator’s lobby power. The above situation raised the question of urgent updating of institutions, in particular those responsible for nuclear safety. The above evidences show that several nuclear safety principles were not followed. This paper intends to highlight some existing safety criteria that were developed from the operational experience of the severe accidents that occurred at TMI and Chernobyl that should be incorporated in the design of new nuclear power plants and to provide appropriate design changes (backfittings) for reactors that belong to the previous generation prior to the occurrence of these accidents, through the study of design vulnerabilities. Furthermore, the main criteria that define an effective regulatory agency are also discussed. Although these

  14. A patient with refractory shock induced by several factors, including obstruction because of a posterior mediastinal hematoma.

    Obinata, Mariko; Ishikawa, Kouhei; Osaka, Hiromichi; Mishima, Kentaro; Omori, Kazuhiko; Oode, Yasumasa; Yanagawa, Youichi

    2015-06-01

    A 44-year-old man who drove a motorcycle experienced a collision with the side of another motorcycle. Because he had sustained a high-energy injury to the spinal cord, he was transferred to our hospital. His circulation was unstable, and received tracheal intubation in addition to thoracostomy for the hemothorax. Whole-body computed tomography (CT) revealed multiple fractures, right hemopneumothorax with pulmonary contusion, and minor liver injury. After infusing 5000 mL of lactated Ringer's solution and 10 units of blood, his circulation remained unstable. On a repeat CT examination, the left atrium was found to be compressed by a posterior mediastinal hematoma induced by the fracture of the thoracic spine, and a diagnosis of shock induced by multiple factors, including hemorrhagic, neurogenic, and obstructive mechanisms, was made. After obtaining stable circulation and respirations, internal fixation of the extremities and extubation were performed on the 12th hospital day. Chest CT performed on the 27th day showed the disappearance of compression of the left atrium by the hematoma. PMID:25572646

  15. The arthritis severity locus Cia5a regulates the expression of inflammatory mediators including Syk pathway genes and proteases in pristane-induced arthritis

    Brenner Max

    2012-12-01

    Full Text Available Abstract Background Cia5a is a locus on rat chromosome 10 that regulates disease severity and joint damage in two models of rheumatoid arthritis, collagen- and pristane-induced arthritis (PIA. In this study, we aimed to identify cellular and molecular processes regulated by Cia5a using microarray-based gene expression analysis of synovial tissues from MHC identical DA (severe erosive disease and DA.F344(Cia5a congenics (mild non-erosive disease rats. Results Synovial tissues from six DA and eight DA.F344(Cia5a rats were analyzed 21 days after the induction of PIA using the Illumina RatRef-12 BeadChip (21,922 genes and selected data confirmed with qPCR. There was a significantly increased expression of pro-inflammatory mediators such as Il1b (5-fold, Il18 (3.9-fold, Cxcl1 (10-fold, Cxcl13 (7.5-fold and Ccl7 (7.9-fold, and proteases like Mmp3 (23-fold, Mmp9 (32-fold, Mmp14 (4.4-fold and cathepsins in synovial tissues from DA, with reciprocally reduced levels in congenics. mRNA levels of 47 members of the Spleen Tyrosine Kinase (Syk pathway were significantly increased in DA synovial tissues compared with DA.F344(Cia5a, and included Syk (5.4-fold, Syk-activating receptors and interacting proteins, and genes regulated by Syk such as NFkB, and NAPDH oxidase complex genes. Nuclear receptors (NR such as Rxrg, Pparg and Rev-erba were increased in the protected congenics, and so was the anti-inflammatory NR-target gene Scd1 (54-fold increase. Tnn (72-fold decrease was the gene most significantly increased in DA. Conclusions Analyses of gene expression in synovial tissues revealed that the arthritis severity locus Cia5a regulates the expression of key mediators of inflammation and joint damage, as well as the expression of members of the Syk pathway. This expression pattern correlates with disease severity and joint damage and along with the gene accounting for Cia5a could become a useful biomarker to identify patients at increased risk for severe and

  16. Patients with neuromyelitis optica have a more severe disease than patients with relapsingremitting multiple sclerosis, including higher risk of dying of a demyelinating disease

    Denis Bernardi Bichuetti

    2013-05-01

    Full Text Available Although neuromyelitis optica (NMO is known to be a more severe disease than relapsing-remitting multiple sclerosis (RRMS, few studies comparing both conditions in a single center have been done. Methods: Comparison of our previously published cohort of 41 NMO patients with 177 RRMS patients followed in the same center, from 1994 to 2007. Results: Mean age of onset was 32.6 for NMO and 30.2 for RRMS (p=0.2062 with mean disease duration of 7.4 years for NMO and 10.3 years for RRMS. Patients with NMO had a higher annualized relapse rate (1.0 versus 0.8, p=0.0013 and progression index (0.9 versus 0.6, p≪0.0001, with more patients reaching expanded disability status scale (EDSS 6.0 (39 versus 17%, p=0.0036. The odds ratio for reaching EDSS 6.0 and being deceased due to NMO in comparison to RRMS were, respectively, 3.14 and 12.15. Conclusion: Patients with NMO have a more severe disease than patients with RRMS, including higher risk of dying of a demyelinating disease.

  17. [Pathogenetic ground of including reamberin and cycloferon combination into the therapy program for patients with severe cases of acute tonsillitis of a mixed viral/bacterial etiology].

    Frolov, V M; Peresadin, N A; Tereshin, V A; Chkhetiani, R B; Kruglova, O V

    2012-03-01

    The increase of severe cases of acute tonsillitis (AT) is presently marked. Severe cases of AT disturb immune and metabolic homoeostasis initiating the development of disease. Therapy optimization is required to select the best treatment. In patients with severe cases of AT of mixed viral/bacterial etiology before the treatment it is revealed the increase of general activity of lactatedehydrigenase (LDH) and increase of the level of cathode "anaerobic" factions LDH4+5 and the decline of concentration ATP in the blood. There was a compensatory rise of level of ADP and АМP. The substantial decline of serum interferon (CIF) activity and diminishing maintenance of α-interferon (α-IFN) and γ-interferon (γ-IFN) in the blood of the patients, that testified to oppressing of interferonogenesis. Treatment of severe cases of AT of mixed viral/bacterial etiology of modern detoxic preparation reamberin and immunoactive preparation cycloferon combination positively influences the studied laboratory indexes. The improvement of power metabolism is marked, that was characterized by normalization of level adenine nucleotides (ATP, АDP, АМP) and general activity of LDH and its izoenzimes spectrum. At the same time the increase of CIF level is set, maintenances α-IFN and γ-IFN in the blood, that testified to the improvement of interferonogenesis. The results demonstrate the therapeutic potential of reamberin and cycloferon combination for treatment of patients with AT of mixed viral/bacterial etiology. PMID:22573749

  18. A novel missense mutation in the NDP gene in a child with Norrie disease and severe neurological involvement including infantile spasms.

    Lev, Dorit; Weigl, Yuval; Hasan, Mariana; Gak, Eva; Davidovich, Michael; Vinkler, Chana; Leshinsky-Silver, Esther; Lerman-Sagie, Tally; Watemberg, Nathan

    2007-05-01

    Norrie disease (ND) is a rare X-linked recessive disorder characterized by congenital blindness and in some cases, mental retardation and deafness. Other neurological complications, particularly epilepsy, are rare. We report on a novel mutation identified in a patient with ND and profound mental retardation. The patient was diagnosed at the age of 6 months due to congenital blindness. At the age of 8 months he developed infantile spasms, which were diagnosed at 11 months as his EEG demonstrated hypsarrhythmia. Mutation analysis of the ND gene (NDP) of the affected child and his mother revealed a novel missense mutation at position c.134T > A resulting in amino acid change at codon V45E. To the best of our knowledge, such severe neurological involvement has not been previously reported in ND patients. The severity of the phenotype may suggest the functional importance of this site of the NDP gene. PMID:17334993

  19. The HER2 amplicon includes several genes required for the growth and survival of HER2 positive breast cancer cells — A data description

    Vesa Hongisto

    2014-12-01

    Full Text Available A large number of breast cancers are characterized by amplification and overexpression of the chromosome segment surrounding the HER2 (ERBB2 oncogene. As the HER2 amplicon at 17q12 contains multiple genes, we have systematically explored the role of the HER2 co-amplified genes in breast cancer cell growth and their relation to trastuzumab resistance. We integrated array comparative genomic hybridization (aCGH data of the HER2 amplicon from 71 HER2 positive breast tumors and 10 cell lines with systematic functional RNA interference analysis of 23 core amplicon genes with several phenotypic endpoints in a panel of trastuzumab responding and non-responding HER2 positive breast cancer cells. In this Data in Brief we give a detailed description of the experimental procedures and the data analysis methods used in the study (1.

  20. Reduced NODAL Signaling Strength via Mutation of Several Pathway Members Including FOXH1 Is Linked to Human Heart Defects and Holoprosencephaly

    Roessler, Erich; Ouspenskaia, Maia V.; Karkera, Jayaprakash D.; Vélez, Jorge I.; Kantipong, Amy; Lacbawan, Felicitas; Bowers, Peter; Belmont, John W; Towbin, Jeffrey A; Goldmuntz, Elizabeth; Feldman, Benjamin; Muenke, Maximilian

    2008-01-01

    Abnormalities of embryonic patterning are hypothesized to underlie many common congenital malformations in humans including congenital heart defects (CHDs), left-right disturbances (L-R) or laterality, and holoprosencephaly (HPE). Studies in model organisms suggest that Nodal-like factors provide instructions for key aspects of body axis and germ layer patterning; however, the complex genetics of pathogenic gene variant(s) in humans are poorly understood. Here we report our studies of FOXH1, ...

  1. Reduced NODAL Signaling Strength via Mutation of Several Pathway Members Including FOXH1 Is Linked to Human Heart Defects and Holoprosencephaly

    Roessler, Erich; Ouspenskaia, Maia V.; Karkera, Jayaprakash D.; Vélez, Jorge I.; Kantipong, Amy; Lacbawan, Felicitas; Bowers, Peter; Belmont, John W.; Towbin, Jeffrey A.; Goldmuntz, Elizabeth; Feldman, Benjamin; Muenke, Maximilian

    2008-01-01

    Abnormalities of embryonic patterning are hypothesized to underlie many common congenital malformations in humans including congenital heart defects (CHDs), left-right disturbances (L-R) or laterality, and holoprosencephaly (HPE). Studies in model organisms suggest that Nodal-like factors provide instructions for key aspects of body axis and germ layer patterning; however, the complex genetics of pathogenic gene variant(s) in humans are poorly understood. Here we report our studies of FOXH1, CFC1, and SMAD2 and summarize our mutational analysis of three additional components in the human NODAL-signaling pathway: NODAL, GDF1, and TDGF1. We identify functionally abnormal gene products throughout the pathway that are clearly associated with CHD, laterality, and HPE. Abnormal gene products are most commonly detected in patients within a narrow spectrum of isolated conotruncal heart defects (minimum 5%–10% of subjects), and far less commonly in isolated laterality or HPE patients (∼1% for each). The difference in the mutation incidence between these groups is highly significant. We show that apparent gene dosage discrepancies between humans and model organisms can be reconciled by considering a broader combination of sequence variants. Our studies confirm that (1) the genetic vulnerabilities inferred from model organisms with defects in Nodal signaling are indeed analogous to humans; (2) the molecular analysis of an entire signaling pathway is more complete and robust than that of individual genes and presages future studies by whole-genome analysis; and (3) a functional genomics approach is essential to fully appreciate the complex genetic interactions necessary to produce these effects in humans. PMID:18538293

  2. Delineation of a de novo 7q21.3q31.1 Deletion by CGH-SNP Arrays in a Girl with Multiple Congenital Anomalies Including Severe Glaucoma.

    Martínez-Jacobo, L; Córdova-Fletes, C; Ortiz-López, R; Rivas, F; Saucedo-Carrasco, C; Rojas-Martínez, A

    2013-09-01

    In this study, we present a female patient with a constitutional de novo deletion in 7q21.3q31.1 as determined by G-banding and CGH-SNP arrays. She exhibited, among other features, psychomotor retardation, congenital severe bilateral glaucoma, a cleft palate, and heart defect. Microarray assay disclosed a deleted 12.5-Mb region roughly 88 kb downstream the ectrodactyly critical region; thus, the patient's final karyotype was 46,XX.arr 7q21.3q31.1(96,742,140-109,246,085)×1 dn. This girl represents the fourth patient described so far with congenital glaucoma and a deletion encompassing or overlapping the 7q21.3q31.1 region, and confirms the presence of a locus or loci related to such a clinical feature. According to our results, the proneness to ocular defects secondary to 7q intermediate deletions could be caused by co-deletion of TAC1, HBP1, and a small cluster of cytochrome P450 genes (subfamily 3A). This conclusion is supported by their functional roles and expression locations as well as because TAC1 is related to the functional pathway of the MYOC gene whose mutations are linked to glaucoma. Moreover, given that this girl is clinically reminiscent of several phenotypes related to diverse deletions within 7q21q32, our results and observations offer a general overview of the gene content of deletions/phenotypes overlapping 7q21.3q31.1 and confirm that loci distal to DLX genes including the CUX1 gene and potential regulatory elements downstream from DLX5 are unrelated to ectrodactyly. PMID:24167464

  3. Delineation of a de novo 7q21.3q31.1 Deletion by CGH-SNP Arrays in a Girl with Multiple Congenital Anomalies Including Severe Glaucoma

    Martínez-Jacobo, L.; Córdova-Fletes, C.; Ortiz-López, R.; Rivas, F; Saucedo-Carrasco, C.; Rojas-Martínez, A.

    2013-01-01

    In this study, we present a female patient with a constitutional de novo deletion in 7q21.3q31.1 as determined by G-banding and CGH-SNP arrays. She exhibited, among other features, psychomotor retardation, congenital severe bilateral glaucoma, a cleft palate, and heart defect. Microarray assay disclosed a deleted 12.5-Mb region roughly 88 kb downstream the ectrodactyly critical region; thus, the patient's final karyotype was 46,XX.arr 7q21.3q31.1(96,742,140-109,246,085)×1 dn. This girl repres...

  4. Severe Sarcoidosis.

    Kouranos, Vasileios; Jacob, Joe; Wells, Athol U

    2015-12-01

    In sarcoidosis, reduction in mortality and the prevention of disability due to major organ involvement are treatment goals. Thus, it is important to recognize severe disease and identify patients at higher risk of progression to severe disease. In this article, fibrotic lung disease and cardiac sarcoidosis are reviewed as the major contributors to sarcoidosis mortality and morbidity. In the absence of a standardized definition of severe pulmonary disease, a multidisciplinary approach to clinical staging is suggested, based on symptoms, pulmonary function tests, and imaging findings at presentation, integrated with the duration of disease and longitudinal disease behavior during early follow-up. PMID:26593144

  5. Sever's Disease

    ... results from physical activities and sports that involve running and jumping, especially those that take place on hard surfaces, such as track, basketball, soccer, and gymnastics. Sever's disease also can result from ...

  6. Optical modulator including grapene

    Liu, Ming; Yin, Xiaobo; Zhang, Xiang

    2016-06-07

    The present invention provides for a one or more layer graphene optical modulator. In a first exemplary embodiment the optical modulator includes an optical waveguide, a nanoscale oxide spacer adjacent to a working region of the waveguide, and a monolayer graphene sheet adjacent to the spacer. In a second exemplary embodiment, the optical modulator includes at least one pair of active media, where the pair includes an oxide spacer, a first monolayer graphene sheet adjacent to a first side of the spacer, and a second monolayer graphene sheet adjacent to a second side of the spacer, and at least one optical waveguide adjacent to the pair.

  7. Analytic device including nanostructures

    Di, Fabrizio, E.

    2015-07-02

    A device for detecting an analyte in a sample comprising: an array including a plurality of pixels, each pixel including a nanochain comprising: a first nanostructure, a second nanostructure, and a third nanostructure, wherein size of the first nanostructure is larger than that of the second nanostructure, and size of the second nanostructure is larger than that of the third nanostructure, and wherein the first nanostructure, the second nanostructure, and the third nanostructure are positioned on a substrate such that when the nanochain is excited by an energy, an optical field between the second nanostructure and the third nanostructure is stronger than an optical field between the first nanostructure and the second nanostructure, wherein the array is configured to receive a sample; and a detector arranged to collect spectral data from a plurality of pixels of the array.

  8. Long-term closed chest partial and total cardiopulmonary bypass by peripheral cannulation for severe right and/or left ventricular failure, including ventricular fibrillation. The use of a percutaneous spring in the pulmonary artery position to decompress the left heart.

    Kolobow, T; Rossi, F; Borelli, M; Foti, G

    1988-01-01

    The authors report that total cardiopulmonary bypass (CPBP) for severe heart failure can be safely maintained for several days through peripheral cannulation alone. In two healthy sheep under general anesthesia, the authors cannulated the right external jugular vein and the right subclavian artery. A special spring was attached to a 7F Swan-Ganz catheter and positioned at the level of the pulmonary artery (PA) valve, rendering it partially incompetent. The extracorporeal circuit included a venous reservoir, a roller pump, a membrane lung, and a blood pulsator set at 25 beats/min. Ventricular fibrillation was induced with 110 VAC. Extracorporeal blood flow was raised to 100-120 ml/kg min. Mechanical pulmonary ventilation was changed to 5% CO2 in room air. During bypass, the wedge pressure (WP) averaged 9-13 mmHg, PA pressure 7-13 mmHg, and central venous pressure 1-9 mmHg. After 38 and 48 hr respectively the hearts were defibrillated with DC shock. There was total heart failure with no ejection from right or left. We continued with TCPBP. The right heart recovered after 1 and 3 hr respectively. After 7 and 5 hr, respectively, there was some aortic ejection. By 11 and 4 hr, respectively, the sheep were off bypass and on room air, with return to baseline cardiac function. Throughout the recovery the WP averaged 4-8 mmHg. At autopsy, all hearts were soft and normal in appearance. Histologic examination of the lungs and the heart was unremarkable. The authors conclude that the PA spring readily decompressed the LV. Ventilating lungs with 5% CO2 in air during CPBP sustained excellent lung function.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3196550

  9. Patients with neuromyelitis optica have a more severe disease than patients with relapsingremitting multiple sclerosis, including higher risk of dying of a demyelinating disease Pacientes com neuromielite óptica apresentam doença mais incapacitante que pacientes com esclerose múltipla, incluindo maior chance de falecerem de uma doença desmielinizante

    Denis Bernardi Bichuetti

    2013-05-01

    Full Text Available Although neuromyelitis optica (NMO is known to be a more severe disease than relapsing-remitting multiple sclerosis (RRMS, few studies comparing both conditions in a single center have been done. Methods: Comparison of our previously published cohort of 41 NMO patients with 177 RRMS patients followed in the same center, from 1994 to 2007. Results: Mean age of onset was 32.6 for NMO and 30.2 for RRMS (p=0.2062 with mean disease duration of 7.4 years for NMO and 10.3 years for RRMS. Patients with NMO had a higher annualized relapse rate (1.0 versus 0.8, p=0.0013 and progression index (0.9 versus 0.6, p≪0.0001, with more patients reaching expanded disability status scale (EDSS 6.0 (39 versus 17%, p=0.0036. The odds ratio for reaching EDSS 6.0 and being deceased due to NMO in comparison to RRMS were, respectively, 3.14 and 12.15. Conclusion: Patients with NMO have a more severe disease than patients with RRMS, including higher risk of dying of a demyelinating disease.Embora a neuromielite óptica (NMO seja reconhecida como mais grave que a esclerose múltipla remitente recorrente (EMRR, existem poucos estudos comparando as duas doenças em um único centro. Métodos: Comparação de nossa coorte publicada de 41 pacientes com NMO com 177 pacientes com EMRR seguidos no mesmo centro, de 1994 a 2007. Resultados: A média de idade inicial foi de 32,6 anos em NMO e 30,2 anos em EMRR (p=0,2062, com tempo médio de doença de 7,4 anos para NMO e 10,3 anos EMRR. Pacientes com NMO apresentaram maior taxa anualizada de surtos (1,0 versus 0,8, p=0,0013 e índice de progressão (0,9 versus 0,6, p≪0,0001, com mais pacientes atingindo EDSS 6,0 (39 versus 17%, p=0,0036. Os riscos relativos de se alcançar 6,0 EDSS e falecer em decorrência de NMO em comparação com EMRR, foram, respectivamente, 3,14 e 12,15. Conclusão: Pacientes com NMO têm uma doença mais grave do que os pacientes com EMRR, incluindo maior risco de morrer de uma doença desmielinizante.

  10. [Severe depression : psychoanalysis].

    Bouvet de la Maisonneuve, O

    2009-12-01

    The indication for psychoanalysis in severe depression is not clear. And yet, demands for this type of intervention are increasing, despite the absence of any form of consensus on the subject. Freud considered depression as a failure of analytical efforts and, based on this observation, revised his theory, in particular to include the notions of narcissism and the death drive. Many analysts have been reluctant to follow his teachings on this last point and provide depressed patients with analytical-type therapies aimed at restoring narcissism. Melanie Klein pushed Freud's ideas about depression even further and brought such therapies back to the heart of analytical practice. Jacques Lacan took the debate to another level by proposing an overhaul of the principles on which analysis has been based. Today, while following certain precautionary rules, true psychoanalyses can be proposed to patients with severe depression, whether of the bipolar, recurring or even neurotic type that can reach this level of severity. PMID:20141799

  11. Several real variables

    Kantorovitz, Shmuel

    2016-01-01

    This undergraduate textbook is based on lectures given by the author on the differential and integral calculus of functions of several real variables. The book has a modern approach and includes topics such as: •The p-norms on vector space and their equivalence •The Weierstrass and Stone-Weierstrass approximation theorems •The differential as a linear functional; Jacobians, Hessians, and Taylor's theorem in several variables •The Implicit Function Theorem for a system of equations, proved via Banach’s Fixed Point Theorem •Applications to Ordinary Differential Equations •Line integrals and an introduction to surface integrals This book features numerous examples, detailed proofs, as well as exercises at the end of sections. Many of the exercises have detailed solutions, making the book suitable for self-study. Several Real Variables will be useful for undergraduate students in mathematics who have completed first courses in linear algebra and analysis of one real variable.

  12. Severe Aplastic Anemia (SAA)

    ... Email this page Print this page Severe aplastic anemia (SAA) Severe aplastic anemia (SAA) is a disease in which the bone ... blood cells for the body. Tweet Severe aplastic anemia Symptoms of SAA How transplant can treat SAA ...

  13. Nutrition in Severe Dementia

    Glaucia Akiko Kamikado Pivi

    2012-01-01

    Full Text Available An increasing proportion of older adults with Alzheimer's disease or other dementias are now surviving to more advanced stages of the illness. Advanced dementia is associated with feeding problems, including difficulty in swallowing and respiratory diseases. Patients become incompetent to make decisions. As a result, complex situations may arise in which physicians and families decide whether artificial nutrition and hydration (ANH is likely to be beneficial for the patient. The objective of this paper is to present methods for evaluating the nutritional status of patients with severe dementia as well as measures for the treatment of nutritional disorders, the use of vitamin and mineral supplementation, and indications for ANH and pharmacological therapy.

  14. Severe service sealing solutions

    Successful sealing usually requires much more than initial leak-tightness. Friction and wear must also be acceptable, requiring a good understanding of tribology at the sealing interface. This paper describes various sealing solutions for severe service conditions. The CAN2A and CAN8 rotary face seals use tungsten carbide against carbon-graphite to achieve low leakage and long lifetime in nuclear main coolant pumps. The smaller CAN6 seal successfully uses tungsten carbide against silicon carbide in reactor water cleanup pump service. Where friction in CANDU fuelling machine rams must be essentially zero, a hydrostatic seal using two silicon carbide faces is the solution. In the NRU reactor moderator pumps, where pressure is much lower, eccentric seals that prevent boiling at the seal faces are giving excellent service. All these rotary face seals rely on supplementary elastomer seals between their parts. An integrated engineering approach to high performance sealing with O-rings is described. This is epitomized in critical Space Shuttle applications, but is increasingly being applied in CANDU plants. It includes gland design, selection and qualification of material, quality assurance, detection of defects and the effects of lubrication, surface finish, squeeze, stretch and volume constraints. In conclusion, for the severe service applications described, customized solutions have more than paid for themselves by higher reliability, lower maintenance requirements and reduced outage time. (author)

  15. [Treatment of severe scoliosis].

    Helenius, Ilkka; Pajulo, Olli

    2015-01-01

    Untreated severe scoliosis results in a serious malposition of the back, restrictive lung disease and increases mortality compared with the normal population. Idiopathic scoliosis rarely reaches a severe degree. In the treatment of severe scoliosis, preoperative head traction of several weeks' duration has proven a safe and effective method of correcting the malposition, and will also make scoliosis surgery technically easier. Most cases of severe scoliosis can be treated with anterior pedicle screw instrumentation, and vertebrectomy is only seldom required. PMID:26638663

  16. Palmer Drought Severity Index

    National Oceanic and Atmospheric Administration, Department of Commerce — PDSI from the Dai dataset. The Palmer Drought Severity Index (PDSI) is devised by Palmer (1965) to represent the severity of dry and wet spells over the U.S. based...

  17. Dengue and Severe Dengue

    ... 2014 Fact sheets Features Commentaries 2014 Multimedia Contacts Dengue and severe dengue Fact sheet Updated July 2016 Key facts Dengue ... risk of developing severe dengue. Global burden of dengue The incidence of dengue has grown dramatically around ...

  18. Severe anaphylaxis: the secret ingredient.

    Buergi, Andreas; Jung, Barbara; Padevit, Christian; John, Hubert; Ganter, Michael T

    2014-02-01

    In this case report, we describe a healthy urological patient who suffered severe intraoperative anaphylaxis to chlorhexidine, an ingredient contained in frequently used lubricants (Instillagel, Endosgel). Chlorhexidine is a well-known skin disinfectant and antiseptic component in mouthwash or other over the counter antiseptic pharmaceuticals. There is little awareness that commonly used lubricants may contain hidden chlorhexidine. After severe intraoperative anaphylaxis, it is important to investigate all potential (including hidden) agents that might have caused this life-threatening reaction. PMID:25611155

  19. Chronic obstructive pulmonary disease severity is associated with severe pneumonia

    Jung Seop Eom

    2015-01-01

    Full Text Available CONTEXT: Chronic obstructive pulmonary disease (COPD is a heterogeneous disorder, and various aspects of COPD may be associated with the severity of pneumonia in such patients. AIMS: We examined the risk factors associated with severe pneumonia in a COPD population. MATERIALS AND METHODS: We performed a retrospective observational study using a prospectively collected database of pneumonia patients who were admitted to our hospital through emergency department between 2008 and 2012. Patients with hospital-acquired pneumonia and those with an immunocompromised status were excluded. RESULTS: Of 148 pneumonia patients with COPD for whom chest computed tomography (CT scans were available, 106 (71.6% and 42 (28.4% were classified as non-severe and severe pneumonia, respectively. Multivariate logistic regression analysis revealed that the severity of airflow limitation [odds ratio (OR, 2.751; 95% confidence interval (CI, 1.074-7.050; P = 0.035] and the presence of emphysema on a chest CT scan (OR, 3.366; 95% CI, 1.104-10.265; P = 0.033 were independently associated with severe pneumonia in patients with COPD. CONCLUSIONS: The severity of COPD including the airflow limitation grade and the presence of pulmonary emphysema were independently associated with the development of severe pneumonia.

  20. Airborne microorganism monitoring: a comparison of several methods, including a new direct counting technique.

    Hýsek, J; Fisar, Z; Zizka, Z; Kofronova, O; Binek, B

    1991-01-01

    Samples of aerosol from the surrounding air were collected by forcing them to impact onto a solid nutrient medium, onto membrane filters, or onto microscope slides on microcover slips. The samples were cultivated or viewed in a fluorescence microscope by using a technique developed by us, or investigated by scanning electron microscopy. The amounts of microorganisms found by cultivation method, i.e. those forming microcolonies (CFU), were on average 85% lower than the amounts determined by the fluorescence technique. Cultivation of microorganisms trapped on Synpor filters of various pore size resulted in lower counts than conventional cultivation. Among bacteria, the genera Micrococcus, Bacillus and Corynebacterium predominated; the genera Neisseria, Actinomyces, Pseudomonas and others were also found. Of micromycetes, the genera Penicillium, Aspergillus and Cladosporium occurred most frequently in air. In the summer season, yeasts and other micromycetes prevailed, whereas in the winter season the bacteria counts were higher. The total counts of all components of the aeroplankton were higher in summer than in winter. Dust particles bounded mainly bacteria. PMID:1950200

  1. Pharmacotherapy of severe asthma

    Firszt, Rafael; Kraft, Monica

    2010-01-01

    Severe asthma is a complex and heterogeneous phenotype where management can be challenging. While many patients with severe asthma respond to high-dose inhaled corticosteroids in combination with a long-acting β-agonist, there remains a significant subset of patients that require oral corticosteroids to control symptoms. Alternative therapies are needed to help reduce the need for continuous oral corticosteroids; however, there are currently very few effective options. Several new alternative...

  2. Severe asthma in children

    Guilbert, TW; Bacharier, LB; Fitzpatrick, AM

    2014-01-01

    Severe asthma in children is characterized by sustained symptoms despite treatment with high doses of ICS or oral corticosteroids. Children with severe asthma may fall into two categories, difficult-to-treat asthma or severe therapy-resistant asthma. Difficult-to-treat asthma is defined as poor control due to an incorrect diagnosis or comorbidities, poor adherence due to adverse psychological or environmental factors. In contrast, treatment-resistant is defined as difficult asthma despite man...

  3. Severe accident phenomena

    Severe accidents are nuclear reactor accidents in which the reactor core is substantially damaged. The report describes severe reactor accident phenomena and their significance for the safety of nuclear power plants. A comprehensive set of phenomena ranging from accident initiation to containment behaviour and containment integrity questions are covered. The report is based on expertise gained in the severe accident assessment projects conducted at the Technical Research Centre of Finland (VTT). (49 refs., 32 figs., 12 tabs.)

  4. Morbidity of severe obesity.

    Kral, J G

    2001-10-01

    Although obesity is an easy diagnosis to make, its etiologies, pathophysiology, and symptomatology are extraordinarily complex. Progress in surgical technique and anesthesiological management has substantially improved the safety of performing operations on the severely obese in the last 20 years. These improvements have occurred more or less empirically, without a full understanding of etiology or pathophysiology, although this has advanced concomitantly with improvements in practice. This review has attempted to provide a framework to facilitate progress in the neglected areas of patient selection and choice of operation, in an effort to improve long-term outcome. Despite the disparate etiologies of obesity and its diverse comorbidities and complications, there are unifying interdependent pathogenetic mechanisms of great relevance to the practice of antiobesity surgery. The rate of eating, whether driven by HPA dysfunction, ambient stress, or related hereditary susceptibility factors including the increased energy demands of an expanded body fat mass, participates in a cycle that results in disordered satiety (see Fig. 3). This leads to substrate overload, causing extensive metabolic abnormalities such as atherogenesis, insulin resistance, thrombogenesis, and carcinogenesis. This interpretation of the pathophysiology of obesity ironically accords with the original meaning of the word obesity: "to overeat." The ultimate solution to the problem of obesity--preventing it--will not be forthcoming until the food industry is forced to lower production and change its marketing strategies, as the liquor and tobacco industries in the United States were compelled to do. This cannot occur until the large and fast-growing populations of industrialized nations become educated in the personal implications of the energy principle. Regardless of whether school curricula are modified to prioritize health education, the larger problems of cultural and economic change remain for

  5. Model for safety reports including descriptive examples

    Several safety reports will be produced in the process of planning and constructing the system for disposal of high-level radioactive waste in Sweden. The present report gives a model, with detailed examples, of how these reports should be organized and what steps they should include. In the near future safety reports will deal with the encapsulation plant and the repository. Later reports will treat operation of the handling systems and the repository

  6. Severe Malnutrition: A Global Approach.

    Pelletier, Jean-Gerard

    1993-01-01

    This report examines the immediate and underlying causes of malnutrition in the developing world. The first section discusses the effects of malnutrition on childhood development and examines the efficacy of nutritional rehabilitation. The second section addresses the medical effects of severe malnutrition, including the onset of ponderostatural…

  7. Severe accidents, a US approach

    The attitude of the American nuclear industry and the regulatory authorities in the United States toward severe accidents has often seemed ambivalent. It was common a few years ago to assume the position that severe accidents should not be included in the design basis of the plant. This view was associated with the concept of the maximum credible accident. A severe accident that would lead to a large release of fission products from the reactor core was simply regarded as having so low a likelihood as not to be credible. That does not mean that it had a zero probability of occurring. Because of the way the plant was designed, built, and operated, severe accidents were regarded as having a low enough probability that no further special measures were necessary regarding them. (author)

  8. Antifungals in severe asthma

    Parulekar, Amit D.; Diamant, Zuzana; Hanania, Nicola A.

    2015-01-01

    Purpose of review Despite guideline-based treatment, many patients with severe asthma continue to have uncontrolled disease. Fungal allergy is being increasingly recognized in the pathogenesis of severe asthma. Limited data exist on the approach to treatment of fungal asthma. This review summarizes

  9. Biodiversity conservation including uncharismatic species

    Muñoz, Joaquin

    2007-01-01

    (Chapron 2006; Schwartz 2006), and the main threats to biodiversity (including invasive species) (Bawa 2006). I suggest, however, that these articles do not really deal with biodiversity. Rather, they all focus on a few obviously charismatic groups (mammals, birds, some plants, fishes, human culture......). Mammals and birds have traditionally been proposed as umbrella or flagship species (‘‘species that needs such large tracts of habitat that saving it will automatically save many other species’’––Simberloff 1998), to identify areas suitable as nature reserves (Kerr 1997; Sergio et al. 2005)....

  10. Theory including future not excluded

    Nagao, K.; Nielsen, H.B.

    2013-01-01

    We study a complex action theory (CAT) whose path runs over not only past but also future. We show that, if we regard a matrix element defined in terms of the future state at time T and the past state at time TA as an expectation value in the CAT, then we are allowed to have the Heisenberg equation......, Ehrenfest's theorem, and the conserved probability current density. In addition,we showthat the expectation value at the present time t of a future-included theory for large T - t and large t - T corresponds to that of a future-not-included theory with a proper inner product for large t - T. Hence, the CAT...... with future explicitly present in the formalism and influencing in principle the past is not excluded phenomenologically, because the effects are argued to be very small in the present era. Furthermore, we explicitly derive the Hamiltonian for the future state via a path integral, and confirm that it...

  11. Biomarkers in Severe Asthma.

    Wan, Xiao Chloe; Woodruff, Prescott G

    2016-08-01

    Biomarkers have been critical for studies of disease pathogenesis and the development of new therapies in severe asthma. In particular, biomarkers of type 2 inflammation have proven valuable for endotyping and targeting new biological agents. Because of these successes in understanding and marking type 2 inflammation, lack of knowledge regarding non-type 2 inflammatory mechanisms in asthma will soon be the major obstacle to the development of new treatments and management strategies in severe asthma. Biomarkers can play a role in these investigations as well by providing insight into the underlying biology in human studies of patients with severe asthma. PMID:27401625

  12. Families classification including multiopposition asteroids

    Milani, Andrea; Spoto, Federica; Knežević, Zoran; Novaković, Bojan; Tsirvoulis, Georgios

    2016-01-01

    In this paper we present the results of our new classification of asteroid families, upgraded by using catalog with > 500,000 asteroids. We discuss the outcome of the most recent update of the family list and of their membership. We found enough evidence to perform 9 mergers of the previously independent families. By introducing an improved method of estimation of the expected family growth in the less populous regions (e.g. at high inclination) we were able to reliably decide on rejection of one tiny group as a probable statistical fluke. Thus we reduced our current list to 115 families. We also present newly determined ages for 6 families, including complex 135 and 221, improving also our understanding of the dynamical vs. collisional families relationship. We conclude with some recommendations for the future work and for the family name problem.

  13. Severe Combined Immunodeficiency (SCID)

    ... Content Marketing Share this: Main Content Area Severe Combined Immunodeficiency (SCID) SCID is a group of rare ... prompt treatment and high survival rates. SCID was added in 2010 to the U.S. Department of Health ...

  14. Several inequalities regarding sdepth

    Cimpoeas, Mircea

    2011-01-01

    We give several bounds for $sdepth_S(I+J)$, $sdepth_S(I\\cap J)$, $sdepth_S(S/(I+J))$, $sdepth_S(S/(I\\cap J))$, $sdepth_S(I:J)$ and $sdepth_S(S/(I:J))$ where $I,J\\subset S=K[x_1,...,x_n]$ are monomial ideals. Also, we give several equivalent forms of Stanley Conjecture for $I$ and $S/I$, where $I\\subset S$ is a monomial ideal.

  15. The role of rhinosinusitis in severe asthma

    Jang, An-Soo

    2013-01-01

    The prevalence of asthma is approximately 5% to 10% in the general population. Of these, approximately 5% to 10% are severe asthmatics who respond poorly to asthmatic drugs, including high-dose inhaled steroids. Severe asthmatics have persistent symptoms, frequent symptom exacerbation, and severe airway obstruction even when taking high-dose inhaled steroids. The medical costs of treating severe asthmatics represent ~50% of the total healthcare costs for asthma. Risk factors for severe asthma...

  16. Brake assembly including torque monitor

    This patent describes a brake assembly for selectively braking rotation of an input shaft extending from a control rod drive having a longitudinal centerline axis, the shaft being rotatable for selectively inserting and withdrawing a control rod in a nuclear reactor vessel. It comprises a stationary base; an annular bearing mounted to the base; a brake mounted to the bearing; a backing plate mounted to the bearing; a first braking pad fixedly joined to the backing plate; a rotor disc fixedly connected to the input shaft and disposed adjacent to the first pad; a second braking pad disposed adjacent to the rotor disc; and means for selectively clamping the first and second pads against the rotor disc for braking the input shaft; means for torsionally restraining the brake including: a pin extending outwardly from the backing plate toward the base; and a spring extending from the base to the pin and generally perpendicular to the centerline axis; and means for monitoring the angle for monitoring braking torque capability of the brake

  17. [Surgery for severe aspirations].

    Von Wihl, S; Bouayed, S; Kohler, R; Dulguerov, P

    2012-10-01

    Severe dysphagia resulting in repeated aspirations and pneumonia are difficult to treat with swallowing therapy and surgical treatment is often required. Our study retrospectively reviews our experience with 19 such cases operated by laryngeal suspension and laryngotracheal separation. Restoration of oral nutrition was possible in 45% of laryngeal suspension cases and in 75% of laryngotracheal separation operations. These surgical techniques prevent severe aspirations while conserving phonation, contrarily to total laryngectomy. Tracheocutaneous fistulas were frequent, especially after radiation, implying that the surgical technique should be modified in the future. PMID:23133886

  18. Isotretinoin Use in Severe Acne

    Turgeon, E.W.T.

    1985-01-01

    Isotretinoin, an oral vitamin A derivative, is highly effective in, and at present indicated only for, the treatment of cystic acne, conglobate acne, or severe acne which has failed to respond to conventional therapy, including systemic antibiotics. Isotretinoin use usually results in a prolonged remission, often with complete disappearance of previously resistant lesions. Virtually all patients experience reversible integumentary side effects, which can almost always be controlled with emoll...

  19. Therapeutic options for severe asthma

    Mathew, Jilcy; Aronow, Wilbert S.; Chandy, Dipak

    2012-01-01

    As the overall prevalence of asthma has escalated in the past decades, so has the population of patients with severe asthma. This condition is often difficult to manage due to the relative limitation of effective therapeutic options for the physician and the social and economic burden of the disease on the patient. Management should include an evaluation and elimination of modifiable risk factors such as smoking, allergen exposure, obesity and non-adherence, as well as therapy for co-morbidit...

  20. Severe Strep Infections

    ... studies on ClinicalTrials.gov . Related Links Group A Streptococcal Infections National Library of Medicine, MedlinePlus ​​ Javascript Error Your ... the greatest risk of getting a severe strep infection are Children with chickenpox People with suppressed immune systems Burn ...

  1. Severe congenital neutropenia

    Borregaard, Niels

    2014-01-01

    In this issue of Blood, Tidwell et al1 demonstrate that mutations in the start codon (protein synthesis is initiated at the codon ATG) of neutrophil elastase (ELANE) result in the production of N-terminally truncated elastase, which mislocates to the nucleus and results in severe congenital neutr...... neutropenia (SCN)....

  2. SEVERE ACCIDENT MANAGEMENT TRAINING

    The purpose of this paper is (a) to define the International Atomic Energy Agency's role in the area of severe accident management training, (b) to briefly describe the status of representative severe accident analysis tools designed to support development and validation of accident management guidelines, and more recently, simulate the accident with sufficient accuracy to support the training of technical support and reactor operator staff, and (c) provide an overview of representative design-specific accident management guidelines and training. Since accident management and the development of accident management validation and training software is a rapidly evolving area, this paper is also intended to evolve as accident management guidelines and training programs are developed to meet different reactor design requirements and individual national requirements

  3. Severe Measles Infection

    Rafat, Cédric; Klouche, Kada; Ricard, Jean-Damien; Messika, Jonathan; Roch, Antoine; Machado, Sonia; Sonneville, Romain; Guisset, Olivier; Pujol, Wilfried; Guérin, Claude; Teboul, Jean-Louis; Mrozek, Natacha; Darmon, Michaël; Chemouni, Frank; Schmidt, Matthieu

    2013-01-01

    Abstract France has recently witnessed a nationwide outbreak of measles. Data on severe forms of measles in adults are lacking. We sought to describe the epidemiologic, clinical, treatment, and prognostic aspects of the disease in adult patients who required admission to an intensive care unit (ICU). We performed a retrospective analysis of a cohort of 36 adults admitted to a total of 64 ICUs throughout France for complications of measles from January 1, 2009, to December 31, 2011. All cases ...

  4. Artemether for severe malaria

    Esu, Ekpereonne; Effa, Emmanuel E; Opie, Oko N; Uwaoma, Amirahobu; Meremikwu, Martin M

    2014-01-01

    Background In 2011 the World Health Organization (WHO) recommended parenteral artesunate in preference to quinine as first-line treatment for people with severe malaria. Prior to this recommendation, many countries, particularly in Africa, had begun to use artemether, an alternative artemisinin derivative. This review evaluates intramuscular artemether compared with both quinine and artesunate. Objectives To assess the efficacy and safety of intramuscular artemether versus any other parentera...

  5. One reason, several logics

    Evandro Agazzi

    2011-01-01

    Humans have used arguments for defending or refuting statements long before the creation of logic as a specialized discipline. This can be interpreted as the fact that an intuitive notion of "logical consequence" or a psychic disposition to articulate reasoning according to this pattern is present in common sense, and logic simply aims at describing and codifying the features of this spontaneous capacity of human reason. It is well known, however, that several arguments easily accepted by com...

  6. Treatment of severe malaria.

    Warrell, D. A.

    1989-01-01

    In the treatment of severe Plasmodium falciparum infection antimalarial drugs should, ideally, be given by controlled rate intravenous infusion until the patient is able to swallow tablets. In cases where infection has been acquired in a chloroquine resistant area, and where it has broken through chloroquine prophylaxis or where the geographical origin or species are uncertain, quinine is the treatment of choice. When access to parenteral quinine is likely to be delayed, parenteral quinidine ...

  7. Management of severe accidents

    The definition and the multidimensionality aspects of accident management have been reviewed. The suggested elements in the development of a programme for severe accident management have been identified and discussed. The strategies concentrate on the two tiered approaches. Operative management utilizes the plant's equipment and operators capabilities. The recovery managment concevtrates on preserving the containment, or delaying its failure, inhibiting the release, and on strategies once there has been a release. The inspiration for this paper was an excellent overview report on perspectives on managing severe accidents in commercial nuclear power plants and extending plant operating procedures into the severe accident regime; and by the most recent publication of the International Nuclear Safety Advisory Group (INSAG) considering the question of risk reduction and source term reduction through accident prevention, management and mitigation. The latter document concludes that 'active development of accident management measures by plant personnel can lead to very large reductions in source terms and risk', and goes further in considering and formulating the key issue: 'The most fruitful path to follow in reducing risk even further is through the planning of accident management.' (author)

  8. Acute pancreatitis - severity classification, complications and outcome

    Andersson, Bodil

    2010-01-01

    Acute pancreatitis, with an annual incidence of approximately 35 per 100 000 inhabitants in Sweden, is in most cases mild and self-limiting. Severe acute pancreatitis, affecting 10-15% of the cases is, however, associated with severe complications and even death. The optimal management of acute pancreatitis includes accurate early prediction of the disease severity. The aims of this thesis were to investigate early severity classification, complications and outcome in acute pancreatitis patie...

  9. Containment severe accident thermohydraulic phenomena

    This report describes and discusses the containment accident progression and the important severe accident containment thermohydraulic phenomena. The overall objective of the report is to provide a rather detailed presentation of the present status of phenomenological knowledge, including an account of relevant experimental investigations and to discuss, to some extent, the modelling approach used in the MAAP 3.0 computer code. The MAAP code has been used in Sweden as the main tool in the analysis of severe accidents. The dependence of the containment accident progression and containment phenomena on the initial conditions, which in turn are heavily dependent on the in-vessel accident progression and phenomena as well as associated uncertainties, is emphasized. The report is in three parts dealing with: * Swedish reactor containments, the severe accident mitigation programme in Sweden and containment accident progression in Swedish PWRs and BWRs as predicted by the MAAP 3.0 code. * Key non-energetic ex-vessel phenomena (melt fragmentation in water, melt quenching and coolability, core-concrete interaction and high temperature in containment). * Early containment threats due to energetic events (hydrogen combustion, high pressure melt ejection and direct containment heating, and ex-vessel steam explosions). The report concludes that our understanding of the containment severe accident progression and phenomena has improved very significantly over the parts ten years and, thereby, our ability to assess containment threats, to quantify uncertainties, and to interpret the results of experiments and computer code calculations have also increased. (au)

  10. ACUTE PANCREATITIS - THE SEVERE FORM

    Ioana Grigoras

    2005-01-01

    Full Text Available Acute pancreatitis is an acute inflammatory disease. Frequently it is a challenging condition for the surgeon and for the intensive care physician, taking into account that etiology is sometimes obscure, the pathophysiology is complex and incompletely understood, the timing of surgical treatment is still under debate and the general treatment is mostly supportive. The incidence is about 30 – 50 / 100.000 / year. In 80% of cases the disease is associated with interstitial edema, mild infiltration with inflammatory cells and intra- or peripancreatic fat necrosis. Evolution is benign and self-limited with proper treatment. The severe form occurs less frequent (15 - 20%, results in long lasting hospitalization and is associated with high mortality (30 - 40%, due to infected necrosis and multiple organ failure. Alcoholism and biliary disease account for 80% of cases. Rare etiologies of disease include metabolic factors (hypercalcemia, hyperlipoproteinemia, drug ingestion, obstructive factors (abdominal tumors, trauma, endoscopic retrograde cholecistopancreatography, and s.o., infections (viral, parasitic and hemodynamic factors. Postoperative pancreatitis is a complication after major abdominal surgery (abdominal aorta aneurism repair, extensive upper abdominal surgery, hepatic or cardiac transplant, so.. The common pathophysiological mechanism is pancreatic hypoperfusion. Acute pancreatitis is not a stable disease, being characterized by time-dependent stages with specific morphologic and clinical patterns. The terminology used to designate these stages is stated in the Ulm classification. Since the consensus Conference in Atlanta (1992 the severe form of acute pancreatitis is defined by the presence of organ dysfunction/failure or by the presence of local complications. The initiating event is the premature zymogene activation and the impairment of the exocytosis process with local consequences (ongoing tissue necrosis and general consequences

  11. Several crimes solved

    Relations with the Host States Service

    2007-01-01

    A member of a contractor's personnel suspected of having committed several thefts in and around Building 180 has recently been questioned by the French police. He was immediately tried by the court in Bourg-en-Bresse and sentenced to six months in prison, with a requirement to serve at least three months. His arrest was facilitated, among other things, by a video recording, fast and detailed statements to the CERN Fire Brigade and close collaboration between the members of the personnel concerned, the Reception and Access Control Service and the police. Several laptops and other items of electronic equipment were seized during a search of the culprit's home. A stolen digital camera has yet to be returned to its owner as he has not reported the theft to the CERN Fire Brigade and the police. The person concerned is therefore requested to go to the Gendarmerie in Saint-Genis-Pouilly with the necessary proof of ownership. In addition, the French authorities have informed CERN that the presumed authors of the a...

  12. One reason, several logics

    Evandro Agazzi

    2011-06-01

    Full Text Available Humans have used arguments for defending or refuting statements long before the creation of logic as a specialized discipline. This can be interpreted as the fact that an intuitive notion of "logical consequence" or a psychic disposition to articulate reasoning according to this pattern is present in common sense, and logic simply aims at describing and codifying the features of this spontaneous capacity of human reason. It is well known, however, that several arguments easily accepted by common sense are actually "logical fallacies", and this indicates that logic is not just a descriptive, but also a prescriptive or normative enterprise, in which the notion of logical consequence is defined in a precise way and then certain rules are established in order to maintain the discourse in keeping with this notion. Yet in the justification of the correctness and adequacy of these rules commonsense reasoning must necessarily be used, and in such a way its foundational role is recognized. Moreover, it remains also true that several branches and forms of logic have been elaborated precisely in order to reflect the structural features of correct argument used in different fields of human reasoning and yet insufficiently mirrored by the most familiar logical formalisms.

  13. Measurement by phase severance

    It is claimed that the measurement process is more accurately described by ''quasi-local phase severance'' than by ''wave function collapse''. The approach starts from the observation that the usual route to quantum mechanics starting from the Hamilton-Jacobi equations throws away half the degrees of freedom, namely, the classical initial state parameters. To overcome this difficulty, the full set of Hamilton-Jacobi equations is interpreted as operator equations acting on a state vector. The measurement theory presented is based on the conventional S-matrix boundary condition of N/sub A/ free particles in the distant past and N/sub B/ free particles in the distant future and taking the usual free particle wave functions, multiplied by phase factors

  14. Severe Serous Macular Detachment

    Amani A. Fauzi

    2013-07-01

    Full Text Available We report the occurrence and management of a massive serous detachment of the macula, which followed trabeculectomy and lowering of the intraocular pressure (IOP in a patient with central retinal vein occlusion (CRVO and a previously undiagnosed complex coagulopathy with elevated plasma fibrinogen and homocysteine levels, as well as prothrombin 20210 and factor V Leiden mutations. Our case illustrates prompt resolution of the serous detachment with elevation of the IOP, and acute recurrence of the detachment following subsequent recurrence of hypotony after aqueous tube shunt surgery. Residual cystoid macular edema (CME in the right eye, as well as hemiretinal vein occlusion with serous macular detachment and CME in the fellow left eye responded to bevacizumab. The occurrence of severe macular edema following lowering of intraocular pressure may warrant further evaluation for possible underlying venous occlusive disease or systemic coagulopathy.

  15. Nutrition in Severe Dementia

    Glaucia Akiko Kamikado Pivi; Paulo Henrique Ferreira Bertolucci; Rodrigo Rizek Schultz

    2012-01-01

    An increasing proportion of older adults with Alzheimer's disease or other dementias are now surviving to more advanced stages of the illness. Advanced dementia is associated with feeding problems, including difficulty in swallowing and respiratory diseases. Patients become incompetent to make decisions. As a result, complex situations may arise in which physicians and families decide whether artificial nutrition and hydration (ANH) is likely to be beneficial for the patient. The objective of...

  16. Severe accident simulation at Olkiuoto

    Tirkkonen, H.; Saarenpaeae, T. [Teollisuuden Voima Oy (TVO), Olkiluoto (Finland); Cliff Po, L.C. [Micro-Simulation Technology, Montville, NJ (United States)

    1995-09-01

    A personal computer-based simulator was developed for the Olkiluoto nuclear plant in Finland for training in severe accident management. The generic software PCTRAN was expanded to model the plant-specific features of the ABB Atom designed BWR including its containment over-pressure protection and filtered vent systems. Scenarios including core heat-up, hydrogen generation, core melt and vessel penetration were developed in this work. Radiation leakage paths and dose rate distribution are presented graphically for operator use in diagnosis and mitigation of accidents. Operating on an graphically for operator use in diagnosis and mitigation of accidents. Operating on an 486 DX2-66, PCTRAN-TVO achieves a speed about 15 times faster than real-time. A convenient and user-friendly graphic interface allows full interactive control. In this paper a review of the component models and verification runs are presented.

  17. Severe Exoplanetary Storm

    2009-01-01

    These computer-generated images chart the development of severe weather patterns on the highly eccentric exoplanet HD 80606b during the days after its closest approach to its parent star. An exoplanet is a planet that orbits a star other than our sun. The images were produced by computer simulations that modeled NASA's Spitzer Space Telescope's measurements of heat radiating from the planet. The six frames are evenly spaced in time, starting from 4.4 days after the planet's close approach to the star, a moment known as 'periastron,' and running through 8.9 days after periastron. The blue glow of the crescent is starlight that has been scattered and reflected by the planet. The starlight appears blue because the planet is a very efficient absorber of red light. The night side appears reddish orange as it glows with its own internal heat. These theoretical models allow astronomers to better understand weather patterns on distant planets. While direct telescopic observations of the atmospheres of such worlds may be many decades away, such simulations give us a clue to what we may see when it becomes possible. The Spitzer observations themselves spanned the relatively brief period when the heating of the planet was most intense, running from 20 hours prior to 10 hours after periastron. The data were taken in Nov. of 2007. HD 80606b is located 190 light-years away in the constellation Ursa Major. Its star can be seen with binoculars.

  18. Intracolonic Vancomycin for Severe Clostridium difficile Colitis

    Kim, Peter K.; Huh, Heesun C.; Cohen, Hillel W.; Feinberg, Elyssa J.; Ahmad, Salman; Coyle, Christina; Teperman, Sheldon; Boothe, Hugh

    2013-01-01

    Background: Clostridium difficile colitis is associated with increased age, antibiotic usage, and hospitalization. Severe C. difficile colitis refractory to medical therapy may require surgical intervention including subtotal colectomy. We initiated an adjuvant intracolonic vancomycin (ICV) enema protocol for inpatients with severe C. difficile colitis and compared the response to this therapy in patients from the community and nursing homes.

  19. Problems in severe bilateral urinary tract anomalies

    Thorup, Jørgen Mogens

    1989-01-01

    Management of children with severe infravesical or bilateral ureterovesical obstruction with or without reflux is difficult. Our experience over 10 years includes 29 such children, 19 of whom presented in the first 3 months of life. At the time of diagnosis, 13 had severe disturbance of renal...

  20. Extending Newtonian Dynamics to Include Stochastic Processes

    Zak, Michail

    2009-01-01

    A paper presents further results of continuing research reported in several previous NASA Tech Briefs articles, the two most recent being Stochastic Representations of Chaos Using Terminal Attractors (NPO-41519), [Vol. 30, No. 5 (May 2006), page 57] and Physical Principle for Generation of Randomness (NPO-43822) [Vol. 33, No. 5 (May 2009), page 56]. This research focuses upon a mathematical formalism for describing post-instability motions of a dynamical system characterized by exponential divergences of trajectories leading to chaos (including turbulence as a form of chaos). The formalism involves fictitious control forces that couple the equations of motion of the system with a Liouville equation that describes the evolution of the probability density of errors in initial conditions. These stabilizing forces create a powerful terminal attractor in probability space that corresponds to occurrence of a target trajectory with probability one. The effect in configuration space (ordinary three-dimensional space as commonly perceived) is to suppress exponential divergences of neighboring trajectories without affecting the target trajectory. As a result, the post-instability motion is represented by a set of functions describing the evolution of such statistical quantities as expectations and higher moments, and this representation is stable.

  1. Severe Vitamin D Deficiency Causing Kyphoscoliosis.

    Singhai, Abhishek; Banzal, Subodh

    2013-01-01

    Vitamin D deficiency is common among Indian population. Women are especially at risk for severe vitamin D deficiency. The risk is higher for those who are multiparous and postmenopausal. Poor exposure to sunlight, higher latitude, winter season, inadequate diet, older age, obesity and malabsorption are also important risk factors. Symptoms of hypovitaminosis D, including diffuse or migratory pain affecting several sites (especially the shoulder, pelvis, ribcage and lower back) have also been misdiagnosed as musculoskeletal disorders, including fibromyalgia, polymyalgia rheumatica and ankylosing spondylitis. Here, we report two cases presented with kyphoscoliosis, diagnosed to have severe vitamin D deficiency. PMID:26664847

  2. Treatment of Severe Alcoholic Hepatitis.

    Thursz, Mark; Morgan, Timothy R

    2016-06-01

    Alcoholic hepatitis (AH) is a syndrome of jaundice and liver failure that occurs in a minority of heavy consumers of alcohol. The diagnosis usually is based on a history of heavy alcohol use, findings from blood tests, and exclusion of other liver diseases by blood and imaging analyses. Liver biopsy specimens, usually collected via the transjugular route, should be analyzed to confirm a diagnosis of AH in patients with an atypical history or presentation. The optimal treatment for patients with severe AH is prednisolone, possibly in combination with N-acetyl cysteine. At present, only short-term increases in survival can be expected-no treatment has been found to increase patient survival beyond 3 months. Abstinence is essential for long-term survival. New treatment options, including liver transplantation, are being tested in trials and results eagerly are awaited. PMID:26948886

  3. CANDU safety under severe accidents

    The characteristics of the CANDU reactor relevant to severe accidents are set first by the inherent properties of the design, and second by the Canadian safety/licensing approach. Probabilistic safety assessment studies have been performed on operating CANDU plants, and on the 4 x 880 MW(e) Darlington station now under construction; furthermore a scoping risk assessment has been done for a CANDU 600 plant. They indicate that the summed severe core damage frequency is of the order of 5 x 10-6/year. CANDU nuclear plant designers and owner/operators share information and operational experience nationally and internationally through the CANDU Owners' Group (COG). The research program generally emphasizes the unique aspects of the CANDU concept, such as heat removal through the moderator, but it has also contributed significantly to areas generic to most power reactors such as hydrogen combustion, containment failure modes, fission product chemistry, and high temperature fuel behaviour. Abnormal plant operating procedures are aimed at first using event-specific emergency operating procedures, in cases where the event can be diagnosed. If this is not possible, generic procedures are followed to control Critical Safety Parameters and manage the accident. Similarly, the on-site contingency plans include a generic plan covering overall plant response strategy, and a specific plan covering each category of contingency

  4. Nutritional Considerations for Severely Handicapped Children.

    Sobsey, Dick

    Children and adults with severe disabilities may have nutritional problems due to the effects of the primary disability (including such syndromes as phenylketonuria, galactosemia, and Hurler's Disease), effects related to medications (including anticonvulsants, tranquilizers, and laxatives), effects of food preferences (restrictive food…

  5. Severe Weather Planning for Schools

    Watson, Barbara McNaught; Strong, Christopher; Bunting, Bill

    2008-01-01

    Flash floods, severe thunderstorms, and tornadoes occur with rapid onset and often no warning. Decisions must be made quickly and actions taken immediately. This paper provides tips for schools on: (1) Preparing for Severe Weather Emergencies; (2) Activating a Severe Weather Plan; (3) Severe Weather Plan Checklist; and (4) Periodic Drills and…

  6. Severe chronic allergic (and related) diseases

    Bousquet, J; Anto, J M; Demoly, P;

    2012-01-01

    Concepts of disease severity, activity, control and responsiveness to treatment are linked but different. Severity refers to the loss of function of the organs induced by the disease process or to the occurrence of severe acute exacerbations. Severity may vary over time and needs regular follow......-up. Control is the degree to which therapy goals are currently met. These concepts have evolved over time for asthma in guidelines, task forces or consensus meetings. The aim of this paper is to generalize the approach of the uniform definition of severe asthma presented to WHO for chronic allergic...... and associated factors such as comorbidities and risk factors. This uniform definition will allow a better definition of the phenotypes of severe allergic (and related) diseases for clinical practice, research (including epidemiology), public health purposes, education and the discovery of novel therapies....

  7. Cost per severe accident as an index for severe accident consequence assessment and its applications

    The Fukushima Accident emphasizes the need to integrate the assessments of health effects, economic impacts, social impacts and environmental impacts, in order to perform a comprehensive consequence assessment of severe accidents in nuclear power plants. “Cost per severe accident” is introduced as an index for that purpose. The calculation methodology, including the consequence analysis using level 3 probabilistic risk assessment code OSCAAR and the calculation method of the cost per severe accident, is proposed. This methodology was applied to a virtual 1,100 MWe boiling water reactor. The breakdown of the cost per severe accident was provided. The radiation effect cost, the relocation cost and the decontamination cost were the three largest components. Sensitivity analyses were carried out, and parameters sensitive to cost per severe accident were specified. The cost per severe accident was compared with the amount of source terms, to demonstrate the performance of the cost per severe accident as an index to evaluate severe accident consequences. The ways to use the cost per severe accident for optimization of radiation protection countermeasures and for estimation of the effects of accident management strategies are discussed as its applications. - Highlights: • Cost per severe accident is used for severe accident consequence assessment. • Assessments of health, economic, social and environmental impacts are included. • Radiation effect, relocation and decontamination costs are important cost components. • Cost per severe accident can be used to optimize radiation protection measures. • Effects of accident management can be estimated using the cost per severe accident

  8. Computerised severe accident management aids

    operational regimes. If a severe accident situation occurs, CAMS should be able to switch to use and present pre-calculated transients from severe accident codes such as MAAP. Another approach would be to switch from using the SMABRE code to using the on-line MAAP-code [6] for detailed calculations during severe accident states. The switch could be governed by a very simple rule such as 'Switch to the MAAP-code when core temperature > 700 deg. C'. A third approach could be to use the on-line MARS code for the whole programme, but there are several arguments against this. The on-line MARS code is not available at present, and the system is assumed to be expensive. There is not very much information available about the system, and it is unclear how difficult it will be to include MARS in the CAMS design. The MARS code will presumably not be useful for other operational regimes than the most serious ones. It will therefore not meet the stated objectives. In CAMS the possibility to assess different accident management strategies is achieved by means of the strategy generator and the predictive simulator based on the SMABRE code. By means of interaction with the strategy generator and some stored information on accident management principles, it will be possible to formulate a first control strategy. This strategy is given to the predictive simulator that calculates forward in time. The outcome can be studied by the operator /TSC. Such a calculation can be done assuming no operator actions or with operator actions. A realisation of the proposed CAMS system design will accordingly meet the stated objectives both with respect to normal operation, accident and severe accident operational regimes. The modularized flexible design will allow a smooth expansion of the system with new modules. The system is designed around a central database. The inclusion of a more or less complete plant simulator in the plant monitoring system is adding a new dimension to the plant monitoring task. Any

  9. Thromboelastography in patients with severe sepsis

    Haase, Nicolai; Ostrowski, Sisse Rye; Wetterslev, Jørn;

    2015-01-01

    PURPOSE: To investigate the association between consecutively measured thromboelastographic (TEG) tracings and outcome in patients with severe sepsis. METHODS: Multicentre prospective observational study in a subgroup of the Scandinavian Starch for Severe Sepsis/Septic Shock (6S) Trial (NCT00962156......) comparing hydroxyethyl starch (HES) 130/0.42 vs. Ringer's acetate for fluid resuscitation in severe sepsis. TEG (standard and functional fibrinogen) was measured consecutively for 5 days, and clinical data including bleeding and death was retrieved from the trial database. Statistical analyses included Cox...... subsequent bleeding [HR 2.43 (1.16-5.07)] and possibly explained the excess bleeding with HES in the 6S trial. CONCLUSIONS: In our cohort of patients with severe sepsis, progressive hypocoagulability defined by TEG variables was associated with increased risk of death and increased risk of bleeding....

  10. Severe Weather Data Inventory (SWDI)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Severe Weather Data Inventory (SWDI) is an integrated database of severe weather records for the United States. SWDI enables a user to search through a variety...

  11. Development of severe accident training support system

    In order for appropriate decision-making during plant operation and management, the professional knowledge, expert's opinion, and previous experiences as well as information for current status are utilized. The operation support systems such as training simulators have been developed to assist these decision-making process, and most of them cover from normal operation to emergency operation because of the very low frequency of severe accident and of uncertaintics included in severe accident phenomena and scenarios. However, the architectures for severe accident management are being established based on severe accident management guidelines in some developed countries. Recentrly, in Korea, as teh severe accident management guideline was developed, the basis for establishing severe accident management architecture is prepared and this leads to the development of tool for systematic education and training for personnel related to severe accident management. The severe accident taining support system thus is developed to assist decision-making during execution of severe accident management guidelines by providing plant status information, prefessional knowledge for phenomena and scenarios, expected behavior for strategy execution, and so on

  12. Disease severity scoring systems in dermatology

    Cemal Bilaç; Mustafa Turhan Şahin; Serap Öztürkcan

    2016-01-01

    Scoring systems have been developed to interpret the disease severity objectively by evaluating the parameters of the disease. Body surface area, visual analogue scale, and physician global assessment are the most frequently used scoring systems for evaluating the clinical severity of the dermatological diseases. Apart from these scoring systems, many specific scoring systems for many dermatological diseases, including acne (acne vulgaris, acne scars), alopecia (androgenetic alopecia, tractio...

  13. Severe Vitamin D Deficiency Causing Kyphoscoliosis

    Singhai, Abhishek; Banzal, Subodh

    2013-01-01

    Vitamin D deficiency is common among Indian population. Women are especially at risk for severe vitamin D deficiency. The risk is higher for those who are multiparous and postmenopausal. Poor exposure to sunlight, higher latitude, winter season, inadequate diet, older age, obesity and malabsorption are also important risk factors. Symptoms of hypovitaminosis D, including diffuse or migratory pain affecting several sites (especially the shoulder, pelvis, ribcage and lower back) have also been ...

  14. Severe Hypertriglyceridemia Induced Pancreatitis in Pregnancy

    Natasha Gupta

    2014-01-01

    Full Text Available Acute pancreatitis caused by severe gestational hypertriglyceridemia is a rare complication of pregnancy. Acute pancreatitis has been well associated with gallstone disease, alcoholism, or drug abuse but rarely seen in association with severe hypertriglyceridemia. Hypertriglyceridemia may occur in pregnancy due to normal physiological changes leading to abnormalities in lipid metabolism. We report a case of severe gestational hypertriglyceridemia that caused acute pancreatitis at full term and was successfully treated with postpartum therapeutic plasma exchange. Patient also developed several other complications related to her substantial hypertriglyceridemia including preeclampsia, chylous ascites, retinal detachment, pleural effusion, and chronic pericarditis. This patient had no previous family or personal history of lipid abnormality and had four successful prior pregnancies without developing gestational hypertriglyceridemia. Such a severe hypertriglyceridemia is usually seen in patients with familial chylomicronemia syndromes where hypertriglyceridemia is exacerbated by the pregnancy, leading to fatal complications such as acute pancreatitis.

  15. Ocean storage, including costs and risks

    The long-term effectiveness of ocean storage will have to be based on theoretical understanding and models as there is no way to perform experiments on the required time and space scales for outgassing estimation. Based on observations of tracer behavior, the ventilation time of deep water has been revealed. Calibrated and constrained by these results, most of the OGCMs tell us that CO2 injected into the thermohaline circulation would not come back to the atmosphere in more than several hundred years. There are two types of concepts of ocean storage: one is a lake type concept to keep the CO2 at the ocean floor or a depression site as long as possible, and the other is to inject CO2 into the deep waters so that it is dispersed as quickly as possible. The technological concepts so far for implementation with minimum environmental impacts are much elaborated based on laboratory and computer experiments incorporating the key understanding of the CO2 clathrate properties attained in this decade. The frequently addressed concern of this technology includes the ecological modification of the ocean system. But even in the business-as-usual release of CO2 into the atmosphere, some modification might be foreseen in the deep ocean environment and could be inevitable not caused by the climate change but by the direct influence of the increase in the CO2 concentration in deep waters in future. We cannot stop the CO2 invasion into the deep ocean due to the existing of the excess CO2 in the atmosphere. Whichever release method is used, carbon dioxide we are releasing to the atmosphere now will find its way into the deep oceans. Hence, the right scientific question is whether there exist additional risks to the deep sea environment associated with this technology. If we accept the target of a stabilization level of the atmospheric concentration of CO2, our generation's commitment to the CO2 futures anyway extends to the modification of the deep sea environment induced by the

  16. Radiosensitive severe combined immunodeficiency disease.

    Dvorak, Christopher C; Cowan, Morton J

    2010-02-01

    Inherited defects in components of the nonhomologous end-joining DNA repair mechanism produce a T-B-NK+ severe combined immunodeficiency disease (SCID) characterized by heightened sensitivity to ionizing radiation. Patients with the radiosensitive form of SCID may also have increased short- and long-term sensitivity to the alkylator-based chemotherapy regimens that are traditionally used for conditioning before allogeneic hematopoietic cell transplantation (HCT). Known causes of radiosensitive SCID include deficiencies of Artemis, DNA ligase IV, DNA-dependent protein kinase catalytic subunit, and Cernunnos-XLF, all of which have been treated with HCT. Because of these patients' sensitivity to certain forms of chemotherapy, the approach to donor selection and the type of conditioning regimen used for a patient with radiosensitive SCID requires careful consideration. Significantly more research needs to be done to determine the long-term outcomes of patients with radiosensitive SCID after HCT and to discover novel nontoxic approaches to HCT that might benefit those patients with intrinsic radiosensitivity and chemosensitivity as well as potentially all patients undergoing an HCT. PMID:20113890

  17. Severe Accident Research Program plan update

    In August 1989, the staff published NUREG-1365, ''Revised Severe Accident Research Program Plan.'' Since 1989, significant progress has been made in severe accident research to warrant an update to NUREG-1365. The staff has prepared this SARP Plan Update to: (1) Identify those issues that have been closed or are near completion, (2) Describe the progress in our understanding of important severe accident phenomena, (3) Define the long-term research that is directed at improving our understanding of severe accident phenomena and developing improved methods for assessing core melt progression, direct containment heating, and fuel-coolant interactions, and (4) Reflect the growing emphasis in two additional areas--advanced light water reactors, and support for the assessment of criteria for containment performance during severe accidents. The report describes recent major accomplishments in understanding the underlying phenomena that can occur during a severe accident. These include Mark I liner failure, severe accident scaling methodology, source term issues, core-concrete interactions, hydrogen transport and combustion, TMI-2 Vessel Investigation Project, and direct containment heating. The report also describes the major planned activities under the SARP over the next several years. These activities will focus on two phenomenological issues (core melt progression, and fuel-coolant interactions and debris coolability) that have significant uncertainties that impact our understanding and ability to predict severe accident phenomena and their effect on containment performance SARP will also focus on severe accident code development, assessment and validation. As the staff completes the research on severe accident issues that relate to current generation reactors, continued research will focus on efforts to independently evaluate the capability of new advanced light water reactor designs to withstand severe accidents

  18. Optimization of Weight Including Damage Scenarios Project

    National Aeronautics and Space Administration — M4 Engineering proposes to develop a method of incorporating several analyses into one process and then optimizing the structure. This method will allow for...

  19. Static, Lightweight Includes Resolution for PHP

    Hills, M.A.; Klint, P.; Vinju, J.J.

    2014-01-01

    Dynamic languages include a number of features that are challenging to model properly in static analysis tools. In PHP, one of these features is the include expression, where an arbitrary expression provides the path of the file to include at runtime. In this paper we present two complementary analy

  20. Article Including Environmental Barrier Coating System

    Lee, Kang N. (Inventor)

    2015-01-01

    An enhanced environmental barrier coating for a silicon containing substrate. The enhanced barrier coating may include a bond coat doped with at least one of an alkali metal oxide and an alkali earth metal oxide. The enhanced barrier coating may include a composite mullite bond coat including BSAS and another distinct second phase oxide applied over said surface.

  1. Upgrade Summer Severe Weather Tool

    Watson, Leela

    2011-01-01

    The goal of this task was to upgrade to the existing severe weather database by adding observations from the 2010 warm season, update the verification dataset with results from the 2010 warm season, use statistical logistic regression analysis on the database and develop a new forecast tool. The AMU analyzed 7 stability parameters that showed the possibility of providing guidance in forecasting severe weather, calculated verification statistics for the Total Threat Score (TTS), and calculated warm season verification statistics for the 2010 season. The AMU also performed statistical logistic regression analysis on the 22-year severe weather database. The results indicated that the logistic regression equation did not show an increase in skill over the previously developed TTS. The equation showed less accuracy than TTS at predicting severe weather, little ability to distinguish between severe and non-severe weather days, and worse standard categorical accuracy measures and skill scores over TTS.

  2. Severe hyperkalaemia: demographics and outcome

    Phillips, B. M.; Milner, S.; Zouwail, S.; Roberts, G.; Cowan, M; Riley, S.G.; Phillips, A.O.

    2014-01-01

    Background Few studies have evaluated the prevalence of severe hyperkalaemia in unselected patient populations. We identified all episodes of severe hyperkalaemia occurring in 1 year, and described patient demographics, clinical response and outcome. We also assessed junior doctor knowledge of its causes and significance. Materials and methods A retrospective interrogation of the database of the regional biochemical laboratory identified all episodes of severe hyperkalaemia (K≥ 6.5 mmol/L) oc...

  3. Acute pancreatitis complicating severe dengue

    Vishakha Jain; O P Gupta; Tarun Rao; Siddharth Rao

    2014-01-01

    Dengue is an arthropod borne viral infection endemic in tropical and subtropical continent. Severe dengue is life threatening. Various atypical presentations of dengue have been documented. But we present a rare and fatal complication of severe dengue in form of acute pancreatitis. A 27-year-old male had presented with severe dengue in decompensated shock and with pain in abdomen due to pancreatitis. The pathogenesis of acute pancreatitis in dengue is not clearly understood, but various mecha...

  4. Clinical Practice Guidelines for Severe Sepsis Treatment.

    Julio Héctor Jova Dueñas; Diosdania Alfonso Falcón; Marcos Diosdado Iraola Ferrer; Inti Santana Carballosa; José Noel Marrero.

    2009-01-01

    Clinical Practice Guidelines for Severe Sepsis Treatment. It is a syndrome of inflammatory systemic response caused by documented infection (clinical and/or microbiological), associated with organic dysfunction (respiratory, renal, hepatic, cardiovascular, haematological and neurological), hypotension or hypoperfusion. This document includes a review and update of the concept, risk factors, diagnosis and treatment. It includes assessment guidelines focused on the most important aspects to be ...

  5. Composite Pressure Vessel Including Crack Arresting Barrier

    DeLay, Thomas K. (Inventor)

    2013-01-01

    A pressure vessel includes a ported fitting having an annular flange formed on an end thereof and a tank that envelopes the annular flange. A crack arresting barrier is bonded to and forming a lining of the tank within the outer surface thereof. The crack arresting barrier includes a cured resin having a post-curing ductility rating of at least approximately 60% through the cured resin, and further includes randomly-oriented fibers positioned in and throughout the cured resin.

  6. Novel model for wine fermentation including the yeast dying phase

    Borzì, Alfio; Merger, Juri; Müller, Jonas; Rosch, Achim; Schenk, Christina; Schmidt, Dominik; Schmidt, Stephan; Schulz, Volker; Velten, Kai; von Wallbrunn, Christian; Zänglein, Michael

    2014-01-01

    This paper presents a novel model for wine fermentation including a death phase for yeast and the influence of oxygen on the process. A model for the inclusion of the yeast dying phase is derived and compared to a model taken from the literature. The modeling ability of the several models is analyzed by comparing their simulation results.

  7. Statistics of severe tornadoes and severe tornado outbreaks

    B. D. Malamud

    2012-09-01

    Full Text Available The standard measures of the intensity of a tornado in the USA and many other countries are the Fujita and Enhanced Fujita scales. These scales are based on the damage that a tornado causes. Another measure of the strength of a tornado is its path length of touchdown, L. In this study we consider severe tornadoes, which we define as L≥10 km, in the continental USA (USA Storm Prediction Center Severe Weather Database. We find that for the period 1982–2011, for individual severe tornadoes (L≥10 km: (i There is a strong linear scaling between the number of severe tornadoes in a year and their total path length in that year. (ii The cumulative frequency path length data suggests that, not taking into account any changing trends over time, we would expect in a given year (on average one severe tornado with a path length L≥115 km and in a decade (on average one severe tornado with a path length L≥215 km. (iii The noncumulative frequency-length statistics of severe tornado touchdown path lengths, 20<L<200 km, is well approximated by an inverse power-law relationship with exponent near 3. We then take the total path length of severe tornadoes in a convective day (12:00–12:00 UTC, LD, as a measure of the strength of a 24-h USA tornado outbreak. We find that: (i For 1982–2011, the number of severe tornadoes in a USA convective day outbreak has a strong power-law relationship (exponent 0.80 on the convective day total path length, LD. (ii For 1952–2011, the cumulative frequency path length data for severe tornado outbreaks suggests that we would expect in a given year (on average one daily severe tornado outbreak with total path length LD≥480 km and in a decade (on average one daily severe tornado outbreak with a total path length LD≥1200 km. (iii For 1982–2011, the noncumulative frequency-length statistics of tornado

  8. Lightning and severe thunderstorms in event management.

    Walsh, Katie M

    2012-01-01

    There are a few national position stands/guidelines that address environmental conditions in athletics, yet they do not govern all outdoor sports. Extreme heat and cold, lightning, and severe wind can all be fatal, yet the majority of outdoor sports have no published guidelines addressing these conditions in relation to activity. Available research on extreme heat and cold conditions in athletics provides prevention strategies, to include acclimatization. Lightning and severe wind are two environmental conditions to which humans cannot accommodate, and they both can be deadly. There are strong positions on extreme heat/cold and lightning safety in athletics, but none affiliated with severe winds. Medical personnel involved in planning large outdoor sporting events must know of the presence of nationally published weather-related documents and apply them to their event. In addition, research needs to be expanded in the realm of establishing guidelines for safety to participants and spectators in severe wind conditions. PMID:22580490

  9. Severe Anemia in Malawian Children

    Calis, J.C.J.; Kamija, S.P.; Faragher, E.B.; Brabin, B.J.; Bates, I.; Cuevas, L.E.; Haan, de R.J.; Phiri, A.I.; Malange, P.; Khoka, M.; Hulshof, P.J.M.; Lieshout, L.; Beld, M.G.H.M.; Teo, Y.Y.; Rockett, K.A.; Richardson, A.; Kwiatkowski, D.P.; Molyneux, M.E.; Hensbroek, van M.B.

    2008-01-01

    Background Severe anemia is a major cause of sickness and death in African children, yet the causes of anemia in this population have been inadequately studied. Methods We conducted a case¿control study of 381 preschool children with severe anemia (hemoglobin concentration,

  10. 28 CFR 20.32 - Includable offenses.

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Includable offenses. 20.32 Section 20.32 Judicial Administration DEPARTMENT OF JUSTICE CRIMINAL JUSTICE INFORMATION SYSTEMS Federal Systems and Exchange of Criminal History Record Information § 20.32 Includable offenses. (a) Criminal history...

  11. Severe accident management guidelines tool

    Severe Accident is addressed by means of a great number of documents such as guidelines, calculation aids and diagnostic trees. The response methodology often requires the use of several documents at the same time while Technical Support Centre members need to assess the appropriate set of equipment within the adequate mitigation strategies. In order to facilitate the response, TECNATOM has developed SAMG TOOL, initially named GGAS TOOL, which is an easy to use computer program that clearly improves and accelerates the severe accident management. The software is designed with powerful features that allow the users to focus on the decision-making process. Consequently, SAMG TOOL significantly improves the severe accident training, ensuring a better response under a real situation. The software is already installed in several Spanish Nuclear Power Plants and trainees claim that the methodology can be followed easier with it, especially because guidelines, calculation aids, equipment information and strategies availability can be accessed immediately (authors)

  12. Development of Lab-to-Fab Production Equipment Across Several Length Scales for Printed Energy Technologies, Including Solar Cells

    Hösel, Markus; Dam, Henrik Friis; Krebs, Frederik C

    2015-01-01

    We describe and review how the scaling of printed energy technologies not only requires scaling of the input materials but also the machinery used in the processes. The general consensus that ultrafast processing of technologies with large energy capacity can only be realized using roll-to-roll m...

  13. Development of Lab-to-Fab Production Equipment Across Several Length Scales for Printed Energy Technologies, Including Solar Cells

    Hösel, Markus; Dam, Henrik Friis; Krebs, Frederik C

    2015-01-01

    We describe and review how the scaling of printed energy technologies not only requires scaling of the input materials but also the machinery used in the processes. The general consensus that ultrafast processing of technologies with large energy capacity can only be realized using roll-to-roll m...... lower end of the industrial scale. The machinery bridges the gap through firstly achieving improved ink efficiency without surface contact, followed by better ink efficiency at higher speeds, and finally large-area processing at high speed with very high ink efficiency....

  14. Reconsidering adolescent subjectivity: a 'practice-near' approach to the study of adolescents, including those with severe learning disabilities

    Briggs, Stephen; Hingley-Jones, Helen

    2013-01-01

    This article aims to explore new approaches to working with young people that are relevant to changed techno-social contexts. Firstly an emerging theory of adolescent development is elaborated, based on the notion of subjectivation, which takes into account new contexts and thinking about the development and experiences of young people and which is oriented towards inclusive practice. Secondly, appropriate practice-near methods for exploring and empirically assessing the applicability of this...

  15. Sericin, a protein derived from silkworms, accelerates the proliferation of several mammalian cell lines including a hybridoma

    Terada, Satoshi; Nishimura, Taeko; Sasaki, Masahiro; Yamada, Hideyuki; Miki, Masao

    2002-01-01

    Sericin, a constituent of the silkworm cocoon, was added to the culture of four mammalian cell lines: murine hybridoma 2E3-O,human hepatoblastoma HepG2, human epithelial HeLa and human embryonal kidney 293 cells. The proliferation of all cell lineswas accelerated in the presence of sericin. The hybridoma cellline was further studied. The 2E3-O cell line was so well adapted to serum-free medium that both the proliferation rate and maximum cell density in serum-free ASF103 medium were higher th...

  16. Statistics of severe tornadoes and severe tornado outbreaks

    B. D. Malamud

    2012-03-01

    Full Text Available The standard measures of the intensity of a tornado in the USA and many other countries are the Fujita and Enhanced Fujita scales. These scales are based on the damage that a tornado causes. Another measure of the strength of a tornado is its path length of touchdown, L. In this study we consider 4061 severe tornadoes (defined as L≥10 km in the continental USA for the time period 1981–2010 (USA Storm Prediction Center Severe Weather Database. We find for individual severe tornadoes: (i The noncumulative frequency-length statistics of severe tornado touchdown path lengths, 20 < L < 200 km, is well approximated by an inverse power-law relationship with exponent near 3. (ii There is a strong linear scaling between the number of severe tornadoes in a year and their total path lengths in that year. We then take the total path length of severe tornadoes in a day, LD, as a measure of the strength of a 24-hour USA tornado outbreak. We find that: (i On average, the number of days per year with at least one continental USA severe tornado (path length L≥10 km has increased 16% in the 30-year period 1981–2010. (ii The daily numbers of severe tornadoes in a USA outbreak have a strong power-law relationship (exponent 0.87 on their daily total path lengths, LD, over the range 20 < LD < 1000 km dy−1. (iii The noncumulative frequency-length statistics of tornado outbreaks, 10 < LD < 1000 km dy−1, is well approximated by an inverse power-law relationship with exponent near 1.7. We believe that our robust scaling results provide evidence that touchdown path lengths can be used as quantitative measures of the systematic properties of severe tornadoes and severe tornado outbreaks.

  17. Traditional Therapies for Severe Asthma.

    Wang, Eileen; Hoyte, Flavia C L

    2016-08-01

    Severe asthma is a complex and heterogeneous disease. The European Respiratory Society and American Thoracic Society guidelines define severe asthma for patients 6 years or older as "asthma which requires treatment with high-dose inhaled corticosteroids…plus a second controller or systemic corticosteroids to prevent it from becoming 'uncontrolled' or which remains 'uncontrolled' despite this therapy." This article reviews available traditional therapies, data behind their uses in severe asthma, and varying recommendations. As various asthma endotypes and phenotypes are better understood and characterized, targeted therapies should help improve disease outcomes, efficacy, and cost-effectiveness. PMID:27401628

  18. Haemophilus influenzae Disease (Including Hib) Symptoms

    ... is considered invasive. Symptoms of pneumonia usually include: Fever and chills Cough Shortness of breath or difficulty breathing Sweating ... the blood. It can cause symptoms such as: Fever and chills Excessive tiredness Pain in the belly Nausea with ...

  19. What Does Long-Term Care Include?

    Full Text Available Video: "What Does Long-Term Care Include?" Long-term care involves a variety of services designed to meet a person's health or personal care needs during a short or long period of ...

  20. Births and deaths including fetal deaths

    U.S. Department of Health & Human Services — Access to a variety of United States birth and death files including fetal deaths: Birth Files, 1968-2009; 1995-2005; Fetal death file, 1982-2005; Mortality files,...

  1. Include Passive Solar in Your Renovations.

    Bender, Gerald F.; Probasco, Jack F.

    1981-01-01

    A checklist covers potential energy saving modifications in a building scheduled for renovation, and includes suggestions for room utilization, landscaping, and building envelope, solar control, and active system modifications. (Author)

  2. Including Indigenous Minorities in Decision-Making

    Pristed Nielsen, Helene

    Based on theories of public sphere participation and deliberative democracy, this book presents empirical results from a study of experiences with including Aboriginal and Maori groups in political decision-making in respectively Western Australia and New Zealand......Based on theories of public sphere participation and deliberative democracy, this book presents empirical results from a study of experiences with including Aboriginal and Maori groups in political decision-making in respectively Western Australia and New Zealand...

  3. Including excitons in semiconductor solar cell modelling

    Burgelman, Marc; Minnaert, Ben

    2005-01-01

    Excitons are marginally important in classical semiconductor device physics, and their treatment is not included in standard solar cell modelling. However, in organic semiconductors and solar cells, the role of excitons is essential, as the primary effect of light absorption is exciton generation, and free electrons and holes are created by exciton dissociation. First steps to include excitons in solar cell modelling were presented by Green 1996 and Zhang 1998. Their model was restricted to a...

  4. Gas storage materials, including hydrogen storage materials

    Mohtadi, Rana F; Wicks, George G; Heung, Leung K; Nakamura, Kenji

    2013-02-19

    A material for the storage and release of gases comprises a plurality of hollow elements, each hollow element comprising a porous wall enclosing an interior cavity, the interior cavity including structures of a solid-state storage material. In particular examples, the storage material is a hydrogen storage material such as a solid state hydride. An improved method for forming such materials includes the solution diffusion of a storage material solution through a porous wall of a hollow element into an interior cavity.

  5. Severe Environmental Corrosion Erosion Facility

    Federal Laboratory Consortium — NETL’s Severe Environment Corrosion Erosion Facility in Albany, OR, allows researchers to safely examine the performance of materials in highly corrosive or erosive...

  6. Severe ASR damaged concrete bridges

    Antonio Barbosa, Ricardo; Gustenhoff Hansen, Søren

    2015-01-01

    Technical University of Denmark (DTU) and University of Southern Denmark (SDU) have conducted several full-scale experiments with severe ASR deteriorated bridges. This paper presents few and preliminary results from both the shear tests and the measuring of the material properties. The shear tests...... show that the shear capacity is almost unaffected of ASR despite significant reduction in compressive concrete strength. Furthermore, measurements show a significant tensile reinforcement strain developed due to ASR expansion....

  7. Severe acute malnutrition and infection

    Jones, Kelsey D. J.; Berkley, James A

    2014-01-01

    Severe acute malnutrition (SAM) is associated with increased severity of common infectious diseases, and death amongst children with SAM is almost always as a result of infection. The diagnosis and management of infection are often different in malnourished versus well-nourished children. The objectives of this brief are to outline the evidence underpinning important practical questions relating to the management of infectious diseases in children with SAM and to highlight research gaps. Over...

  8. Chronic Infection and Severe Asthma.

    Carr, Tara F; Kraft, Monica

    2016-08-01

    Chronic bacterial infection is implicated in both the development and severity of asthma. The atypical bacteria Mycoplasma pneumoniae and Chlamydophila pneumoniae have been identified in the airways of asthmatics and correlated with clinical features such as adult onset, exacerbation risks, steroid sensitivity, and symptom control. Asthmatic patients with evidence of bacterial infection may benefit from antibiotic treatment directed towards these atypical organisms. Examination of the airway microbiome may identify microbial communities that confer risk for or protection from severe asthma. PMID:27401621

  9. An Integrated Biochemistry Laboratory, Including Molecular Modeling

    Hall, Adele J. Wolfson Mona L.; Branham, Thomas R.

    1996-11-01

    The dilemma of designing an advanced undergraduate laboratory lies in the desire to teach and reinforce basic principles and techniques while at the same time exposing students to the excitement of research. We report here on a one-semester, project-based biochemistry laboratory that combines the best features of a cookbook approach (high success rate, achievement of defined goals) with those of an investigative, discovery-based approach (student involvement in the experimental design, excitement of real research). Individual modules may be selected and combined to meet the needs of different courses and different institutions. The central theme of this lab is protein purification and design. This laboratory accompanies the first semester of biochemistry (Structure and Function of Macromolecules, a course taken mainly by junior and senior chemistry and biological chemistry majors). The protein chosen as the object of study is the enzyme lysozyme, which is utilized in all projects. It is suitable for a student lab because it is easily and inexpensively obtained from egg white and is extremely stable, and its high isoelectric point (pI = 11) allows for efficient separation from other proteins by ion-exchange chromatography. Furthermore, a literature search conducted by the resourceful student reveals a wealth of information, since lysozyme has been the subject of numerous studies. It was the first enzyme whose structure was determined by crystallography (1). Hendrickson et al. (2) have previously described an intensive one-month laboratory course centered around lysozyme, although their emphasis is on protein stability rather than purification and engineering. Lysozyme continues to be the focus of much exciting new work on protein folding and dynamics, structure and activity (3 - 5). This lab course includes the following features: (i) reinforcement of basic techniques, such as preparation of buffers, simple enzyme kinetics, and absorption spectroscopy; (ii

  10. Spontaneous pnemomedastinum in acute severe asthma

    Aleemuddin N

    2010-01-01

    Full Text Available Spontaneous medastinal emphysema, as a complication of acute severe asthma, is an uncommon entity. It usually runs a benign course and resolves spontaneously without any surgical intervention. Recognition of this complication is critical, as it has to be differentiated from other life threatening ones including oesophageal rupture, Boerhave′s syndrome, acute coronary syndrome and pulmonary embolism. This case is being presented to emphasize its recognition in the differential diagnosis of complications arising from acute severe asthma and to present its management strategy in detail.

  11. Statistics of severe tornadoes and severe tornado outbreaks

    B. D. Malamud; Turcotte, D.L.

    2012-01-01

    The standard measures of the intensity of a tornado in the USA and many other countries are the Fujita and Enhanced Fujita scales. These scales are based on the damage that a tornado causes. Another measure of the strength of a tornado is its path length of touchdown, L. In this study we consider severe tornadoes, which we define as L≥10 km, in the continental USA (USA Storm Prediction Center Severe Weather Database). We find that for the period 1982–2011...

  12. Statistics of severe tornadoes and severe tornado outbreaks

    B. D. Malamud; Turcotte, D.L.

    2012-01-01

    The standard measures of the intensity of a tornado in the USA and many other countries are the Fujita and Enhanced Fujita scales. These scales are based on the damage that a tornado causes. Another measure of the strength of a tornado is its path length of touchdown, L. In this study we consider 4061 severe tornadoes (defined as L≥10 km) in the continental USA for the time period 1981–2010 (USA Storm Prediction Center Severe Weather Database). We find fo...

  13. Immunocompromised Children with Severe Adenoviral Respiratory Infection

    Joanna C. Tylka

    2016-01-01

    Full Text Available Purpose. To investigate the impact of severe respiratory adenoviral infection on morbidity and case fatality in immunocompromised children. Methods. Combined retrospective-prospective cohort study of patients admitted to the intensive care unit (ICU in four children’s hospitals with severe adenoviral respiratory infection and an immunocompromised state between August 2009 and October 2013. We performed a secondary case control analysis, matching our cohort 1 : 1 by age and severity of illness score with immunocompetent patients also with severe respiratory adenoviral infection. Results. Nineteen immunocompromised patients were included in our analysis. Eleven patients (58% did not survive to hospital discharge. Case fatality was associated with cause of immunocompromised state (p=0.015, multiple organ dysfunction syndrome (p=0.001, requirement of renal replacement therapy (p=0.01, ICU admission severity of illness score (p=0.011, and treatment with cidofovir (p=0.005. Immunocompromised patients were more likely than matched controls to have multiple organ dysfunction syndrome (p=0.01, require renal replacement therapy (p=0.02, and not survive to hospital discharge (p=0.004. One year after infection, 43% of immunocompromised survivors required chronic mechanical ventilator support. Conclusions. There is substantial case fatality as well as short- and long-term morbidity associated with severe adenoviral respiratory infection in immunocompromised children.

  14. Imaging findings of severe and critical severe pulmonary infections with A H1N1 influenza

    Objective: To evaluate the pulmonary imaging features in patients with severe or critical severe A H1N1 influenza. Methods: Clinical and imaging findings of 18 cases with H1N1 pneumonia were retrospectively analyzed. These patients were divided into 2 groups including severe group (n=11) and critical group (n=7). Results: Among the severe group, bilateral ill-defined nodules and patch shadows were found in 8 cases, local ill-defined patchy was shown in 3 cases, and consolidation of right inferior lung was demonstrated by CT scan in 1 case. Among the critical group, diffuse ground-glass attenuation with partial consolidation were found in bilateral lungs of 4 cases, subcutaneous emphysema was observed in 1 case. CT showed diffuse ground-glass attenuation and nodular like consolidation in bilateral inferior lungs in 1 case, and other 3 cases showed diffuse consolidation of bilateral lungs. Conclusions: The radiologic findings of severe and critical severe pulmonary infections with H1N1 include ill-defined nodules and patch shadows of bilateral lung in sever patients, diffuse peribronchial ground-glass opacity and multifocal consolidation in critical severe patients. The radiologists should learn the features of H1N1 pneumonia on thoracic plain film and CTT to make diagnosis in time. (authors)

  15. Transmission line including support means with barriers

    Cookson, Alan H.

    1982-01-01

    A gas insulated transmission line includes an elongated outer sheath, a plurality of inner conductors disposed within and extending along the outer sheath, and an insulating gas which electrically insulates the inner conductors from the outer sheath. A support insulator insulatably supports the inner conductors within the outer sheath, with the support insulator comprising a main body portion including a plurality of legs extending to the outer sheath, and barrier portions which extend between the legs. The barrier portions have openings therein adjacent the main body portion through which the inner conductors extend.

  16. Electric Power Monthly, August 1990. [Glossary included

    1990-11-29

    The Electric Power Monthly (EPM) presents monthly summaries of electric utility statistics at the national, Census division, and State level. The purpose of this publication is to provide energy decisionmakers with accurate and timely information that may be used in forming various perspectives on electric issues that lie ahead. Data includes generation by energy source (coal, oil, gas, hydroelectric, and nuclear); generation by region; consumption of fossil fuels for power generation; sales of electric power, cost data; and unusual occurrences. A glossary is included.

  17. 42 CFR 409.10 - Included services.

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Included services. 409.10 Section 409.10 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Inpatient Hospital Services and Inpatient Critical Access Hospital...

  18. Eosinophilic bioactivities in severe asthma.

    Carr, Tara F; Berdnikovs, Sergejs; Simon, Hans-Uwe; Bochner, Bruce S; Rosenwasser, Lanny J

    2016-01-01

    Asthma is clearly related to airway or blood eosinophilia, and asthmatics with significant eosinophilia are at higher risk for more severe disease. Eosinophils actively contribute to innate and adaptive immune responses and inflammatory cascades through the production and release of diverse chemokines, cytokines, lipid mediators and other growth factors. Eosinophils may persist in the blood and airways despite guidelines-based treatment. This review details eosinophil effector mechanisms, surface markers, and clinical outcomes associated with eosinophilia and asthma severity. There is interest in the potential of eosinophils or their products to predict treatment response with biotherapeutics and their usefulness as biomarkers. This is important as monoclonal antibodies are targeting cytokines and eosinophils in different lung environments for treating severe asthma. Identifying disease state-specific eosinophil biomarkers would help to refine these strategies and choose likely responders to biotherapeutics. PMID:27386041

  19. Advanced calculus of several variables

    Kumar, Devendra

    2014-01-01

    ADVANCED CALCULUS OF SEVERAL VARIABLES covers important topics of Transformations and topology on Euclidean in n-space Rn Functions of several variables, Differentiation in Rn, Multiple integrals and Integration in Rn. The topics have been presented in a simple clear and coherent style with a number of examples and exercises. Proofs have been made direct and simple. Unsolved problems just after relevant articles in the form of exercises and typical problems followed by suggestions have been given. This book will help the reader work on the problems of Numerical Analysis, Operations Research, Differential Equations and Engineering applications.

  20. Severe Accident Recriticality Analyses (SARA)

    Recriticality in a BWR has been studied for a total loss of electric power accident scenario. In a BWR, the B4C control rods would melt and relocate from the core before the fuel during core uncovery and heat-up. If electric power returns during this time-window unborated water from ECCS systems will start to reflood the partly control rod free core. Recriticality might take place for which the only mitigating mechanisms are the Doppler effect and void formation. In order to assess the impact of recriticality on reactor safety, including accident management measures, the following issues have been investigated in the SARA project: 1. the energy deposition in the fuel during super-prompt power burst, 2. the quasi steady-state reactor power following the initial power burst and 3. containment response to elevated quasi steady-state reactor power. The approach was to use three computer codes and to further develop and adapt them for the task. The codes were SIMULATE-3K, APROS and RECRIT. Recriticality analyses were carried out for a number of selected reflooding transients for the Oskarshamn 3 plant in Sweden with SIMULATE-3K and for the Olkiluoto 1 plant in Finland with all three codes. The core state initial and boundary conditions prior to recriticality have been studied with the severe accident codes SCDAP/RELAP5, MELCOR and MAAP4. The results of the analyses show that all three codes predict recriticality - both superprompt power bursts and quasi steady-state power generation - for the studied range of parameters, i. e. with core uncovery and heat-up to maximum core temperatures around 1800 K and water flow rates of 45 kg/s to 2000 kg/s injected into the downcomer. Since the recriticality takes place in a small fraction of the core the power densities are high which results in large energy deposition in the fuel during power burst in some accident scenarios. The highest value, 418 cal/g, was obtained with SIMULATE-3K for an Oskarshamn 3 case with reflooding rate

  1. Severe Accident Recriticality Analyses (SARA)

    Frid, W. [Swedish Nuclear Power Inspectorate, Stockholm (Sweden); Hoejerup, F. [Risoe National Lab. (Denmark); Lindholm, I.; Miettinen, J.; Puska, E.K. [VTT Energy, Helsinki (Finland); Nilsson, Lars [Studsvik Eco and Safety AB, Nykoeping (Sweden); Sjoevall, H. [Teoliisuuden Voima Oy (Finland)

    1999-11-01

    Recriticality in a BWR has been studied for a total loss of electric power accident scenario. In a BWR, the B{sub 4}C control rods would melt and relocate from the core before the fuel during core uncovery and heat-up. If electric power returns during this time-window unborated water from ECCS systems will start to reflood the partly control rod free core. Recriticality might take place for which the only mitigating mechanisms are the Doppler effect and void formation. In order to assess the impact of recriticality on reactor safety, including accident management measures, the following issues have been investigated in the SARA project: 1. the energy deposition in the fuel during super-prompt power burst, 2. the quasi steady-state reactor power following the initial power burst and 3. containment response to elevated quasi steady-state reactor power. The approach was to use three computer codes and to further develop and adapt them for the task. The codes were SIMULATE-3K, APROS and RECRIT. Recriticality analyses were carried out for a number of selected reflooding transients for the Oskarshamn 3 plant in Sweden with SIMULATE-3K and for the Olkiluoto 1 plant in Finland with all three codes. The core state initial and boundary conditions prior to recriticality have been studied with the severe accident codes SCDAP/RELAP5, MELCOR and MAAP4. The results of the analyses show that all three codes predict recriticality - both superprompt power bursts and quasi steady-state power generation - for the studied range of parameters, i. e. with core uncovery and heat-up to maximum core temperatures around 1800 K and water flow rates of 45 kg/s to 2000 kg/s injected into the downcomer. Since the recriticality takes place in a small fraction of the core the power densities are high which results in large energy deposition in the fuel during power burst in some accident scenarios. The highest value, 418 cal/g, was obtained with SIMULATE-3K for an Oskarshamn 3 case with reflooding

  2. Spider behaviors include oral sexual encounters.

    Gregorič, Matjaž; Šuen, Klavdija; Cheng, Ren-Chung; Kralj-Fišer, Simona; Kuntner, Matjaž

    2016-01-01

    Several clades of spiders whose females evolved giant sizes are known for extreme sexual behaviors such as sexual cannibalism, opportunistic mating, mate-binding, genital mutilation, plugging, and emasculation. However, these behaviors have only been tested in a handful of size dimorphic spiders. Here, we bring another lineage into the picture by reporting on sexual behavior of Darwin's bark spider, Caerostris darwini. This sexually size dimorphic Madagascan species is known for extreme web gigantism and for producing the world's toughest biomaterial. Our field and laboratory study uncovers a rich sexual repertoire that predictably involves cannibalism, genital mutilation, male preference for teneral females, and emasculation. Surprisingly, C. darwini males engage in oral sexual encounters, rarely reported outside mammals. Irrespective of female's age or mating status males salivate onto female genitalia pre-, during, and post-copulation. While its adaptive significance is elusive, oral sexual contact in spiders may signal male quality or reduce sperm competition. PMID:27126507

  3. Sellafield Site (including Drigg) emergency scheme manual

    This Scheme defines the organisation and procedures available should there be an accident at the Sellafield Site which results in, or may result in, the release of radioactive material, or the generation of a high radiation field, which might present a hazard to employees and/or the general public. Several categories of emergencies on the Sellafield Site are mentioned; a building emergency which is confined to one building, a Site emergency standby when the effects of a building emergency go outside that building, a Site emergency alert (District Emergency Standby) when a release of activity affects Site operations and could have serious Site effects and a District Emergency Alert when a radioactivity release may interfere with the normal activity of the General Public. A Drigg Emergency Standby situation would operate similarly at the Drigg Site. The detailed arrangements and responsibilities of appointed personnel are set out in this manual. (UK)

  4. Plutino Detection Biases, Including the Kozai Resonance

    Lawler, S M

    2013-01-01

    Because of their proximity within the transneptunian region, the plutinos (objects in the 3:2 mean-motion resonance with Neptune) are numerous in flux-limited catalogs, and well-studied theoretically. We perform detailed modelling of the on-sky detection biases for plutinos, with special attention to those that are simultaneously in the Kozai resonance. In addition to the normal 3:2 resonant argument libration, Kozai plutinos also show periodic oscillations in eccentricity and inclination, coupled to the argument of perihelion (omega) oscillation. Due to the mean-motion resonance, plutinos avoid coming to pericenter near Neptune's current position in the ecliptic plane. Because Kozai plutinos are restricted to certain values of omega, perihelion always occurs out of the ecliptic plane, biasing ecliptic surveys against finding these objects. The observed Kozai plutino fraction (fkoz) has been measured by several surveys, finding values between 8% and 25%, while the true fkoz has been predicted to be between 10...

  5. Diabetic emergencies including hypoglycemia during Ramadan

    Jamal Ahmad

    2012-01-01

    Full Text Available Majority of physicians are of the opinion that Ramadan fasting is acceptable for well-balanced type 2 patients conscious of their disease and compliant with their diet and drug intake. Fasting during Ramadan for patients with diabetes carries a risk of an assortment of complications. Islamic rules allow patients not to fast. However, if patient with diabetes wish to fast, it is necessary to advice them to undertake regular monitoring of blood glucose levels several times a day, to reduce the risk of hypoglycemia during day time fasting or hyperglycemia during the night. Patient with type 1 diabetes who fast during Ramadan may be better managed with fast-acting insulin. They should have basic knowledge of carbohydrate metabolism, the standard principles of diabetes care, and pharmacology of various antidiabetic drugs. This Consensus Statement describes the management of the various diabetic emergencies that may occur during Ramadan.

  6. EC6 safety enhancement - including impact of Fukushima lessons learned

    The Enhanced CANDU® 6 (EC6) is the new Generation III CANDU reactor design that meets the most up to date regulatory requirements and customer expectations. EC6 builds on the proven high performance design such as the Qinshan CANDU 6 units and has made improvements to safety and operational performance, and has incorporated extensive operational feedback including Fukushima. The Fukushima Dai-ichi March 11, 2011 event has demonstrated the importance of defence-in-depth considerations for beyond-design basis events, including severe accidents. The EC6 design is based on the defence-in-depth principles and provides further design features that address the lessons learned from Fukushima. (author)

  7. Chapter 14: Acute severe asthma (status asthmaticus).

    Shah, Rachna; Saltoun, Carol A

    2012-01-01

    Acute severe asthma, formerly known as status asthmaticus, is defined as severe asthma unresponsive to repeated courses of beta-agonist therapy such as inhaled albuterol, levalbuterol, or subcutaneous epinephrine. It is a medical emergency that requires immediate recognition and treatment. Oral or parenteral corticosteroids should be administered to all patients with acute severe asthma as early as possible because clinical benefits may not occur for a minimum of 6-12 hours. Approximately 50% of episodes are attributable to upper respiratory infections, and other causes include medical nonadherence, nonsteroidal anti-inflammatory exposure in aspirin-allergic patients, allergen exposure (especially pets) in severely atopic individuals, irritant inhalation (smoke, paint, etc.), exercise, and insufficient use of inhaled or oral corticosteroids. The patient history should be focused on acute severe asthma including current use of oral or inhaled corticosteroids, number of hospitalizations, emergency room visits, intensive-care unit admissions and intubations, the frequency of albuterol use, the presence of nighttime symptoms, exercise intolerance, current medications or illicit drug use, exposure to allergens, and other significant medical conditions. Severe airflow obstruction may be predicted by accessory muscle use, pulsus paradoxus, refusal to recline below 30°, a pulse >120 beats/min, and decreased breath sounds. Physicians' subjective assessments of airway obstruction are often inaccurate. More objective measures of airway obstruction via peak flow (or forced expiratory volume in 1 second) and pulse oximetry before oxygen administration usually are helpful. Pulse oximetry values >90% are less commonly associated with problems although CO(2) retention and a low Pao(2) may be missed. PMID:22794687

  8. Mix design of bituminous materials including reclaimed asphalt pavement

    Dubois, Vincent; De La Roche, Chantal

    2008-01-01

    Reclaimed asphalt, obtained by milling of asphalt road layers can be re-used at once or stored. In the case of storage, an heterogeneity issue may occur when several types of materials, with different origins are mixed. At the scale of a storage zone or a stock pile, composition and properties of the reclaimed asphalts will be different, including variations of the final material properties, constraints for the stock manager, and the necessary adaptation of the manufacturing process. The recl...

  9. Towards a general framework for including noise impacts in LCA

    Cucurachi, Stefano; Heijungs, Reinout; Ohlau, Katrin

    2012-01-01

    Purpose Several damages have been associated with the exposure of human beings to noise. These include auditory effects, i.e., hearing impairment, but also non-auditory physiological ones such as hypertension and ischemic heart disease, or psychological ones such as annoyance, depression, sleep disturbance, limited performance of cognitive tasks or inadequate cognitive development. Noise can also interfere with intended activities, both in daytime and nighttime. ISO 14'040 also indicated the ...

  10. Photoactive devices including porphyrinoids with coordinating additives

    Forrest, Stephen R; Zimmerman, Jeramy; Yu, Eric K; Thompson, Mark E; Trinh, Cong; Whited, Matthew; Diev, Vlacheslav

    2015-05-12

    Coordinating additives are included in porphyrinoid-based materials to promote intermolecular organization and improve one or more photoelectric characteristics of the materials. The coordinating additives are selected from fullerene compounds and organic compounds having free electron pairs. Combinations of different coordinating additives can be used to tailor the characteristic properties of such porphyrinoid-based materials, including porphyrin oligomers. Bidentate ligands are one type of coordinating additive that can form coordination bonds with a central metal ion of two different porphyrinoid compounds to promote porphyrinoid alignment and/or pi-stacking. The coordinating additives can shift the absorption spectrum of a photoactive material toward higher wavelengths, increase the external quantum efficiency of the material, or both.

  11. Is paediatric trauma severity overestimated at triage?

    DO, H Q; Hesselfeldt, R; Steinmetz, J;

    2014-01-01

    BACKGROUND: Severe paediatric trauma is rare, and pre-hospital and local hospital personnel experience with injured children is often limited. We hypothesised that a higher proportion of paediatric trauma victims were taken to the regional trauma centre (TC). METHODS: This is an observational...... follow-up study that involves one level I TC and seven local hospitals. We included paediatric (trauma patients with a driving distance to the TC > 30 minutes. The primary end-point was the proportion of trauma patients arriving in the TC. RESULTS: We included 1934...... trauma patients, 238 children and 1696 adults. A total of 33/238 children (13.9%) vs. 304/1696 adults (17.9%) were transported to the TC post-injury (P = 0.14). Among these, children were significantly less injured than adults [median Injury Severity Score (ISS) 9 vs. 14, P 

  12. Including knowledge creation & enabling in risk management

    Hop, Eirik

    2015-01-01

    As a contribution to Statoil Technical Efficiency Programme (STEP), has the thesis looked at how to improve the risk management process in Statoil ASA. Through theoretical research was the primary research question created: “How can knowledge creation & enabling improve our understanding of risk management?” To create a theoretical foundation, the thesis looked at principles, methods, and models for the adequate assessment and management of risk. This includes a new perspective on ri...

  13. Rotor assembly including superconducting magnetic coil

    Snitchler, Gregory L.; Gamble, Bruce B.; Voccio, John P.

    2003-01-01

    Superconducting coils and methods of manufacture include a superconductor tape wound concentrically about and disposed along an axis of the coil to define an opening having a dimension which gradually decreases, in the direction along the axis, from a first end to a second end of the coil. Each turn of the superconductor tape has a broad surface maintained substantially parallel to the axis of the coil.

  14. Including heavy flavour production in PDF fits

    A.M. Cooper-Sarkar

    2007-01-01

    AT HERA heavy quarks may contribute up to 30% of the structure function $F_2$. The introduction of heavy quarks requires an extension of the DGLAP formalism. The effect of using different heavy flavour number schemes, and different approaches to the running of $\\alpha_s$, are compared using the ZEUS PDF fit formalism. The potential of including charm data in the fit is explored, using $D^*$ double differential cross-sections rather than the inclusive quantity $F_2^{c\\bar{c}}$.

  15. Electric power monthly, September 1990. [Glossary included

    1990-12-17

    The purpose of this report is to provide energy decision makers with accurate and timely information that may be used in forming various perspectives on electric issues. The power plants considered include coal, petroleum, natural gas, hydroelectric, and nuclear power plants. Data are presented for power generation, fuel consumption, fuel receipts and cost, sales of electricity, and unusual occurrences at power plants. Data are compared at the national, Census division, and state levels. 4 figs., 52 tabs. (CK)

  16. The surgery of peripheral nerves (including tumors)

    Fugleholm, Kåre

    2013-01-01

    Surgical pathology of the peripheral nervous system includes traumatic injury, entrapment syndromes, and tumors. The recent significant advances in the understanding of the pathophysiology and cellular biology of peripheral nerve degeneration and regeneration has yet to be translated into improved...... nervous system response to injury are prerequisite to obtain the best possible outcome. Surgery continues to be the primary treatment modality for peripheral nerve tumors and advances in adjuvant oncological treatment has improved outcome after malignant peripheral nerve tumors. The present chapter...

  17. Therapy of moderate and severe psoriasis

    Werfel, Thomas; von der Schulenburg, Johann-Matthias; Greiner, Wolfgang; Kulp, Werner; Claes, Christa

    2006-01-01

    Objective and methods: This health technology assessment (HTA) report synthesises systematically randomized controlled studies (RCT) on the therapy of moderate and severe psoriasis vulgaris which were published between 1999 and 2004; it includes some important clinical studies which have been published after 2004 and thus updates the English HTA report by Griffiths et al. [1]. The major objective is the evaluation of the medical effectiveness of different therapeutical approaches and the cost...

  18. Clinical Practice Guidelines for Severe Asthma Treatment.

    Eddy Pereira Valdes; Moisés Santos Peña; Belkys Rodríguez Llerena.

    2009-01-01

    Clinical Practice Guidelines for Severe Asthma Treatment. This disease is characterized by an overreaction of the tracheobronchial tree with hyperactivity after certain stimulus consisting of a diffuse narrowing of the respiratory ways related with an excessive contraction of the bronchial smooth muscle, hyper-secretion of mucus and mucosa edema. It is spontaneously reversible or reversible after treatment. We include a review of its definition, classification and development, stressing those...

  19. Several Items Comparisons of Intercultural Food Communication

    刘智慧

    2011-01-01

    Introduction This paper is included seven parts,food culture introduction,forms and manners of western food,forms and manners of Chinese food,three main kinds of difference of foods,mergence,taboo and conclusion.I will divide it into several parts to analyze them.I adopt ~me examples and history stories.As all of my expressions,I hope you can enjoy my paper and have a good stomach.

  20. Implantology and the severely resorbed edentulous mandible

    Stellingsma, C.; Vissink, A; Meijer, H.J.A.; Raghoebar, G.M.

    2004-01-01

    Patients with a severely resorbed edentulous mandible often suffer from problems with the lower denture. These problems include: insufficient retention of the lower denture, intolerance to loading by the mucosa, pain, difficulties with eating and speech, loss of soft-tissue support, and altered facial appearance. These problems are a challenge for the prosthodontist and surgeon. Dental implants have been shown to provide a reliable basis for fixed and removable prostheses. This has resulted i...

  1. Severe combined immune deficiency syndrome

    To determine the clinico-demographic features and laboratory parameters of children with severe combined immunodeficiency (SCID). Study Design: Case series. Place and Duration of Study: Department of Paediatrics and Child Health, the Aga Khan University, Karachi, from July 2006 to July 2011. Methodology: Thirteen infants who were discharged with a diagnosis of SCID were inducted in the study. Their clinicodemographic features and laboratory parameters were determined. Descriptive statistics has been used for computing frequency and percentage. Results: The median age at diagnosis was five months; 5 infants presented within 3 months of life. Three-fourth (77%) were males. Most of the infants were severely malnourished (85%) at the time of presentation. More than two-thirds (69%) were products of consanguineous marriages. All subjects had severe lymphopenia (absolute lymphocyte count (ALC) ranging between 170 – 2280) and low T and B lymphocyte counts. Conclusion: SCID should be considered in infants presenting with severe and recurrent infections. Low ALC (< 2500/mm3), is a reliable diagnostic feature of SCID. These infants should be promptly referred to a facility where stem cell transplant can be done. (author)

  2. Combination of several data sources

    The problem of combining several uncertain data sources is discussed. Two methods based on subjective Bayesian analysis and on the Shafer-Dempster theory of evidence are proposed. The uncertainty of the resulting estimates is discussed and the methods are applied to some exemplary cases. Some conclusions concerning the methods are given. (orig.)

  3. Severe hypophosphataemia in anorexia nervosa.

    Cariem, A. K.; Lemmer, E. R.; Adams, M. G.; Winter, T. A.; O'Keefe, S J

    1994-01-01

    In addition to well-described acid-base and electrolyte disturbances, anorexia nervosa may be complicated by severe hypophosphataemia. We report a case of anorexia nervosa complicated by life-threatening hypophosphataemia manifesting as generalized muscle weakness and bulbar muscle dysfunction, resulting in an aspiration pneumonia and cardiorespiratory arrest.

  4. Bioimpedance in Severely Malnourished Children

    Girma Nigatu, Tsinuel

    Worldwide severe acute malnutrition (SAM) affects millions of children and considerably contributes to under-five mortality, mainly in low-income settings. Among children with SAM, deaths occur largely in those with oedema and during early phase of treatment often aggravated by infection. Treatment...

  5. Horner's syndrome in severe tetanus.

    Syam, B.; Owens, D

    1992-01-01

    A 66 year old man was admitted with a left Horner's syndrome, and trismus due to tetanus. Three days later he had respiratory arrests, classical tetanic spasms and was ventilated. He had associated severe autonomic dysfunction, tachyarrhythmias, hypotension, sweating and constipation. There was complete resolution of the left Horner's syndrome with recovery from tetanus.

  6. [Invasive yeast infections in severely burned patients].

    Renau, Ana Isabel; García-Vidal, Carolina; Salavert, Miguel

    2016-01-01

    Currently, there are few studies on candidaemia in the severely burned patient. These patients share the same risk factors for invasive fungal infections as other critically ill patients, but have certain characteristics that make them particularly susceptible. These include the loss of skin barrier due to extensive burns, fungal colonisation of the latter, and the use of hydrotherapy or other topical therapies (occasionally with antimicrobials). In addition, the increased survival rate achieved in recent decades in critically burned patients due to the advances in treatment has led to the increase of invasive Candida infections. This explains the growing interest in making an earlier and more accurate diagnosis, as well as more effective treatments to reduce morbidity and mortality of candidaemia in severe burned patients. A review is presented on all aspects of the burned patient, including the predisposition and risk factors for invasive candidiasis, pathogenesis of candidaemia, underlying immunodeficiency, local epidemiology and antifungal susceptibility, evolution and prognostic factors, as well as other non-Candida yeast infections. Finally, we include specific data on our local experience in the management of candidaemia in severe burned patients, which may serve to quantify the problem, place it in context, and offer a realistic perspective. PMID:27395025

  7. The severe accident research program at KIT

    The understanding of the plant behaviour under beyond design basis accidents as well as the interaction of the operators with the plant is the most important prerequisite to develop proper strategies to both control the accident progression and to minimize the radiological risk that may derive from operating nuclear power plants. In view of the Fukushima accident, a review of many issues important to safety e.g. severe accident analysis methodologies and assumptions, emergency operational procedures, severe accident management procedures (SAM), decision lines of the emergency team, etc. is needed to draw conclusions in order to avoid a repetition of Fukushima-like accidents.In addition, situations like the ‘black control room’ need to be reconsidered and a re-evaluation of the necessary instrumentation for hypothetical severe accident situations is urgently needed. If the real plant state during core meltdown accidents is unknown, no effective measures can be initiated by the emergency team in order to assure the integrity of the safety barriers and hence the release of radioactive material to the environment. The work performed in this area is integrated in the European Networks such as SARNET (Severe Accident Research Network) for the severe accidents, and for emergency management in the NERIS-TP. In future all the activities will be included in the NUGENIA platform. A brief overview of the KIT activities together with the experimental test facilities is given

  8. The clinical management in extremely severe COPD.

    Ambrosino, Nicolino; Simonds, Anita

    2007-08-01

    Chronic obstructive pulmonary disease (COPD) affects 6% of the general population and is the fourth-leading cause of death in the United States with severe and very severe disease accounting for 15% and 3% of physician diagnoses of COPD. Guidelines make few recommendations regarding providing the provision of care for the most severe stages of disease, namely Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages III and IV with chronic respiratory failure. The effectiveness of inhaled drug therapy in very severe patients has not been assessed yet. Health care systems in many countries include public funding of long-term oxygen therapy for eligible candidates. Currently, there is little evidence for the use of mechanical ventilatory support in the routine management of hypercapnic patients. Pulmonary rehabilitation should be considered as a significant component of therapy, even in the most severe patients. Although Lung Volume Reduction Surgery has been shown to improve mortality, exercise capacity, and quality of life in selected patients, this modality is associated with significant morbidity and an early mortality rate in the most severe patients. Despite significant progress over the past 25 years, both short- and long-term outcomes remain significantly inferior for lung transplantation relative to other "solid" organ recipients. Nutritional assessment and management is an important therapeutic option in patients with chronic respiratory diseases. Morphine may significantly reduce dyspnoea and does not significantly accelerate death. No consistent improvement in dyspnoea over placebo has been shown with anxiolytics. Supplemental oxygen during exercise reduces exertional breathlessness and improves exercise tolerance of the hypoxaemic patient. Non-invasive ventilation has been used as a palliative treatment to reduce dyspnoea. Hypoxaemic COPD patients, on long-term oxygen therapy, may show reduced health-related quality of life, cognitive function

  9. Severe accident testing of electrical penetration assemblies

    This report describes the results of tests conducted on three different designs of full-size electrical penetration assemblies (EPAs) that are used in the containment buildings of nuclear power plants. The objective of the tests was to evaluate the behavior of the EPAs under simulated severe accident conditions using steam at elevated temperature and pressure. Leakage, temperature, and cable insulation resistance were monitored throughout the tests. Nuclear-qualified EPAs were produced from D. G. O'Brien, Westinghouse, and Conax. Severe-accident-sequence analysis was used to generate the severe accident conditions (SAC) for a large dry pressurized-water reactor (PWR), a boiling-water reactor (BWR) Mark I drywell, and a BWR Mark III wetwell. Based on a survey conducted by Sandia, each EPA was matched with the severe accident conditions for a specific reactor type. This included the type of containment that a particular EPA design was used in most frequently. Thus, the D. G. O'Brien EPA was chosen for the PWR SAC test, the Westinghouse was chosen for the Mark III test, and the Conax was chosen for the Mark I test. The EPAs were radiation and thermal aged to simulate the effects of a 40-year service life and loss-of-coolant accident (LOCA) before the SAC tests were conducted. The design, test preparations, conduct of the severe accident test, experimental results, posttest observations, and conclusions about the integrity and electrical performance of each EPA tested in this program are described in this report. In general, the leak integrity of the EPAs tested in this program was not compromised by severe accident loads. However, there was significant degradation in the insulation resistance of the cables, which could affect the electrical performance of equipment and devices inside containment at some point during the progression of a severe accident. 10 refs., 165 figs., 16 tabs

  10. Severe accident testing of electrical penetration assemblies

    Clauss, D.B. (Sandia National Labs., Albuquerque, NM (USA))

    1989-11-01

    This report describes the results of tests conducted on three different designs of full-size electrical penetration assemblies (EPAs) that are used in the containment buildings of nuclear power plants. The objective of the tests was to evaluate the behavior of the EPAs under simulated severe accident conditions using steam at elevated temperature and pressure. Leakage, temperature, and cable insulation resistance were monitored throughout the tests. Nuclear-qualified EPAs were produced from D. G. O'Brien, Westinghouse, and Conax. Severe-accident-sequence analysis was used to generate the severe accident conditions (SAC) for a large dry pressurized-water reactor (PWR), a boiling-water reactor (BWR) Mark I drywell, and a BWR Mark III wetwell. Based on a survey conducted by Sandia, each EPA was matched with the severe accident conditions for a specific reactor type. This included the type of containment that a particular EPA design was used in most frequently. Thus, the D. G. O'Brien EPA was chosen for the PWR SAC test, the Westinghouse was chosen for the Mark III test, and the Conax was chosen for the Mark I test. The EPAs were radiation and thermal aged to simulate the effects of a 40-year service life and loss-of-coolant accident (LOCA) before the SAC tests were conducted. The design, test preparations, conduct of the severe accident test, experimental results, posttest observations, and conclusions about the integrity and electrical performance of each EPA tested in this program are described in this report. In general, the leak integrity of the EPAs tested in this program was not compromised by severe accident loads. However, there was significant degradation in the insulation resistance of the cables, which could affect the electrical performance of equipment and devices inside containment at some point during the progression of a severe accident. 10 refs., 165 figs., 16 tabs.

  11. A kicked quantum system including the continuum

    The behaviour of a quantum particle in a separable one-term potential with three-dimensional form factor is investigated under the influence of an external force which alters the potential strength periodically or quasiperiodically. The unperturbed system possesses one bound state and a continuum of scattering states which has treated almost analytically. First numerical results, fully including the emission channel, indicate, for certain parameter combinations with commensurate or incommensurate frequency ratios, either a regular or an irregular dynamical behaviour of the system. 17 refs.; 3 figs

  12. Development of severe accident management advisory and training simulator (SAMAT)

    The most operator support systems including the training simulator have been developed to assist the operator and they cover from normal operation to emergency operation. For the severe accident, the overall architecture for severe accident management is being developed in some developed countries according to the development of severe accident management guidelines which are the skeleton of severe accident management architecture. In Korea, the severe accident management guideline for KSNP was recently developed and it is expected to be a central axis of logical flow for severe accident management. There are a lot of uncertainties in the severe accident phenomena and scenarios and one of the major issues for developing a operator support system for a severe accident is the reduction of these uncertainties. In this paper, the severe accident management advisory system with training simulator, SAMAT, is developed as all available information for a severe accident are re-organized and provided to the management staff in order to reduce the uncertainties. The developed system includes the graphical display for plant and equipment status, the previous research results by knowledge-base technique, and the expected plant behavior using the severe accident training simulator. The plant model used in this paper is oriented to severe accident phenomena and thus can simulate the plant behavior for a severe accident. Therefore, the developed system may make a central role of the information source for decision-making for a severe accident management, and will be used as the training simulator for severe accident management

  13. Including Language Access into Medicaid ACO Design.

    Gershon, Rachel; Morris, Lisa; Ferguson, Warren

    2016-09-01

    Quality health care relies upon communication in a patient's preferred language. Language access in health care occurs when individuals are: (1) Welcomed by providers regardless of language ability; and (2) Offered quality language services as part of their care. Federal law generally requires access to health care and quality language services for deaf and Limited English Proficient (LEP) patients in health care settings, but these patients still find it hard to access health care and quality language services.Meanwhile, several states are implementing Medicaid Accountable Care Organization (ACO) initiatives to reduce health care costs and improve health care quality. Alternative payment methods used in these initiatives can give Accountable Care Organizations more flexibility to design linguistically accessible care, but they can also put ACOs at increased financial risk for the cost of care. If these new payment methods do not account for differences in patient language needs, ACO initiatives could have the unintended consequence of rewarding ACOs who do not reach out to deaf and LEP communities or offer quality language services.We reviewed public documents related to Medicaid ACO initiatives in six states. Some of these documents address language access. More could be done, however, to pay for language access efforts. This article describes Medicaid ACO initiatives and explores how different payment tools could be leveraged to reward ACOs for increased access to care and quality language services. We find that a combination of payment tools might be helpful to encourage both access and quality. PMID:27587453

  14. Aerosol simulation including chemical and nuclear reactions

    Marwil, E.S.; Lemmon, E.C.

    1985-01-01

    The numerical simulation of aerosol transport, including the effects of chemical and nuclear reactions presents a challenging dynamic accounting problem. Particles of different sizes agglomerate and settle out due to various mechanisms, such as diffusion, diffusiophoresis, thermophoresis, gravitational settling, turbulent acceleration, and centrifugal acceleration. Particles also change size, due to the condensation and evaporation of materials on the particle. Heterogeneous chemical reactions occur at the interface between a particle and the suspending medium, or a surface and the gas in the aerosol. Homogeneous chemical reactions occur within the aersol suspending medium, within a particle, and on a surface. These reactions may include a phase change. Nuclear reactions occur in all locations. These spontaneous transmutations from one element form to another occur at greatly varying rates and may result in phase or chemical changes which complicate the accounting process. This paper presents an approach for inclusion of these effects on the transport of aerosols. The accounting system is very complex and results in a large set of stiff ordinary differential equations (ODEs). The techniques for numerical solution of these ODEs require special attention to achieve their solution in an efficient and affordable manner. 4 refs.

  15. Concrete under severe conditions. Environment and loading

    The objective of the CONSEC Conferences is to focus on concrete infrastructures, either subjected to severe environment or severe loading, or any combination of severe conditions. Experience from the performance of existing concrete structures, and especially under severe environmental conditions, severe accidental loading or extended lifespan, has demonstrated the need for better integration of structural and durability design, new design concepts including reliability-based durability design, performance-based material requirements, structural robustness, and an improved basis for documentation of obtained construction quality and durability properties during concrete construction. An improved basis for operation and preventive maintenance of concrete structures including repairs and retrofitting is also very important. Premature corrosion of reinforcing steel, inadequate structural design for seismic or blast loading, are examples of reduced service life of concrete structures that not only represent technical and economical problems, but also a huge waste of natural resources and hence also, an environmental and ecological problem. Experience of structures effectively submitted to severe conditions represents a unique benchmark for quantifying the actual safety and durability margin of concrete structures. In fact for several reasons, most concrete design codes, job specifications and other requirements for concrete structures have frequently shown to yield insufficient and unsatisfactory results and ability to solve the above problems, as well as issues raised by specific very long-term or very severe requirements for nuclear and industrial waste management, or civil works of strategic relevance. Recently available high to ultra-high performance concrete may find rational and valuable application in such cases. It is very important, therefore, to bring people with different professional backgrounds together to exchange experience and develop multi

  16. Brief Report: Concurrent Validity of Autism Symptom Severity Measures

    Reszka, Stephanie S.; Boyd, Brian A.; McBee, Matthew; Hume, Kara A.; Odom, Samuel L.

    2014-01-01

    The autism spectrum disorder (ASD) diagnostic classifications, according to the DSM-5, include a severity rating. Several screening and/or diagnostic measures, such as the autism diagnostic and observation schedule (ADOS), Childhood Autism Rating Scale (CARS) and social responsiveness scale (SRS) (teacher and parent versions), include an…

  17. Therapy of moderate and severe psoriasis

    Werfel, Thomas

    2006-04-01

    Full Text Available Objective and methods: This health technology assessment (HTA report synthesises systematically randomized controlled studies (RCT on the therapy of moderate and severe psoriasis vulgaris which were published between 1999 and 2004; it includes some important clinical studies which have been published after 2004 and thus updates the English HTA report by Griffiths et al. [1]. The major objective is the evaluation of the medical effectiveness of different therapeutical approaches and the cost effectiveness with relevance for Germany. Results: The major conclusions from the results of medical RCT on moderate and severe psoriasis vulgaris are: Oral fumarates are effective in the treatment of moderate to severe psoriasis vulgaris. However, fumarates quiet frequently cause moderate side effects. Cyclosporine and methotrexate are both effective in the treatment of severe psoriasis vulgaris. Both substances have a different spectrum of side effects which may limit the individual applicability. Acetritin is only moderately effective in the treatment of severe psoriasis of the plaque type. Calcipotriol or UV-radiation used at the same time can increase the clinical effectiveness of acetritin. Systemic PUVA, balneo-PUVA and UVB therapy are all effective for the treatment of severe psoriasis. The combination of UV therapy with vitamin D3 analogues or with topical steroids is more effective than the treatment with UV radiation alone. Saltwater baths increase the effectiveness of UVB therapy. No RCT on the therapeutical effects of topical tar or of dithranol in combination with UV therapy have been published so far. A continuous therapy with PUVA should not be applied due to its proven photocarcinogenicity. Three substances from the group of biologicals (Efalizumab, Etanercept, and Infliximab are now available in Europe and a further substance (Alefacept is available in the USA for the treatment of moderate to severe psoriasis. All biologicals have been

  18. Large errors and severe conditions

    Smith, D L; Van Wormer, L A

    2002-01-01

    Physical parameters that can assume real-number values over a continuous range are generally represented by inherently positive random variables. However, if the uncertainties in these parameters are significant (large errors), conventional means of representing and manipulating the associated variables can lead to erroneous results. Instead, all analyses involving them must be conducted in a probabilistic framework. Several issues must be considered: First, non-linear functional relations between primary and derived variables may lead to significant 'error amplification' (severe conditions). Second, the commonly used normal (Gaussian) probability distribution must be replaced by a more appropriate function that avoids the occurrence of negative sampling results. Third, both primary random variables and those derived through well-defined functions must be dealt with entirely in terms of their probability distributions. Parameter 'values' and 'errors' should be interpreted as specific moments of these probabil...

  19. Severe hypertension in elapid envenomation

    Meenakshisundaram, Ramachandran; Senthilkumaran, Subramanian; Grootveld, Martin; Thirumalaikolundusubramanian, Ponniah

    2013-01-01

    Snakebite is not an uncommon medical emergency in India; however, symptoms of autonomic dysfunction in snakebite are rare. The elapid snake envenomation is a frequent occurrence in India, and the krait bite is prevalent in the south Indian region. Here, we present three cases of snakebite with severe hypertension and requiring intravenous nitroglycerin (NTG). As the level of blood pressure (BP) decreased significantly following antisnake venom (ASV) injection in all three cases, it is likely ...

  20. CANDU safety under severe accidents

    The characteristics of the CANDU reactor relevant to severe accidents are set first by the inherent properties of the design, and second by the Canadian safety/licensing approach. The pressure-tube concept allows the separate, low-pressure, heavy-water moderator to act as a backup heat sink even if there is no water in the fuel channels. Should this also fail, the calandria shell itself can contain the debris, with heat being transferred to the water-filled shield tank around the core. Should the severe core damage sequence progress further, the shield tank and the concrete reactor vault significantly delay the challenge to containment. Furthermore, should core melt lead to containment overpressure, the containment behaviour is such that leaks through the concrete containment wall reduce the possibility of catastrophic structural failure. The Canadian licensing philosophy requires that each accident, together with failure of each safety system in turn, be assessed (and specified dose limits met) as part of the design and licensing basis. In response, designers have provided CANDUs with two independent dedicated shutdown systems, and the likelihood of Anticipated Transients Without Scram is negligible. Probabilistic safety assessment studies have been performed on operating CANDU plants, and on the 4 x 880 MW(e) Darlington station now under construction; furthermore a scoping risk assessment has been done for a CANDU 600 plant. They indicate that the summed severe core damage frequency is of the order of 5 x 10-6/year. 95 refs, 3 tabs

  1. ACCREDITATION FOR TECHNICAL ABILITIES INCLUDING COMPUTER SKILLS

    Halit Hami OZ

    2013-01-01

    Full Text Available Sector Skills are defined by state-sponsored, employer-led organizations that cover specific economic sectors in the European Union and other countries in the world to reduce skills gaps and shortages, improve productivity, boost the skills of their sector workforces and improve learning supply. The accreditation and registration systems used by professional bodies raise the profile of the profession. In many countries including the European Union, professional associations are beginning to accept practice-based accreditation, generally as an alternative to their mainstream systems. Besides studying the certain agencies in the European Union for assessing/accreditating practical abilities , Accreditation for practical abilities of Information Communication Technology and Business Management/Language domains developed by Accreditation Council for Practical abilities are also studied in detail as an example to establish a similar agency in Turkey.

  2. Including electronic effects in damage cascade simulations

    A method for including the effects of electronic losses and electron-phonon coupling in radiation damage simulations has been developed and implemented for 10 keV cascades in Fe. The MD simulations are coupled to a continuum model for the electronic energy and energy lost by the atoms, due to electronic friction and electron-phonon coupling, is gained by electronic system. Electronic energy transport is described by the heat diffusion equation and energy is returned to the lattice via a stochastic force. Thus the temperature of the atomic system is controlled by a Langevin thermostat at the local electronic temperature, which varies with time and space. The results of simulations with this inhomogeneous thermostat are compared with those of homogeneous (constant temperature) thermostat simulations for a range of electron-phonon coupling strengths. The residual defect concentration was found to have a non-monotonic variation with coupling strength.

  3. Input parameters and scenarios, including economic inputs

    Boklund, Anette; Hisham Beshara Halasa, Tariq

    2012-01-01

    place, a receiving herd needed to be found. The distance, in which the receiving herd should be found, was calculated from movement data for animals and from data from trucks and abattoirs for movements to slaughter and milk tankers. For persons visiting herds, we used a combination of expert opinions......Geographical locations of the farms are the core in these models. We used geographical data, number of animals and specification of herd types for the 50,853 herds in the Danish Husbandry Register (CHR) in 2007. For each herd, the daily probability of moving animals, to another herd or to the......, disease was simulated to spread via direct contacts (movements of animals), indirect contacts (trucks and persons) and local spread (mice, birds, airborne spread in limited distances). Furthermore, in some scenarios airborne spread was included. For all contact types, when a contact was simulated to take...

  4. Critical point anomalies include expansion shock waves

    Nannan, N. R., E-mail: ryan.nannan@uvs.edu [Mechanical Engineering Discipline, Anton de Kom University of Suriname, Leysweg 86, PO Box 9212, Paramaribo, Suriname and Process and Energy Department, Delft University of Technology, Leeghwaterstraat 44, 2628 CA Delft (Netherlands); Guardone, A., E-mail: alberto.guardone@polimi.it [Department of Aerospace Science and Technology, Politecnico di Milano, Via La Masa 34, 20156 Milano (Italy); Colonna, P., E-mail: p.colonna@tudelft.nl [Propulsion and Power, Delft University of Technology, Kluyverweg 1, 2629 HS Delft (Netherlands)

    2014-02-15

    From first-principle fluid dynamics, complemented by a rigorous state equation accounting for critical anomalies, we discovered that expansion shock waves may occur in the vicinity of the liquid-vapor critical point in the two-phase region. Due to universality of near-critical thermodynamics, the result is valid for any common pure fluid in which molecular interactions are only short-range, namely, for so-called 3-dimensional Ising-like systems, and under the assumption of thermodynamic equilibrium. In addition to rarefaction shock waves, diverse non-classical effects are admissible, including composite compressive shock-fan-shock waves, due to the change of sign of the fundamental derivative of gasdynamics.

  5. Critical point anomalies include expansion shock waves

    From first-principle fluid dynamics, complemented by a rigorous state equation accounting for critical anomalies, we discovered that expansion shock waves may occur in the vicinity of the liquid-vapor critical point in the two-phase region. Due to universality of near-critical thermodynamics, the result is valid for any common pure fluid in which molecular interactions are only short-range, namely, for so-called 3-dimensional Ising-like systems, and under the assumption of thermodynamic equilibrium. In addition to rarefaction shock waves, diverse non-classical effects are admissible, including composite compressive shock-fan-shock waves, due to the change of sign of the fundamental derivative of gasdynamics

  6. AMS at the ANU including biomedical applications

    Fifield, L.K.; Allan, G.L.; Cresswell, R.G.; Ophel, T.R. [Australian National Univ., Canberra, ACT (Australia); King, S.J.; Day, J.P. [Manchester Univ. (United Kingdom). Dept. of Chemistry

    1993-12-31

    An extensive accelerator mass spectrometry program has been conducted on the 14UD accelerator at the Australian National University since 1986. In the two years since the previous conference, the research program has expanded significantly to include biomedical applications of {sup 26}Al and studies of landform evolution using isotopes produced in situ in surface rocks by cosmic ray bombardment. The system is now used for the measurement of {sup 10}Be, {sup 14}C, {sup 26}Al, {sup 36}Cl, {sup 59}Ni and {sup 129}I, and research is being undertaken in hydrology, environmental geochemistry, archaeology and biomedicine. On the technical side, a new test system has permitted the successful off-line development of a high-intensity ion source. A new injection line to the 14UD has been established and the new source is now in position and providing beams to the accelerator. 4 refs.

  7. CERN Technical Training: LABVIEW courses include RADE

    HR Department

    2009-01-01

    The contents of the "LabView Basic I" and "LabView Intermediate II" courses have recently been changed to include, respectively, an introduction to and expert training in the Rapid Application Development Environment (RADE). RADE is a LabView-based application developed at CERN to integrate LabView in the accelerator and experiment control infrastructure. It is a suitable solution to developing expert tools, machine development analysis and independent test facilities. The course names have also been changed to "LabVIEW Basics I with RADE Introduction" and "LabVIEW Intermediate II with Advanced RADE Application". " LabVIEW Basics I with RADE Introduction" is designed for: Users preparing to develop applications using LabVIEW, or NI Developer Suite; users and technical managers evaluating LabVIEW or NI Developer Suite in purchasing decisions; users pursuing the Certified LabVIEW Developer certification. The course prepares participants to develop test and measurement, da...

  8. CERN Technical Training: LABVIEW courses include RADE

    HR Department

    2009-01-01

    The contents of the "LabView Basic I" and "LabView Intermediate II" courses have recently been changed to include, respectively, an introduction to and expert training in the Rapid Application Development Environment (RADE). RADE is a LabView-based application developed at CERN to integrate LabView in the accelerator and experiment control infrastructure. It is a suitable solution to developing expert tools, machine development analysis and independent test facilities. The course names have also been changed to "LabVIEW Basics I with RADE Introduction" and "LabVIEW Intermediate II with Advanced RADE Application". " LabVIEW Basics I with RADE Introduction" is designed for: Users preparing to develop applications using LabVIEW, or NI Developer Suite; users and technical managers evaluating LabVIEW or NI Developer Suite in purchasing decisions; users pursuing the Certified LabVIEW Developer certification. The course pr...

  9. CLIC expands to include the Southern Hemisphere

    Roberto Cantoni

    2010-01-01

    Australia has recently joined the CLIC collaboration: the enlargement will bring new expertise and resources to the project, and is especially welcome in the wake of CERN budget redistributions following the recent adoption of the Medium Term Plan.   The countries involved in CLIC collaboration With the signing of a Memorandum of Understanding on 26 August 2010, the ACAS network (Australian Collaboration for Accelerator Science) became the 40th member of in the multilateral CLIC collaboration making Australia the 22nd country to join the collaboration. “The new MoU was signed by the ACAS network, which includes the Australian Synchrotron and the University of Melbourne”, explains Jean-Pierre Delahaye, CLIC Study Leader. “Thanks to their expertise, the Australian institutes will contribute greatly to the CLIC damping rings and the two-beam test modules." Institutes from any country wishing to join the CLIC collaboration are invited to assume responsibility o...

  10. CERN Technical Training: LABVIEW courses include RADE

    HR Department

    2009-01-01

    The contents of "LabView Basic I" and "LabView Intermediate II" trainings have been recently changed to include, respectively, an introduction and an expert training on the Rapid Application Development Environment (RADE). RADE is a LabView-based application developed at CERN to integrate LabView in the accelerator and experiment control infrastructure. It is a suitable solution to develop expert tools, machine development analysis and independent test facilities. The course names have also been changed to "LabVIEW Basics I with RADE Introduction" and "LabVIEW Intermediate II with Advanced RADE Application". " LabVIEW Basics I with RADE Introduction" is designed for: Users preparing to develop applications using LabVIEW, or NI Developer Suite; users and technical managers evaluating LabVIEW or NI Developer Suite in purchasing decisions; users pursuing the Certified LabVIEW Developer certification. The course prepare...

  11. Severe accident management. Optimized guidelines and strategies

    the accident progression in near future, to identify the currently most critical tasks as well as upcoming tasks, and to qualify the emergency response team to make informed decisions for the severe accident mitigation based on state-of-the-art knowledge. In this paper, this severe accident management concept is introduced and explained. It is also shown that AREVA is able to apply this methodology to other (including non-OEM) plant types, thus providing a comprehensive safety analysis of the existing plant state with already available safety systems and instrumentation. In addition, the possible need and potential for hardware refitting can be assessed as well. Finally, the severe accident management procedures are then established or updated accordingly. (author)

  12. Sarnet lecture notes on nuclear reactor severe accident phenomenology

    The 'Severe Accident Phenomenology Short Course' is part of the Excellence Spreading activities of the European Severe Accident Research NETwork of Excellence SARNET (project of the EURATOM 6. Framework programme). It was held at Cadarache, 9-13 January 2006. The course was divided in 14 lectures covering all aspects of severe accident phenomena that occur during a scenario. It also included lectures on PSA-2, Safety Assessment and design measures in new LWR plants for severe accident mitigation (SAM). This book presents the lecture notes of the Severe Accident Phenomenology Short Course and condenses the essential knowledge on severe accident phenomenology in 2008. (authors)

  13. Predictive Factors for Severe Outcomes in Ischemic Colitis

    Choi, Seok Reyol; Jee, Sam Ryong; Song, Geun Am; Park, Seun Ja; Lee, Jong Hun; Song, Chul Soo; Park, Hee Ug

    2015-01-01

    Background/Aims Ischemic colitis includes a wide clinical spectrum ranging from mild to severe forms. This study aimed to determine the factors that are related to the occurrence of severe ischemic colitis. Methods This multicenter study was conducted retrospectively in Korea. The patients were divided into mild and severe groups. This study surveyed clinical characteristics, blood tests, endoscopic findings, and imaging studies. Results In the comparison of comorbidities, the severe group ha...

  14. PLUTINO DETECTION BIASES, INCLUDING THE KOZAI RESONANCE

    Lawler, S. M.; Gladman, B. [Department of Physics and Astronomy, 6224 Agricultural Road, University of British Columbia, Vancouver, BC V6T 1Z1 (Canada)

    2013-07-01

    Because of their relative proximity within the trans-Neptunian region, the plutinos (objects in the 3:2 mean-motion resonance with Neptune) are numerous in flux-limited catalogs, and well-studied theoretically. We perform detailed modeling of the on-sky detection biases for plutinos, with special attention to those that are simultaneously in the Kozai resonance. In addition to the normal 3:2 resonant argument libration, Kozai plutinos also show periodic oscillations in eccentricity and inclination, coupled to the argument of perihelion ({omega}) oscillation. Due to the mean-motion resonance, plutinos avoid coming to pericenter near Neptune's current position in the ecliptic plane. Because Kozai plutinos are restricted to certain values of {omega}, perihelion always occurs out of the ecliptic plane, biasing ecliptic surveys against finding these objects. The observed Kozai plutino fraction f{sub koz}{sup obs} has been measured by several surveys, finding values between 8% and 25%, while the true Kozai plutino fraction f{sub koz}{sup true} has been predicted to be between 10% and 30% by different giant planet migration simulations. We show that f{sub koz}{sup obs} varies widely depending on the ecliptic latitude and longitude of the survey, so debiasing to find the true ratio is complex. Even a survey that covers most or all of the sky will detect an apparent Kozai fraction that is different from f{sub koz}{sup true}. We present a map of the on-sky plutino Kozai fraction that would be detected by all-sky flux-limited surveys. This will be especially important for the Panoramic Survey Telescope and Rapid Response System and Large Synoptic Survey Telescope projects, which may detect large numbers of plutinos as they sweep the sky. f{sub koz}{sup true} and the distribution of the orbital elements of Kozai plutinos may be a diagnostic of giant planet migration; future migration simulations should provide details on their resonant Kozai populations.

  15. Therapeutic considerations for severe nodular acne.

    Newman, Marissa D; Bowe, Whitney P; Heughebaert, Carol; Shalita, Alan R

    2011-02-01

    Severe nodular acne, defined as grade 4 or 5 acne on the Investigator's Static Global Assessment scale, is a skin condition characterized by intense erythema, inflammation, nodules, cysts, and scarring. Both the well known risk of physical scarring and the more recent recognition that acne can be a chronic, psychologically distressing disease with significant adverse effects on a patient's quality of life, have prompted earlier, more aggressive treatment with more effective medications, in the hope of preventing progression to more severe, nodular forms of the disease. Oral antibacterials, primarily tetracyclines, have long been the first-line therapy for severe nodular acne, which frequently remained refractory to therapy. However, concerns of antibacterial adverse effects, patient adherence, and antimicrobial resistance prompted the search for alternate therapies and combinations thereof in order to target the multifactorial pathogenesis of the disease. Isotretinoin, an oral retinoid introduced in 1982, has since become the gold standard therapy in severe acne and has revolutionized its treatment. Several adjunctive agents exist. Oral antibacterials are indicated as an alternative for patients with severe acne who cannot tolerate oral retinoids, or for whom a contraindication exists. In order to prevent bacterial resistance, antibacterials should always be used in combination with benzoyl peroxide, a nonantibiotic antimicrobial agent with anti-inflammatory activity. Topical retinoids are often added to this regimen. In women, hormonal agents, which include oral contraceptives, spironolactone, and oral corticosteroids, and, in Europe, cyproterone acetate, may be used as monotherapy or concomitantly with isotretinoin. For rapid treatment of inflammatory nodules, intralesional corticosteroids are effective. These treatment modalities have been studied, refined, and combined in novel ways in order to target the multifactorial pathogenesis of the disease, and in this

  16. Alternating phase focussing including space charge

    Longitudinal stability can be obtained in a non-relativistic drift tube accelerator by traversing each gap as the rf accelerating field rises. However, the rising accelerating field leads to a transverse defocusing force which is usually overcome by magnetic focussing inside the drift tubes. The radio frequency quadrupole is one way of providing simultaneous longitudinal and transverse focusing without the use of magnets. One can also avoid the use of magnets by traversing alternate gaps between drift tubes as the field is rising and falling, thus providing an alternation of focussing and defocusing forces in both the longitudinal and transverse directions. The stable longitudinal phase space area is quite small, but recent efforts suggest that alternating phase focussing (APF) may permit low velocity acceleration of currents in the 100-300 ma range. This paper presents a study of the parameter space and a test of crude analytic predictions by adapting the code PARMILA, which includes space charge, to APF. 6 refs., 3 figs

  17. Langevin simulations of QCD, including fermions

    We encounter critical slow down in updating when xi/a -> infinite and in matrix inversion (needed to include fermions) when msub(q)a -> 0. A simulation that purports to solve QCD numerically will encounter these limits, so to face the challenge in the title of this workshop, we must cure the disease of critical slow down. Physically, this critical slow down is due to the reluctance of changes at short distances to propagate to large distances. Numerically, the stability of an algorithm at short wavelengths requires a (moderately) small step size; critical slow down occurs when the effective long wavelength step size becomes tiny. The remedy for this disease is an algorithm that propagates signals quickly throughout the system; i.e. one whose effective step size is not reduced for the long wavelength conponents of the fields. (Here the effective ''step size'' is essentially an inverse decorrelation time.) To do so one must resolve various wavelengths of the system and modify the dynamics (in CPU time) of the simulation so that all modes evolve at roughly the same rate. This can be achieved by introducing Fourier transforms. I show how to implement Fourier acceleration for Langevin updating and for conjugate gradient matrix inversion. The crucial feature of these algorithms that lends them to Fourier acceleration is that they update the lattice globally; hence the Fourier transforms are computed once per sweep rather than once per hit. (orig./HSI)

  18. Common paths to ASD severity and PTSD severity

    Hansen, Maj; Armour, Cherie; Wittmann, Lutz;

    Numerous studies have identified risk factors for acute and long term posttraumatic symptoms following traumatic exposure. However, little is known about possible common pathways to the development of acute stress disorder (ASD) and posttraumatic stress disorder (PTSD). Research suggests that a...... common pathway to ASD and PTSD may lie in peritraumatic responses and cognitions. Using structural equation modeling we examined the role of three peritraumatic factors (tonic immobility, panic and dissociation) and three cognitive factors (anxiety sensitivity, negative cognitions about the world, and...... negative cognitions about self ) on the development of ASD and PTSD severity in a national study of Danish bank robbery victims (N = 450). Peritraumatic panic, anxiety sensitivity, and negative cognitions about self were found to be significant common risk factors, whereas peritraumatic dissociation was...

  19. Renal artery embolization in severe nephrotic syndrome.

    Solak, Yalcin; Koc, Osman; Ucar, Ramazan; Ozbek, Orhan; Ergenc, Hasan; Gaipov, Abduzhappar; Turk, Suleyman

    2016-07-01

    Introduction Severe nephrotic syndrome is associated with increased morbidity and mortality. Renal artery embolization (RAE) has been used in a number of renal diseases such as renal tumors, arteriovenous fistulas etc. However, data regarding benefits of RAE in patients with symptomatic severe proteinuria is limited. We decided to evaluate role of RAE in the setting of severe symptomatic nephrotic syndrome. Methods Eight patients who had undergone transcatheter renal artery embolization with polyvinyl alcohol (PVA) were included. Clinico-demographic characteristics as well as baseline laboratory data including level of proteinuria, serum albumin, C-reactive protein and LDL cholesterol levels were recorded for each patient. After RAE, outpatient clinic control laboratory values were also assessed. Findings All patients except one underwent bilateral RAE (four simultaneous or three sequential). Two patients experienced postembolization syndrome characterized by flank pain, fever, and leukocytosis, which was self-limited and responded to analgesics in all patients. There was no technical complications associated with RAE procedure. All patients became anuric except one. Serum albumin levels increased and serum LDL-cholesterol levels decreased considerably in treated patients. Discussion Renal artery embolization with the purpose of amelioration in nephrotic syndrome complications was effective and free of major technical complications in our patients. PMID:26833695

  20. SAMSON: Severe Accident Management System Online Network

    SAMSON, Severe Accident Management System Online Network, is a computational tool used in the event of a nuclear power plant accident by accident managers in the Technical Support Centers (TSC) and Emergency Offsite Facilities (EOF). SAMSON examines over 150 status points monitored by nuclear power plant process computers during a severe accident and makes predictions about when core damage, support plate failure, and reactor vessel failure will occur. These predictions are based on the current state of the plant assuming that all safety equipment not already operating will fail. The status points analyzed include radiation levels, flow rates, pressure levels, temperatures and water levels. SAMSON uses an expert system as well as neural networks trained with the back propagation learning algorithm to make predictions. Previous training on data from accident analysis code allows SAMSON to associate different states in the plant with different times to critical failures. The accidents currently recognized by SAMSON include steam generator tube ruptures (SGTR), with breaks ranging from one tube to eights tubes, and loss of coolant accidents (LOCA), with breaks ranging from 0.001 square feet in size to breaks 3.0 square feet. SAMSON contains several neural networks for each accident type and break size, and chooses the correct network after accident classification by in expert system. SAMSON also provides information concerning the status of plant sensors and recovery strategies

  1. Pathogenesis of severe acute respiratory syndrome

    ZHANG Ding-mei; LU Jia-hai; ZHONG Nan-shan

    2008-01-01

    Severe acute respiratory syndrome (SARS) first emerged in Guangdong province,China in November2002.During the following 3 months,it spread rapidly across the world,resulting in approximately 800 deaths.In 2004,subsequent sporadic cases emerged in Singapore and China.A novel coronavims,SARS-CoV,was identified as the etiological agent of SARS.1,2 This virus belongs to a family of large,positive,single-stranded RNA viruses.Nevertheless,genomic characterization shows that the SARS-CoV is only moderately related to other known coronaviruses.3 In contrast with previously described coronaviruses,SARS-CoV infection typically causes severe symptoms related to the lower respiratory tract.The SARS-CoV genome includes 14 putative open reading frames encoding 28 potential proteins,and the functions of many of these proteins are not known.4 A number of complete and partial autopsies of SARS patients have been reported since the first outbreak in 2003.The predominant pathological finding in these cases was diffuse alveolar damage (DAD).This severe pulmonary injury of SARS patients is caused both by direct viral effects and immunopathogenetic factors.5 Many important aspects of the pathogenesis of SARS have not yet been fully clarified.In this article,we summarize the most important mechanisms involved in the complex pathogenesis of SARS,including clinical characters,host and receptors,immune system response and genetic factors.

  2. Neurological morbidity of severe epilepsy.

    Janz, D

    1988-01-01

    The "severity" of a disease is a relative expression and its definition will vary depending on the perspective of the observer. The patient's subjective perception of the disease, the way it is regarded socially by the community, and the doctor's objective assessment rarely coincide. In fact, they are frequently diametrically opposed. As far as the patient's personal perception of epilepsy is concerned, there has apparently been no satisfactory attempt thus far at a systematic grading of the subjective handicap, despite the growth of interest in psychological matters and the self-help movement. Similarly, social ability or disability cannot be adequately assessed on the basis of medical criteria such as frequency and type of seizures. We present a grading system which will serve as an example of an appropriate method of assessing social abilities, and which will permit the patient's occupational potential to be estimated in relation to the risk of accidents resulting from seizures. From the medical point of view, the impairment of a patient's abilities due to epilepsy is a function of the patient's responsiveness to treatment. We present a critical review of the factors which have an effect on the therapeutic prognosis: the causes of epilepsy, underlying structural lesions, the incidence of convulsive status epilepticus, various types of attacks, and the different epileptic syndromes. Taking two examples--epilepsy presenting in the form of absence and epilepsy with complex focal seizures--we show that ultimately the "severity of epilepsy" can only be defined from the medical standpoint on the basis of several factors whose value is of a predictive nature. PMID:3292232

  3. Severe accident source term reassessment

    This paper summarizes the status of the reassessment of severe reactor accident source terms, which are defined as the quantity, type, and timing of fission product releases from such accidents. Concentration is on the major results and conclusions of analyses with modern methods for both pressurized water reactors (PWRs) and boiling water reactors (BWRs), and the special case of containment bypass. Some distinctions are drawn between analyses for PWRs and BWRs. In general, the more the matter is examined, the consequences, or probability of serious consequences, seem to be less. (author)

  4. Pneumothorax in severe thoracic traumas

    The authors reviewed CT scans and supine chest X-ray of 47 patients affected by severe thoracic trauma, examined in 1985-86. The sensibility of the two methodologies in the assessment of pneumothorax was compared. CT detected 25 pneumothorax, whereas supine chest X-ray allowed a diagnosis in 18 cases only. In 8 of the latter (44.4%) the diagnosis was made possible by the presence of indirect signs of pneumothorax only - the most frequent being the deep sulcus sign. The characterization of pneumothorax is important especially in the patients who need to be treated with mechanical ventilation therapy, or who are to undergo surgery in total anaesthesia

  5. Pulse oximetry in severe anaemia

    Ramsing, T; Rosenberg, J

    1992-01-01

    Measurement of arterial oxygen saturation by pulse oximetry was performed in two patients with acute and chronic anaemia (haemoglobin concentrations: 2.9 mmol/l (4.7 g/dl) and 1.9 mmol/l (3.0 g/dl), respectively) using a Radiometer OXI and a Nellcor N-200 pulse oximeter. The two oximeters read...... alternating different values in the two patients. In conclusion, pulse oximeters are able to give a value for oxygen saturation even at extreme anaemia, and when a high value is given, it possibly reflects arterial oxygen saturation. The value of pulse oximetry in severe anaemia is discussed....

  6. Emerging Biologics in Severe Asthma.

    Pavord, Ian D; Hilvering, Bart; Shrimanker, Rahul

    2016-08-01

    Asthma is a heterogeneous disease that can be classified into different clinical endotypes, depending on the type of airway inflammation, clinical severity, and response to treatment. This article focuses on the eosinophilic endotype of asthma, which is defined by the central role that eosinophils play in the pathophysiology of the condition. It is characterized by persistently elevated sputum and/or blood eosinophils and by a significant response to treatments that suppress eosinophilia. Eosinophil activity in the airway may be more important than their numbers and this needs to be investigated. Transcriplomic or Metabolomic signatures may also be useful to identify this endotype. PMID:27401629

  7. Upgrade Summer Severe Weather Tool in MIDDS

    Wheeler, Mark M.

    2010-01-01

    The goal of this task was to upgrade the severe weather database from the previous phase by adding weather observations from the years 2004 - 2009, re-analyze the data to determine the important parameters, make adjustments to the index weights depending on the analysis results, and update the MIDDS GUI. The added data increased the period of record from 15 to 21 years. Data sources included local forecast rules, archived sounding data, surface and upper air maps, and two severe weather event databases covering east-central Florida. Four of the stability indices showed increased severe weather predication. The Total Threat Score (TTS) of the previous work was verified for the warm season of 2009 with very good skill. The TTS Probability of Detection (POD) was 88% and the False alarm rate (FAR) of 8%. Based on the results of the analyses, the MIDDS Severe Weather Worksheet GUI was updated to assist the duty forecaster by providing a level of objective guidance based on the analysis of the stability parameters and synoptic-scale dynamics.

  8. Disease severity scoring systems in dermatology

    Cemal Bilaç

    2016-06-01

    Full Text Available Scoring systems have been developed to interpret the disease severity objectively by evaluating the parameters of the disease. Body surface area, visual analogue scale, and physician global assessment are the most frequently used scoring systems for evaluating the clinical severity of the dermatological diseases. Apart from these scoring systems, many specific scoring systems for many dermatological diseases, including acne (acne vulgaris, acne scars, alopecia (androgenetic alopecia, tractional alopecia, bullous diseases (autoimmune bullous diseases, toxic epidermal necrolysis, dermatitis (atopic dermatitis, contact dermatitis, dyshidrotic eczema, hidradenitis suppurativa, hirsutismus, connective tissue diseases (dermatomyositis, skin involvement of systemic lupus erythematosus (LE, discoid LE, scleroderma, lichen planoplaris, mastocytosis, melanocytic lesions, melasma, onychomycosis, oral lichen planus, pityriasis rosea, psoriasis (psoriasis vulgaris, psoriatic arthritis, nail psoriasis, sarcoidosis, urticaria, and vitiligo, have also been developed. Disease severity scoring methods are ever more extensively used in the field of dermatology for clinical practice to form an opinion about the prognosis by determining the disease severity; to decide on the most suitable treatment modality for the patient; to evaluate the efficacy of the applied medication; and to compare the efficiency of different treatment methods in clinical studies.

  9. SEEPAGE MODEL FOR PA INCLUDING DRIFT COLLAPSE

    C. Tsang

    2004-09-22

    The purpose of this report is to document the predictions and analyses performed using the seepage model for performance assessment (SMPA) for both the Topopah Spring middle nonlithophysal (Tptpmn) and lower lithophysal (Tptpll) lithostratigraphic units at Yucca Mountain, Nevada. Look-up tables of seepage flow rates into a drift (and their uncertainty) are generated by performing numerical simulations with the seepage model for many combinations of the three most important seepage-relevant parameters: the fracture permeability, the capillary-strength parameter 1/a, and the percolation flux. The percolation flux values chosen take into account flow focusing effects, which are evaluated based on a flow-focusing model. Moreover, multiple realizations of the underlying stochastic permeability field are conducted. Selected sensitivity studies are performed, including the effects of an alternative drift geometry representing a partially collapsed drift from an independent drift-degradation analysis (BSC 2004 [DIRS 166107]). The intended purpose of the seepage model is to provide results of drift-scale seepage rates under a series of parameters and scenarios in support of the Total System Performance Assessment for License Application (TSPA-LA). The SMPA is intended for the evaluation of drift-scale seepage rates under the full range of parameter values for three parameters found to be key (fracture permeability, the van Genuchten 1/a parameter, and percolation flux) and drift degradation shape scenarios in support of the TSPA-LA during the period of compliance for postclosure performance [Technical Work Plan for: Performance Assessment Unsaturated Zone (BSC 2002 [DIRS 160819], Section I-4-2-1)]. The flow-focusing model in the Topopah Spring welded (TSw) unit is intended to provide an estimate of flow focusing factors (FFFs) that (1) bridge the gap between the mountain-scale and drift-scale models, and (2) account for variability in local percolation flux due to

  10. Including lifestyle medicine in undergraduate medical curricula

    Edward Phillips

    2015-02-01

    Full Text Available Purpose: Currently, there is no model to integrate the discipline of lifestyle medicine (LM into undergraduate medical education. Furthermore, there are no guidelines, validated assessment tools, or evaluation or implementation plans in place. Background: The World Health Organization predicts that by 2020, two-thirds of disease worldwide will be the result of poor lifestyle choices. Fewer than 50% of US primary care physicians routinely provide specific guidance on nutrition, physical activity, or weight control. Methods: We are establishing a plan to integrate LM into medical school education in collaboration with the investing stakeholders, including medical school deans and students, medical curriculum developers and researchers, medical societies, governing bodies, and policy institutes. Three planning and strategy meetings are being held to address key areas of focus – with a particular interest in nutrition, physical activity, student self-care, and behavior change – to develop specific implementation guidelines and landmarks. Results: After the first two meetings, the proposed areas of focus were determined to be: 1 supporting of deans and key personnel, 2 creation of federal and state policy commitments, 3 use of assessment as a driver of LM, 4 provision of high-quality evidence-based curricular material on an easily navigated site, and 5 engaging student interest. Implementation strategies for each focus area will be addressed in an upcoming planning meeting in early 2015. Conclusion: This initiative is expected to have important public health implications by efficiently promoting the prevention and treatment of non-communicable chronic disease with a scalable and sustainable model to educate physicians in training and practice.

  11. Severity of dilated cardiomyopathy (DCM)

    In order to assess the severity of dilated cardiomyopathy, thallium scan was performed in 60 cases. In 16 of all, serial thallium scan was performed in the periods of average 26 months. In these cases, extension of perfusion defect was observed from apical to inferoposterior regions. Therefore, we classified dilated cardiomyopathy into three groups by thallium scan; (I) dilated left ventricular type (n = 16), (II) apical hypoperfusion type (n = 12), (III) inferoposterior perfusion defect type (n = 32). These groups were correlated with hemodynamic findings. All patients had also cardiac catheterization and gated blood pool scan. As results, group III had high incidence of right ventricular and lung thallium uptake and patchy pattern compared to other groups. Group III had also high incidence of dyspnoea on exertion, S3 and ECG abnormalities. In hemodynamics, end-diastolic ventricular volume index and end-systolic ventricular volume index increased and, right ventricular ejection fraction and left ventricular ejection fraction decreased according to the severity of dilated cardiomyopathy from group I to III. In addition, the incidence of mitral regurgitation and dyskinesis was observed highly in group III. In conclusion, perfusion defect was frequently demonstrated in dilated cardiomyopathy without coronary artery stenosis. And right and left ventricular function was depressed according to the extension of perfusion defect. (author)

  12. Large errors and severe conditions

    Physical parameters that can assume real-number values over a continuous range are generally represented by inherently positive random variables. However, if the uncertainties in these parameters are significant (large errors), conventional means of representing and manipulating the associated variables can lead to erroneous results. Instead, all analyses involving them must be conducted in a probabilistic framework. Several issues must be considered: First, non-linear functional relations between primary and derived variables may lead to significant 'error amplification' (severe conditions). Second, the commonly used normal (Gaussian) probability distribution must be replaced by a more appropriate function that avoids the occurrence of negative sampling results. Third, both primary random variables and those derived through well-defined functions must be dealt with entirely in terms of their probability distributions. Parameter 'values' and 'errors' should be interpreted as specific moments of these probability distributions. Fourth, there are pragmatic reasons for seeking convenient analytical formulas to approximate the 'true' probability distributions of derived parameters generated by Monte Carlo simulation. This paper discusses each of these issues and illustrates the main concepts with realistic examples involving radioactivity decay and nuclear astrophysics

  13. Mechanical ventilation for severe asthma.

    Leatherman, James

    2015-06-01

    Acute exacerbations of asthma can lead to respiratory failure requiring ventilatory assistance. Noninvasive ventilation may prevent the need for endotracheal intubation in selected patients. For patients who are intubated and undergo mechanical ventilation, a strategy that prioritizes avoidance of ventilator-related complications over correction of hypercapnia was first proposed 30 years ago and has become the preferred approach. Excessive pulmonary hyperinflation is a major cause of hypotension and barotrauma. An appreciation of the key determinants of hyperinflation is essential to rational ventilator management. Standard therapy for patients with asthma undergoing mechanical ventilation consists of inhaled bronchodilators, corticosteroids, and drugs used to facilitate controlled hypoventilation. Nonconventional interventions such as heliox, general anesthesia, bronchoscopy, and extracorporeal life support have also been advocated for patients with fulminant asthma but are rarely necessary. Immediate mortality for patients who are mechanically ventilated for acute severe asthma is very low and is often associated with out-of-hospital cardiorespiratory arrest before intubation. However, patients who have been intubated for severe asthma are at increased risk for death from subsequent exacerbations and must be managed accordingly in the outpatient setting. PMID:26033128

  14. The vver severe accident management

    The basic approach to the VVER safety management is based on the defence-in-depth principle the main idea of which is the multiplicity of physical barriers on the way of dangerous propagation on the one hand and the diversity of measures to protect each of them on the other hand. The main events of severe accident with loss of core cooling at NPP with WWER can be represented as a sequence of NPP states, in which each subsequent state is more severe than the previous one. The following sequence of states of the accident progression is supposed to be realistic and the most probable: -) loss of efficient core cooling; -) core melting, relocation of the molten core to the lower head and molten pool formation, -) reactor vessel damage, and -) containment damage and fission products release. The objectives of accident management at the design basis stage, the determining factors and appropriate determining parameters of processes are formulated in this paper. The same approach is used for the estimation of processes parameters at beyond design basis accident progression. The accident management goals and the determining factors and parameters are also listed in that case which is characterized by the loss of integrity of the fuel cladding. The accident management goal at the stage of core melt relocation implies the need for an efficient core-catcher

  15. Severe accident recriticality analyses (SARA)

    Frid, W.; Højerup, C.F.; Lindholm, I.;

    2001-01-01

    Recriticality in a BWR during reflooding of an overheated partly degraded core, i.e. with relocated control rods, has been studied for a total loss of electric power accident scenario. In order to assess the impact of recriticality on reactor safety, including accident management strategies, the ...

  16. Compact Radar Transceiver with Included Calibration

    McLinden, Matthew; Rincon, Rafael

    2013-01-01

    The Digital Beamforming Synthetic Aperture Radar (DBSAR) is an eight-channel phased array radar system that employs solid-state radar transceivers, a microstrip patch antenna, and a reconfigurable waveform generator and processor unit. The original DBSAR transceiver design utilizes connectorized electronic components that tend to be physically large and heavy. To achieve increased functionality in a smaller volume, PCB (printed circuit board) transceivers were designed to replace the large connectorized transceivers. One of the most challenging problems designing the transceivers in a PCB format was achieving proper performance in the calibration path. For a radar loop-back calibration path, a portion of the transmit signal is coupled out of the antenna feed and fed back into the receiver. This is achieved using passive components for stability and repeatability. Some signal also leaks through the receive path. As these two signal paths are correlated via an unpredictable phase, the leakage through the receive path during transmit must be 30 dB below the calibration path. For DBSAR s design, this requirement called for a 100-dB isolation in the receiver path during transmit. A total of 16 solid-state L-band transceivers on a PCB format were designed. The transceivers include frequency conversion stages, T/R switching, and a calibration path capable of measuring the transmit power-receiver gain product during transmit for pulse-by-pulse calibration or matched filtering. In particular, this calibration path achieves 100-dB isolation between the transmitted signal and the low-noise amplifier through the use of a switching network and a section of physical walls achieving attenuation of radiated leakage. The transceivers were designed in microstrip PCBs with lumped elements and individually packaged components for compactness. Each transceiver was designed on a single PCB with a custom enclosure providing interior walls and compartments to isolate transceiver

  17. Severe Heterotopic Ossification following Total Knee Replacement

    Alexander L. Dodds

    2014-01-01

    Full Text Available Although the incidence of minor heterotopic ossification is probably higher than what is usually expected, severe heterotopic ossification (HO is an extremely rare event following total knee replacement surgery. We present the case of a 66-year-old woman who initially had achieved an excellent range of motion following bilateral uncemented rotating platform total knee replacement, before presenting with pain and loss of range of motion at 2 months after surgery. Severe HO was diagnosed on X-rays. Treatment consisted of nonoperative measures only, including physiotherapy with hydrotherapy and anti-inflammatories. She eventually regained her range of motion when seen at 8 months after operation. This case illustrates that nonoperative treatment without the use of radiotherapy or surgery can be used to safely resolve stiffness caused by HO after total knee replacement.

  18. Experimental reproduction of severe bluetongue in sheep.

    MacLachlan, N J; Crafford, J E; Vernau, W; Gardner, I A; Goddard, A; Guthrie, A J; Venter, E H

    2008-05-01

    Sheep inoculated with a virulent South African strain of bluetongue (BT) virus serotype 4 developed severe clinical signs and lesions characteristic of fulminant BT, including coronitis, hemorrhage and ulceration of the mucosal lining of the oral cavity and forestomaches, hemorrhage in the wall of the pulmonary artery, and focally extensive necrosis of skeletal muscle, especially of the neck. At necropsy, up to 14 days after infection, the infected sheep exhibited striking pulmonary edema, edema of the subcutaneous tissues and fascial planes of the head and neck, and pleural and pericardial effusion of varying severity. A reliable model for experimental reproduction of fulminant BT in sheep will facilitate future studies to better characterize the pathogenesis of this disease, particularly as it regards the mechanisms responsible for the increased vascular permeability that characterizes BT and related orbiviral diseases such as African horse sickness. PMID:18487487

  19. Korean Conference on Several Complex Variables

    Byun, Jisoo; Gaussier, Hervé; Hirachi, Kengo; Kim, Kang-Tae; Shcherbina, Nikolay

    2015-01-01

    This volume includes 28 chapters by authors who are leading researchers of the world describing many of the up-to-date aspects in the field of several complex variables (SCV). These contributions are based upon their presentations at the 10th Korean Conference on Several Complex Variables (KSCV10), held as a satellite conference to the International Congress of Mathematicians (ICM) 2014 in Seoul, Korea. SCV has been the term for multidimensional complex analysis, one of the central research areas in mathematics. Studies over time have revealed a variety of rich, intriguing, new knowledge in complex analysis and geometry of analytic spaces and holomorphic functions which were "hidden" in the case of complex dimension one. These new theories have significant intersections with algebraic geometry, differential geometry, partial differential equations, dynamics, functional analysis and operator theory, and sheaves and cohomology, as well as the traditional analysis of holomorphic functions in all dimensions. This...

  20. Source term formation in CANDU severe accidents

    The paper presents the phenomena involved in the most important CANDU severe accident (LOCA+LOECC, SBO, SGTR, EFF). Fission products are grouped in classes taking into consideration the half time, volatility, chemistry and biological activity. An analysis of the paths on which the release of the fission products to the environment occurs is performed. For each type of CANDU severe accident the process of source term formation, the magnitude and structure of source term and also the timing are presented on the basis of SOPHAEROS, CPA and IODE (modules included in ASTEC code) calculations, completed with literature results. The discussion about the involved sources of uncertainties is also presented taking into account the complexity of phenomena, the great number of parameters and limited availability of experimental data. Some general recommendations are developed in order to use the results in achieving the procedures for protective actions during a reactor accident. (authors)

  1. Management of severe perioperative bleeding

    Kozek-Langenecker, Sibylle A; Afshari, Arash; Albaladejo, Pierre;

    2013-01-01

    The aims of severe perioperative bleeding management are three-fold. First, preoperative identification by anamesis and laboratory testing of those patients for whom the perioperative bleeding risk may be increased. Second, implementation of strategies for correcting preoperative anaemia and...... with an assessment of the quality of the evidence in order to allow anaesthetists throughout Europe to integrate this knowledge into daily patient care wherever possible. The Guidelines Committee of the European Society of Anaesthesiology (ESA) formed a task force with members of scientific...... cross-sectional surveys were selected. At the suggestion of the ESA Guideline Committee, the Scottish Intercollegiate Guidelines Network (SIGN) grading system was initially used to assess the level of evidence and to grade recommendations. During the process of guideline development, the official...

  2. Severe scurvy: an underestimated disease.

    Levavasseur, M; Becquart, C; Pape, E; Pigeyre, M; Rousseaux, J; Staumont-Sallé, D; Delaporte, E

    2015-09-01

    Scurvy is one of the oldest diseases in human history. Nowadays, although scurvy tends to become a forgotten disease in developed country, rare cases still occur, especially in people undergoing extreme diet, old people or children with poor diet and patients with malabsorption. We describe three cases of scurvy. The first case is a patient diagnosed with Crohn's disease, the second one is in a context of anorexia nervosa and drug addiction, and the third case is in a context of social isolation. Early recognition of scurvy can be difficult because symptoms may appear nonspecific and can mimic more common conditions. In any patient with spontaneous hematoma and purpura, in the context of nutritional disorder, scurvy should be systematically considered. As this disease can lead to severe complications, such as bone pain, heart failure or gastrointestinal symptoms, nothing should delay vitamin C supplementation, which is a simple and rapidly effective treatment. PMID:26081492

  3. Severe Urticaria Following Erythromycin Therapy

    Anada S. Prasad

    1960-01-01

    Full Text Available Enythromycin is believed to cause no serlous reactions after large doses, nausea, rarely vomiting and occasionally abdominal pain and diarrhea may occur, (Herrell, 1954. According to' Kagan and Faller (1955 no allergic reaction to' erythromycin has been reported. Phlebitis and thrombosis have been observed, (Shoe maker & Yow, 1954. In a report by Solomon and Johnson, (1955 toxic reactions were recorded as being uncommon. In a large series of cases, only one patient had a rash, another had fever possibly due to the drug, nne had nausea and vomiting and 4 had loose bowel movements while under therapy. Among the 122 patients treated with erythromcin, therapy was stopped owing to side effects in only one. My patient had severe urticaria within 24 hours of beginning therapy with erythromycin and a positive skin test was observed. It was believed to be an allergic reaction caused by the drug.

  4. Extended 1D Method for Coherent Synchrotron Radiation including Shielding

    Sagan, David; Mayes, Christopher; Sae-Ueng, Udom

    2008-01-01

    Coherent Synchrotron Radiation can severely limit the performance of accelerators designed for high brightness and short bunch length. Examples include light sources based on ERLs or FELs, and bunch compressors for linear colliders. In order to better simulate Coherent Synchrotron Radiation, the established 1-dimensional formalism is extended to work at lower energies, at shorter bunch lengths, and for an arbitrary configuration of multiple bends. Wide vacuum chambers are simulated by means of vertical image charges. This formalism has been implemented in the general beam dynamics code "Bmad" and its results are here compared to analytical approximations, to numerical solutions of the Maxwell equations, and to the simulation code "elegant".

  5. Cinacalcet effect on severe hyperparathyroidism

    Al Saran Khalid

    2010-01-01

    Full Text Available To determine the efficacy and safety of cinacalcet, a calcimimetic drug that suppress parathyroid hormone (PTH production, we studied its effect on 20 patients (13 males on maintenance hemodialysis (HD, 80% of them have persistent high PTH levels (i.e. more than 80 pmol/L, the remaining patients had PTH levels more than 60 pmol/L. Five of 20 (25% patients dropped out from the study (2 because of severe GIT upset, one showed severe myalgia and arthralgia, one patient due to non compliance and one died at home due to cardiac arrest. The remaining 15 patients (10 males had a mean age of 40 ± 12.86 years and dialysis duration of 29.13 ± 18.27 months. The follow-up period on cinacalcet was 4 months with a single daily oral dose started with 30 mg/day and increased gradually according to the PTH levels. Nine (60% pa-tients were on concomitant active vitamin D during the study period with a mean dose of 7.33 ± 3.39 μg/week. There was a significant decrease in the serum PTH levels at the end the study compared to that at the start (46.4 ± 4.7 pmol/L versus 93.3 ± 25.6 pmol/L, respectively, P< 0.000, and the target PTH level (< 31.6 pmol/L was achieved in 54% of patients. No significant changes in serum Ca and phosphorous levels were observed. We conclude that cinacalcet is an effective therapy to suppress the serum PTH levels and allows favorable management of the serum calcium and phosphorus levels in HD patients. The drug was well tolerated; however, GIT discomfort is a significant side effect that may necessitate drug withdrawal in some patients.

  6. Management of Children with Severe, Severe-profound, and Profound Sensorineural Hearing Loss.

    Iseli, Claire; Buchman, Craig A

    2015-12-01

    Management of children with severe, severe-profound, and profound sensorineural hearing loss is best achieved using a family-centered approach by a team of health professionals, including audiologists, speech pathologists, otolaryngologists, pediatricians, genetic counselors, and early intervention programs. Early diagnosis and intervention offers the best chance for speech and language acquisition. Although hearing aids can provide some of the needed information, they are often not sufficient for spoken language development and a cochlear implant is needed. This must be combined with a strong audiology and speech therapy rehabilitation program. PMID:26293693

  7. Severe Anaemia during Late Pregnancy

    Mahenaz Akhtar

    2012-01-01

    Full Text Available Vitamin B12 deficiency is uncommon in pregnancy, it occurs in 10–28% of uncomplicated pregnancies, and is associated with a few complications. We present a case report of a 21-year-old patient with severe anaemia during late pregnancy caused by vitamin B12 deficiency. At 38 weeks gestation and with a BMI of 48.9, a history of rupture of membranes was given but not confirmed. On examination, she appeared pale and therefore full blood counts were done. Interestingly her haemoglobin (Hb levels were 3.7 g/dL. Folate and vitamin B12 levels were also found to be low, and the diagnosis of anaemia caused by vitamin B12 deficiency was made. After treatment with vitamin B12 injections, folic acid and blood transfusions, the patient’s haemoglobin levels improved from 3.7 g/dL to 10.7 g/dL. The conclusion is that effective history taking, diagnosis, and management can prevent many complications that are usually associated with vitamin B12 deficiency anaemia.

  8. Clinical Practice Guidelines for Severe Chronic Obstructive Pulmonary Disease.

    Niurka Mercedes Galende Hernández; Diosdania Alfonso Falcón; Carlos Alberto Martell Alonso; Alexis Díaz Mesa; Inti Santana Carballosa

    2009-01-01

    Clinical Practice Guidelines for Severe Chronic Obstructive Pulmonary Disease. This concept includes simple chronic bronchitis, asthmatic bronchitis, chronic obstructive bronchitis, and pulmonary emphysema; although this two last are the most commonly included. Risk factors, classification and treatment are commented, stressing the strategy of mechanical ventilation and the indications for mechanical invasive and no invasive ventilation. It includes assessment guidelines focused on the most i...

  9. Ionic liquids, electrolyte solutions including the ionic liquids, and energy storage devices including the ionic liquids

    Gering, Kevin L.; Harrup, Mason K.; Rollins, Harry W.

    2015-12-08

    An ionic liquid including a phosphazene compound that has a plurality of phosphorus-nitrogen units and at least one pendant group bonded to each phosphorus atom of the plurality of phosphorus-nitrogen units. One pendant group of the at least one pendant group comprises a positively charged pendant group. Additional embodiments of ionic liquids are disclosed, as are electrolyte solutions and energy storage devices including the embodiments of the ionic liquid.

  10. Severe accident risks from external events

    Randall O Gauntt

    2013-01-01

    This paper reviews the early development of design requirements for seismic events in USA early developing nuclear electric generating fleet.Notable safety studies,including WASH-1400,Sandia Siting Study and the NUREG-1150 probabilistic risk study,are briefly reviewed in terms of their relevance to extreme accidents arising from seismic and other severe accident initiators.Specific characteristic about the nature of severe accidents in nuclear power plant (NPP) are reviewed along with present day state-of-art analysis methodologies (methods for estimation of leakages and consequences of releases (MELCOR) and MELCOR accident consequence code system (MACCS)) that are used to evaluate severe accidents and to optimize mitigative and protective actions against such accidents.It is the aim of this paper to make nuclear operating nations aware of the risks that accompany a much needed energy resource and to identify some of the tools,techniques and landmark safety studies that serve to make the technology safer and to maintain vigilance and adequate safety culture for the responsible management of this valuable but unforgiving technology.

  11. [The Nutrition Care of Severe Burn Patients].

    Hsieh, Yu-Hsiu

    2016-02-01

    In addition to recent advances in burn patient care techniques such as maintaining warm circumambient temperature, the early excision of wounds, and the use of closed dressing, providing nutrition support through early feeding has proven instrumental in greatly increasing the survival rate of burn patients. Severe burns complicated by many factors initiate tremendous physiological stress that leads to postburn hypermetabolism that includes enhanced tissue catabolism, the loss of muscle mass, and decreases in the body's reservoirs of protein and energy. These problems have become the focus of burn therapy. Treating severe burns aims not only to enhance survival rates but also to restore normal bodily functions as completely as possible. Recent research evaluating the application of anabolic agents and immune-enhance formula for severe burns therapy has generated significant controversy. Inadequate caloric intake is one of the main differences among the related studies, with the effect of many special nutrients such as bran acid amides not taken into consideration. Therefore, considering the sufficiency of caloric and protein intake is critical in assessing effectiveness. Only after patients receive adequate calories and protein may the effect of special nutrients such as glutamine and supplements be evaluated effectively. PMID:26813059

  12. Profile of acute severe malaria with hepatopathy

    Aminul Khan

    2014-10-01

    Full Text Available Background: The single most dreaded complication in severe malaria is cerebral malaria, but extracerebral serious complications are becoming frequent in endemic areas, which include hepatic dysfunctions with jaundice. Materials and Methods: This prospective case series study was undertaken to observe the clinical profile in 81cases of complicated malaria presenting with jaundice out of 344 hospitalized patients diagnosed with acute severe malaria. Liver function tests were assessed and the patients were followed up to 4 weeks. Results: 85% cases with jaundice had Plasmodium falciparum (Pf infection. Significant findings included a predominantly hemolytic jaundice (mean bilirubin 7.6 mg%, unconjugated 4.83 mg%, conjugated 2.79 mg%, raised ALT > AST (mean 101.2 vs.74.7 iu and a mean prothrombin time of 3 sec > control. Acute renal failure was common (77%. No residual hepatic dysfunctions were detected in survivors on follow-up. Mortality was 10%, mostly due to delayed diagnosis and associated serious co-morbid conditions. Conclusion: Differentiating fulminant viral hepatitis with multi-organ failure and early treatment of associated complications are crucial to reduce mortality in malaria presenting with jaundice. Hemolytic jaundice with mild and relatively early reversibility of hepatocellular dysfunction usually points towards complicated Pf malaria. Histologically, there is mild hepatic derangement. Acute renal failure is commonly associated. Vivax malaria can also cause hepatic dysfunctions. Mere presence of jaundice does not increase mortality compared to those without jaundice

  13. Current severe accident research facilities and projects

    The Working Group on the Analysis and Management of Accidents (GAMA) is mainly composed of technical specialists in the areas of coolant system thermal-hydraulics, in-vessel protection, containment protection, and fission product retention. Its general functions include the exchange of information on national and international activities in these areas, the exchange of detailed technical information, and the discussion of progress achieved in respect of specific technical issues. Severe accident management is one of the important tasks of the group. This document is an update of the 'Current Severe Accident Research Facilities and Projects' list. Facilities and projects are sorted according to the following criteria: In-Vessel Phenomena: Core Degradation and Melt Progression, Molten Core Debris Interaction with the Reactor Pressure Vessel Lower Head and Mechanical Behaviour of Reactor Pressure Vessel Lower Head; In-Vessel and Ex-Vessel Molten Fuel/Coolant Interactions; Ex-Vessel Phenomena: Molten Core Debris/Concrete Interactions, Molten Core/Ceramic Interaction, Melt Release (including DCH), Melt Spreading and Catching Devices Studies, Melt Coolability, Corium Melt properties; Hydrogen Transport and Combustion: Mixing and Distribution, Deflagration, Deflagration-to-Detonation Transition, Passive Recombiner Performance; Mechanical Behaviour of Reactor Pressure Vessel Lower Head; Containment Structural Integrity: Containment Failure Experiment and Analysis, Material Properties and Structural Behaviour, Containment Thermal-Hydraulics, Containment Cooling, Cable Penetration Integrity; Fission Products and Aerosols: Effects of Specific Elements on Iodine Volatility, Release of Low-Volatility Fission Products/Late In-Vessel Fission Product Release, Reactor Materials Release, Aerosol and Iodine Behaviour in Reactor Coolant System and Containment, Retention, Resuspension and Revaporization in Primary Circuit, Aerosol Nucleation and Transport, Source Term, Containment

  14. Night eating syndrome: implications for severe obesity.

    Cleator, J; Abbott, J; Judd, P; Sutton, C; Wilding, J P H

    2012-01-01

    Night eating syndrome (NES) was first identified in 1955 by Stunkard, a psychiatrist specialising in eating disorders (ED). Over the last 20 years considerable progress has been made in defining NES as a significant clinical entity in its own right and it has now been accepted for inclusion in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) due for publication in 2013. NES is considered a dysfunction of circadian rhythm with a disassociation between eating and sleeping. Core criteria include a daily pattern of eating with a significantly increased intake in the evening and/or night time, as manifested by one or both of the following: at least 25% of food intake is consumed after the evening meal or at least two episodes of nocturnal eating per week. An important recent addition to core criteria includes the presence of significant distress and/or impairment in functioning. Stunkard's team recommend further investigation on the pathogenesis of NES, in particular its relationship with traumatic life events, psychiatric comorbidity, the age of onset of NES and course of NES over time. The relationship between NES and other ED also requires further clarification as night-eaters exhibit some features of other ED; previous guidance to separate NES from other ED may have hindered earlier characterisation of NES. Evidence from European and American studies suggests NES features strongly in populations with severe obesity. The complex interplay between depression, impaired sleep and obesity-related comorbidity in severely obese individuals makes understanding NES in this context even more difficult. This review examines evidence to date on the characterisation of NES and concludes by examining the applicability of current NES criteria to individuals with severe obesity. PMID:23446659

  15. Correspondence between future-included and future-not-included theories

    Nagao, Keiichi

    2013-01-01

    We briefly review the correspondence principle proposed in our previous paper, which claims that if we regard a matrix element defined in terms of the future state at time $T_B$ and the past state at time $T_A$ as an expectation value in the complex action theory whose path runs over not only past but also future, the expectation value at the present time $t$ of a future-included theory for large $T_B-t$ and large $t-T_A$ corresponds to that of a future-not-included theory with a proper inner product for large $t-T_A$. This correspondence principle suggests that the future-included theory is not excluded phenomenologically.

  16. Iodine behaviour in severe accidents

    Dutton, L.M.C.; Grindon, E.; Handy, B.J.; Sutherland, L. [NNC Ltd., Knutsford (United Kingdom); Bruns, W.G.; Sims, H.E. [AEA Technology, Harwell (United Kingdom); Dickinson, S. [AEA Technology, Winfrith (United Kingdom); Hueber, C.; Jacquemain, D. [IPSN/CEA, Cadarache, Saint Paul-Lez-Durance (France)

    1996-12-01

    A description is given of analyses which identify which aspects of the modelling and data are most important in evaluating the release of radioactive iodine to the environment following a potential severe accident at a PWR and which identify the major uncertainties which affect that release. Three iodine codes are used namely INSPECT, IODE and IMPAIR, and their predictions are compared with those of the PSA code MAAP. INSPECT is a mechanistic code which models iodine behaviour in the aqueous aerosol, spray water and sump water, and the partitioning of volatile species between the aqueous phases and containment gas space. Organic iodine is not modelled. IODE and IMPAIR are semi-empirical codes which do not model iodine behaviour in the aqueous aerosol, but model organic iodine. The fault sequences addressed are based on analyses for the Sizewell `B` design. Two types of sequence have been analysed.: (a) those in which a major release of fission products from the primary circuit to the containment occur, e.g. a large LOCAS, (b) those where the release by-passes the containment, e.g. a leak into the auxiliary building. In the analysis of the LOCA sequences where the pH of the sump is controlled to be a value of 8 or greater, all three codes predict that the oxidation of iodine to produce gas phase species does not make a significant contribution to the source term due to leakage from the reactor building and that the latter is dominated by iodide in the aerosol. In the case where the pH of the sump is not controlled, it is found that the proportion of gas phase iodine increases significantly, although the cumulative leakage predicted by all three codes is not significantly different from that predicted by MAAP. The radiolytic production of nitric acid could be a major factor in determining the pH, and if the pH were reduced, the codes predict an increase in gas phase iodine species leaked from the containment. (author) 4 figs., 7 tabs., 13 refs.

  17. Giant negative T waves after treatment of severe hyperkalaemia

    Folkeringa, J.R.; Volders, P. G. A.; Gorgels, A.P.M.; Crijns, H. J. G. M.

    2003-01-01

    We present the case of a 79-year-old female with severe hyperkalaemia and severe prerenal insufficiency due to dehydration and nephrotoxic medications, including spironolactone. The ECG showed AV nodal rhythm and tented T waves. After treatment with fluids, insulin, polystyrene sulphonate and sodium bicarbonate, the serum potassium level and kidney function normalised. Several days later, she developed QT prolongation with giant negative T waves without signs of ischaemia.

  18. Severe Ovarian Hyperstimulation Syndrome Coexisting with a Bilateral Ectopic Pregnancy.

    Chii-Shinn Shiau; Ming-Yang Chang; Chi-Hsin Chiang; Ching-Chang Hsieh; T'sang-T'ang Hsieh

    2004-01-01

    Management of severe ovarian hyperstimulation syndrome (OHSS) includes hospitalizationfor fluid and electrolyte management. Abdominal paracentesis is also used as minimallyinvasive form of management in selected cases of severe OHSS following ovulationinduction. However, if pregnancy ensues, the syndrome persists for a longer period, and theclinical manifestations of severe OHSS could mask the picture of a bleeding gestational sac.It could be easily overlooked unless the possibility of an ect...

  19. Intensive therapy of severe complications of influenza

    V. I. Kozhokaru

    2012-01-01

    Full Text Available Definition of risk factors and clinical characteristics of heavy complications of influenza for working out of criteria of polymodal intensive therapy and resuscitation was the work purpose. Results of linical supervision by 114 sick heavy form of influenza with pulmonary and extra pulmonary complications are presented. All patients suffered from virus pneumonia and sharp defeat of lungs /sharp respirator distress-syndrome (OPL/ORDS. Pulmonary complications included bacterial (85, 96 % and micotic (2, 63 % pneumonia, thrombosis of legoch arteries (19,29 %, the sharp respiratory insufficiency, caused by the polyneuropathy of a critical condition of the patient (18,42 %, the exssudative pleuritis (9,65 %, spontaneous pheumothorax (4,39 %, spontaneous pheumomediastinum (2,69 %. Extra pulmonary complications concerned the swell of brain at 100 % of patients, including, with development of a brain coma (26,32 %, sepsis (85,96 %, including, with development of septic shock (68,42 %, syndrome of disseminated intravenous coagulation (49,12 %, multyorgan insufficiency (56,14 %, sharp heavy miocarditis (22,81 %, sharp nephritic insufficiency (18,42 %, sharp hepatic insufficiency (10,52 %. Early development of pathophysiological processes (the expressed infringements of a gas exchange and an acid-base condition, a secondary immunodeficiency, heamodynamical insufficiency,m etc. leads to underestimation of severity of the patient’s condition and to failer of algorithm of polymodal intensive therapy. Development of severe complications(sepsis, septic shock, sharp respirator distress-syndrome demands expansion for epidemic of specialized medicalstructures on rendering timely intensive therapy and resuscitation.

  20. Severity of Depression and Magnitude of Productivity Loss

    Beck, Arne; Crain, A. Lauren; Solberg, Leif I.; Unützer, Jürgen; Glasgow, Russell E.; Maciosek, Michael V; Whitebird, Robin

    2011-01-01

    PURPOSE Depression is associated with lowered work functioning, including absences, impaired productivity, and decreased job retention. Few studies have examined depression symptoms across a continuum of severity in relationship to the magnitude of work impairment in a large and heterogeneous patient population, however. We assessed the relationship between depression symptom severity and productivity loss among patients initiating treatment for depression.

  1. Severe fuel damage scoping test postirradiation examination results

    The fuel bundle from the Severe Fuel Damage Scoping Test, conducted in the Power Burst Facility as part of the international Severe Fuel Damage Research Program, was examined posttest. This paper presents the results of the nondestructive portion of the examination, including gross gamma scanning, neutron radiography, and tomographic reconstruction of cross sections through the bundle using the neutron radiographs

  2. Launch Lock Assemblies Including Axial Gap Amplification Devices and Spacecraft Isolation Systems Including the Same

    Barber, Tim Daniel (Inventor); Hindle, Timothy (Inventor); Young, Ken (Inventor); Davis, Torey (Inventor)

    2014-01-01

    Embodiments of a launch lock assembly are provided, as are embodiments of a spacecraft isolation system including one or more launch lock assemblies. In one embodiment, the launch lock assembly includes first and second mount pieces, a releasable clamp device, and an axial gap amplification device. The releasable clamp device normally maintains the first and second mount pieces in clamped engagement; and, when actuated, releases the first and second mount pieces from clamped engagement to allow relative axial motion there between. The axial gap amplification device normally residing in a blocking position wherein the gap amplification device obstructs relative axial motion between the first and second mount pieces. The axial gap amplification device moves into a non-blocking position when the first and second mount pieces are released from clamped engagement to increase the range of axial motion between the first and second mount pieces.

  3. Genetics Home Reference: severe congenital neutropenia

    ... Home Health Conditions severe congenital neutropenia severe congenital neutropenia Enable Javascript to view the expand/collapse boxes. ... PDF Open All Close All Description Severe congenital neutropenia is a condition that causes affected individuals to ...

  4. Property transfer assessments should include radon gas testing

    There are two emerging influences that will require radon gas testing as part of many property transfers and most environmental assessments. These requirements come from lending regulators and state legislatures and affect single family, multifamily, and commercial properties. Fannie Mae and others have developed environmental investigation guidelines for protection from long term legal liabilities in the purchase of environmentally contaminated real estate. These guidelines include radon gas testing for many properties. Several states have enacted laws that require environmental disclosure forms be prepared to ensure that the parties involved in certain real estate transactions are aware of the environmental liabilities that may come with the transfer of property. Indiana has recently enacted legislation that would require the disclosure of the presence of radon gas on many commercial real estate transactions. With more banks and state governments following this trend, radon gas testing should be performed during all property transfers and environmental assessments to protect the parties involved from any long term legal liabilities

  5. Exploring the severe winter haze in Beijing

    G. J. Zheng

    2014-07-01

    Full Text Available Extreme haze episodes repeatedly shrouded Beijing during the winter of 2012–2013, causing major environmental and health problems. To better understand these extreme events, we analyzed the hourly observation data of PM2.5 and its major chemical composition, with support of model simulations. Severe winter haze was shown to result from stable synoptic meteorological conditions over a large part of northeastern China, rather than from an abrupt increase in emissions. Build-up of secondary species, including organics, sulfate, nitrate, and ammonium, was the major driving force behind these polluted periods. The contribution of organic matter decreased with increasing pollution level while sulfate and nitrate contributions increased. Correspondingly, the ratio of secondary organic carbon to elemental carbon decreased and had a stable diurnal pattern during heavily polluted periods, indicating weakened photochemical activity due to the dimming effect of high loading of aerosol particles. Under such conditions, the strong increase in sulfate and nitrate contributions to PM2.5 was attributed to an elevated conversion ratio, reflecting more active heterogeneous reactions with gradually increasing relative humidity. Moreover, we found that high aerosol concentration was a regional phenomenon. The accumulation process of aerosol particles occurred successively from southeast cities to Beijing. The "apparent" sharp increase in PM2.5 concentration of up to several hundred μg m−3 per hour recorded in Beijing represented rapid "recovery" from an "interruption" to the continuous pollution accumulation over the region, rather than purely local chemical production. This suggests that regional transport of pollutants played an important role during these severe pollution events.

  6. Promoting physical health in severe mental illness

    Blanner Kristiansen, C.; Juel, A.; Vinther Hansen, M.;

    2015-01-01

    Objective: To explore physical health problems and their causes in patients with severe mental illness, as well as possibilities for prevention and treatment from the patients' and staff's perspectives. Method: We conducted six focus groups with patients and staff separately, from three out......-patient clinics treating patients with schizophrenia or substance-use disorder comorbid to another psychiatric disorder. Focus groups were audio-recorded, transcribed verbatim and analysed using a template approach. Results: Paramount physical health problems are weight issues, cardiovascular diseases and poor...... physical shape. Main causes are lifestyle, the mental disorder and organisational issues. Patients and staff expressed similar opinions regarding physical health problems and their causes. Possibilities for prevention and treatment includes a case manager and binding communities with like-minded, as well...

  7. Deletion of GPIHBP1 causing severe chylomicronemia.

    Rios, Jonathan J; Shastry, Savitha; Jasso, Juan; Hauser, Natalie; Garg, Abhimanyu; Bensadoun, André; Cohen, Jonathan C; Hobbs, Helen H

    2012-05-01

    Lipoprotein lipase (LPL) is a hydrolase that cleaves circulating triglycerides to release fatty acids to the surrounding tissues. The enzyme is synthesized in parenchymal cells and is transported to its site of action on the capillary endothelium by glycophosphatidylinositol (GPI)-anchored high-density lipoprotein-binding protein 1 (GPIHBP1). Inactivating mutations in LPL; in its cofactor, apolipoprotein (Apo) C2; or in GPIHBP1 cause severe hypertriglyceridemia. Here we describe an individual with complete deficiency of GPIHBP1. The proband was an Asian Indian boy who had severe chylomicronemia at 2 months of age. Array-based copy-number analysis of his genomic DNA revealed homozygosity for a 17.5-kb deletion that included GPIHBP1. A 44-year-old aunt with a history of hypertriglyceridemia and pancreatitis was also homozygous for the deletion. A bolus of intravenously administered heparin caused a rapid increase in circulating LPL and decreased plasma triglyceride levels in control individuals but not in two GPIHBP1-deficient patients. Thus, short-term treatment with heparin failed to attenuate the hypertriglyceridemia in patients with GPIHBP1 deficiency. The increasing resolution of copy number microarrays and their widespread adoption for routine cytogenetic analysis is likely to reveal a greater role for submicroscopic deletions in Mendelian conditions. We describe the first neonate with complete GPIHBP1 deficiency due to homozygosity for a deletion of GPIHBP1. PMID:22008945

  8. Several accidents about ERHRS of CEFR

    An analysis of about several unusual accidents about Emergency Residual Heat Removal System (ERHRS) of China Experiment Fast Reactor (CEFR) is presented. CEFR is a pool-type sodium-cooled fast reactor. The ERHRS of this reactor is designed in passive principle, which enhances the interior reliability of CEFR. It consists of two sets of independent channels. Each channel is comprised of decay heat exchanger (DHX), intermediate circuit, sodium-air heat exchanger (AHX) and related auxiliary system. Both DHX are located in the hot pool of the main vessel directly, which is used to cool the hot sodium. The whole set of ERHRS is completely passive except the ventilation valves of AHX. But, as a very important set of engineered safety features which is the final way to remove the heat from the reactor core, it is necessary to pay attention to all of the possibilities that may reduce this ability. Several accidents are analyzed including when the ventilation valves couldn't be opened, when only one set of ERHRS could work and so on. The calculation results show that the ERHRS can keep the reactor in a safety status. Even though it is, experiments are still necessary in the view of engineering. (author)

  9. Pathogenic alteration in severe burn wounds.

    Fu, Yang; Xie, Bing; Ben, DaoFeng; Lv, KaiYang; Zhu, ShiHui; Lu, Wei; Tang, HongTai; Cheng, DaSheng; Ma, Bing; Wang, GuangYi; Xiao, ShiChu; Wang, GuangQing; Xia, ZhaoFan

    2012-02-01

    The present study aims to define the trend of time related changes with local bacterial alteration of bacterial resistance in severe burns in our burn center during a 12-year period. Retrospective analysis of microbiological results on severely burned wounds between 1998 and 2009 was carried out. A study of 3615 microbial isolates was performed. Staphylococcus aureus was the most commonly isolated pathogen (38.2%) followed by A. baumannii (16.2%), Streptococcus viridans (11.4%), Pseudomonas aeruginosa (10.4%), coagulase-negative staphylococci (CNS, 9.2%). The species ratios of S. aureus and A. baumannii increased significantly from 1st to 8th week of hospitalization, while those of Streptococcus viridans, P. aeruginosa and coagulase-negative staphylococci decreased during the same period. Bacterial resistance rates were compared between the periods 1998-2003 and 2004-2009. Vancomycin remained as the most sensitive antibiotic in S. aureus including methicillin-resistant S. aureus (MRSA). It was very likely that the majority of infections caused by Streptococcus viridans, P. aeruginosa and coagulase-negative staphylococci occurred in the early stage of burn course and the majority of infections caused by A. baumannii occurred 4 weeks after admission. The use of different antibiotics was probably the major contributor to these trends. PMID:22100426

  10. Severe accident management concept for LWRS

    Although the advanced built-in engineered safety features and the highly trained personnel have led to extremely low probabilities of core melt accidents, there is a common understanding that even for such very unlikely accidents the plant operators must have the ability and means to mitigate the consequences of such events. This paper outlines a concept for the management of severe accidents based on 1) Computer simulations. 2) Various strategies based on core and containment damage states. 3) Calculational Aids. 4) Procedures. 5) Technical basis report. 6) Training. 7) Drills. The major benefit of this concept is the fact that there is no dedicated operating manual for severe accidents; rather the required mitigative strategies and measures are incorporated into existing accident management manuals leading to truly integrated accident management at the plant. At present this concept is going to be implemented in the NPP Geogen. Although this approach is primarily developed for existing PWRs it is also applicable to other LWRs including new NPP designs. Specific features of the plant can be taken into account by an adaptation of the concept. (authors)

  11. A framework for the assessment of severe accident management strategies

    Severe accident management can be defined as the use of existing and/or altemative resources, systems and actors to prevent or mitigate a core-melt accident. For each accident sequence and each combination of severe accident management strategies, there may be several options available to the operator, and each involves phenomenological and operational considerations regarding uncertainty. Operational uncertainties include operator, system and instrumentation behavior during an accident. A framework based on decision trees and influence diagrams has been developed which incorporates such criteria as feasibility, effectiveness, and adverse effects, for evaluating potential severe accident management strategies. The framework is also capable of propagating both data and model uncertainty. It is applied to several potential strategies including PWR cavity flooding, BWR drywell flooding, PWR depressurization and PWR feed and bleed

  12. A framework for the assessment of severe accident management strategies

    Kastenberg, W.E. [ed.; Apostolakis, G.; Dhir, V.K. [California Univ., Los Angeles, CA (United States). Dept. of Mechanical, Aerospace and Nuclear Engineering] [and others

    1993-09-01

    Severe accident management can be defined as the use of existing and/or altemative resources, systems and actors to prevent or mitigate a core-melt accident. For each accident sequence and each combination of severe accident management strategies, there may be several options available to the operator, and each involves phenomenological and operational considerations regarding uncertainty. Operational uncertainties include operator, system and instrumentation behavior during an accident. A framework based on decision trees and influence diagrams has been developed which incorporates such criteria as feasibility, effectiveness, and adverse effects, for evaluating potential severe accident management strategies. The framework is also capable of propagating both data and model uncertainty. It is applied to several potential strategies including PWR cavity flooding, BWR drywell flooding, PWR depressurization and PWR feed and bleed.

  13. ACR-1000: Enhanced response to severe accidents

    Full text: Atomic Energy of Canada Limited (AECL) developed the Advanced CANDU Reactor-TM700 (ACR-700TM) as an evolutionary advancement of the current CANDU 6R reactor. As further advancement of the ACR design, AECL is currently developing the ACR-1000TM for the Canadian and international market. The ACR-1000 is aimed at producing electrical power for a capital cost and a unit-energy cost significantly less than that of the current generation of operating nuclear plants, while achieving shorter construction schedule, high plant capacity factor, improved operations and maintenance, increased operating life. and enhanced safety features. The reference ACR-1000 plant design is based on an integrated two-unit plant, using enriched fuel and light-water coolant, with each unit having a nominal gross output of about 1200 MWe. This paper presents the ACR-1000 features that are designed to mitigate limited core damage and severe core damage states, including core retention within vessel, core damage termination, and containment integrity maintenance. Core retention within vessel in CANDU-type reactors includes both retention within fuel channels, and retention within the calandria vessel. The moderator heavy water in the ACR-1000 calandria vessel, as in any other CANDU-type reactor, provides ample heat removal capacity in severe accidents. The ACR-1000 calandria vessel design permits for passive rejection of decay heat from the moderator to the shield water. Also, the calandria vessel will be designed for debris retention. Core damage termination is achieved by flooding of the core components with water and keeping them flooded thereafter. Successful termination can be achieved in the fuel channels, calandria vessel or calandria vault by water supply by the Long Term Cooling (LTC) pumps and by gravity feed from the Reserve Water System. The ACR-1000 containment is required to withstand external events such as earthquakes, tornados, floods and aircraft crashes. Containment

  14. [Severe accidental hypothermia in an elderly woman].

    Knobel, B; Mikhlin, A

    2001-11-01

    Profound hypothermia (core temperature of less than 28 degrees C) is a life threatening state and a medical emergency associated with a high mortality rate. The prognosis depends on underlying diseases, advanced or very early age, the duration prior to treatment, the degree of hemodynamic deterioration, and especially, the methods of treatment, including active external or internal rewarming. This is a case study of an 80-year-old female patient with severe accidental hypothermia (core temperature 27 degrees C). She was found in her home lying immobile on the cold floor after a fall. The patient was in a profound coma with cardiocirculatory collapse, and the medical staff treating her was inclined to pronounce her deceased. On her arrival at the hospital, she was resuscitated, put on a respirator and actively warmed. Very severe metabolic disorders were found, including a marked metabolic acidosis composed of diabetic ketoacidosis (she had suffered from insulin treated type 2 diabetes mellitus) and lactic acidosis with a very high anion gap (42) and a hyperosmotic state (blood glucose 1202 mg/dl). There were pathognomonic electrocardiographic abnormalities, J-wave of Osborn and prolonged repolarization. Slow atrial fibrillation with a ventricular response of 30 bpm followed by a nodal rhythm of 12 bpm and reversible cardiac arrest were recorded. The pulse and blood pressure were unobtainable. Despite the successful resuscitation and hemodynamic and cognitive improvement, rhabdomyolysis (CKP 6580 u/L), renal failure and hepatic damage developed. She was extubated and treated with intravenous fluids containing dopamine, bicarbonate, insulin and antibiotics. Her medical condition gradually improved, and she was discharged clear minded, functioning very well and independent. Renal and liver tests returned eventually to normal limits. Progressive bradycardia, hypotension and death due to ventricular fibrillation or asystole commonly occur during severe hypothermia

  15. Hurricane Isabel gives accelerators a severe test

    Hurricane Isabel was at category five--the most violent on the Saffir-Simpson scale of hurricane strength--when it began threatening the central Atlantic seaboard of the US. Over the course of several days, precautions against the extreme weather conditions were taken across the Jefferson Lab site in south-east Virginia. On 18 September 2003, when Isabel struck North Carolina's Outer Banks and moved northward, directly across the region around the laboratory, the storm was still quite destructive, albeit considerably reduced in strength. The flood surge and trees felled by wind substantially damaged or even devastated buildings and homes, including many belonging to Jefferson Lab staff members. For the laboratory itself, Isabel delivered an unplanned and severe challenge in another form: a power outage that lasted nearly three-and-a-half days, and which severely tested the robustness of Jefferson Lab's two superconducting machines, the Continuous Electron Beam Accelerator Facility (CEBAF) and the superconducting radiofrequency ''driver'' accelerator of the laboratory's free-electron laser. Robustness matters greatly for science at a time when microwave superconducting linear accelerators (linacs) are not only being considered, but in some cases already being built for projects such as neutron sources, rare-isotope accelerators, innovative light sources and TeV-scale electron-positron linear colliders. Hurricane Isabel interrupted a several-week-long maintenance shutdown of CEBAF, which serves nuclear and particle physics and represents the world's pioneering large-scale implementation of superconducting radiofrequency (SRF) technology. The racetrack-shaped machine is actually a pair of 500-600 MeV SRF linacs interconnected by recirculation arc beamlines. CEBAF delivers simultaneous beams at up to 6 GeV to three experimental halls. An imminent upgrade will double the energy to 12 GeV and add an extra hall for ''quark confinement'' studies. On a smaller scale

  16. Chronic lymphocytic leukemia: a clinical review including Korean cohorts

    Jeon, Young-Woo; Cho, Seok-Goo

    2016-01-01

    Only 5th decade ago, chronic lymphocytic leukemia (CLL) was only recognized as disease group of presenting features like peripheral lymphocytosis, organomegaly including of splenomegaly. As understanding of disease biology and molecular diagnostic tools are getting improved gradually, characterization of variation in CLL’s clinical courses was facilitated, resulting in better risk stratification and targeted treatments. Consequently multiple new targeted agents have been used in treatment of CLL, it makes improved clinical outcome. Rituximab containing chemoimmunotherapy (combination of rituximab, fludarabine, and cyclophosphamide) have shown better overall response rate and progression-free survival on fit patients’ group in front-line setting, result in standard first-line therapeutic option for CLL. Furthermore, after introducing that the B-cell receptor is crucial for the evolution and progression of CLL, emerging treatments targeting highly activated surface antigens and oncogenic signaling pathways have been associated with several successes in recent decades. These include new anti-CD 20 monoclonal antibody (obinutuzumab), the bruton tyrosine kinase inhibitor (ibrutinib), the phosphatidylinositol 3-kinase inhibitor (idelalisib), and B-cell CLL/lymphoma 2 inhibitor (ABT-199 and ABT-263). So, we discuss not only general pathophysiology of CLL, but also rapidly advancing treatment strategies that are being studied or approved for treatment of CLL. PMID:27044858

  17. Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

    ORAU' s Oak Ridge Institute for Science Education (HCTT-CHE)

    2011-04-14

    The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster - readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that - help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. This tool has been reviewed by a variety of key subject matter experts from federal, state, and local agencies and organizations. It also has been piloted with various communities that consist of different population sizes, to include large urban to small rural communities.

  18. Chronic lymphocytic leukemia: a clinical review including Korean cohorts.

    Jeon, Young-Woo; Cho, Seok-Goo

    2016-05-01

    Only 5th decade ago, chronic lymphocytic leukemia (CLL) was only recognized as disease group of presenting features like peripheral lymphocytosis, organomegaly including of splenomegaly. As understanding of disease biology and molecular diagnostic tools are getting improved gradually, characterization of variation in CLL's clinical courses was facilitated, resulting in better risk stratification and targeted treatments. Consequently multiple new targeted agents have been used in treatment of CLL, it makes improved clinical outcome. Rituximab containing chemoimmunotherapy (combination of rituximab, fludarabine, and cyclophosphamide) have shown better overall response rate and progression-free survival on fit patients' group in front-line setting, result in standard first-line therapeutic option for CLL. Furthermore, after introducing that the B-cell receptor is crucial for the evolution and progression of CLL, emerging treatments targeting highly activated surface antigens and oncogenic signaling pathways have been associated with several successes in recent decades. These include new anti-CD 20 monoclonal antibody (obinutuzumab), the bruton tyrosine kinase inhibitor (ibrutinib), the phosphatidylinositol 3-kinase inhibitor (idelalisib), and B-cell CLL/lymphoma 2 inhibitor (ABT-199 and ABT-263). So, we discuss not only general pathophysiology of CLL, but also rapidly advancing treatment strategies that are being studied or approved for treatment of CLL. PMID:27044858

  19. Case studies: Former centrally planned economics, including the Russian Federation

    The current conditions at former uranium mining sites in the Russian Federation are a direct consequence of the Soviet era operation of uranium mines without effective management of the environmental and social aspects of production and without remediation of contaminated areas, much less planning and design for remediation and long term containment of wastes. Mining operations without environmental protection or closure plans were the normal operating approach in the USA and other western countries but the resulting problems were being recognized in the 1960s and most of the legacy sites have since been cleaned up. Similar operating conditions without effective pollution control and closure concepts prevailed at uranium sites in other centrally planned economies such as the Central Asian Republics, East Germany, Czechoslovakia and Hungary prior to 1990. Currently, many mining areas in eastern and western European countries, including Spain, Hungary and the Czech Republic, have instituted effective remediation standards at major mining sites, including programmes applicable to existing as well as new uranium and other metal mines. These programmes are in areas in which long and active mining traditions provide a set of strong working models for effective environmental controls for current and proposed mines in the Russian Federation and other countries in transition from centrally planned economies. Several community surveys document hundreds of homes with radiation levels as much as 10 to 20 times the level requiring remedial action under international standards acknowledged by Russian investigators. The mining districts of southeastern Chita, (the Russian Federation) including Baley (thorium contamination) and others, reported high indoor radiation areas such as Krasnokamensk and Nerchinsk, which are among the first population exposures to these worldwide problems identified in the Russian Federation. Effective national and international attention to the severity

  20. Occupational Radiation Protection in Severe Accident Management

    As an early response to the Fukushima Daiichi NPP accident, the Information System on Occupational Exposure (ISOE) Bureau decided to focus on the following issues as an initial response of the joint program after having direct communications with the Japanese official participants in April 2011: - Management of high radiation area worker doses: It has been decided to make available the experience and information from the Chernobyl accident in terms of how emergency worker / responder doses were legally and practically managed, - Personal protective equipment for highly-contaminated areas: It was agreed to collect information about the types of personnel protective equipment and other equipment (e.g. air bottles, respirators, air-hoods or plastic suits, etc.), as well as high-radiation area worker dosimetry use (e.g. type, number and placement of dosimetry) for different types of emergency and high-radiation work situations. Detailed information was collected on dose criteria which are used for emergency workers /responders and their basis, dose management criteria for high dose/dose rate areas, protective equipment which is recommended for emergency workers / responders, recommended individual monitoring procedures, and any special requirement for assessment from the ISOE participating nuclear utilities and regulatory authorities and made available for Japanese utilities. With this positive response of the ISOE official participants and interest in the situation in Fukushima, the Expert Group on Occupational Radiation Protection in Severe Accident Management (EG-SAM) was established by the ISOE Management Board in May 2011. The overall objective of the EG-SAM is to contribute to occupational exposure management (providing a view on management of high radiation area worker doses) within the Fukushima plant boundary with the ISOE participants and to develop a state-of-the-art ISOE report on best radiation protection management practices for proper radiation

  1. Code strategy for simulating Severe Accident Scenario

    Severe accident scenarios of Sodium-cooled fast reactors involves various phenomena: core degradation, melt progression towards the core catcher, corium behaviour on the core catcher, energetic corium/sodium interactions, structure mechanical behaviour during expansion phase, containment behaviour, and fission production release and transport. In order to simulate the complete accident scenarios, CEA strategy relies on two sets of calculation codes: a reference set of codes and a set of simplified coupled models dedicated to Probabilistic Risk Assessment analyses. Concerning the reference set, that includes SAS-SFR, SIMMER, CONTAIN, EUROPLEXUS, and TOLBIAC, CEA started, with JAEA and KIT, a validation process based on existing experimental results such as CABRI and SCARABEE programs, and recently against the EAGLE1&2 program results, in the frame of a specific contract with JAEA. Furthermore, CEA is preparing additional experimental programs including in-pile experiments in IGR (NNC reactor), and out-of-pile experiments in the future experimental FOURNAISE facility to be built in CEA Cadarache (France). (author)

  2. Asthma Is More Severe in Older Adults

    Zein, Joe G.; Dweik, Raed A.; Comhair, Suzy A.; Bleecker, Eugene R.; Moore, Wendy C.; Peters, Stephen P.; Busse, William W.; Jarjour, Nizar N.; Calhoun, William J.; Castro, Mario; Chung, K. Fan; Fitzpatrick, Anne; Israel, Elliot; Teague, W. Gerald; Sally E. Wenzel

    2015-01-01

    Background: Severe asthma occurs more often in older adult patients. We hypothesized that the greater risk for severe asthma in older individuals is due to aging, and is independent of asthma duration. Methods: This is a cross-sectional study of prospectively collected data from adult participants (N=1130; 454 with severe asthma) enrolled from 2002 – 2011 in the Severe Asthma Research Program. Results: The association between age and the probability of severe asthma, which was performed by ap...

  3. 76 FR 23812 - Reliability and Continuity of Communications Networks, Including Broadband Technologies; Effects...

    2011-04-28

    ... Documents in Rulemaking Proceedings, 63 FR 24121 (1998). Electronic Filers: Comments may be filed... COMMISSION Reliability and Continuity of Communications Networks, Including Broadband Technologies; Effects on Broadband Communications Networks of Damage or Failure of Network Equipment or Severe...

  4. Relationship between affective symptoms and malnutrition severity in severe Anorexia Nervosa.

    Lama Mattar

    Full Text Available BACKGROUND: Very few studies have investigated the relationship between malnutrition and psychological symptoms in Anorexia Nervosa (AN. They have used only body weight or body mass index (BMI for the nutritional assessment and did not always report on medication, or if they did, it was not included in the analysis of results, and they did not include confounding factors such as duration of illness, AN subtype or age. The present study investigates this relationship using indicators other than BMI/weight, among which body composition and biological markers, also considering potential confounders related to depression and anxiety. METHODS: 155 AN patients, (DSM-IV were included consecutively upon admission to inpatient treatment. Depression, anxiety, obsessive behaviours and social functioning were measured using various scales. Nutritional status was measured using BMI, severity of weight loss, body composition, and albumin and prealbumin levels. RESULTS: No correlation was found between BMI at inclusion, fat-free mass index, fat mass index, and severity of weight loss and any of the psychometric scores. Age and medication are the only factors that affect the psychological scores. None of the psychological scores were explained by the nutritional indicators with the exception of albumin levels which was negatively linked to the LSAS fear score (p = 0.024; beta = -0.225. Only the use of antidepressants explained the variability in BDI scores (p = 0.029; beta = 0.228 and anxiolytic use explained the variability in HADs depression scores (p = 0.037; beta = 0.216. CONCLUSION: The present study is a pioneer investigation of various nutritional markers in relation to psychological symptoms in severely malnourished AN patients. The clinical hypothesis that malnutrition partly causes depression and anxiety symptoms in AN in acute phase is not confirmed, and future studies are needed to back up our results.

  5. Severe Accidents in the Energy Sector

    A comprehensive database on severe accidents, with main emphasis on the ones associated with the energy sector, has been established by the Paul Scherrer Institute (PSI). Fossil energy carriers, nuclear power and hydro power are covered in ENSAD (Energy related Severe Accident Database), and the scope of work includes all stages of the analysed energy chains, i.e. exploration, extraction, transports, processing, storage and waste disposal. The database has been developed using a wide variety of sources. As opposed to the previous studies the ambition of the present work has been, whenever feasible, to cover a relatively broad spectrum of damage categories of interest. This includes apart from fatalities also serious injuries, evacuations, land or water contamination, and economic losses. Currently, ENSAD covers 13,914 accidents, of which 4290 are energy related, and 1943 are considered as severe accidents. Significant effort has been directed towards the examination of the relevance of the worldwide accident records to the Swiss specific conditions, particularly in the context of nuclear and hydro power. For example, a detailed investigation of large dam failures and their consequences was carried out. Generally, while Swiss specific aspects are emphasised, the major part of the collected and analysed data, as well as the insights gained, are considered to be of general interest. In particular, three sets of the aggregated results are provided based on world wide occurrence, on OECD countries, and on non OECD countries, respectively. Significant differences exist between the aggregated, normalised damage rates assessed for the various energy carriers: On the world wide basis, the broader picture obtained by coverage of full energy chains leads to aggregated immediate fatality rates being much higher for the fossil fuels than what one would expect if power plants only were considered. The highest rates apply to LPG, followed by hydro, oil, coal, natural gas and

  6. Severe Accidents in the Energy Sector

    Hirschberg, S.; Spiekerman, G.; Dones, R

    1998-11-01

    A comprehensive database on severe accidents, with main emphasis on the ones associated with the energy sector, has been established by the Paul Scherrer Institute (PSI). Fossil energy carriers, nuclear power and hydro power are covered in ENSAD (Energy related Severe Accident Database), and the scope of work includes all stages of the analysed energy chains, i.e. exploration, extraction, transports, processing, storage and waste disposal. The database has been developed using a wide variety of sources. As opposed to the previous studies the ambition of the present work has been, whenever feasible, to cover a relatively broad spectrum of damage categories of interest. This includes apart from fatalities also serious injuries, evacuations, land or water contamination, and economic losses. Currently, ENSAD covers 13,914 accidents, of which 4290 are energy related, and 1943 are considered as severe accidents. Significant effort has been directed towards the examination of the relevance of the worldwide accident records to the Swiss specific conditions, particularly in the context of nuclear and hydro power. For example, a detailed investigation of large dam failures and their consequences was carried out. Generally, while Swiss specific aspects are emphasised, the major part of the collected and analysed data, as well as the insights gained, are considered to be of general interest. In particular, three sets of the aggregated results are provided based on world wide occurrence, on OECD countries, and on non OECD countries, respectively. Significant differences exist between the aggregated, normalised damage rates assessed for the various energy carriers: On the world wide basis, the broader picture obtained by coverage of full energy chains leads to aggregated immediate fatality rates being much higher for the fossil fuels than what one would expect if power plants only were considered. The highest rates apply to LPG, followed by hydro, oil, coal, natural gas and

  7. Clinical versus laboratory for estimating of dehydration severity

    Majid Malaki

    2012-01-01

    Full Text Available Background : Acute gastroenteritis is a common cause of dehydration and precise estimation of dehydration is a vital matter for clinical decisions. We try to find how much clinically diagnosed scales are compatible with laboratory tests measures. Materials and Methods : During 2 years 95 infants and children aged between 2 and 108 months entered to emergency room with acute gastroenteritis. They were categorized as mild, moderate and severe dehydration, their recorded laboratory tests include blood urea nitrogen (BUN, creatinine, venous blood gases values were expressed by means ±95% of confidence interval and compared by mann-whitney test in each groups with SPSS 16, sensitivity, specificity and likelihood ratio measured for defined cut off values in severe dehydration group, P value less than 0.05 was significant. Result : Severe dehydration includes 3% of all hospitalization due to dehydration. Laboratory tests cannot differentiate mild to moderate dehydration definietly but this difference is significant between severe to mild and severe to moderate dehydration. Conclusion : R outine laboratory test are not generally helpful for dehydration severity estimation but they can be discriminate severe from mild or moderate dehydration exclusively. Creatinine higher than 0.9 mg/dl and Base deficit beyond-16 are specific (90% for severe dehydration estimation in infant and children.

  8. Severe accident aerosol research in Finland

    The retention of fission products in the steam generator tubing and in the secondary side is poorly understood at the moment. Most experimental programs have concentrated on the initial stages of deposition. Much less attention has been paid to the situations when deposition-resuspension-revaporisation are important as the deposit layers are getting thicker. The understanding of fission product deposition in realistic steam generator conditions is needed to design efficient accident management procedures. For example if there is large deposition already in the ruptured pipe(s), the accident management procedure is different from the case where most deposition would occur in the secondary side. This is considered very important because steam generator tube rupture sequences are included in the risk dominant sequences. Aerosol deposition has been studied widely in laboratory scale. However, most of the studies have concentrated on situations where the deposit layer is thin and do not significantly affect the process. In severe accident applications the most important deposition studies have been LACE, STORM, TUBA, TRANSAT and AIDA programmes. None of these tests considered steam generator conditions. Thus we can say that there is basic knowledge on aerosol deposition and removal from gas streams in water pools, but it can not be applied directly to steam generator tube rupture cases. At the moment the effectiveness of such accident management procedures as secondary side flooding can not be verified as there is no experimental data and the models in severe accident codes are poor or non-existing. As a results of this work we will get data on deposition in the tubing, in the break location and in the secondary side. Experiments will be performed in horizontal steam generators (VVER reactors). (orig.)

  9. Streptozotocin, Type I Diabetes Severity and Bone

    Motyl Katherine

    2009-03-01

    Full Text Available Abstract As many as 50% of adults with type I (T1 diabetes exhibit bone loss and are at increased risk for fractures. Therapeutic development to prevent bone loss and/or restore lost bone in T1 diabetic patients requires knowledge of the molecular mechanisms accounting for the bone pathology. Because cell culture models alone cannot fully address the systemic/metabolic complexity of T1 diabetes, animal models are critical. A variety of models exist including spontaneous and pharmacologically induced T1 diabetic rodents. In this paper, we discuss the streptozotocin (STZ-induced T1 diabetic mouse model and examine dose-dependent effects on disease severity and bone. Five daily injections of either 40 or 60 mg/kg STZ induce bone pathologies similar to spontaneously diabetic mouse and rat models and to human T1 diabetic bone pathology. Specifically, bone volume, mineral apposition rate, and osteocalcin serum and tibia messenger RNA levels are decreased. In contrast, bone marrow adiposity and aP2 expression are increased with either dose. However, high-dose STZ caused a more rapid elevation of blood glucose levels and a greater magnitude of change in body mass, fat pad mass, and bone gene expression (osteocalcin, aP2. An increase in cathepsin K and in the ratio of RANKL/OPG was noted in high-dose STZ mice, suggesting the possibility that severe diabetes could increase osteoclast activity, something not seen with lower doses. This may contribute to some of the disparity between existing studies regarding the role of osteoclasts in diabetic bone pathology. Examination of kidney and liver toxicity indicate that the high STZ dose causes some liver inflammation. In summary, the multiple low-dose STZ mouse model exhibits a similar bone phenotype to spontaneous models, has low toxicity, and serves as a useful tool for examining mechanisms of T1 diabetic bone loss.

  10. Streptozotocin, Type I Diabetes Severity and Bone

    Motyl Katherine

    2009-01-01

    Full Text Available Abstract As many as 50% of adults with type I (T1 diabetes exhibit bone loss and are at increased risk for fractures. Therapeutic development to prevent bone loss and/or restore lost bone in T1 diabetic patients requires knowledge of the molecular mechanisms accounting for the bone pathology. Because cell culture models alone cannot fully address the systemic/metabolic complexity of T1 diabetes, animal models are critical. A variety of models exist including spontaneous and pharmacologically induced T1 diabetic rodents. In this paper, we discuss the streptozotocin (STZ-induced T1 diabetic mouse model and examine dose-dependent effects on disease severity and bone. Five daily injections of either 40 or 60 mg/kg STZ induce bone pathologies similar to spontaneously diabetic mouse and rat models and to human T1 diabetic bone pathology. Specifically, bone volume, mineral apposition rate, and osteocalcin serum and tibia messenger RNA levels are decreased. In contrast, bone marrow adiposity and aP2 expression are increased with either dose. However, high-dose STZ caused a more rapid elevation of blood glucose levels and a greater magnitude of change in body mass, fat pad mass, and bone gene expression (osteocalcin, aP2. An increase in cathepsin K and in the ratio of RANKL/OPG was noted in high-dose STZ mice, suggesting the possibility that severe diabetes could increase osteoclast activity, something not seen with lower doses. This may contribute to some of the disparity between existing studies regarding the role of osteoclasts in diabetic bone pathology. Examination of kidney and liver toxicity indicate that the high STZ dose causes some liver inflammation. In summary, the multiple low-dose STZ mouse model exhibits a similar bone phenotype to spontaneous models, has low toxicity, and serves as a useful tool for examining mechanisms of T1 diabetic bone loss.

  11. Transdermal fluid loss in severely burned patients

    Lange, Thomas

    2010-01-01

    Full Text Available Introduction: The skin protects against fluid and electrolyte loss. Burn injury does affect skin integrity and protection against fluid loss is lost. Thus, a systemic dehydration can be provoked by underestimation of fluid loss through burn wounds. Purpose: We wanted to quantify transdermal fluid loss in burn wounds. Method: Retrospective study. 40 patients admitted to a specialized burn unit were analyzed and separated in two groups without (Group A or with (Group B hypernatremia. Means of daily infusion-diuresis-ratio (IDR and the relationship to totally burned surface area (TBSA were analyzed. Results: In Group A 25 patients with a mean age of 47±18 years, a mean TBSA of 23±11%, and a mean abbreviated burned severity index (ABSI score of 6.9±2.1 were summarized. In Group B 15 patients with a mean age of 47±22 years, a mean TBSA of 30±13%, and a mean ABSI score of 8.1±1.7 were included. Statistical analysis of the period from day 3 to day 6 showed a significant higher daily IDR-amount in Group A (Group A vs. Group B: 786±1029 ml vs. –181±1021 ml; p<0.001 and for daily IDR-TBSA-ratio (Group A vs. Group B: 40±41 ml/% vs. –4±36 ml/%; p<0.001. Conclusions: There is a systemic relevant transdermal fluid loss in burn wounds after severe burn injury. Serum sodium concentration can be used to calculate need of fluid resuscitation for fluid maintenance. There is a need of an established fluid removal strategy to avoid water and electrolyte imbalances.

  12. An Unusual Ocular Emergency in Severe Dengue

    Nagaraj, Kalpana Badami; Jayadev, Chaitra; Yajmaan, Soumya; Prakash, Savitha

    2014-01-01

    Dengue, one of the most common mosquito-borne flavivirus diseases affecting humans, is spread by the Aedes aegypti mosquito. Most people infected with dengue virus are asymptomatic or only have mild symptoms such as an uncomplicated fever; few have more severe features, while in a small proportion it is life-threatening. Severe dengue is defined as that associated with severe bleeding, severe organ dysfunction, or severe plasma leakage. Ophthalmic manifestations can involve both the anterior and posterior segment. We report an ocular emergency of proptosis and globe rupture in a patient with severe dengue. PMID:25371643

  13. An unusual ocular emergency in severe dengue

    Kalpana Badami Nagaraj

    2014-01-01

    Full Text Available Dengue, one of the most common mosquito-borne flavivirus diseases affecting humans, is spread by the Aedes aegypti mosquito. Most people infected with dengue virus are asymptomatic or only have mild symptoms such as an uncomplicated fever; few have more severe features, while in a small proportion it is life-threatening. Severe dengue is defined as that associated with severe bleeding, severe organ dysfunction, or severe plasma leakage. Ophthalmic manifestations can involve both the anterior and posterior segment. We report an ocular emergency of proptosis and globe rupture in a patient with severe dengue.

  14. Cost of severe haemophilia in Toronto.

    Heemstra, H E; Zwaan, T; Hemels, M; Feldman, B M; Blanchette, V; Kern, M; Einarson, T R

    2005-05-01

    Our objective was to determine costs and trends in treating boys with severe haemophilia A before our centre routinely used prophylaxis. One reviewer extracted data from patient charts to determine resource consumption for 17 boys with severe haemophilia A from 1978 to 1998 at Toronto's Hospital for Sick Children. Resources included factor concentrate, doctors and health care professionals (physiotherapists/social workers), tests (laboratory, radiological and diagnostic) and hospitalizations. Subgroup analysis on those patients infected with HIV and/or hepatitis were also performed. Costs in Canadian Dollars were taken from standard lists and discounted at 3%. Total average cost (range) 62 292 dollars (3339-121 738) per year patient(-1); the largest fraction, 59 910 dollars (3103-119 480), 96.2% was accounted for by factor VIII. Hospitalizations accounted for 1832 dollars (0-5217) per patient year(-1) including drugs, nursing care and stay. Doctor and health care professionals visits averaged 252 dollars (36-462) and 72 dollars (0-175) per patient year(-1), laboratory and other tests cost 201 dollars (22-377) and 26 dollars (2-60) per patient year(-1), respectively. The average number of bleeds was 12.9 (2.0-22.0) per patient year(-1), decreasing since 1977 by 0.68 per patient year(-1) (R(2) = 0.56). Hospitalizations averaged 0.22 (0-4) per patient year(-1), lasting 2.3 days. From 1984, hospitalizations decreased by 0.025 patient(-1) year(-1) (R(2) = 0.76). Concurrently, the average treatment costs increased by 5456 dollars patient(-1) year(-1) (R(2) = 0.81). Clotting factor concentrate cost per patient increased by 5521 dollars year(-1) (R(2) = 0.82). Patients with virally transmitted diseases had considerable higher costs. The cost per year was substantial. Costs increased with virally transmitted diseases. Number of bleeds and hospitalizations over the period of study decreased and costs increased because of factor use in secondary prophylaxis. PMID:15876271

  15. Traumatic Brain Injury (TBI): Moderate or Severe

    Traumatic Brain Injury (TBI) Moderate or Severe Definition A TBI is classified as moderate or severe when a patient experiences ... skull and enters the brain Defense and Veterans Brain Injury Center PATFIAE MN TI LSI ES Traumatic Brain ...

  16. Metal ions affecting the gastrointestinal system including the liver.

    Naughton, Declan P; Nepusz, Tamás; Petroczi, Andrea

    2011-01-01

    In the present context, metal ions can be categorized into several classes including those that are essential for life and those that have no known biological function and thus can be considered only as potentially hazardous. Many complexities arise with regard to metal toxicity and there is a paucity of studies relating to many metals which are frequent components of the diet. For many people ingestion of mineral supplements is considered a risk-free health choice despite growing evidence to the contrary. Numerous approaches have been developed to assess risk associated with ingestion of metal ions. These include straightforward estimation of safe limits such as oral reference dose which are often based on data derived from animal experiments. More convoluted approaches such as the Target Hazard Quotient involve assessment of hazard with frequent exposure over long durations such as a lifetime. The latter calculation also affords facile consideration of the effects of many metals together. In many cases, rigorous data are unavailable, hence, large factors of uncertainty are employed to relate risk to humans. Owing to the nature of metal toxicity, data pertaining to the gastrointestinal tract and liver are often acquired from diseases of metal homeostasis or episodes of considerable metal overload. Whilst these studies provide evidence for mechanisms of metal-induced toxicity such as enhancing oxidative stress, extrapolation of these results to healthy individuals or patients with chronic inflammatory diseases is not straightforward. In summary, the diverse nature of metals and their effects on human tissues along with a paucity of studies on the full range of their effects, warrant further in-depth studies on the association of metals to ageing, chronic inflammatory diseases, and cancer. PMID:21473378

  17. Solving the high energy evolution equation including running coupling corrections

    We study the solution of the nonlinear Balitsky-Kovchegov evolution equation with the recently calculated running coupling corrections [I. I. Balitsky, Phys. Rev. D 75, 014001 (2007). and Y. Kovchegov and H. Weigert, Nucl. Phys. A784, 188 (2007).]. Performing a numerical solution we confirm the earlier result of Albacete et al. [Phys. Rev. D 71, 014003 (2005).] (obtained by exploring several possible scales for the running coupling) that the high energy evolution with the running coupling leads to a universal scaling behavior for the dipole-nucleus scattering amplitude, which is independent of the initial conditions. It is important to stress that the running coupling corrections calculated recently significantly change the shape of the scaling function as compared to the fixed coupling case, in particular, leading to a considerable increase in the anomalous dimension and to a slow-down of the evolution with rapidity. We then concentrate on elucidating the differences between the two recent calculations of the running coupling corrections. We explain that the difference is due to an extra contribution to the evolution kernel, referred to as the subtraction term, which arises when running coupling corrections are included. These subtraction terms were neglected in both recent calculations. We evaluate numerically the subtraction terms for both calculations, and demonstrate that when the subtraction terms are added back to the evolution kernels obtained in the two works the resulting dipole amplitudes agree with each other. We then use the complete running coupling kernel including the subtraction term to find the numerical solution of the resulting full nonlinear evolution equation with the running coupling corrections. Again the scaling regime is recovered at very large rapidity with the scaling function unaltered by the subtraction term

  18. Severe Psychomotor Delay in a Severe Presentation of Cat-Eye Syndrome

    Guillaume Jedraszak

    2015-01-01

    Full Text Available Cat-eye syndrome is a rare genetic syndrome of chromosomal origin. Individuals with cat-eye syndrome are characterized by the presence of preauricular pits and/or tags, anal atresia, and iris coloboma. Many reported cases also presented with variable congenital anomalies and intellectual disability. Most patients diagnosed with CES carry a small supernumerary bisatellited marker chromosome, resulting in partial tetrasomy of 22p-22q11.21. There are two types of small supernumerary marker chromosome, depending on the breakpoint site. In a very small proportion of cases, other cytogenetic anomalies are reportedly associated with the cat-eye syndrome phenotype. Here, we report a patient with cat-eye syndrome caused by a type 1 small supernumerary marker chromosome. The phenotype was atypical and included a severe developmental delay. The use of array comparative genomic hybridization ruled out the involvement of another chromosomal imbalance in the neurological phenotype. In the literature, only a few patients with cat-eye syndrome present with a severe developmental delay, and all of the latter carried an atypical partial trisomy 22 or an uncharacterized small supernumerary marker chromosome. Hence, this is the first report of a severe neurological phenotype in cat-eye syndrome with a typical type 1 small supernumerary marker chromosome. Our observation clearly complicates prognostic assessment, particularly when cat-eye syndrome is diagnosed prenatally.

  19. Strategy for the Development of Severe Accident Analysis Technology

    To ensure the safety of people living near the nuclear power plants during the postulated events of severe accidents, a severe accident management strategy is prepared for the operating reactors and dedicated engineered features for the severe accidents are under research and development for the new reactors, such as GEN-III reactors. To accomplish these tasks, not only a proper understanding of fundamental physics of severe accident phenomena but also reliable computer codes for analyzing the severe accident phenomena is very necessary. This report deals with a strategic plan for a development and provision of computer code system for analyzing the severe accidents. This reports includes a summary of major phenomena of severe accidents, an peer review of the computer codes for analyzing the integral behavior of severe accident scenario and computer codes for analyzing the specific phenomena. Finally, a strategic plan for an equipment of severe accident computer codes either by use of already available computer codes or a development of our own computer codes, which could be competitive with world class foreign computer codes

  20. Acute respiratory distress syndrome associated with severe ulcerative colitis

    Shiho; Sagara; Yasuo; Horie; Yumiko; Anezaki; Hideaki; Miyazawa; Masahiro; Iizuka

    2010-01-01

    Various extraintestinal manifestations including pulmonary abnormalities have been reported in patients with ulcerative colitis. Acute respiratory distress syndrome (ARDS) is a serious and fatal pulmonary manifestation. We have experienced a 67-year-old male patient with ARDS associated with a severe type of ulcerative colitis (UC). Severe dyspnea symptoms occurred during the treatment of UC in a previous hospital and the patient was transferred to our hospital on June 27, 2007. Both blood and sputa culture...

  1. Inequalities for derivatives of rational functions on several intervals

    We describe a solution of the problem of finding rational trigonometric functions with fixed denominator that deviate least from zero on several subintervals of the period. The resulting representation is used to prove inequalities that estimate the derivatives of rational trigonometric and algebraic functions with fixed denominator in terms of their values on several intervals. Particular cases of these inequalities include the well-known inequalities of Videnskii, Rusak, Totik and others

  2. Treatment options for severe hypertriglyceridemia (SHTG): the role of apheresis

    Ewald, Nils; Kloer, Hans-Ulrich

    2012-01-01

    Hypertriglyceridemia is associated with a number of severe diseases such as acute pancreatitis and coronary artery disease. In severe hypertriglyceridemia (SHTG, triglycerides > 1,000 mg/dL), rapid lowering of plasma triglycerides (TG) has to be achieved. Treatment regimes include nutritional intervention, the use of antihyperlipidemic drugs, and therapeutic apheresis. Apheretic treatment is indicated in medical emergencies such as hypertriglyceridemic pancreatitis. Reviewing the current lite...

  3. Severe Dermatophytosis and Acquired or Innate Immunodeficiency: A Review

    Claire Rouzaud; Roderick Hay; Olivier Chosidow; Nicolas Dupin; Anne Puel; Olivier Lortholary; Fanny Lanternier

    2015-01-01

    Dermatophytes are keratinophilic fungi responsible for benign and common forms of infection worldwide. However, they can lead to rare and severe diseases in immunocompromised patients. Severe forms include extensive and/or invasive dermatophytosis, i.e., deep dermatophytosis and Majocchi’s granuloma. They are reported in immunocompromised hosts with primary (autosomal recessive CARD9 deficiency) or acquired (solid organ transplantation, autoimmune diseases requiring immunosuppressive treatmen...

  4. Computed tomography in severe protein energy malnutrition.

    Househam, K C; Villiers, J.F.

    1987-01-01

    Computed tomography of the brain was performed on eight children aged 1 to 4 years with severe protein energy malnutrition. Clinical features typical of kwashiorkor were present in all the children studied. Severe cerebral atrophy or brain shrinkage according to standard radiological criteria was present in every case. The findings of this study suggest considerable cerebral insult associated with severe protein energy malnutrition.

  5. Advanced methodology for generation expansion planning including interconnected systems

    Zhao, M.; Yokoyama, R.; Yasuda, K. [Tokyo Metropolitan Univ. (Japan); Sasaki, H. [Hiroshima Univ. (Japan); Ogimoto, K. [Electric Power Development Co. Ltd., Tokyo (Japan)

    1994-12-31

    This paper reviews advanced methodology for generation expansion planning including interconnected systems developed in Japan, putting focus on flexibility and efficiency in a practical application. First, criteria for evaluating flexibility of generation planning considering uncertainties are introduced. Secondly, the flexible generation mix problem is formulated as a multi-objective optimization with more than two objective functions. The multi-objective optimization problem is then transformed into a single objective problem by using the weighting method, to obtain the Pareto optimal solution, and solved by a dynamics programming technique. Thirdly, a new approach for electric generation expansion planning of interconnected systems is presented, based on the Benders Decomposition technique. That is, large scale generation problem constituted by the general economic load dispatch problem, and several sub problems which are composed of smaller scale isolated system generation expansion plans. Finally, the generation expansion plan solved by an artificial neural network is presented. In conclusion, the advantages and disadvantages of this method from the viewpoint of flexibility and applicability to practical generation expansion planning are presented. (author) 29 refs., 10 figs., 4 tabs.

  6. Efficient Algorithms for Electrostatic Interactions Including Dielectric Contrasts

    Christian Holm

    2013-10-01

    Full Text Available Coarse-grained models of soft matter are usually combined with implicit solvent models that take the electrostatic polarizability into account via a dielectric background. In biophysical or nanoscale simulations that include water, this constant can vary greatly within the system. Performing molecular dynamics or other simulations that need to compute exact electrostatic interactions between charges in those systems is computationally demanding. We review here several algorithms developed by us that perform exactly this task. For planar dielectric surfaces in partial periodic boundary conditions, the arising image charges can be either treated with the MMM2D algorithm in a very efficient and accurate way or with the electrostatic layer correction term, which enables the user to use his favorite 3D periodic Coulomb solver. Arbitrarily-shaped interfaces can be dealt with using induced surface charges with the induced charge calculation (ICC* algorithm. Finally, the local electrostatics algorithm, MEMD(Maxwell Equations Molecular Dynamics, even allows one to employ a smoothly varying dielectric constant in the systems. We introduce the concepts of these three algorithms and an extension for the inclusion of boundaries that are to be held fixed at a constant potential (metal conditions. For each method, we present a showcase application to highlight the importance of dielectric interfaces.

  7. Effectiveness of panretinal photocoagulation in severe diabetic retinopathy

    Astakhov, Yuri S.; Shadrichev, Fedor Y.; Lisochkina, Alla B.

    1999-02-01

    Diabetic Retinopathy (DR) is one of the most severe complications of diabetes mellitus. In 1994, in St. Petersburg, a new system of ophthalmologic care for diabetic patients was set up. For Russia, this system represents an example of adequate care for subjects with DM, including screening strategies, documentation and education of patients and general ophthalmologists. According to our data, about one half of examined patients had DR, and about 20% of patients were in need of laser treatment. The aim of present study was to evaluate the effectiveness of panretinal photocoagulation (PRP) in cases of severe DR, including advanced nonproliferative DR (preproliferative DR) and proliferative DR. Data concerning 1073 diabetics are included in this study. PRP was performed in 736 cases (1163 eyes). DR stabilization was estimated after one year follow-up PRP enabled preventing severe visual loss in patients with preproliferative DR and proliferative DR. Our system of specialized ophthalmic care for diabetic patients proved to be effective.

  8. Pulse radiolysis study on several fluoroquinolones

    Zhang Peng [Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai 201800 (China); Graduate University of Chinese Academy of Science, Beijing 100049 (China); Yao Side [Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai 201800 (China); Li Haixia; Song Xiyu; Liu Yancheng [Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai 201800 (China); Graduate University of Chinese Academy of Science, Beijing 100049 (China); Wang Wenfeng, E-mail: wangwenfeng@sinap.ac.c [Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai 201800 (China)

    2011-04-15

    Reactions of several fluoroquinolones (FQs), including enoxacin, norfloxacin, and ciprofloxacin, with various reactive species such as e{sub aq}{sup -}, N{sup {center_dot}}{sub 3}, and {sup {center_dot}O}H are investigated by pulse radiolysis techniques. The FQ radical anions formed in the reactions of FQs with e{sub aq}{sup -} could either be protonated or deprotonated, and the absorption of FQ radical anions was located around 370 nm. The absorption of the neutral radicals produced in the protonation, and the radical dianions produced in the deprotonation of FQ radical anions were located in the 500-750 nm region. The FQ radical cations formed in the reactions of FQs with N{sub 3}{sup {center_dot}} showed an absorption band around 360 nm. Due to the strong bleaching below 350 nm, the absorption maxima ({lambda}{sub max}) of FQ radical anions, and the {lambda}{sub max} of FQ radical cations were not confirmed. The absorption of the FQ radical anions and cations was clearly pH dependent. Under neutral conditions, the reaction rate constants of FQs with e{sub aq}{sup -} and {sup {center_dot}O}H, which are diffusion controlled, were determined.

  9. Sarcoidosis: assessment of disease severity using HRCT

    The value of high-resolution computed tomography (HRCT) in diagnosing and assessing inflammatory activity in sarcoidosis is well established. The aim of the present study was to address the intra- and inter-observer agreements of the HRCT score by Oberstein et al. [8], and to evaluate the relationship between HRCT findings and disease severity expressed in respiratory functional impairment in sarcoidosis. The clinical records of 80 known sarcoidosis patients visiting the outpatient clinic between January 2000 and August 2001, who underwent a HRCT as well as lung function tests (including exercise testing), were reviewed. Two readers scored the first 60 HRCT images twice. Weighted kappa and intra-class correlation coefficient were used to assess the reliability of the HRCT scoring system. Spearman's rank correlation coefficients and multiple regression analyses were performed to evaluate the relationship between HRCT findings (first reading, reader A) and respiratory functional impairment. Intra- and inter-reader reliability demonstrated good agreement. All HRCT subscores, except enlargement of lymph nodes, were correlated to the FEV1, FVC, DLco, Pao2max (all p2max (p <0.001). Furthermore, HRCT abnormalities, but not the chest radiographic stage, were strongly associated with functional parameters. Abnormal changes of lung parenchyma, established by HRCT features, were associated with respiratory functional impairment in sarcoidosis. Moreover, compared with the radiographic stages, HRCT findings appeared to be much more sensitive in depicting respiratory disability, especially abnormal gas exchange. (orig.)

  10. Elevated Fra-1 expression causes severe lipodystrophy.

    Luther, Julia; Driessler, Frank; Megges, Matthias; Hess, Andreas; Herbort, Bettina; Mandic, Vice; Zaiss, Mario M; Reichardt, Anne; Zech, Christine; Tuckermann, Jan P; Calkhoven, Cornelis F; Wagner, Erwin F; Schett, Georg; David, Jean-Pierre

    2011-05-01

    A shift from osteoblastogenesis to adipogenesis is one of the underlying mechanisms of decreased bone mass and increased fat during aging. We now uncover a new role for the transcription factor Fra-1 in suppressing adipogenesis. Indeed, Fra1 (Fosl1) transgenic (Fra1tg) mice, which developed progressive osteosclerosis as a result of accelerated osteoblast differentiation, also developed a severe general lipodystrophy. The residual fat of these mice appeared immature and expressed lower levels of adipogenic markers, including the fatty acid transporter Cd36 and the CCAAT/enhancer binding protein Cebpa. Consequently accumulation of triglycerides and free fatty acids were detected in the serum of fasting Fra1tg mice. Fra-1 acts cell autonomously because the adipogenic differentiation of Fra1 transgenic primary osteoblasts was drastically reduced, and overexpression of Fra-1 in an adipogenic cell line blocked their differentiation into adipocytes. Strikingly, Cebpa was downregulated in the Fra-1-overexpressing cells and Fra-1 could bind to the Cebpa promoter and directly suppress its activity. Thus, our data add to the known common systemic control of fat and bone mass, a new cell-autonomous level of control of cell fate decision by which the osteogenic transcription factor Fra-1 opposes adipocyte differentiation by inhibiting C/EBPα. PMID:21486951

  11. Correlation between frequency of hospitalization of patients with severe copd and severity indices

    Eleni Gaki

    2011-01-01

    Full Text Available SUMMARY.Backgrou nd: Several parameters have been proposed as riskfactors for hospitalization of patients with chronic obstructivepulmonary disease (COPD. Objectives: The aim of this studywas to investigate the association between changes in parametersexpressing various different aspects of disease severity and thefrequency of hospitalization of patients with severe COPD withoutco-morbidities. Population and methods: Of 117 patients withsevere COPD recruited for prospective study, 74 completed 2-yearmonitoring and were classified into 2 groups according to their frequencyof hospitalization: Group A (n=39 ≤2 hospitalizations/year,Group B >2 hospitalizations/year (n=35. Parameters measured atbaseline and 2 years included: FEV1 % pred, FEV1/FVC ratio, ratio ofinspiratory capacity (IC to total lung capacity (TLC(IC/TLC, bodymass index (BMI, fat free mass index (FFMI, 6 minute walk distance(6MWD, the Borg dyspnoea scale before and after 6MWD, dyspnoeaaccording to the Medical Research Council (MRC scale, pH and8-isoprostane in exhaled breath condensate (EBC, serum levels ofC-reactive protein (CRP and fibrinogen, arterial blood gases, theBMI, airflow obstruction, dyspnoea, and exercise capacity (BODEindex and quality of life. Results: The patients with more frequenthospitalizations showed greater change in the baseline study variablesafter 2 years. The specific differences were loss of muscle mass,deterioration of airway obstruction, decrease in exercise capacity,increase in airways and systemic inflammation and impairment inquality of life. The most significant changes found to be associatedwith hospitalization frequency using a regression model were inCRP, 6MWD, fibrinogen, 8-isoprostane and BODE. Co nclusions:In this selected cohort of patients with severe COPD, increased hospitalizationfrequency was associated with changes in parametersexpressing deterioration in exercise capacity and in systemic andairways inflammation. Pneumon 2011, 24(2:164-170.

  12. Surviving severe traumatic brain injury in Denmark

    Odgaard, Lene; Poulsen, Ingrid; Kammersgaard, Lars Peter;

    2015-01-01

    PURPOSE: To identify all hospitalized patients surviving severe traumatic brain injury (TBI) in Denmark and to compare these patients to TBI patients admitted to highly specialized rehabilitation (HS-rehabilitation). PATIENTS AND METHODS: Patients surviving severe TBI were identified from The...... severe TBI were admitted to HS-rehabilitation. Female sex, older age, and non-working status pre-injury were independent predictors of no HS-rehabilitation among patients surviving severe TBI. CONCLUSION: The incidence rate of hospitalized patients surviving severe TBI was stable in Denmark and the...

  13. Toward characterization and definition of fibromyalgia severity

    Yeh Yating

    2010-04-01

    Full Text Available Abstract Background There are no standard criteria for defining or assessing severity of fibromyalgia (FM as a condition as fibromyalgia is associated with multiple symptom domains. The objective of this study was to evaluate whether patient self-reported severity of FM is associated with severity of pain and sleep interference and the presence of core co-morbidities. Methods We recruited individuals ≥ 18 years of age with a clinician-confirmed diagnosis of FM ≥ 3 months and a current pain rating >2 on a 0-10 numeric rating scale (NRS. Patients completed a questionnaire by mail in which they self-rated their FM severity (very mild, mild, moderate, and severe, their current pain severity and extent of sleep interference (NRS; mild, 0-3; moderate, 4-6, severe, 7-10, and provided information (yes/no on the presence of core comorbidities (symptoms of depression, anxiety, sleep problems, back pain, neck pain and medication use for FM. The core symptoms of FM were stratified to assist with patient characterization. Analysis of variance (ANOVA was used to explore the relationship between self-reported FM severity and continuous variables (pain severity and sleep interference, and Mantel-Haenszel chi-square analysis was used to evaluate the trend in the proportions of patients reporting use of medications and core symptoms of FM by severity of FM. To complement patient-reported FM severity and to understand physicians' perspectives, a survey was performed among 28 physician specialists (rheumatology, neurology, anesthesiology/pain management, family practice, internal medicine, and psychiatry to determine what they assessed when evaluating FM severity in clinical practice. Results The population (N = 129 of FM patients was predominantly female (89.1%, with a mean age of 49.4 ± 11.0 years, and 81.4% reported duration ≥ 2 years. Self-reported FM severity was moderate/severe in 86.0% of patients; mean current pain score was 6.40 ± 2.19 (moderate

  14. Severe asthma and the omalizumab option

    Johnston Chambless

    2008-05-01

    Full Text Available Abstract Atopic diseases and asthma are increasing at a remarkable rate on a global scale. It is now well recognized that asthma is a chronic inflammatory disease of the airways. The inflammatory process in many patients is driven by an immunoglobulin E (IgE-dependent process. Mast cell activation and release of mediators, in response to allergen and IgE, results in a cascade response, culminating in B lymphocyte, T lymphocyte, eosinophil, fibroblast, smooth muscle cell and endothelial activation. This complex cellular interaction, release of cytokines, chemokines and growth factors and inflammatory remodeling of the airways leads to chronic asthma. A subset of patients develops severe airway disease which can be extremely morbid and even fatal. While many treatments are available for asthma, it is still a chronic and incurable disease, characterized by exacerbation, hospitalizations and associated adverse effects of medications. Omalizumab is a new option for chronic asthma that acts by binding to and inhibiting the effects of IgE, thereby interfering with one aspect of the asthma cascade reviewed earlier. This is a humanized monoclonal antibody against IgE that has been shown to have many beneficial effects in asthma. Use of omalizumab may be influenced by the cost of the medication and some reported adverse effects including the rare possibility of anaphylaxis. When used in selected cases and carefully, omalizumab provides a very important tool in disease management. It has been shown to have additional effects in urticaria, angioedema, latex allergy and food allergy, but the data is limited and the indications far from clear. In addition to decreasing exacerbations, it has a steroid sparing role and hence may decrease adverse effects in some patients on high-dose glucocorticoids. Studies have shown improvement in quality of life measures in asthma following the administration of omalizumab, but the effects on pulmonary function are

  15. Severe alcoholic hepatitis-current concepts, diagnosis and treatment options

    Won; Kim; Dong; Joon; Kim

    2014-01-01

    Alcoholic hepatitis(AH) is an acute hepatic manifesta-tion occurring from heavy alcohol ingestion. Alcoholic steatohepatitis(ASH) is histologically characterized by steatosis, inflammation, and fibrosis in the liver. Despite the wide range of severity at presentation, those with severe ASH(Maddrey’s discriminant function ≥ 32) typically present with fever, jaundice, and abdominal tenderness. Alcohol abstinence is the cornerstone of therapy for AH and, in the milder forms, is sufficient for clinical recovery. Severe ASH may progress to multi-or-gan failure including acute kidney injury and infection. Thus, infection and renal failure have a major impact on survival and should be closely monitored in patients with severe ASH. Patients with severe ASH have a re-ported short-term mortality of up to 40%-50%. Severe ASH at risk of early death should be identified by one of the available prognostic scoring systems before consid-ering specific therapies. Corticosteroids are the main-stay of treatment for severe ASH. When corticosteroids are contraindicated, pentoxifylline may be alternatively used. Responsiveness to steroids should be assessed at day 7 and stopping rules based on Lille score should come into action. Strategically, future studies for pa-tients with severe ASH should focus on suppressing inflammation based on cytokine profiles, balancing he-patocellular death and regeneration, limiting activation of the innate immune response, and maintaining gut mucosal integrity.

  16. Relationship of Vascular Factors on Electrophysiologic Severity of Diabetic Neuropathy

    Hwang, Jeong-Won; Kwon, Hee Kyu

    2016-01-01

    Objective To investigate the impact of vascular factors on the electrophysiologic severity of diabetic neuropathy (DPN). Methods Total 530 patients with type 2 diabetes were enrolled retrospectively. We rated severity of DPN from 1 (normal) to 4 (severe) based on electrophysiologic findings. We collected the data concerning vascular factors (including brachial-ankle pulse wave velocity [PWV], ankle brachial index, ultrasound of carotid artery, lipid profile from the blood test, and microalbuminuria [MU] within 24 hours urine), and metabolic factors of diabetes (such as glycated hemoglobin [HbA1c]). We analyzed the differences among the four subgroups using χ2 test and ANOVA, and ordinal logistic regression analysis was performed to investigate the relationship between significant variables and severity of DPN. Results The severity of DPN was significantly associated with duration of diabetes, HbA1c, existence of diabetic retinopathy and nephropathy, PWV, presence of plaque, low density lipoprotein-cholesterol and MU (p<0.05). Among these variables, HbA1c and presence of plaque were more significantly related with severity of DPN in logistic regression analysis (p<0.001), and presence of plaque showed the highest odds ratio (OR=2.52). Conclusion Our results suggest that markers for vascular wall properties, such as PWV and presence of plaque, are significantly associated with the severity of DPN. The presence of plaque was more strongly associated with the severity of DPN than other variables. PMID:26949670

  17. Severe ovarian hyperstimulation syndrome coexisting with a bilateral ectopic pregnancy.

    Shiau, Chii-Shinn; Chang, Ming-Yang; Chiang, Chi-Hsin; Hsieh, Ching-Chang; Hsieh, Tsang-Tang

    2004-02-01

    Management of severe ovarian hyperstimulation syndrome (OHSS) includes hospitalization for fluid and electrolyte management. Abdominal paracentesis is also used as minimally invasive form of management in selected cases of severe OHSS following ovulation induction. However, if pregnancy ensues, the syndrome persists for a longer period, and the clinical manifestations of severe OHSS could mask the picture of a bleeding gestational sac. It could be easily overlooked unless the possibility of an ectopic pregnancy is kept in mind in cases of severe OHSS exacerbated by early pregnancy with or without a previous ectopic pregnancy history. We report a case of severe OHSS with simultaneous bilateral tubal pregnancy following intrauterine insemination (IUI). A 31-year-old woman with polycystic ovarian disease developed severe OHSS during the therapeutic course of IUI. An emergent exploratory laparotomy was performed 14 days after admission, and the operative findings showed persistent profuse bleeding from the bilateral fimbrial ends with marked enlargement of the ampullary portions. A linear salpingotomy was performed by a longitudinal incision along the area of maximal distension of the dilated fallopian tubes to preserve her fertility. We recommend that in cases of severe OHSS exacerbated by early pregnancy, serial serum beta-hCG and transvaginal ultrasound follow-up may be necessary due to the potential association of severe OHSS in pregnancy with an ectopic pregnancy. PMID:15095961

  18. Perspective on post-Fukushima severe accident research

    After the Fukushima Daiichi accident in March 2011 several investigation committees issued reports with lessons learned from the accident, in which some recommendations on severe accident research are included. The review of specific severe accident research items had already started before Fukushima accident in working group of Atomic Energy Society of Japan (AESJ) in terms of significance of consequences, uncertainties of phenomena and maturity of assessment methodology. Re-investigation started after the Fukushima accident in this working group to cover additional effects of Fukushima accident, such as core degradation behaviors, sea water injection, containment failure/leakage and re-criticality. The review results are categorized in nine major fields; core degradation behavior, core melt coolability/retention in containment vessel, function of containment vessel, source term, hydrogen behavior, fuel-coolant interaction, molten core concrete interaction, recriticality and instrumentation in severe accident conditions. In January 2012, in collaboration with this working group, Research Expert Committee on Evaluation of Severe Accident was established in AESJ in order to investigate severe accident related issues for future LWR development. Based on these activities and also author's personal view, the present paper describes the seven important severe accident research issues after Fukushima accident. They are (1) investigation of damaged core and components, (2) advanced severe accident analysis capabilities and associated experimental investigations, (3) development of reliable passive cooling system for core/containment, (4) analysis of hydrogen behavior and investigation of hydrogen measures, (5) enhancement of removal function of radioactive materials of containment venting, (6) advanced instrumentation for the diagnosis of severe accident and (7) assessment of advanced containment design which exchides long-term evacuation in any severe accident situations

  19. Severe dementia: diagnosis, patient management, prevention of complications

    A.B. Lokshina

    2014-05-01

    Full Text Available Timely diagnosis and the early start of therapy for cognitive impairments (CI are extremely important. Unfortunately, there is a serious problem of belated CI diagnosis (it is often diagnosed only at the stage of severe dementia. The article discusses the current CI classification by the severity level. Special attention is paid to clinical symptoms, diagnostic criteria, and the basic principles of managing dementia patients. The differences in the severity levels of dementia are discussed in detail; special attention is given to severe dementia. It is noted that the presence of severe dementia in the patient is indicated by permanent dependence on physical assistance. The demand for structuring the clinical assessment of the state of cognitive functions and of the CI influence on daily activity is emphasized. For this purpose, it is recommended that special clinical scales listing cognitive symptoms that are most typical of various stages of cognitive deficit are used. The Clinical Dementia Rating (CDR Scale is one of the well-proved scales. The main approaches for managing patients with severe dementia, including modern drugs for correction of CI and behavioral disorders, are discussed. The possibility and advisability are discussed for treating severe dementia with acetylcholinesterase inhibitors and/or a competitive blocker of the NMDA-receptor, memantine. Special attention is paid to behavioral disorders in patients with severe dementia. These disorders require both the medication correction and psychological support from relatives. The critical significance is emphasized for the proper patient care and for the correction of associated disorders, including pelvic disorders. Neurogenic inappropriate urination often accompanies the manifestations of CI and other neuropsychiatric disorders in patients with severe dementia. The main groups of medications that are used for drug therapy of this condition, as well as possibilities for using modern

  20. Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

    HCTT-CHE

    2011-04-14

    The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster—readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that—help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners' (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. While the purpose of the CAT is to further prepare the community for an influenza pandemic, its framework is an extension of the traditional all-hazards approach to planning and preparedness. As such, the information gathered by the tool is useful in preparation for most widespread public health emergencies. This tool is primarily intended for use by those involved in healthcare emergency preparedness (e.g., community planners, community disaster preparedness coordinators, 9-1-1 directors, hospital emergency preparedness coordinators). It is divided into sections based on the core agency partners, which may be involved in the community's influenza pandemic influenza response.

  1. Caffeinated drinks, alcohol consumption and hangover severity

    Penning, R.; de Haan, L.; Verster, J.C.

    2011-01-01

    This study examined the relationship between consumption of caffeinated beverages and alcohol, and effects on next day hangover severity. In 2010, a survey funded by Utrecht University was conducted among N=549 Dutch students. Beverages consumed on their latest drinking session that produced a hangover were recorded. Hangover severity was scored using the Acute Hangover Scale. No significant correlation between caffeine use and hangover severity was found. Subjects who mixed alcohol with cola...

  2. Severe giardiasis and cryptosporidiosis in Scotland, UK.

    Robertson, L J

    1996-01-01

    Hospital discharge data from 1990-4 for 26 hospitals were used to estimate and compare the cost and describe the epidemiology of severe giardiasis and cryptosporidiosis in Scotland, UK. The incidence of severe cryptosporidiosis was almost double that of severe giardiasis and the median duration of hospitalization was longer for cryptosporidiosis than giardiasis. Impaired immunity was frequently listed as co-diagnosis with cryptosporidiosis and associated with extended hospitalization. Althoug...

  3. Asthma severity and exposure to occupational asthmogens

    Le Moual, Nicole; Siroux, Valérie; Pin, Isabelle; Kauffmann, Francine; Kennedy, Susan,

    2005-01-01

    RATIONALE: Severe asthma is a public health problem with limited information regarding preventable causes. Although occupational exposures have been implicated as important risk factors for asthma and asthma exacerbations, associations between occupational exposures and asthma severity have not been reported. OBJECTIVE: To examine associations between occupational exposures and asthma severity. METHODS: The Epidemiological Study on the Genetics and Environment of Asthma combines a case-contro...

  4. [Current management of imported severe malaria].

    Venanzi, E; López-Vélez, R

    2016-09-01

    Severe malaria is a diagnostic and therapeutic emergency with great impact worldwide for incidence and mortality. The clinical presentation of severe malaria can be very polymorphic and rapidly progressing. Therefore a correct diagnosis and an early and adequate antiparasitic and support therapy are essential. This paper attempts to outline the diagnosis frame and the treatment of severe malaria for adults, paediatric patients and for pregnant. PMID:27608318

  5. Exchange Transfusion in Severe Falciparum Malaria

    Dongare, Harshad Chandrakant; Khatib, Khalid Ismail

    2016-01-01

    Malaria is endemic in India with the incidence of P. falciparum Malaria increasing gradually over the last decade. Severe malaria is an acute disease, caused by P. falciparum, but increasingly also by P. vivax with major signs of organ dysfunction and/or high levels of parasitaemia (>10%) in blood smear. Use of exchange transfusion with antimalarial drug therapy as an additional modality of treatment in severe Falciparum malaria is controversial and is unclear. We report a case of severe mala...

  6. Stimulation of Actin Polymerization by Filament Severing

    Carlsson, A E

    2005-01-01

    The extent and dynamics of actin polymerization in solution are calculated as functions of the filament severing rate, using a simple model of in vitro polymerization. The model is solved by both analytic theory and stochastic-growth simulation. The results show that severing essentially always enhances actin polymerization by freeing up barbed ends, if barbed-end cappers are present. Severing has much weaker effects if only pointed-end cappers are present. In the early stages of polymerizati...

  7. State energy severance taxes, 1985-1993

    This report analyzes changes in aggregate and State-level energy severance taxes for 1985 through 1993. Data are presented for crude oil, natural gas, and coal. The report highlights trends in severance tax receipts relative to energy prices and production, using severance tax data published by the Bureau of the Census of the US Department of Commerce and production data published by the Energy Information Administration

  8. Severe Hypertriglyceridemia Induced Pancreatitis in Pregnancy

    Natasha Gupta; Seema Ahmed; Lemuel Shaffer; Paula Cavens; Josef Blankstein

    2014-01-01

    Acute pancreatitis caused by severe gestational hypertriglyceridemia is a rare complication of pregnancy. Acute pancreatitis has been well associated with gallstone disease, alcoholism, or drug abuse but rarely seen in association with severe hypertriglyceridemia. Hypertriglyceridemia may occur in pregnancy due to normal physiological changes leading to abnormalities in lipid metabolism. We report a case of severe gestational hypertriglyceridemia that caused acute pancreatitis at full term an...

  9. Mobilization in Severe Sepsis: An Integrative Review

    Govindan, Sushant; Iwashyna, Theodore J.; Odden, Andrew; Flanders, Scott A; Chopra, Vineet

    2015-01-01

    Severe sepsis is a leading cause of long-term morbidity in the United States. Up to half of severe sepsis is treated in non-intensive care unit (ICU) settings, making it applicable to hospitalist practice. Evidence has demonstrated benefits from physical therapy (PT) in myriad conditions; whether PT may benefit severe sepsis patients either within or outside the ICU is unknown. Therefore, we conduct a review of the literature to understand whether early mobilization improves outcomes in patie...

  10. Remigration of migrants with severe disease

    Nørredam, Marie Louise; Højbjerg Hansen, Olof; Petersen, Jørgen Holm;

    2015-01-01

    study. Consequently, we studied whether migrants with severe disease were more likely to emigrate compared with migrants without severe disease. METHODS: A historic prospective cohort study was conducted based on all adult refugees and family reunification immigrants (n = 114,331) who obtained residence...... calculated for emigration among migrants with different levels of disease severity, adjusting for sex, age and income. RESULTS: Results showed progressively fewer emigrations with increasing disease severity. Migrants with low (HR = 0.92; 95% CI: 0.80-1.06), moderate (HR = 0.84; 95% CI: 0.67-1.06) and high...

  11. Severe Accident Test Station Design Document

    Snead, Mary A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Yan, Yong [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Howell, Michael [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Keiser, James R. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Terrani, Kurt A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2015-09-01

    The purpose of the ORNL severe accident test station (SATS) is to provide a platform for evaluation of advanced fuels under projected beyond design basis accident (BDBA) conditions. The SATS delivers the capability to map the behavior of advanced fuels concepts under accident scenarios across various temperature and pressure profiles, steam and steam-hydrogen gas mixtures, and thermal shock. The overall facility will include parallel capabilities for examination of fuels and irradiated materials (in-cell) and non-irradiated materials (out-of-cell) at BDBA conditions as well as design basis accident (DBA) or loss of coolant accident (LOCA) conditions. Also, a supporting analytical infrastructure to provide the data-needs for the fuel-modeling components of the Fuel Cycle Research and Development (FCRD) program will be put in place in a parallel manner. This design report contains the information for the first, second and third phases of design and construction of the SATS. The first phase consisted of the design and construction of an out-of-cell BDBA module intended for examination of non-irradiated materials. The second phase of this work was to construct the BDBA in-cell module to test irradiated fuels and materials as well as the module for DBA (i.e. LOCA) testing out-of-cell, The third phase was to build the in-cell DBA module. The details of the design constraints and requirements for the in-cell facility have been closely captured during the deployment of the out-of-cell SATS modules to ensure effective future implementation of the in-cell modules.

  12. Severe accident analysis to verify the effectiveness of severe accident management guidelines for large pressurized heavy water reactor

    Gokhale, O.S., E-mail: onkarsg@barc.gov.in; Mukhopadhyay, D., E-mail: dmukho@barc.gov.in; Lele, H.G., E-mail: hglele@barc.gov.in; Singh, R.K., E-mail: rksingh@barc.gov.in

    2014-10-15

    Highlights: • The progression of severe accident initiated from high pressure scenario of station black out has been analyzed using RELAP5/SCDAP. • The effectiveness of SAMG actions prescribed has been established through analysis. • The time margin available to invoke the SAMG action has been specified. - Abstract: The pressurized heavy water reactor (PHWR) contains both inherent and engineered safety features that help the reactor become resistant to severe accident and its consequences. However in case of a low frequency severe accident, despite the safety features, procedural action should be in place to mitigate the accident progression. Severe accident analysis of such low frequency event provides insight into the accident progression and basis to develop the severe accident management guidelines (SAMG). Since the order of uncertainty in the progression path of severe accident is very high, it is necessary to study the consequences of the SAMG actions prescribed. The paper discusses severe accident analysis for large PHWRs for multiple failure transients involving a high pressure scenario (initiation event like SBO with loss of emergency core cooling system and loss of moderator cooling). SAMG actions prescribed for such a scenario include water injection into steam generator, calandria vessel or calandria vault at different stages of accident. The effectiveness of SAMG actions prescribed has been investigated. It is found that there is sufficient time margin available to the operator to execute these SAMG actions and the progression of severe accident is arrested in all the three cases.

  13. Severe accident analysis to verify the effectiveness of severe accident management guidelines for large pressurized heavy water reactor

    Highlights: • The progression of severe accident initiated from high pressure scenario of station black out has been analyzed using RELAP5/SCDAP. • The effectiveness of SAMG actions prescribed has been established through analysis. • The time margin available to invoke the SAMG action has been specified. - Abstract: The pressurized heavy water reactor (PHWR) contains both inherent and engineered safety features that help the reactor become resistant to severe accident and its consequences. However in case of a low frequency severe accident, despite the safety features, procedural action should be in place to mitigate the accident progression. Severe accident analysis of such low frequency event provides insight into the accident progression and basis to develop the severe accident management guidelines (SAMG). Since the order of uncertainty in the progression path of severe accident is very high, it is necessary to study the consequences of the SAMG actions prescribed. The paper discusses severe accident analysis for large PHWRs for multiple failure transients involving a high pressure scenario (initiation event like SBO with loss of emergency core cooling system and loss of moderator cooling). SAMG actions prescribed for such a scenario include water injection into steam generator, calandria vessel or calandria vault at different stages of accident. The effectiveness of SAMG actions prescribed has been investigated. It is found that there is sufficient time margin available to the operator to execute these SAMG actions and the progression of severe accident is arrested in all the three cases

  14. Problematic severe asthma: a proposed approach to identifying children who are severely resistant to therapy.

    Konradsen, Jon R; Nordlund, Björn; Lidegran, Marika; Pedroletti, Christophe; Grönlund, Hans; van Hage, Marianne; Dahlen, Barbro; Hedlin, Gunilla

    2011-02-01

    Children with problematic severe asthma (PA) are either difficult to treat because of the presence of aggravating factors or else severely resistant to therapy. We investigated a cohort of school-aged children with PA and compared these children to age-matched peers with controlled persistent asthma (CA). The aims were to characterize features of children suffering from PA and identify children who were severely resistant to therapy. In this cross-sectional, multicenter comparison of children with different manifestations of persistent asthma, PA was defined as insufficient asthma control despite level 4 treatment, according to GINA. The protocol included questionnaires, spirometry, methacholine provocation, measurement of fraction of nitric oxide in exhaled (FE(NO) ) and nasal air, blood sampling for inflammatory biomarkers and atopy, and computerized tomography of sinuses and lungs (in the PA group only). Of the 54 children with PA, 61% had therapy-resistant asthma, with the remaining being difficult to treat because of identified aggravating factors. Children with PA more often had parents with asthma (p=0.003), came from families with a lower socioeconomic status (p=0.01), were less physically active (p=0.04), and had more comorbidity with rhinoconjunctivitis (p=0.01) than did the 39 children with CA. The former also exhibited lower FEV(1) values (p=0.02) and increased bronchial hyper-responsiveness (p=0.01), but there were no differences in atopy (p=0.81) or FE(NO) (p=0.16). A non-invasive protocol, involving a standardized and detailed clinical characterization, revealed distinguishing features of children with PA and enabled the identification of children with therapy-resistant asthma. PMID:20880352

  15. Changes in Fat Distribution in Children Following Severe Burn Injury

    Patel, Pavankumar; Hanaa S. Sallam; Ali, Arham; Chandalia, Manisha; Suman, Oscar; Finnerty, Celeste C.; Herndon, David N; Abate, Nicola

    2014-01-01

    Background: Children with severe cutaneous burn injury show persistent metabolic abnormalities, including inflammation and insulin resistance. Such abnormalities could potentially increase their future risk for developing type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). This could be related to changes in body composition and fat distribution.

  16. Severely Handicapped Language Proficiency Instrument (SH-LPI). Manual.

    Valdez, Cheryl; Schnell-Torosian, Roxanne

    A test of English language proficiency designed for administration to school children with severe disabilities is presented. The test packet contains a manual for test administrators, a five-page form for recording student testing data, and a score sheet. The manual offers an introduction to the instrument, including its rationale, definitions of…

  17. Strategic Planning under Severe Constraints in a State College

    Geisler, Jerry L.; Gilliard, Debbie J.

    2007-01-01

    This paper examines the difficulties of strategic planning under severe constraints in a state college. Constraints include the planning models available, the governance structure of the college and other externalities, and a not-for-profit model of constraints by Newman and Wallender. After presenting the planning challenges, we discuss…

  18. Effective Communication Programming for Language Minority Students with Severe Disabilities.

    Duran, Elva

    This paper discusses how the classroom participation and communication of language minority students with severe disabilities can be facilitated through the use of many methods based on principles of English-as-a-Second-Language (ESL) instruction. The specific method described include: (1) total physical response, (2) the natural approach, (3)…

  19. Ludwig's angina after severe thrombocytopenic purpura associated with dengue fever

    Maria Antonia Campos

    2014-01-01

    Full Text Available Here, we report a case of Ludwig's angina, which required surgery because of toothache. The patient had dengue and severe thrombocytopenia as confirmed by clinical and laboratory diagnoses. However, dengue is not included among the predisposing factors for Ludwig's angina.

  20. 26 CFR 26.2642-6 - Qualified severance.

    2010-04-01

    ...-6 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) ESTATE AND GIFT...-skipping transfer (GST) tax purposes and the inclusion ratio of each new resulting trust may differ from... severance may result in a gift subject to gift tax, may cause any trust to be included in the gross...

  1. The Detection Techniques for Several Different Types of Fiducial Markers

    Chuen-Horng Lin; Yu-Ching Lin; Hau-Wei Lee

    2013-01-01

    The detection techniques are proposed for several different types of fiducial mark (FM) in this paper. This study proposes "traditional fiducial mark positioning", "concentric circles fiducial mark detection" and "straight lines intersection mark positioning" methods according to different mark patterns. For traditional fiducial mark positioning method, two processing methods are proposed, including automatic detection of "reference fiducial mark" and fiducial mark positioning. The concentric...

  2. Adalimumab in Recalcitrant Severe Psoriasis Associated with Atopic Dermatitis

    Savas Yayli

    2013-11-01

    Full Text Available Tumor necrosis factor-α inhibitors may induce various cutaneous side effects including eczematous-like lesions. The management of such side effects can be challenging. Herein, we report a case of a 55-year-old man who had a flare-up and subsequent improvement of atopic dermatitis during treatment of severe psoriasis with adalimumab.

  3. Severe hypothyroidism masquerading as renal impairment

    Bistrup, C; Jensen, Dorte Møller; Kvetny, J;

    1996-01-01

    A case of severe hypothyroidism in a 51-year old male is presented. The patient was especially complaining of weakness, stiffness and moderate pain in the proximal muscle groups together with rhinorrhea and nasal stenosis. Because of severely elevated S-creatine-kinase combined with reduced...

  4. Creative Arts for the Severely Handicapped.

    Sherrill, Claudine, Ed.

    The monograph on creative arts for severely handicapped persons presents 18 papers on program development and implementation. Among topics addressed are personnel preparation, self expression as a human right, mainstreaming severely and profoundly handicapped children in creative arts, square dancing, adapting wheelchair dance, arts for the…

  5. Unassisted Assessment of Stroke Severity Using Telemedicine

    Van Hooff, Robbert-Jan; De Smedt, Ann; De Raedt, Sylvie; Moens, Maarten; Marien, Peter; Paquier, Philippe; De Keyser, Jacques; Brouns, Raf

    2013-01-01

    Background and Purpose-Quantification of stroke severity through telemedicine consultation is challenging and relies on professional support at the patient's bedside. We aimed to develop a novel scale for assessing stroke severity through telemedicine without assistance from a third party (Unassiste

  6. SEVERE PANCREATITIS AFTER ENDOSCOPIC SPHYNCTEROTOMY - CLINICAL REPORT

    R. Neagoe

    2010-02-01

    Full Text Available Pancreatitis remains the major complication of endoscopic retrograde cholangiopancreatography (ERCP, and hyperenzynemia after ERCP is common. Severe post-ERCP pancreatitis is rare but it demands hospitalization and sometimes interventions (percutaneous drainage or surgery due to complications. We present a case of severe post-ERCP pancreatitis wich required surgical approach, with good postoperative outcome.

  7. Euthanasia of Severely Handicapped Infants: Ethical Issues.

    Cohen, Libby

    Ethical decisions are involved in life and death decisions for severely handicapped infants. Although it has become common practice for physicians not to treat severely handicapped infants, the ethical considerations involved in euthanasia are complex. A review of the literature reveals that concerns center around the quality of life of the…

  8. Trajectories of Autism Severity in Early Childhood

    Venker, Courtney E.; Ray-Subramanian, Corey E.; Bolt, Daniel M.; Weismer, Susan Ellis

    2014-01-01

    Relatively little is known about trajectories of autism severity using calibrated severity scores (CSS) from the Autism Diagnostic Observation Schedule, but characterizing these trajectories has important theoretical and clinical implications. This study examined CSS trajectories during early childhood. Participants were 129 children with autism…

  9. Epidemiology and Pulmonary Physiology of Severe Asthma.

    O'Toole, Jacqueline; Mikulic, Lucas; Kaminsky, David A

    2016-08-01

    The epidemiology and physiology of severe asthma are inherently linked because of varying phenotypes and expressions of asthma throughout the population. To understand how to better treat severe asthma, we must use both population data and physiologic principles to individualize therapies among groups with similar expressions of this disease. PMID:27401616

  10. Severe Eosinophilic Endometritis Following Diagnostic Curettage

    Desai SR

    2010-07-01

    Full Text Available Severe Eosinophilic Endometritis appears after injury from a preoperative diagnostic procedure. It is an unusual and distinctive inflammatory uterine disease process, in response to eosinophil chemotactic substances. We report this case of a 55-year-old lady who developed severe eosinophilic endometritis following a diagnostic curettage

  11. Severe Eosinophilic Endometritis Following Diagnostic Curettage

    Desai SR; Shweta A. Shinagare

    2010-01-01

    Severe Eosinophilic Endometritis appears after injury from a preoperative diagnostic procedure. It is an unusual and distinctive inflammatory uterine disease process, in response to eosinophil chemotactic substances. We report this case of a 55-year-old lady who developed severe eosinophilic endometritis following a diagnostic curettage.

  12. Treatment of very severe brain injuries

    杨振九; 杨佳勇; 冯承宣; 宋伟健; 孙强

    2004-01-01

    Objective: To sum up the experience in treating very severe traumatic brain injuries.Methods: Retrospective analysis of 68 patients with very severe traumatic brain injuries treated in our hospital from 1997 to 2002 was done.Results: Forty-one (60%) patients died. In the 50 patients treated surgically 27 (40%) survived, 8 recovered well, 9 had moderate disability and 10 had sever deficits. The 18 patients treated non-operatively all died.Conclusions: Much attention should be given to the observation of the changes of severe brain injuries with cranial base injury. Timely operative decompression, basic life support, keeping effective brain blood perfusion and effective oxygen supply, improving cerebral microcirculation and preventing or controlling complications are the main methods to raise the successful rate of treating very severe brain injuries and the life quality of the patients.

  13. Benchmarking Severe Accident Computer Codes for Heavy Water Reactor Applications

    Requests for severe accident investigations and assurance of mitigation measures have increased for operating nuclear power plants and the design of advanced nuclear power plants. Severe accident analysis investigations necessitate the analysis of the very complex physical phenomena that occur sequentially during various stages of accident progression. Computer codes are essential tools for understanding how the reactor and its containment might respond under severe accident conditions. The IAEA organizes coordinated research projects (CRPs) to facilitate technology development through international collaboration among Member States. The CRP on Benchmarking Severe Accident Computer Codes for HWR Applications was planned on the advice and with the support of the IAEA Nuclear Energy Department's Technical Working Group on Advanced Technologies for HWRs (the TWG-HWR). This publication summarizes the results from the CRP participants. The CRP promoted international collaboration among Member States to improve the phenomenological understanding of severe core damage accidents and the capability to analyse them. The CRP scope included the identification and selection of a severe accident sequence, selection of appropriate geometrical and boundary conditions, conduct of benchmark analyses, comparison of the results of all code outputs, evaluation of the capabilities of computer codes to predict important severe accident phenomena, and the proposal of necessary code improvements and/or new experiments to reduce uncertainties. Seven institutes from five countries with HWRs participated in this CRP

  14. Premature menopause and severity of coronary artery disease

    Hamidreza Nasri

    2011-01-01

    Full Text Available Background: Relationship between premature menopause and presence, severity and life-threatening events of coro-nary artery disease (CAD has been suggested in recent observations. The present study tried to assess relationship be-tween age of menopause and severity of CAD in a sample of women with suspected CAD. Methods: In a cross-sectional study, we included 189 consecutive women with suspected CAD that were candidate for coronary angiography and admitted to the Shafa hospital in Kerman city. Our final population for analysis included women who underwent natural menopause (n = 148 or premature menopause (n = 41. CAD severity was classified according to the number of coronary artery stenosis ≥ 50% in coronary angiography. Results: Among 189 study patients with suspected CAD, 22.0% of those with early menopause and 23.6% of those with normal menopause suffered three coronary vessels involvement, while normal angiography features was shown in 39.0%o and 40.5%>, respectively. Regarding severity of CAD and left main lesions, no significant differences were found between the patients with and without premature menopause. According to the multivariable logistic regression model and with the presence of other patients′ variables as cofounders, age of menopause could not predict the presence and severity of CAD in patients with suspected CAD. However, patients′ age (OR: 1.11, p < 0.001 and family history of CAD (OR: 2.05, p = 0.04 were main predictors of the severity of CAD in these patients. Conclusions: Premature menopause does not predict occurrence or severity of CAD in women with suspected CAD, but women age and their family history of CAD are main predictors of the severity of CAD.

  15. Protecting against natural hazards - Information seeking behaviour in anticipation of severe weather events

    Jeuring, Jelmer

    2011-01-01

    Protection against natural hazards - Information seeking behaviour in anticipation of severe weather events Severe weather events can have considerable impact on society, including tourism organisations and tourists. Providing accurate and timely information about possible risks due to environmental

  16. OSSA - An optimized approach to severe accident management: EPR application

    There is a recognized need to provide nuclear power plant technical staff with structured guidance for response to a potential severe accident condition involving core damage and potential release of fission products to the environment. Over the past ten years, many plants worldwide have implemented such guidance for their emergency technical support center teams either by following one of the generic approaches, or by developing fully independent approaches. There are many lessons to be learned from the experience of the past decade, in developing, implementing, and validating severe accident management guidance. Also, though numerous basic approaches exist which share common principles, there are differences in the methodology and application of the guidelines. AREVA/Framatome-ANP is developing an optimized approach to severe accident management guidance in a project called OSSA ('Operating Strategies for Severe Accidents'). There are still numerous operating power plants which have yet to implement severe accident management programs. For these, the option to use an updated approach which makes full use of lessons learned and experience, is seen as a major advantage. Very few of the current approaches covers all operating plant states, including shutdown states with the primary system closed and open. Although it is not necessary to develop an entirely new approach in order to add this capability, the opportunity has been taken to develop revised full scope guidance covering all plant states in addition to the fuel in the fuel building. The EPR includes at the design phase systems and measures to minimize the risk of severe accident and to mitigate such potential scenarios. This presents a difference in comparison with existing plant, for which severe accidents where not considered in the design. Thought developed for all type of plants, OSSA will also be applied on the EPR, with adaptations designed to take into account its favourable situation in that field

  17. Monitoring severe accidents using AI techniques

    After the Fukushima nuclear accident in 2011, there has been increasing concern regarding severe accidents in nuclear facilities. Severe accident scenarios are difficult for operators to monitor and identify. Therefore, accurate prediction of a severe accident is important in order to manage it appropriately in the unfavorable conditions. In this study, artificial intelligence (AI) techniques, such as support vector classification (SVC), probabilistic neural network (PNN), group method of data handling (GMDH), and fuzzy neural network (FNN), were used to monitor the major transient scenarios of a severe accident caused by three different initiating events, the hot-leg loss of coolant accident (LOCA), the cold-leg LOCA, and the steam generator tube rupture in pressurized water reactors (PWRs). The SVC and PNN models were used for the event classification. The GMDH and FNN models were employed to accurately predict the important timing representing severe accident scenarios. In addition, in order to verify the proposed algorithm, data from a number of numerical simulations were required in order to train the AI techniques due to the shortage of real LOCA data. The data was acquired by performing simulations using the MAAP4 code. The prediction accuracy of the three types of initiating events was sufficiently high to predict severe accident scenarios. Therefore, the AI techniques can be applied successfully in the identification and monitoring of severe accident scenarios in real PWRs.

  18. Monitoring Severe Accidents Using AI Techniques

    It is very difficult for nuclear power plant operators to monitor and identify the major severe accident scenarios following an initiating event by staring at temporal trends of important parameters. The objective of this study is to develop and verify the monitoring for severe accidents using artificial intelligence (AI) techniques such as support vector classification (SVC), probabilistic neural network (PNN), group method of data handling (GMDH) and fuzzy neural network (FNN). The SVC and PNN are used for event classification among the severe accidents. Also, GMDH and FNN are used to monitor for severe accidents. The inputs to AI techniques are initial time-integrated values obtained by integrating measurement signals during a short time interval after reactor scram. In this study, 3 types of initiating events such as the hot-leg LOCA, the cold-leg LOCA and SGTR are considered and it is verified how well the proposed scenario identification algorithm using the GMDH and FNN models identifies the timings when the reactor core will be uncovered, when CET will exceed 1200 .deg. F and when the reactor vessel will fail. In cases that an initiating event develops into a severe accident, the proposed algorithm showed accurate classification of initiating events. Also, it well predicted timings for important occurrences during severe accident progression scenarios, which is very helpful for operators to perform severe accident management

  19. The American 'severe fuel damage program'

    The TMI-2 accident has initiated a new phase of safety research. It is necessary to consider severe accidents with degraded or molten core. For NRC there was a need for an improved understanding of this reactor behaviour and the 'Severe Fuel Dage Program' was initiated. Planned are in-pile experiments in PBF, NRU and ESSOR and in addition separate effects tests and results from TMI-2. The analytical component of the program is the development of different versions of the code SCDAP for the detailed analysis during severe accident transients. (Author)

  20. Understanding, Avoiding, and Managing Severe Filler Complications.

    Rzany, Berthold; DeLorenzi, Claudio

    2015-11-01

    Any injectable filler may elicit moderate-to-severe adverse events, ranging from nodules to abscesses to vascular occlusion. Fortunately, severe adverse events are uncommon for the majority of fillers currently on the market. Because these are rare events, it is difficult to identify the relevant risk factors and to design the most efficacious treatment strategies. Poor aesthetic outcomes are far more common than severe adverse events. These in contrast should be easily avoidable by ensuring that colleagues receive proper training and follow best practices. PMID:26441099

  1. Hand eczema severity and quality of life

    Agner, Tove; Andersen, Klaus E; Brandao, Francisco M;

    2008-01-01

    Background and Objectives: Hand eczema is a chronic disease with negative impact on quality of life (QoL). In this study, QoL in hand eczema patients is assessed and related to age, sex, severity, and diagnostic subgroups. Methods: A total of 416 patients with hand eczema from 10 European patch...... test clinics participated in the study. Data on QoL were obtained from a self-administered questionnaire using the Dermatology Life Quality Index (DLQI). Severity was assessed by a scoring system (Hand Eczema Severity Index, HECSI) as well as frequency of eruptions and sick leave due to hand eczema...

  2. Management of severe and rigid idiopathic scoliosis.

    Teixeira da Silva, Luis Eduardo Carelli; de Barros, Alderico Girão Campos; de Azevedo, Gustavo Borges Laurindo

    2015-07-01

    Frequently, severe idiopathic scoliosis patients are first seen in a spine centre after years of deformity evolution, presenting with large curves, severe rib hump, shoulder and trunk imbalance and cardiorespiratory complications related to neglected scoliosis. Severe rigid idiopathic scoliosis has traction, internal temporary distraction, releases, osteotomies and apical vertebral resection are often used in combination to achieve optimal results. Indications must be tailored by surgeons considering resources, deformity characteristics and patient's profile. Vertebral resection procedures may have potential neurological and clinical risks and should be one of the last treatment options performed by experienced surgical team. Neuromonitoring is essential during these procedures. PMID:26033753

  3. Severity rating scales for ciguatera fish poisoning.

    Lange, W R

    1993-06-01

    Severity of ciguatera fish poisoning is often quite variable. Two symptom check list rating scales were developed for quantifying illness severity and for selectively monitoring response to therapy in patients with chronic toxicity. Content validity was ascertained, and internal consistency reliability was demonstrated by means of the Cronbach alpha correlation coefficient (alpha = 0.9475). It was concluded that these instruments were valid and reliable, and that they conveniently and accurately recorded illness severity and treatment efficacy. They should prove useful in clinical settings and epidemiologic investigations. PMID:8342175

  4. Anthropogenic activities including pollution and contamination of coastal marine environment.

    Ansari, Z.A.; Matondkar, S.G.P.

    background, discahrges of toxic effluents and inflow of nutrients, irretrievable water consumption and damage of aquatic organisms, landing of commercial species, destruction of shorewline and construction of drilling rig. Simultaneous impact of several...

  5. Defining childhood severe falciparum malaria for intervention studies.

    Philip Bejon

    2007-08-01

    Full Text Available BACKGROUND: Clinical trials of interventions designed to prevent severe falciparum malaria in children require a clear endpoint. The internationally accepted definition of severe malaria is sensitive, and appropriate for clinical purposes. However, this definition includes individuals with severe nonmalarial disease and coincident parasitaemia, so may lack specificity in vaccine trials. Although there is no "gold standard" individual test for severe malaria, malaria-attributable fractions (MAFs can be estimated among groups of children using a logistic model, which we use to test the suitability of various case definitions as trial endpoints. METHODS AND FINDINGS: A total of 4,583 blood samples were taken from well children in cross-sectional surveys and from 1,361 children admitted to a Kenyan District hospital with severe disease. Among children under 2 y old with severe disease and over 2,500 parasites per microliter of blood, the MAFs were above 85% in moderate- and low-transmission areas, but only 61% in a high-transmission area. HIV and malnutrition were not associated with reduced MAFs, but gastroenteritis with severe dehydration (defined by reduced skin turgor, lower respiratory tract infection (clinician's final diagnosis, meningitis (on cerebrospinal fluid [CSF] examination, and bacteraemia were associated with reduced MAFs. The overall MAF was 85% (95% confidence interval [CI] 83.8%-86.1% without excluding these conditions, 89% (95% CI 88.4%-90.2% after exclusions, and 95% (95% CI 94.0%-95.5% when a threshold of 2,500 parasites/mul was also applied. Applying a threshold and exclusion criteria reduced sensitivity to 80% (95% CI 77%-83%. CONCLUSIONS: The specificity of a case definition for severe malaria is improved by applying a parasite density threshold and by excluding children with meningitis, lower respiratory tract infection (clinician's diagnosis, bacteraemia, and gastroenteritis with severe dehydration, but not by excluding

  6. Analysis of severe accidents in pressurized heavy water reactors

    such as PHWRs and RBMKs with the most important potential differences in severe accident behaviour of other reactor types. This publication provides a set of suggestions, on the basis of current international practices on how to perform deterministic analysis of severe accidents in PHWRs by means of the available computer codes. A more general framework for these suggestions is also provided, including a description of factors important to the analysis, an overview of severe accident phenomena and status in their modelling, categorization of available computer codes, and practical examples of various applications of analysis. This publication also provides information on severe accident management for PHWRs. An overview of the main procedural elements of accident management, i.e. emergency operating procedures and severe accident management guidelines is also introduced

  7. Severe accident countermeasure plan (draft) for nuclear power plants

    Nuclear power plants should be designed, constructed, and operated properly so that the likelihood of occurrence of a severe accident and its consequence may be minimized. The Korea Institute of Nuclear Safety has been reviewing the Nuclear Safety Policy Statement and the preceding severe accident countermeasure plan and prepared a new draft plan in order to provide a reasonable regulatory position for severe accidents. This plan has been prepared by taking into account the different reactor types and the characteristics of operating plants, new plants using the existing design, and new ones including the next generation plants. The major elements included in the plan are: establishment and application of the safety goal, performance of the probabilistic safety assessment and establishment of countermeasure plans for the vulnerabilities, provisions for severe accidents prevention and mitigation capability, set-up of a severe accident management program implementation system. Each element has been set up to move progressively toward an upgrading in safety of currently operating plants and future ones

  8. Validation of severe accident management guidance for the wolsong plants

    Full text: Full text: The severe accident management(SAM) guidance has been developed for the Wolsong nuclear power plants in Korea. The Wolsong plants are 700MWe CANDU-type reactors with heavy water as the primary coolant, natural uranium-fueled pressurized, horizontal tubes, surrounded by heavy water moderator inside a horizontal calandria vessel. The guidance includes six individual accident management strategies: (1) injection into primary heat transport system (2) injection into calandria vessel (3) injection into calandria vault (4) reduction of fission product release (5) control of reactor building condition (6) reduction of reactor building hydrogen. The paper provides the approaches to validate the SAM guidance. The validation includes the evaluation of:(l) effectiveness of accident management strategies, (2) performance of mitigation systems or components, (3) calculation aids, (4) strategy control diagram, and (5) interface with emergency operation procedure and with radiation emergency plan. Several severe accident sequences with high probability is selected from the plant specific level 2 probabilistic safety analysis results for the validation of SAM guidance. Afterward, thermal hydraulic and severe accident phenomenological analyses is performed using ISAAC(Integrated Severe Accident Analysis Code for CANDU Plant) computer program. Furthermore, the experiences obtained from a table-top-drill is also discussed

  9. Risk factors related to the severity of diabetic retinopathy

    Corrêa Zélia Maria da Silva

    2003-01-01

    Full Text Available PURPOSE: To determine the relationship between the severity or stage of diabetic retinopathy and associated risk factors in a southern Brazilian population. METHODS: Transversal study of diabetic patients without previous ophthalmologic treatment, seen at a University eye clinic. These patients underwent fundus photography, complete blood work-up, systemic blood pressure measurement, urine analysis, and were questioned about risk factors previously determined by the authors. The presence or absence of risk factors was compared to the severity of diabetic retinopathy. RESULTS: Eighty-one patients were selected, 28 male, 53 female, 55 Caucasians, 26 African descendants, 28 had insulin-dependent diabetes mellitus, 53 had non-insulin-dependent diabetes mellitus. Factors related to more severe diabetic retinopathy include: insulin-dependent diabetes mellitus (a<0.01, nephropathy (a<0.05, proteinuria (a<0.05, duration of the disease (p<0.001, elevated fasting plasma glucose (p=0.11, glycosylated hemoglobin (HbA (1c (p=0.001, total serum cholesterol (p=0.019, lower hematocrit (p=0.004 and hemoglobin (p=0.001. CONCLUSIONS: The severity of diabetic retinopathy appears to be associated with risk factors such as duration of disease, type of diabetes, poor metabolic control, hemoglobin levels, total cholesterol and proteinuria. Factors apparently not related to severity of diabetic retinopathy include gender, age, systemic hypertension and hypomagnesemia.

  10. Faults of Europe including Turkey (flt4_2l)

    U.S. Geological Survey, Department of the Interior — This coverage includes arcs that describe faults found in the surface outcrops of bedrock of Europe including Turkey (Albania, Andorra, Austria, Belgium, Bosnia and...

  11. Should Relational Aggression Be Included in DSM-V?

    Keenan, Kate; Coyne, Claire; Lahey, Benjamin B.

    2008-01-01

    The study examines whether relational aggression should be included in DSM-V disruptive behavior disorders. The results conclude that some additional information is gathered from assessing relational aggression but not enough to be included in DSM-V.

  12. Partially ionized plasmas including the third symposium on uranium plasmas

    Krishnan, M. [ed.

    1976-09-01

    Separate abstracts are included for 28 papers on electrically generated plasmas, fission generated plasmas, nuclear pumped lasers, gaseous fuel reactor research, and applications. Five papers have been previously abstracted and included in ERA.

  13. Outcome of Severe Receptive Language Disorder

    J Gordon Millichap

    2007-01-01

    The clinical and familial characteristics of severe receptive specific language impairment (SLI) were studied in 58 affected children (ratio of boys to girls 2:1) at the Department of Child Life and Health, University of Edinburgh, Scotland.

  14. Deterministic analyses of severe accident issues

    Severe accidents in light water reactors involve complex physical phenomena. In the past there has been a heavy reliance on simple assumptions regarding physical phenomena alongside of probability methods to evaluate risks associated with severe accidents. Recently GE has developed realistic methodologies that permit deterministic evaluations of severe accident progression and of some of the associated phenomena in the case of Boiling Water Reactors (BWRs). These deterministic analyses indicate that with appropriate system modifications, and operator actions, core damage can be prevented in most cases. Furthermore, in cases where core-melt is postulated, containment failure can either be prevented or significantly delayed to allow sufficient time for recovery actions to mitigate severe accidents

  15. Staphylococcus aureus and hand eczema severity

    Haslund, P; Bangsgaard, N; Jarløv, J O;

    2009-01-01

    BACKGROUND: The role of bacterial infections in hand eczema (HE) remains to be assessed. OBJECTIVES: To determine the prevalence of Staphylococcus aureus in patients with HE compared with controls, and to relate presence of S. aureus, subtypes and toxin production to severity of HE. METHODS......: Bacterial swabs were taken at three different visits from the hand and nose in 50 patients with HE and 50 controls. Staphylococcus aureus was subtyped by spa typing and assigned to clonal complexes (CCs), and isolates were tested for exotoxin-producing S. aureus strains. The Hand Eczema Severity Index...... was used for severity assessment. RESULTS: Staphylococcus aureus was found on the hands in 24 patients with HE and four controls (P aureus was found to be related to increased severity of the eczema (P aureus types on the hands...

  16. Selected Geomagnetic Measurements From Several Satellites

    National Oceanic and Atmospheric Administration, Department of Commerce — More than 17 million selected magnetic observations from several orbiting low-altitude satellites are contained in this digital collection. Except for MAGSAT, all...

  17. Containment leakage during severe accident conditions

    An alternate to the THRESHOLD model used in most severe accident risk assessments has been investigated. One reference plant for each of six containment types has been studied to determine the magnitude of containment leakage that would result from the pressures and temperatures associated with severe accident conditions. Containment penetrations having the greatest potential for early containment leakage are identified. The studies indicate that containment leakage through penetrations prior to reaching containment threshold pressures (currently reported containment shell failure pressures) should be considered in severe accident risk assessments. Failure of non-metallic seals for containment penetrations can be a significant source of containment leakage under severe accident pressure and temperature conditions. Although studies of containment types are useful in identifying sources of containment leakage, final conclusions may need to be plant specific. Recommendations concerning future studies to better develop the use of continuous leakage models are provided. 9 references, 4 figures, 2 tables

  18. Clinical severity and prognosis of hand eczema

    Hald, M; Agner, T; Blands, J;

    2009-01-01

    to identify factors associated with severe disease and a poor prognosis. METHODS: Study participants were 799 patients with HE from nine dermatological clinics in Denmark. Severity assessment of the HE was done at baseline and at the 6-month follow-up using the Hand Eczema Severity Index (HECSI) and......BACKGROUND: Hand eczema (HE) is a frequent, long-lasting disease with both personal and societal repercussions. Consequently, more information is needed on factors that maintain symptoms. OBJECTIVES: In this study, patients with HE were followed for 6 months from the first visit to a dermatologist...... unskilled worker was a predictor for a poor prognosis at follow-up (P = 0.04), and the presence of frequent symptoms during the previous 12 months was associated with severe initial disease (P = 0.02) and a poor prognosis (P = 0.04). CONCLUSIONS: Overall, the disease had improved 6 months after the...

  19. Severe accidents in Nuclear Power Plants

    For the assessment of the safety of nuclear power plants it is of great importance the analyses of severe accidents since they allow to estimate the possible failure models of the containment, and also permit knowing the magnitude and composition of the radioactive material that would be released to the environment in case of an accident upon population and the environment. This paper presents in general terms the basic principles for conducting the analysis of severe accidents, the fundamental sources in the generation of radionuclides and aerosols, the transportation and deposition processes, and also makes reference to de main codes used in the modulation of severe accidents. The final part of the paper contents information on how severe accidents are dialed with the regulatory point view in different countries

  20. Numerical module for debris behavior under severe accident conditions

    The late phase of a hypothetical severe accident in a nuclear reactor is characterized by the appearance of porous debris and liquid pools in core region and lower head of the reactor vessel. Thermal hydraulics and heat transfer in these regions are very important for adequate analysis of severe accident dynamics. The purpose of this work is to develop a universal module which is able to model above-mentioned phenomena on the basis of modern physical concepts. The original approach for debris evolution is developed from classical principles using a set of parameters including debris porosity; average particle diameter; temperatures and mass fractions of solid, liquid and gas phases; specific interface areas between different phases; effective thermal conductivity of each phase, including radiative heat conductivity; mass and energy fluxes through the interfaces. The calculation results of several tests on modeling of porous debris behavior, including the MP-1 experiment, are presented in comparison with experimental data. The results are obtained using this module implemented into the Russian best estimate code, RATEG/SVECHA/HEFEST, which was developed for modeling severe accident thermal hydraulics and late phase phenomena in VVER nuclear power plants. (author)

  1. Severity assessment of acute pulmonary embolism: evaluation using helical CT

    The objective was to evaluate the helical CT (HCT) criteria that could indicate severe pulmonary embolism (PE). In a retrospective study, 81 patients (mean age 62 years) with clinical suspicion of PE explored by HCT were studied. The patients were separated into three different groups according to clinical severity and treatment decisions: group SPE included patients with severe PE based on clinical data who were treated by fibrinolysis or embolectomy (n=20); group NSPE included patients with non-severe PE who received heparin (n=30); and group WPE included patients without PE (n=31). For each patient we calculated a vascular obstruction index based on the site of obstruction and the degree of occlusion in the pulmonary artery. We noted the HCT signs, i.e., cardiac and pulmonary artery dimensions, that could indicate acute cor pulmonale. According to multivariate analysis, factors significantly correlated with the severity of PE were: the vascular obstruction index (group SPE: 54%; group NSPE: 24%; p<0.001); the maximum minor axis of the left ventricle (group SPE: 30.2 mm; group NSPE: 40.4 mm; p<0.001); the diameter of the central pulmonary artery (group SPE: 32.4 mm; group NSPE: 28.3 mm; p<0.001); the maximum minor axis of the right ventricle (group SPE: 47.5 mm; group NSPE: 42.7 mm; p=0.029); the right ventricle/left ventricle minor axis ratio (group SPE: 1.63; group NSPE: 1.09; p<0.0001). Our data suggest that hemodynamic severity of PE can be assessed on HCT scans by measuring four main criteria: the vascular obstruction index; the minimum diameter of the left ventricle; the RV:LV ratio; and the diameter of the central pulmonary artery. (orig.)

  2. Current management of severe acquired aplastic anemia

    Phillip Scheinberg

    2011-01-01

    Overall survival in severe aplastic anemia has markedlyimproved in the past four decades due to advances in stem celltransplantation, immunosuppressive therapies and supportive care.Horse anti-thymocyte globulin plus cyclosporine is the standardimmunosuppressive regimen in severe aplastic anemia, and oftenemployed as initial therapy as most are not candidates for a matchedrelated stem cell transplantation. With this regimen, hematologicresponse can be achieved in 60 to 70% of cases, but relap...

  3. Very Severe Aplastic Anemia appearing after Thymectomy

    Park, Chi Young; Kim, Hee Je; Kim, Yoo Jin; Park, Yoon Hee; Lee, Jong Wook; Min, Woo Sung; Kim, Chun Choo

    2003-01-01

    Aplastic anemia is a rare complication of thymoma and is extremely infrequent after thymectomy. We present a case of a 60-year-old woman with very severe aplastic anemia appearing sixteen months after thymectomy for a thymoma. She underwent thymectomy for a thymoma in April 2000. Preoperative examination revealed no hematologic abnormality. About sixteen months after the operation, she was readmitted because of pancytopenia with cough and fever. Bone marrow aspiration revealed a very severe h...

  4. Severe allergic reactions to guinea pig

    Shaw Jeffrey L; Levy Michael B; Zacharisen Michael C; Kurup Viswanath P

    2005-01-01

    Abstract Background Allergic sensitization and reactions to guinea pig (Cavia porcellus) have been well documented in laboratory animal handlers, primarily manifesting as rhinitis, conjunctivitis, and asthma. Severe allergic reactions, however, are rare. Methods We report two patients with severe allergic reactions following non-occupational exposure to guinea pigs. The first patient, an 11-year-old female, developed ocular, nasal, skin and laryngeal edema symptoms immediately after handling ...

  5. Enteral Nutrition in Severe Acute Pancreatitis

    Rudra Prasad Doley; Thakur Deen Yadav; Jai Dev Wig; Gurpreet Singh; Kishore Gurumoorthy Subramanya Bharathy; Ashwini Kudari; Rajesh Gupta; Vikas Gupta; Rakesh Kochhar; Kuchhangi Sureshchandra Poornachandra; Usha Dutta; Chetna Vaishnavi

    2009-01-01

    Context There is controversy concerning the merits of enteral and pa renteral nutrition in the manage ment of patients with severe acute pancreatitis. Objective This study was undertaken to evalua te the effect of enteral nutrition versus parenteral nutrition on serum markers of inflammation and outcome in patients with severe acute pancreatitis. Setting Tertiary care centre in North India. Design A prospective clinical trial. Metho...

  6. Severe Heterotopic Ossification following Total Knee Replacement

    Dodds, Alexander L.; Keene, Gregory C. R.

    2014-01-01

    Although the incidence of minor heterotopic ossification is probably higher than what is usually expected, severe heterotopic ossification (HO) is an extremely rare event following total knee replacement surgery. We present the case of a 66-year-old woman who initially had achieved an excellent range of motion following bilateral uncemented rotating platform total knee replacement, before presenting with pain and loss of range of motion at 2 months after surgery. Severe HO was diagnosed on X-...

  7. Recurrent severe vomiting due to hyperthyroidism

    Chen, Li-ying; Zhou, Bo; Chen, Zhou-wen; Fang, Li-zheng

    2010-01-01

    Thyrotoxicosis may present in many ways; severe vomiting as a prominent symptom of thyrotoxicosis is uncommon. In this paper, we report a 24-year-old Chinese male with hyperthyroidism who presented with recurrent severe vomiting. The patient had had intermittent vomiting for seven years and had lost approximately 15 kg of weight. Gastroscopic examinations revealed chronic gastritis and one occasion peptic ulcer. He was treated with antacid and proton pump inhibitors, but his symptoms had no r...

  8. Long-term reductions in tinnitus severity

    Folmer Robert L

    2002-01-01

    Abstract Background This study was undertaken to assess long-term changes in tinnitus severity exhibited by patients who completed a comprehensive tinnitus management program; to identify factors that contributed to changes in tinnitus severity within this population; to contribute to the development and refinement of effective assessment and management procedures for tinnitus. Methods Detailed questionnaires were mailed to 300 consecutive patients prior to their initial appointment at the Or...

  9. Long-term reductions in tinnitus severity

    Folmer, Robert L.

    2002-01-01

    Background This study was undertaken to assess long-term changes in tinnitus severity exhibited by patients who completed a comprehensive tinnitus management program; to identify factors that contributed to changes in tinnitus severity within this population; to contribute to the development and refinement of effective assessment and management procedures for tinnitus. Methods Detailed questionnaires were mailed to 300 consecutive patients prior to their initial appointment at the Oregon Heal...

  10. Pazopanib-Induced Severe Acute Pancreatitis

    Kawakubo, Kazumichi; Hata, Hiroo; Kawakami, Hiroshi; Kuwatani, Masaki; Kawahata, Shuhei; Kubo, Kimitoshi; Imafuku, Keisuke; Kitamura, Shinya; Sakamoto, Naoya

    2015-01-01

    Pazopanib is an oral angiogenesis inhibitor targeting vascular endothelial growth factor receptors, platelet-derived growth factor receptors, and c-Kit approved for the treatment of renal cell carcinoma and soft tissue sarcoma. Nonselective kinase inhibitors, such as sunitinib and sorafenib, are known to be associated with acute pancreatitis. There are few case reports of severe acute pancreatitis induced by pazopanib treatment. We present a case of severe acute pancreatitis caused by pazopan...

  11. Pulse Clarithromycin Therapy In Severe ACNE Vulgaris

    Rathi Sanjay K

    2002-01-01

    Full Text Available Three patients with severe acne vulgaris, not responding with long courses of doxycycline, minocycline and erythromycin were given oral clarithromycin in pulsed regimen. The patients were given 7 days course of clarithromycin 250mg twice daily, which was repeated after a gap of 10 days. Such 3 courses were given. The lesions responded significantly. No significant side effect was noted. Pulse clarithromycin therapy seems to be a good alternative and effective tool in the management of severe acne vulgaris.

  12. 20 CFR 220.114 - Evaluation of symptoms, including pain.

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Evaluation of symptoms, including pain. 220... RETIREMENT ACT DETERMINING DISABILITY Medical Considerations § 220.114 Evaluation of symptoms, including pain...'s symptoms, including pain, and the extent to which the claimant's symptoms can reasonably...

  13. Class II malocclusion occlusal severity description

    Guilherme Janson

    2010-08-01

    Full Text Available OBJECTIVES: It is well known that the efficacy and the efficiency of a Class II malocclusion treatment are aspects closely related to the severity of the dental anteroposterior discrepancy. Even though, sample selection based on cephalometric variables without considering the severity of the occlusal anteroposterior discrepancy is still common in current papers. In some of them, when occlusal parameters are chosen, the severity is often neglected. The purpose of this study is to verify the importance given to the classification of Class II malocclusion, based on the criteria used for sample selection in a great number of papers published in the orthodontic journal with the highest impact factor. MATERIAL AND METHODS: A search was performed in PubMed database for full-text research papers referencing Class II malocclusion in the history of the American Journal of Orthodontics and Dentofacial Orthopedics (AJO-DO. RESULTS: A total of 359 papers were retrieved, among which only 72 (20.06% papers described the occlusal severity of the Class II malocclusion sample. In the other 287 (79.94% papers that did not specify the anteroposterior discrepancy severity, description was considered to be crucial in 159 (55.40% of them. CONCLUSIONS: Omission in describing the occlusal severity demands a cautious interpretation of 44.29% of the papers retrieved in this study.

  14. Summary of a workshop on severe accident management for BWRs

    Severe accident management can be defined as the use of existing and/or alternative resources, systems and actions to prevent or mitigate a core-melt accident. For each accident sequence and each combination of strategies there may be several options available to the operator; and each involves phenomenological and operational considerations regarding uncertainty. Operational uncertainties include operator, system and instrument behavior during an accident. During the period September 26--28, 1990, a workshop was held at the University of California, Los Angeles, to address these uncertainties for Boiling Water Reactors (BWRs). This report contains a summary of the workshop proceedings

  15. Fate in digestion in vitro of several food components, including some toxic compounds coming from omega-3 and omega-6 lipids

    Goicoechea, E.; Brandon, E.F.A.; Blokland, M.H.; Guillén, M.D.

    2011-01-01

    In this study it was proved the formation of oxygenated alpha,beta-unsaturated aldehydes (OaßUAs) of 6, 7, 9 and 10 carbon atoms during the thermal treatment (190 °C with aeration) of a commercial vegetable oil rich in omega-3 and omega-6 acyl groups, which also contained small amounts of added prot

  16. Clinical significance of combined determination of several tumor markers (including CYFRA21-1, NSE, CA-50 and CEA) in patients with pulmonary cancer

    Objective: To enhance the diagnosis of pulmonary cancer by determination of optimal combinations of various tumor markers. Methods: Serum CYFRA21-1, NSE, CA-50 (with RIA) and CEA (with CLIA) contents were determined in 107 patients with various types of pulmonary cancers, 66 patients with various benign pulmonary diseases and 59 controls. Results: It was revealed that CYFRA21-1 determination was most sensitive for detection of squamous cell carcinoma. The same was true for CEA in the detection of adenocarcinoma. NSE determination was very specific for small cell carcinoma. Combined determinations of either CYFRA21-l + NSE or CYFRA21-1 + NSE + CEA were excellent for general screening. Conclusion: Combined determination of these tumor markers could be applied expediently as supplementary diagnostic measure for pulmonary malignancies. (authors)

  17. Determination of potassium in several plants and study of potassium transfer to different beverages, including tequila, by measurement of 40K

    Measurement of 40K was used for determination of potassium concentrations in leaves of agave and maguey cactus leaves, and coffee beans of various origins. The procedure was also used to study potassium transfer to tequila (alcoholic drink made of agave cactus), and the cactus and coffee infusions using 40K as a natural radioactive tracer. Counting of 40K in Marinelli containers with the aid of a low background NaI(Tl) scintillation detection system for 12-24 hours was employed. The method appeared to be simple and suitable for determination of potassium concentrations in large samples, which eliminates homogeneity problems. (author)

  18. Measurement of Fragmentation Products including Angular Distributions for 3, 5, and 10 GeV/A C and Si on several nuclear targets at the AGS

    Pinsky, L; Broggi, F; Brugger, M; Campanella, M; Carboni, M; Cerutti, F; Colleoni, P; Crystl, M; D'Ambrosio, C; Elkhayari, N; Empl, A; Fassó, A; Ferrari, A; Ferrari, A; Gadioli, E; Garzelli, M V; Geutersloh, S; Heilbronn, L; Lantz, M; Lebourgeois, M; Lee, K T; Lukasik, G; Mairani, A; Margiotta, A; Mayes, B; Miller, J; Morone, M C; Mostacci, A; Muraro, S; Parodi, K; Patera, V; Pelliccioni, M; Ranft, J; Reddell, B; Roesler, S; Rollet, S; Sala, P R; Sarchiapone, L; Sioli, M; Smirnov, G; Sommerer, F; Theis, C; Trovati, S; Villari, R; Vinke, H; Vlachoudis, V; Vollaire, J; Wilson, T; Zapp, N; Zeitlin, C

    2010-01-01

    Motivated by differences in the predicted fragmentation of heavy ions at energies around 5 GeV/A as employed in the event generators used by the FLUKA Monte Carlo Code [1], a set of measurements were carried out at the AGS facility at the Brookhaven National Laboratory to determine as much information as possible about the cross sections to allow harmonization of those event generators for these incident lab energies. The FLUKA Code employs the RQMD event generator of Sorge [2] for heavy ion interactions starting at 100 MeV/A and extending into the region around 5 GeV/A. Above those energies the DPMJET code of Ranft and Roesler [3] is typically employed to simulate such interactions. The detailed predictions of these event generators had some disagreement in the vicinity of this crossover energy and in order to tune these codes to be in closer harmony at the transition, and of course to be simulating nature as closely as possible, data were taken at 3, 5 and 10 GeV/A with beams of Fe, Si and C on a variety of...

  19. Transient analysis of 220 MWe Indian PHWRs to prevent ECCS line up following reactor trip with several measures including incorporation of a small size pressuriser

    Full text: In a pressurised heavy water reactor (PHWR) nuclear power plant, those transients where large thermal shrinkage in the primary heat transport (PHT) volume takes place can result in the lowering of PHT system pressure. During some of the reactor trip incidents as reported from the operating units, the minimum PHT pressure obtained has resulted in the unwanted line up of emergency core cooling system (ECCS). This line up is undesirable from the consideration of thermal cycling and hot/cold inventory transfers. A reduction of the dip in the PHT system pressure can be achieved by minimizing the PHT temperature fall and consequent system shrinkage during such transients. To minimize the heat transfer from the primary coolant to the secondary coolant in the steam generator (SG), the SGPC (steam generator pressure controller) set point has to be increased during such incidences. This will lead to a higher steam pressure and temperature in the SG thus reducing the temperature difference and heat transfer between primary and secondary coolant. Another option is to increase the net feed to the PHT volume i.e. by increasing the holdup inventory in a fixed boundary. This can be achieved by having a pressuriser volume riding over the pressure system boundary. In this paper, it is proposed to study the effect of a small size pressuriser of 10 and 6 M3 in the low pressure transients. This would also serve the important design objective of minimizing the reactor trips on PHT low pressure. This transient study has been carried out using the integrated system process dynamics analysis code. This code incorporates the mathematical models for the primary and secondary side heat transport systems along with associated controls. These models are based on coupled solutions of unsteady state mass, momentum and energy conservation equations. The present paper deals with the details of the different schemes considered along with the results obtained with discussion

  20. Analyzing the severity of accidents on the German Autobahn.

    Manner, Hans; Wünsch-Ziegler, Laura

    2013-08-01

    We study the severity of accidents on the German Autobahn in the state of North Rhine-Westphalia using data for the years 2009 until 2011. We use a multinomial logit model to identify statistically relevant factors explaining the severity of the most severe injury, which is classified into the four classes fatal, severe injury, light injury and property damage. Furthermore, to account for unobserved heterogeneity we use a random parameter model. We study the effect of a number of factors including traffic information, road conditions, type of accidents, speed limits, presence of intelligent traffic control systems, age and gender of the driver and location of the accident. Our findings are in line with studies in different settings and indicate that accidents during daylight and at interchanges or construction sites are less severe in general. Accidents caused by the collision with roadside objects, involving pedestrians and motorcycles, or caused by bad sight conditions tend to be more severe. We discuss the measures of the 2011 German traffic safety programm in the light of our results. PMID:23628941

  1. Health Behaviours during Pregnancy in Women with Very Severe Obesity.

    Mohd-Shukri, Nor A; Duncan, Andrew; Denison, Fiona C; Forbes, Shareen; Walker, Brian R; Norman, Jane E; Reynolds, Rebecca M

    2015-10-01

    The health behaviours of pregnant women with very severe obesity are not known, though these women are at high risk of pregnancy complications. We carried out a prospective case-control study including 148 very severely obese (BMI >40 kg/m²) and 93 lean (BMI Diet, physical activity, smoking, alcohol and folic acid consumption were assessed by questionnaire in early and late (16 and 28 weeks gestation) pregnancy. Circulating levels of iron, vitamin B12 and folate and other essential trace elements and minerals were measured in a subset at each time point. The findings biochemically confirmed that very severely obese women consumed diets that were energy-rich but poor in essential micronutrients. A third of all women met physical activity recommendations for pregnancy. A third of very severely obese women and two thirds of lean women took folic acid supplements prior to pregnancy. Very severely obese women were more likely to smoke but less likely to drink alcohol than lean women (all p < 0.05). Women with very severe obesity have low self-reported intakes and circulating levels of essential micronutrients in pregnancy and few follow current recommendations for pregnancy nutrition and lifestyle. These high-risk women represent a group to target for education about health behaviours prior to and during pregnancy. PMID:26457716

  2. Health Behaviours during Pregnancy in Women with Very Severe Obesity

    Nor A. Mohd-Shukri

    2015-10-01

    Full Text Available The health behaviours of pregnant women with very severe obesity are not known, though these women are at high risk of pregnancy complications. We carried out a prospective case-control study including 148 very severely obese (BMI >40 kg/m2 and 93 lean (BMI <25 kg/m2 pregnant women. Diet, physical activity, smoking, alcohol and folic acid consumption were assessed by questionnaire in early and late (16 and 28 weeks gestation pregnancy. Circulating levels of iron, vitamin B12 and folate and other essential trace elements and minerals were measured in a subset at each time point. The findings biochemically confirmed that very severely obese women consumed diets that were energy-rich but poor in essential micronutrients. A third of all women met physical activity recommendations for pregnancy. A third of very severely obese women and two thirds of lean women took folic acid supplements prior to pregnancy. Very severely obese women were more likely to smoke but less likely to drink alcohol than lean women (all p < 0.05. Women with very severe obesity have low self-reported intakes and circulating levels of essential micronutrients in pregnancy and few follow current recommendations for pregnancy nutrition and lifestyle. These high-risk women represent a group to target for education about health behaviours prior to and during pregnancy.

  3. Multivariate Frequency-Severity Regression Models in Insurance

    Edward W. Frees

    2016-02-01

    Full Text Available In insurance and related industries including healthcare, it is common to have several outcome measures that the analyst wishes to understand using explanatory variables. For example, in automobile insurance, an accident may result in payments for damage to one’s own vehicle, damage to another party’s vehicle, or personal injury. It is also common to be interested in the frequency of accidents in addition to the severity of the claim amounts. This paper synthesizes and extends the literature on multivariate frequency-severity regression modeling with a focus on insurance industry applications. Regression models for understanding the distribution of each outcome continue to be developed yet there now exists a solid body of literature for the marginal outcomes. This paper contributes to this body of literature by focusing on the use of a copula for modeling the dependence among these outcomes; a major advantage of this tool is that it preserves the body of work established for marginal models. We illustrate this approach using data from the Wisconsin Local Government Property Insurance Fund. This fund offers insurance protection for (i property; (ii motor vehicle; and (iii contractors’ equipment claims. In addition to several claim types and frequency-severity components, outcomes can be further categorized by time and space, requiring complex dependency modeling. We find significant dependencies for these data; specifically, we find that dependencies among lines are stronger than the dependencies between the frequency and average severity within each line.

  4. Severity of depressive episodes during the course of depressive disorder

    Kessing, L.V.

    2008-01-01

    Background It is not clear whether the severity of depressive episodes changes during the course of depressive disorder. Aims To investigate whether the severity of depressive episodes increases during the course of illness. Method Using a Danish nationwide case register, all psychiatric inpatien...... contact and calendar year. Conclusions The increasing severity of depressive episodes emphasises the importance of early and sustained prophylactic treatment. Declaration of interest None Udgivelsesdato: 2008......Background It is not clear whether the severity of depressive episodes changes during the course of depressive disorder. Aims To investigate whether the severity of depressive episodes increases during the course of illness. Method Using a Danish nationwide case register, all psychiatric inpatients...... and out-patients with a main ICD-10 diagnosis of a single mild, moderate or severe depressive episode at the end of first contact were identified. Patients included in the study were from the period 1994-2003. Results A total of 19 392 patients received a diagnosis of a single depressive episode at...

  5. Iodine–paint interactions during nuclear reactor severe accidents

    Highlights: • Iodine interacts with containment paint in several ways. • Some mechanistic understanding is required. • Paint aging and degradation mechanisms. • Iodine adsorption and release mechanisms. • The Severe Accident Research Network (SARNET) facilitates collaboration between members. - Abstract: To assess the radiological consequences of a severe reactor accident, it is important to be able to predict the behaviour of iodine in containment. Some interactions between iodine and containment paint (e.g., adsorption) have been well known for a long time. However, in recent years, new phenomena have been identified that can affect the gas phase iodine concentration in the longer term (e.g., the release of molecular iodine and organic iodides from irradiated painted surfaces). Several international collaborations and organizations around the world are currently addressing different aspects of this topic, including laboratory experiments and theoretical studies (ab initio) designed to improve the mechanistic understanding of the phenomena. Knowledge of the underlying mechanisms will provide explanations for behavioural differences observed between paint types, and will support the extrapolation of laboratory results to the safety analyses of nuclear reactors. The purpose of this paper is to present a selection of recent work performed by Severe Accident Research Network (SARNET) members regarding iodine–paint interactions and paint aging in order to improve the common understanding and better define what has still to be done in this area. The Severe Accident Research Network (SARNET) provides a framework within which members can share and discuss results

  6. Severe complications associated with transcatheter hepatic arterial chemoembolization

    Transcatheter hepatic arterial chemoembolization (THACE) has been widely used in the treatment of advanced primary hepatic carcinoma (PHC)and metastatic hepatic carcinoma (MHC). Although the incidence of severe complications associated with THACE is unusual (0%-5%), its prognosis is generally worse and mortality is higher than that of postemholization syndrome. Therefore, to minimize the risk associated with THACE has to be achieved through the understanding of these severe complications related to the selection of indication,the use of chemoembolic agents and manipulation ora cathether or guide wire, etc. In this paper, according to the involved anatomic organs, these severe complications are divided into six categories as follows: (1)complications of the liver, including acute hepatic failure, liver infarction (necrosis), liver abcess and liver (or tumor)ruptrure; (2)complications of the celiac artery and its branches, included of iatrogenic dissection, stricture or occlusion, perforation or pseudoaneurysm and multiple intrahepatic aneurysms; (3)complications of intrahepatic biliary system, included of cholecystitis and gallbladder infarction, bile duct necrosis and intrahepatic biloma formation; (4)complications of extrahepatic structures, included of nontarget embolism or infarction of the brain, spinal cord, lung, spleen, gastroduodenum and pancreas; (5)bleeding of upper digestive tract; (6)the orthers. And the incidence, pathogenesis, predisposing factors, clinical and imaging manifestations of these complications are also discussed in detail, it may be of great advantage to its correct diagnosis promptly and appropriate management. (authors)

  7. Conclusions on severe accident research priorities

    Highlights: • Estimation of research priorities related to severe accident phenomena. • Consideration of new topics, partly linked to the severe accidents at Fukushima. • Consideration of results of recent projects, e.g. SARNET, ASAMPSA2, OECD projects. - Abstract: The objectives of the SARNET network of excellence are to define and work on common research programs in the field of severe accidents in Gen. II–III nuclear power plants and to further develop common tools and methodologies for safety assessment in this area. In order to ensure that the research conducted on severe accidents is efficient and well-focused, it is necessary to periodically evaluate and rank the priorities of research. This was done at the end of 2008 by the Severe Accident Research Priority (SARP) group at the end of the SARNET project of the 6th Framework Programme of European Commission (FP6). This group has updated this work in the FP7 SARNET2 project by accounting for the recent experimental results, the remaining safety issues as e.g. highlighted by Level 2 PSA national studies and the results of the recent ASAMPSA2 FP7 project. These evaluation activities were conducted in close relation with the work performed under the auspices of international organizations like OECD or IAEA. The Fukushima-Daiichi severe accidents, which occurred while SARNET2 was running, had some effects on the prioritization and definition of new research topics. Although significant progress has been gained and simulation models (e.g. the ASTEC integral code, jointly developed by IRSN and GRS) were improved, leading to an increased confidence in the predictive capabilities for assessing the success potential of countermeasures and/or mitigation measures, most of the selected research topics in 2008 are still of high priority. But the Fukushima-Daiichi accidents underlined that research efforts had to focus still more to improve severe accident management efficiency

  8. The development of severe accident analysis technology

    Kim, Heuy Dong; Cho, Sung Won; Kim, Sang Baek; Park, Jong Hwa; Lee, Kyu Jung; Park, Lae Joon; Hu, Hoh; Hong, Sung Wan [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1993-07-01

    The objective of the development of severe accident analysis technology is to understand the severe accident phenomena such as core melt progression and to provide a reliable analytical tool to assess severe accidents in a nuclear power plant. Furthermore, establishment of the accident management strategies for the prevention/mitigation of severe accidents is also the purpose of this research. The study may be categorized into three areas. For the first area, two specific issues were reviewed to identify the further research direction, that is the natural circulation in the reactor coolant system and the fuel-coolant interaction as an in-vessel and an ex-vessel phenomenological study. For the second area, the MELCOR and the CONTAIN codes have been upgraded, and a validation calculation of the MELCOR has been performed for the PHEBUS-B9+ experiment. Finally, the experimental program has been established for the in-vessel and the ex-vessel severe accident phenomena with the in-pile test loop in KMRR and the integral containment test facilities, respectively. (Author).

  9. Severe accident issue resolution -- definition and perspective

    The purpose of this discussion is to introduce the session on the Progress on the Resolution of Severe Accident Issues. There has been much work in the area of resolution of severe accident issues over the past few years. This work has been focused on those issues most important to risk as assessed by comprehensive studies such as NUREG-1150. In particular, issues associated with early containment failure have been analyzed. These efforts to resolve issues have been hampered by the fact that open-quotes issue resolutionclose quotes has not always been well defined. The term open-quotes issue resolutionclose quotes conjures tip different images for the regulator, the accident analyst, the physicist, and the probabalist. In fact it is common to have as many different images of issue resolution as there are people in the room. This issue is complicated by the fact that the uncertainty in severe accident issues is enormous. (When convolved, the quantitative uncertainty in an integrated analysis due to severe accident issues can span several orders of magnitude.) In this summary, hierarchy is presented in an attempt to add some perspective to the resolution of issues in the face of large uncertainties. Recommendations are also made for analysts communicating in the area of issue resolution

  10. Coolability of severely degraded CANDU cores. Revised

    Meneley, D.A.; Blahnik, C.; Rogers, J.T.; Snell, V.G.; Nijhawan, S

    1996-01-01

    Analytical and experimental studies have shown that the separately cooled moderator in a CANDU reactor provides an effective heat sink in the event of a loss-of-coolant accident (LOCA) accompanied by total failure of the emergency core cooling system (ECCS). The moderator heat sink prevents fuel melting and maintains the integrity of the fuel channels, therefore terminating this severe accident short of severe core damage. Nevertheless, there is a probability, however low, that the moderator heat sink could fail in such an accident. The pioneering work of Rogers (1984) for such a severe accident using simplified models showed that the fuel channels would fail and a bed of dry, solid debris would be formed at the bottom of the calandria which would heat up and eventually melt. However, the molten pool of core material would be retained in the calandria vessel, cooled by the independently cooled shield-tank water, and would eventually resolidify. Thus, the calandria vessel would act inherently as a 'core-catcher' as long as the shield tank integrity is maintained. The present paper reviews subsequent work on the damage to a CANDU core under severe accident conditions and describes an empirically based mechanistic model of this process. It is shown that, for such severe accident sequences in a CANDU reactor, the end state following core disassembly consists of a porous bed of dry solid, coarse debris, irrespective of the initiating event and the core disassembly process. (author)

  11. Perioperative management of severe anorexia nervosa.

    Hirose, K; Hirose, M; Tanaka, K; Kawahito, S; Tamaki, T; Oshita, S

    2014-02-01

    As the prevalence of anorexia nervosa (AN) increased, surgery in severe AN patients also increased in the 2000s. We experienced a surgical case of a patient with severe AN, showing an extremely low BMI of 8.6 kg m(-2). We investigated the problems associated with this case and propose criteria to manage severe AN. We endeavour to report on the perioperative management of rare and severe symptoms and surgical indications of severely malnourished patients. All published reports were identified through comprehensive searches using PubMed, BioMedLib, and the Japan Medical Abstracts Society with the following terms and keywords: 'anorexia nervosa', 'eating disorder', 'hypoglycaemia', 'leucocytopaenia', 'gelatinous bone marrow', 'surgery', and 'operation'. In cases of AN with a BMI under 13 kg m(-2), marked hypoglycaemia, leucocytopaenia <3.0×10(9) litre(-1), or both, potentially fatal complications frequently occur. Accordingly, patients need strict nutritional support to avoid re-feeding syndrome until surgery. During the course of anaesthesia, careless loading of glucose or catecholamine may lead to disturbance of electrolytes or fatal arrhythmia. Intensive care and early feeding as soon as possible after surgery are important to prevent surgical site infection. Although not many perioperative cases of AN have been reported, clinicians must be aware of the danger and the causes of mortality in critical cases. Thus, the decision to undertake surgery must be taken carefully and close perioperative coordination among physicians, surgeons, psychiatrists, anaesthesiologists, and intensivists is essential. PMID:24366724

  12. Kiss-induced severe anaphylactic reactions

    Atanasković-Marković Marina

    2010-01-01

    Full Text Available Introduction. Ingestion is the principal route for food allergens to trigger allergic reaction in atopic persons. However, in some highly sensitive patients severe symptoms may develop upon skin contact and by inhalation. The clinical spectrum ranges from mild facial urticaria and angioedema to life-threatening anaphylactic reactions. Outline of Cases. We describe cases of severe anaphylactic reactions by skin contact, induced by kissing in five children with prior history of severe anaphylaxis caused by food ingestion. These cases were found to have the medical history of IgE mediated food allergy, a very high total and specific serum IgE level and very strong family history of allergy. Conclusion. The presence of tiny particles of food on the kisser's lips was sufficient to trigger an anaphylactic reaction in sensitized children with prior history of severe allergic reaction caused by ingestion of food. Allergic reaction provoked with food allergens by skin contact can be a risk factor for generalized reactions. Therefore, extreme care has to be taken in avoiding kissing allergic children after eating foods to which they are highly allergic. Considering that kissing can be a cause of severe danger for the food allergic patient, such persons should inform their partners about the risk factor for causing their food hypersensitivity.

  13. The development of severe accident analysis technology

    The objective of the development of severe accident analysis technology is to understand the severe accident phenomena such as core melt progression and to provide a reliable analytical tool to assess severe accidents in a nuclear power plant. Furthermore, establishment of the accident management strategies for the prevention/mitigation of severe accidents is also the purpose of this research. The study may be categorized into three areas. For the first area, two specific issues were reviewed to identify the further research direction, that is the natural circulation in the reactor coolant system and the fuel-coolant interaction as an in-vessel and an ex-vessel phenomenological study. For the second area, the MELCOR and the CONTAIN codes have been upgraded, and a validation calculation of the MELCOR has been performed for the PHEBUS-B9+ experiment. Finally, the experimental program has been established for the in-vessel and the ex-vessel severe accident phenomena with the in-pile test loop in KMRR and the integral containment test facilities, respectively. (Author)

  14. Occurrence and severity of agitated behavior after severe traumatic brain injury

    Moth Wolffbrandt, Mia; Poulsen, Ingrid; Engberg, Aase W; Hornnes, Nete

    2013-01-01

    To investigate the occurrence and severity of agitation in patients after severe traumatic brain injury (TBI), to identify predictors of agitation and to study interrater reliability for a translated version of the Agitated Behavior Scale (ABS)....

  15. A review of severe accident assessment

    One of the most difficult problems on evaluation of external costs on nuclear power generation is value on a severe accident risk. Once forming a severe accident, its effect is very important and extends to a wide range, to give a lot of damages. It is a main area of study on externality of energy to compare various risks by means of price conversion at unit kWh. Here was outlined on research examples on main severe accident risks before then. A common fact on estimation cost such research examples is to limit it to direct cost (mainly to health damage) at accident phenomenon. As an actual problem, it is very difficult to substantially quantify such parameters because of basically belonging to social psychology. It is due to no finding out decisive evaluation method on this problem to be adopted conventional EED (Expert Expected Damages) approach in the ExternE Phase III, either. (G.K.)

  16. Bone scanning in severe external otitis

    Levin, W.J.; Shary, J.H. 3d.; Nichols, L.T.; Lucente, F.E.

    1986-11-01

    Technetium99 Methylene Diphosphate bone scanning has been considered an early valuable tool to diagnose necrotizing progressive malignant external otitis. However, to our knowledge, no formal studies have actually compared bone scans of otherwise young, healthy patients with severe external otitis to scans of patients with clinical presentation of malignant external otitis. Twelve patients with only severe external otitis were studied with Technetium99 Diphosphate and were compared to known cases of malignant otitis. All scans were evaluated by two neuroradiologists with no prior knowledge of the clinical status of the patients. Nine of the 12 patients had positive bone scans with many scans resembling those reported with malignant external otitis. Interestingly, there was no consistent correlation between the severity of clinical presentation and the amount of Technetium uptake. These findings suggest that a positive bone scan alone should not be interpreted as indicative of malignant external otitis.

  17. Bone scanning in severe external otitis

    Technetium99 Methylene Diphosphate bone scanning has been considered an early valuable tool to diagnose necrotizing progressive malignant external otitis. However, to our knowledge, no formal studies have actually compared bone scans of otherwise young, healthy patients with severe external otitis to scans of patients with clinical presentation of malignant external otitis. Twelve patients with only severe external otitis were studied with Technetium99 Diphosphate and were compared to known cases of malignant otitis. All scans were evaluated by two neuroradiologists with no prior knowledge of the clinical status of the patients. Nine of the 12 patients had positive bone scans with many scans resembling those reported with malignant external otitis. Interestingly, there was no consistent correlation between the severity of clinical presentation and the amount of Technetium uptake. These findings suggest that a positive bone scan alone should not be interpreted as indicative of malignant external otitis

  18. Assessment of problematic severe asthma in children

    Carlsen, K. C. L.; Hedlin, G.; Bush, A.;

    2011-01-01

    Assessment of problematic severe asthma in children should be performed in a stepwise manner to ensure an optimal approach. A four-step assessment scheme is proposed. First, a full diagnostic work-up is performed to exclude other diseases which mimic asthma. Secondly, a multi-disciplinary assessm......Assessment of problematic severe asthma in children should be performed in a stepwise manner to ensure an optimal approach. A four-step assessment scheme is proposed. First, a full diagnostic work-up is performed to exclude other diseases which mimic asthma. Secondly, a multi...... our current knowledge in all these steps are highlighted, and recommendations for current clinical practice and future research are made. The lack of good data and the heterogeneity of problematic severe asthma still limit our ability to optimise the management on an individual basis in this small...

  19. The relationships between posttraumatic stress disorder severity, depression severity and physical health

    Rytwinski, Nina K; Avena, Jennifer S; Echiverri-Cohen, Aileen M; Zoellner, Lori A.; Feeny, Norah C.

    2013-01-01

    This study examines the relationship among posttraumatic stress disorder (PTSD) severity, depression severity, and subjective and objective physical health in a sample of 200 adults with PTSD. PTSD severity was correlated with subjective, but not objective, health. Similarly, depression symptoms had an indirect effect on the relationship between PTSD symptom severity and three measures of subjective physical health. Finally, depression symptoms had an indirect effect on the relationship betwe...

  20. From asthma severity to control: a shift in clinical practice

    Pedersen, Søren

    2009-01-01

    -driven management rather than management based on disease severity. Good asthma control is associated with reductions in patients' perception of the asthma burden, reduced healthcare resource utilisation, lower levels of impairment/restriction, normal quality of life, and low risk of exacerbations. Asthma control...... involves the control of several outcomes. Its assessment should include components relevant to achievement of best possible clinical control and reduction of future risk of adverse outcomes. Focusing on a single or a few outcomes can lead to incorrect control assessment and increased risk of under......-treatment. Several validated asthma control assessment tools have been developed to facilitate correct assessment of the level of control in clinical practice. It is hoped that focusing on control will reduce the frequency of sub-optimal treatment in the primary care setting. Further validation of the best way to...

  1. Pediatric Hereditary Angioedema: Onset, Diagnostic Delay, and Disease Severity.

    Christiansen, Sandra C; Davis, Donna K; Castaldo, Anthony J; Zuraw, Bruce L

    2016-09-01

    Hereditary angioedema (HAE) typically presents in childhood. Large gaps remain in our understanding of the natural history of HAE during childhood. We examined age of onset, delay in diagnosis, androgen exposure, and their influence on ultimate disease severity in a large cohort of patients with HAE. Median age of first swelling was 11 years with a median age at diagnosis of 19 years. Earlier onset of symptoms correlated with longer delays in diagnosis (P < .001) and predicted a more severe disease course, including increased number of attacks per year (P = .0009) and hospital admissions (P = .009). Earlier age of onset also significantly correlated with increased perceived HAE severity (P = .0002), negative overall life impact (P < .0001), and use of anabolic androgen. Our observations highlight the importance of early HAE diagnosis and suggest the necessity of a disease management plan once the diagnosis has been made. PMID:26581355

  2. On the graphic simulation of severe accidents using IBM PC

    In this paper some methods of developing a graphical simulation system using IBM PC and MELCOR code were discussed. Most TH codes, which can calculate the severe accident phenomena parameters, are now running on workstations or supercomputers, to meet the complicated calculations. But the recent progress in computer engineering including personal computers make it possible to run TH codes in small microprocessor environments. Therefore we have surveyed some technical aspects in developing a severe accident graphical simulation system using IBM PC and MELCOR code. Especially noticing the complicated calculation results and the difficulties in obtaining continuous data due to the large data size, which are main defects of TH codes, we also surveyed the graphical methods to overcome these problems. The proposed methods are expected to play important roles in developing our graphic simulation system of severe accidents

  3. Plant specific severe accident management - the implementation phase

    Many plants are in the process of developing on-site guidance for technical staff to respond to a severe accident situation severe accident management guidance (SAMG). Once the guidance is developed, the SAMG must be implemented at the plant site, and this involves addressing a number of additional aspects. In this paper, approaches to this implementation phase are reviewed, including review and verification of plant specific SAMG, organizational aspects and integration with the emergency plan, training of SAMG users, validation and self-assessment and SAMG maintenance. Examples draw on experience from assisting numerous plants to implement symptom based severe accident management guidelines based on the Westinghouse Owners Group approach, in Westinghouse, non-Westinghouse and VVER plant types. It is hoped that it will be of use to those plant operators about to perform these activities.(author)

  4. 76 FR 81986 - Honeywell International, Inc., Automation and Control Solutions Division, Including On-Site...

    2011-12-29

    ..., 2010 (75 FR 49531). The notice was amended on December 7, 2010 to include several on-site leased worker firms. The amended notice was published in the Federal Register on December 13, 2010 (75 FR 77664-77665... Employment and Training Administration Honeywell International, Inc., Automation and Control...

  5. Elementary Contraceptive Information to be Included in Beijing’s Middle School Textbooks

    2002-01-01

    From September this year, trial editions of Sex Health Guidance for Senior Middle School Students, and Sex Health Guidance for Junior Middle School Students, will be used in several schools in Haidian District, Beijing. Haidian Education Commission has sent out notices to all middle schools in the district, including secondary specialized schools,

  6. Idiopathic Polyhydramnios: Severity and Perinatal Morbidity.

    Wiegand, Samantha L; Beamon, Carmen J; Chescheir, Nancy C; Stamilio, David

    2016-06-01

    Objective To estimate the association between the severity of idiopathic polyhydramnios and adverse outcomes. Study Design Retrospective cohort study of deliveries at one hospital from 2000 to 2012 with an amniotic fluid index (AFI) measurement ≥24 + 0 weeks' gestation. Pregnancies complicated by diabetes, multiples, or fetal anomalies were excluded. Exposure was the degree of polyhydramnios: normal (AFI 5-24 cm), mild (≥ 24-30 cm), and moderate-severe (> 30 cm). Primary outcomes were perinatal mortality, neonatal intensive care unit (NICU) admission, and postpartum hemorrhage. Results There were 10,536 pregnancies: 10,188 with a normal AFI, 274 mild (78.74%), and 74 moderate-severe polyhydramnios (21.26%). Adverse outcomes were increased with idiopathic polyhydramnios: NICU admission (adjusted odds ratio [AOR] 3.71, 95% confidence interval [CI] 2.77-4.99), postpartum hemorrhage (AOR 15.81, 95% CI 7.82-31.96), macrosomia (AOR 3.41, 95% CI 2.61-4.47), low 5-minute Apgar score (AOR 2.60, 95% CI 1.57-4.30), and cesarean (AOR 2.16, 95% CI 1.74-2.69). There were increasing odds of macrosomia (mild: AOR 3.19, 95% CI 2.36-4.32; moderate-severe: AOR 4.44, 95% CI 2.53-7.79) and low 5-minute Apgar score (mild: AOR 2.24, 95% CI 1.23-4.08; moderate-severe: AOR 3.93, 95% CI 1.62-9.55) with increasing severity of polyhydramnios. Conclusion Idiopathic polyhydramnios is independently associated with increased risks of morbidity. There appears to be a dose-response relationship for neonatal macrosomia and low 5-minute Apgar score risks. PMID:26862725

  7. Estuary wader capacity following severe weather mortality

    The building of a tidal power barrage across an estuary may lead to substantial changes in its ecology. Many of Britain's estuaries hold internationally important numbers of waders. Careful consideration, therefore, needs to be given to the likely effects of tidal power barrages on wader populations. The opportunity for increased understanding of the mechanisms which govern wader populations was provided by a period of severe winter weather in 1991, which resulted in a substantial mortality of waders in eastern England. Such conditions are known to be stressful to birds and the study objectives were to investigate both the effects of and recovery from severe weather. (author)

  8. Coal severance taxation and local public finance

    Ervin, O.L.

    1982-01-01

    This paper: 1) elaborates the local impacts rationale and investigates the use of the rationale or justification among states applying a coal severance tax; 2) summarizes and assesses existing evidence of local coal-related socio-economic and fiscal impacts; 3) investigates state provisions for distribution of severance tax revenues to local jurisdictions; 4) presents evidence on the fiscal condition of selected local governments in coal producing areas; and 5) draws some conclusions about the validity and public policy implications of the local impacts rationale.

  9. Linkage and Genetic Association in Severe Asthma.

    Jones, Bridgette L; Rosenwasser, Lanny J

    2016-08-01

    A significant body of work in the genetics of asthma currently exists. However, current knowledge has not been clarifying in understanding the pathophysiology of asthma and therapeutic treatment of the disease. Severe asthma in adults and children is a significant burden in relation to disproportionate disease morbidity, mortality, and health utilization. This disease phenotype is not well understood; current effective treatment regimens are limited. Genetic studies may lead to improved understanding of the pathophysiology of severe asthma and identification of relevant subsets, which allow more targeted and effective therapies and the realization of Precision Medicine in asthma. PMID:27401617

  10. Severe Accident Management Measures Introduced in Belgian NPP's

    In response to the Belgian Safety Authorities' request to address the severe accident issue within a decennial safety review, Tractebel, on behalf of the Belgian Utility, Electrabel, examined in detail specific severe accident topics and provided the Utility with several measures that could be implemented to reduce the risk associated with beyond-design accidents. The present paper summarizes the key elements of the approach applied in Belgium: - Presentation of plant-specific studies related to severe accident issues; - Use of PSA results; - Inputs of international R and D projects; - Selection and justification of severe accident measures; - Comparative study between possible mitigative measures; - Definition and justification of implemented severe accident management strategies. The vulnerability to severe accidents as well as the potential causes of containment failures have been identified leading to the study of possible countermeasures taking into account the combination of conservative design and post-TMI measures already implemented . A section of the paper will also be devoted to the specific study made for the selection, the sizing and the implementation of hydrogen control means. After the description of the selected measures implemented, the paper also describes the content of the 'Severe Accident Management Guidelines' developed by Tractebel for the Tihange NPPs and for the Doel NPPs. This project aimed at providing the operators with procedures or guidelines enabling to deal with complex situations not formally considered in the standard Emergency Response Guidelines, including accidents in which a significant portion of the core melts. The objective of these SAMG's programs is to indicate actions that must bring the plant to a controlled stable state and, above all, mitigate any challenges to the fission product barriers. The plant personnel must use the available plant information to determine the best severe accident management measures. Obviously

  11. Recent Developments in Level 2 PSA and Severe Accident Management

    In 1997, CSNI WGRISK produced a report on the state of the art in Level 2 PSA and severe accident management - NEA/CSNI/R(1997)11. Since then, there have been significant developments in that more Level 2 PSAs have been carried out worldwide for a variety of nuclear power plant designs including some that were not addressed in the original report. In addition, there is now a better understanding of the severe accident phenomena that can occur following core damage and the way that they should be modelled in the PSA. As requested by CSNI in December 2005, the objective of this study was to produce a report that updates the original report and gives an account of the developments that have taken place since 1997. The aim has been to capture the most significant new developments that have occurred rather than to provide a full update of the original report, most of which is still valid. This report is organised using the same structure as the original report as follows: Chapter 2: Summary on state of application, results and insights from recent Level 2 PSAs. Chapter 3: Discussion on key severe accident phenomena and modelling issues, identification of severe accident issues that should be treated in Level 2 PSAs for accident management applications, review of severe accident computer codes and the use of these codes in Level 2 PSAs. Chapter 4: Review of approaches and practices for accident management and SAM, evaluation of actions in Level 2 PSAs. Chapter 5: Review of available Level 2 PSA methodologies, including accident progression event tree / containment event tree development. Chapter 6: Aspects important to quantification, including the use of expert judgement and treatment of uncertainties. Chapter 7: Examples of the use of the results and insights from the Level 2 PSA in the context of an integrated (risk informed) decision making process

  12. Gene-Environment Interactions in Severe Mental Illness

    Rudolf eUher

    2014-05-01

    Full Text Available Severe mental illness is a broad category that includes schizophrenia, bipolar disorder and severe depression. Both genetic disposition and environmental exposures play important roles in the development of severe mental illness. Multiple lines of evidence suggest that the roles of genetic and environmental depend on each other. Gene-environment interactions may underlie the paradox of strong environmental factors for highly heritable disorders, the low estimates of shared environmental influences in twin studies of severe mental illness and the heritability gap between twin and molecular heritability estimates. Sons and daughters of parents with severe mental illness are more vulnerable to the effects of prenatal and postnatal environmental exposures, suggesting that the expression of genetic liability depends on environment. In the last decade, gene-environment interactions involving specific molecular variants in candidate genes have been identified. Replicated findings include an interaction between a polymorphism in the AKT1 gene and cannabis use in the development of psychosis and an interaction between the length polymorphism of the serotonin transporter gene and childhood maltreatment in the development of persistent depressive disorder. Bipolar disorder has been underinvestigated, with only a single study showing an interaction between a functional polymorphism in BDNF and stressful life events triggering bipolar depressive episodes. The first systematic search for gene-environment interactions has found that a polymorphism in CTNNA3 may sensitise the developing brain to the pathogenic effect of cytomegalovirus in utero, leading to schizophrenia in adulthood. Strategies for genome-wide investigations will likely include coordination between epidemiological and genetic research efforts, systematic assessment of multiple environmental factors in large samples, and prioritization of genetic variants.

  13. Incidence, severity, prognostic significance of thrombocytopenia in malaria

    Bezwada Srinivasa Rao

    2015-01-01

    Full Text Available Background: Malaria is an infectious disease caused by plasmodium parasite. P. falciparum account for majority of morbidity and mortality. Thrombocytopenia and anaemia are the most frequently associated hematological complications in malaria. The low platelet count together with acute febrile syndrome emerged as the strongest predictor of malaria a finding that is frequent and present even before anemia and splenomegaly sets in. Severe thrombocytopenia is a good predictor of poor prognosis than mild and moderate thrombocytopenia. The aim is to study the incidence, severity, prognostic significance of thrombocytopenia in malaria. Methods: This was an observational and prospective study. The study enrolled 100 patients with thrombocytopenia and fever who were proven to have malaria either by peripheral smear or Quantitative Buffy Coat (QBC test or malarial antigen assay were included in the study and patients with thrombocytopenia due to other causes were excluded from the study. Platelet count was estimated on a fully automated quantitative analyzer. All the 100 patients were followed during the hospital stay and upto discharge or till the outcome. Results: The incidence of thrombocytopenia was 73% indicating a common association in malaria. Complicated malaria was observed in 58.80% of P. falciparum infection whereas 66% of P. vivax infection was associated with uncomplicated malaria. Severe thrombocytopenia showed positive correlation with severity of malaria. Thrombocytopenic patients with effective anti-malarial treatment showed 95.90% recovery and 3 patients 4.10% had mortality. Patients with severe thrombocytopenia were 8.5 times more likely to have complicated malaria with P <0.001 according to student and lsquo;t' test. Conclusion: Thrombocytopenia is the most common hematological finding in malaria. Severe thrombocytopenia showed positive correlation with complicated malaria and a good predictor of poor prognosis. Patients with classical

  14. On scene injury severity prediction (OSISP) algorithm for car occupants.

    Buendia, Ruben; Candefjord, Stefan; Fagerlind, Helen; Bálint, András; Sjöqvist, Bengt Arne

    2015-08-01

    Many victims in traffic accidents do not receive optimal care due to the fact that the severity of their injuries is not realized early on. Triage protocols are based on physiological and anatomical criteria and subsequently on mechanisms of injury in order to reduce undertriage. In this study the value of accident characteristics for field triage is evaluated by developing an on scene injury severity prediction (OSISP) algorithm using only accident characteristics that are feasible to assess at the scene of accident. A multivariate logistic regression model is constructed to assess the probability of a car occupant being severely injured following a crash, based on the Swedish Traffic Accident Data Acquisition (STRADA) database. Accidents involving adult occupants for calendar years 2003-2013 included in both police and hospital records, with no missing data for any of the model variables, were included. The total number of subjects was 29128, who were involved in 22607 accidents. Partition between severe and non-severe injury was done using the Injury Severity Score (ISS) with two thresholds: ISS>8 and ISS>15. The model variables are: belt use, airbag deployment, posted speed limit, type of accident, location of accident, elderly occupant (>55 years old), sex and occupant seat position. The area under the receiver operator characteristic curve (AUC) is 0.78 and 0.83 for ISS>8 and ISS>15, respectively, as estimated by 10-fold cross-validation. Belt use is the strongest predictor followed by type of accident. Posted speed limit, age and accident location contribute substantially to increase model accuracy, whereas sex and airbag deployment contribute to a smaller extent and seat position is of limited value. These findings can be used to refine triage protocols used in Sweden and possibly other countries with similar traffic environments. PMID:26005884

  15. Top 10 Threats to Computer Systems Include Professors and Students

    Young, Jeffrey R.

    2009-01-01

    In this article, the author presents the top-10 list of campus computer-security risks he compiled based on several recent computing surveys and interviews with more than a dozen college-technology leaders. The list, ordered from least to most serious, is by no means scientific, but it gives a sense of where today's battle lines are--and why…

  16. Systemic Medications for Psoriasis and Psoriatic Arthritis Including Biologics

    ... as antimetabolites. It was initially used to treat cancer. Methotrexate was found to be effective in clearing psoriasis ... sold as a generic. The doses administered for cancer are considerably higher than those given for psoriasis ... is prescribed for adults with severe psoriasis or ...

  17. ASTRO-F/FIS observing simulation including detector characteristics

    Jeong, Woong-Seob; Pak, Soojong; Lee, Hyung Mok; Nakagawa, Takao; Kim, Minjin; Oh, Sang Hoon; Kaneda, Hidehiro; Makiuti, Sin'itirou; Shirahata, Mai; Matsuura, Shuji; Patrashin, Mikhail A.; Pearson, Chris; Shibai, Hiroshi

    2004-01-01

    We have examined the effects of transients, glitches caused by cosmic ray hits, and the crosstalk of the far-infrared detector arrays on-board ASTRO-F on its survey mode data. We used simple model fits to laboratory measurements for the transients and glitch profiles. We also tested several correction methods, based on these models, to recover the original signal.

  18. Severe forms of concealed penis without hypospadias: Surgical strategies

    de Jesus, Lisieux Eyer; Dekermacher, Samuel; Anderson, Kleber M.

    2015-01-01

    Introduction: Concealed penis (CP) may vary in severity and includes megaprepuce (MP) as a variant. Many different surgical strategies have been described in order to maximize penile exposure and to deal with skin deficiency. We describe the strategies that we use to overcome technical problems in severe cases of CP. Materials and Methods: Six consecutive cases of severe CP (including 3 with MP) were treated in a 2-year period between January 2011 and April 2013. These patients were treated using extensive degloving, removal of dysplastic dartos, Alexander's preputial flap, scrotal flaps and skin grafts. Three patients had been previously circumcised. Cases associated with hypospadias, obesity, disorders of sexual differentiation and micropenises were excluded. Results: All six patients attained good results, with good exposure of the penis, ability to void standing with a well-directed flow and reasonable esthetic results. A technical algorithm for the treatment of primary or recurring cases of CP is proposed. Conclusion: Alexander’ s distally based ventral preputial flap is a useful technical resource to treat MP cases. Free skin grafts and/or laterally based scrotal flaps may be used to cover the penis after release in severe cases of CP. PMID:26604447

  19. Is ketamine a lifesaving agent in childhood acute severe asthma?

    Hendaus, Mohamed A; Jomha, Fatima A; Alhammadi, Ahmed H

    2016-01-01

    Children with acute severe asthma exacerbation are at risk of developing respiratory failure. Moreover, conventional aggressive management might be futile in acute severe asthma requiring intubation and invasive ventilation. The aim of this review is to detail evidence on the use of ketamine in childhood asthma exacerbations. A search of the MEDLINE, EMBASE, and Cochrane databases was performed, using different combinations of the following terms: ketamine, asthma, use, exacerbation, and childhood. In addition, we searched the references of the identified articles for additional articles. We then reviewed titles and included studies that were relevant to the topic of interest. Finally, the search was limited to studies published in English and Spanish from 1918 to June 2015. Due to the scarcity in the literature, we included all published articles. The literature reports conflicting results of ketamine use for acute severe asthma in children. Taking into consideration the relatively good safety profile of the drug, ketamine might be a reasonable option in the management of acute severe asthma in children who fail to respond to standard therapy. Furthermore, pediatricians and pediatric emergency clinicians administering ketamine should be knowledgeable about the unique actions of this drug and its potential side effects. PMID:26955277

  20. A case of severe low back pain after surgery.

    Rhodin, Annica

    2014-06-01

    The etiology of chronic back pain is often unknown but can include failed spinal surgery. Pain can often be of mixed type and it is important to evaluate pain mechanisms. Comorbid factors often contribute to pain chronicity. Multimodal treatment, including opioid rotation where indicated, may offer a successful management approach. Other rehabilitative procedures such as physiotherapy, exercise therapy, and good sleep hygiene may have a profound impact on patient quality of life. Spinal cord stimulation may be an effective option for some patients with failed spinal surgery syndrome. A case of severe low back pain after surgery in a 45-year-old man is presented to illustrate this. PMID:24801975

  1. Severe accident sequence assessment for boiling water reactors: program overview

    The Severe Accident Sequence Assessment (SASA) Program was started at the Oak Ridge National Laboratory (ORNL) in June 1980. This report documents the initial planning, specification of objectives, potential uses of the results, plan of attack, and preliminary results. ORNL was assigned the Brown's Ferry Unit 1 Plant with the station blackout being the initial sequence set to be addressed. This set includes: (1) loss of offsite and onsite ac power with no coolant injection; and (2) loss of offsite and onsite ac power with high pressure coolant injection (HPCI) and reactor core isolation cooling (RCIC) as long as dc power supply lasts. This report includes representative preliminary results for the former case

  2. Microfluidic devices and methods including porous polymer monoliths

    Hatch, Anson V.; Sommer, Gregory j.; Singh, Anup K.; Wang, Ying-Chih; Abhyankar, Vinay

    2015-12-01

    Microfluidic devices and methods including porous polymer monoliths are described. Polymerization techniques may be used to generate porous polymer monoliths having pores defined by a liquid component of a fluid mixture. The fluid mixture may contain iniferters and the resulting porous polymer monolith may include surfaces terminated with iniferter species. Capture molecules may then be grafted to the monolith pores.

  3. Solar Energy Education. Reader, Part II. Sun story. [Includes glossary

    1981-05-01

    Magazine articles which focus on the subject of solar energy are presented. The booklet prepared is the second of a four part series of the Solar Energy Reader. Excerpts from the magazines include the history of solar energy, mythology and tales, and selected poetry on the sun. A glossary of energy related terms is included. (BCS)

  4. 7 CFR 1437.303 - Aquaculture, including ornamental fish.

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Aquaculture, including ornamental fish. 1437.303... ASSISTANCE PROGRAM Determining Coverage Using Value § 1437.303 Aquaculture, including ornamental fish. (a... humans; and (3) Ornamental fish propagated and reared in an aquatic medium. (b) The aquacultural...

  5. Including Siblings in the Treatment of Child Sexual Abuse.

    Baker, Juanita N.; Tanis, Heyley J.; Rice, Jennifer B.

    2001-01-01

    Describes the necessity of including siblings in the treatment of victims of child sexual abuse. Theoretical and practical reasons to include siblings in treatment are discussed. Case examples using a particular intervention approach and results of client satisfaction surveys are described. (Contains 18 references.) (GCP)

  6. 20 CFR 404.1312 - World War II service included.

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false World War II service included. 404.1312... DISABILITY INSURANCE (1950- ) Wage Credits for Veterans and Members of the Uniformed Services World War II Veterans § 404.1312 World War II service included. Your service was in the active service of the...

  7. 31 CFR 103.51 - Dollars as including foreign currency.

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Dollars as including foreign currency... RECORDKEEPING AND REPORTING OF CURRENCY AND FOREIGN TRANSACTIONS General Provisions § 103.51 Dollars as including foreign currency. Wherever in this part an amount is stated in dollars, it shall be deemed to...

  8. 26 CFR 1.1013-1 - Property included in inventory.

    2010-04-01

    ... 26 Internal Revenue 11 2010-04-01 2010-04-01 true Property included in inventory. 1.1013-1 Section... inventory. The basis of property required to be included in inventory is the last inventory value of such property in the hands of the taxpayer. The requirements with respect to the valuation of an inventory...

  9. Microfluidic devices and methods including porous polymer monoliths

    Hatch, Anson V; Sommer, Gregory J; Singh, Anup K; Wang, Ying-Chih; Abhyankar, Vinay V

    2014-04-22

    Microfluidic devices and methods including porous polymer monoliths are described. Polymerization techniques may be used to generate porous polymer monoliths having pores defined by a liquid component of a fluid mixture. The fluid mixture may contain iniferters and the resulting porous polymer monolith may include surfaces terminated with iniferter species. Capture molecules may then be grafted to the monolith pores.

  10. Making Way and Making Sense: Including Newcomers in Interaction

    Pillet-Shore, Danielle

    2010-01-01

    In our everyday interactions as they unfold in real time, how do we do including? This article examines a specific set of interactional moments when the potential to be included (or not) recurs: when a newcomer arrives to some social scene where two or more already-present persons are actively engaged in some activity and that newcomer displays…

  11. Repetitive intratracheal bleomycin models several features of idiopathic pulmonary fibrosis

    Degryse, Amber L.; Tanjore, Harikrishna; Xu, Xiaochuan C.; Polosukhin, Vasiliy V.; Jones, Brittany R.; McMahon, Frank B.; Gleaves, Linda A.; Blackwell, Timothy S.; Lawson, William E.

    2010-01-01

    Single-dose intratracheal bleomycin has been instrumental for understanding fibrotic lung remodeling, but fails to recapitulate several features of idiopathic pulmonary fibrosis (IPF). Since IPF is thought to result from recurrent alveolar injury, we aimed to develop a repetitive bleomycin model that results in lung fibrosis with key characteristics of human disease, including alveolar epithelial cell (AEC) hyperplasia. Wild-type and cell fate reporter mice expressing β-galactosidase in cells...

  12. Dependence of severe accident source terms on containment performance

    The results of the BMI-2104 analyses for the assessment of severe accident fission product source terms from the point of view of the effectiveness of the containment in attenuating the radioactivity that is predicted to be released to it are examined. The containment performance assumptions considered include design leakage, leak-before-break, large threshold failure and failure to isolate. The results are expressed and discussed in terms of the effective containment decontamination factors inferred from these analyses

  13. Recurrent severe hyperandrogenism during pregnancy: a case report

    Holt, H B; Medbak, S; Kirk, D.; Guirgis, R; Hughes, I.; Cummings, M H; Meeking, D R

    2005-01-01

    This report describes the case of a 28 year old woman with virilisation occurring in two successive pregnancies. Recurrent maternal virilisation is rare (seven previous reports) and this case is unique in its severity. Differential diagnoses include ovarian disease and fetal aromatase deficiency. New techniques to exclude a fetal cause were used in this case. This patient presented during the third trimester of her first pregnancy with rapid onset of hirsuitism, increased musculature, and dee...

  14. FACTORS RELATED TO SEVERE ACUTE ASTHMA ATTACK AND TREATMENT

    Kohinur Begum et al

    2012-01-01

    Asthma is a major public health burden that affects a large number of individuals. The prevalence of this chronic disease is very high in Bangladesh. This study is intended to understand the causes of disease and factors that contribute to its progression and to develop improved treatment strategies. The study population included severe acute attack of asthma patients admitted to National Institute of Diseases of the Chest and Hospital, Mohakhali, Dhaka, Bangladesh during October-December 201...

  15. Tritiation and characterization of several polyamine natural products

    Methods are presented to tritiate the polyamines putrescine and spermine. - Highlights: • This paper describes the synthesis of [3H] putrescine and [3H] spermine. • Several diverse tritiation methods were used to accomplish these radiolabellings including tritium reduction of an olefin as well as tritium reduction of a bis nitrile precursor. • This paper also describes the characterization of [3H] putrescine by tritium NMR

  16. Summary on Several Key Techniques in 3D Geological Modeling

    Gang Mei

    2014-01-01

    Several key techniques in 3D geological modeling including planar mesh generation, spatial interpolation, and surface intersection are summarized in this paper. Note that these techniques are generic and widely used in various applications but play a key role in 3D geological modeling. There are two essential procedures in 3D geological modeling: the first is the simulation of geological interfaces using geometric surfaces and the second is the building of geological objects by means of vario...

  17. Day treatment of patients with severe work-related complaints

    Meesters Y; Horwitz EH; van Velzen CJ

    2012-01-01

    Ybe Meesters, Ernst H Horwitz, Carol JM van VelzenUniversity of Groningen, University Medical Center Groningen, University Center for Psychiatry, Groningen, The NetherlandsAbstract: A day treatment program was developed for patients suffering with severe work-related complaints who were unable to function at work because of this. The program consisted of a number of treatment modalities, including Cognitive Behavioural Therapy, protocolized nonverbal therapies, and activation. The main object...

  18. Severe Thrombotic Events Associated with Dengue Fever, Brazil

    da Costa, Paulo Sérgio Gonçalves; Ribeiro, Geyza Machado; Junior, Cleber Soares; da Costa Campos, Lenilton

    2012-01-01

    Dengue fever has been a major problem in hospital settings in Brazil for the past 15 years. The main concern has been the severe forms, i.e., dengue hemorrhagic fever and dengue shock syndrome. Hemorrhagic events of different degrees have also been a major concern. We report five cases of large vein thrombotic events associated with the acute phase of dengue fever, including a previously non-reported case of mesenteric vein thrombosis. Complications such as these could have been overlooked in...

  19. OIL YIELD STABILITY OF SEVERAL SUNFLOWER OS HYBRIDS

    Vlado Guberac; Sonja Marić; Anto Mijić; Miroslav Krizmanić

    2006-01-01

    The aim of this research work was to assess height, stability and adaptability of oil yield in several Croatian sunflower hybrids. Trials were conducted on three locations (Osijek, Karanac and Feričanci) during vegetation years 2002 and 2003. In the research work nine experimental and five recognized sunflower hybrids of Agricultural Institute Osijek were included. Four parameters were used for analysis of stability and adaptability: ecovalence, regression coefficient, deviation from regres...

  20. Rhabdomyolysis and Acute Kidney Injury due to Severe Heat Stroke

    Carlos Fragachán G.; Máximo H. Trujillo

    2011-01-01

    We present a case of heat stroke (HS) and acute kidney injury (AKI) due to severe rhabdomyolysis in a 14-year-old previously healthy female patient. When she was practicing strenuous exercise she suffered acute seizures and high fever. These symptoms were followed by coma and multiple organ failure (MOF), which included AKI, encephalopathy, fulminant hepatic failure (FHF), and disseminated intravascular coagulation (DIC). The patient was managed in the ICU with renal replacement therapy, vent...

  1. Symptom severity of bipolar disorder during the menopausal transition

    Marsh, Wendy K.; Gershenson, Bernice; Rothschild, Anthony J.

    2015-01-01

    Background Little is known about the mood symptom experience of women with bipolar disorder during the menopausal transition (MT). Yet times of rapid hormonal decline, such as the postpartum, are associated with increased risk of severe mood episodes in bipolar disorder, and the MT is a time of increased risk for unipolar depression in women with or without a history of depression. Methods Enrollment included 56 women 40–60 years old diagnosed in the bipolar spectrum who were experiencing men...

  2. Tritiation and characterization of several suicide substrate enzyme inactivators

    Methods are presented to tritiate the enzyme inhibitors pargyline and caracemide. - Highlights: • This paper describes the synthesis of [3H] pargyline and [3H] caracemide. • Several diverse tritiation methods were used to accomplish these labellings and include halogenation–tritium dehalogenation as well as the preparation of [3H] methyl isocyanate. • This paper also describes the characterization of these substances by tritium NMR

  3. Several Affinity Tags Commonly Used in Chromatographic Purification

    Xinyu Zhao; Guoshun Li; Shufang Liang

    2013-01-01

    Affinity tags have become powerful tools from basic biological research to structural and functional proteomics. They were widely used to facilitate the purification and detection of proteins of interest, as well as the separation of protein complexes. Here, we mainly discuss the benefits and drawbacks of several affinity or epitope tags frequently used, including hexahistidine tag, FLAG tag, Strep II tag, streptavidin-binding peptide (SBP) tag, calmodulin-binding peptide (CBP), glutathione S...

  4. Brain CT findings of severely multiple handicapped children

    Brain CT were performed in 63 severely multiple handicapped children (30 males and 33 females) ranging in age from 2 to 21 years. Abnormal findings including ventricular dilatation and cortical atrophy were detected in 56 of the patients (88.9%). There was no specific finding for athetosis type cerebral palsy. There was no constant relationship between underlying diseases and CT findings.(Namekawa, K.)

  5. Bothrops lanceolatus Bites: Guidelines for Severity Assessment and Emergent Management

    Resiere, Dabor; Mégarbane, Bruno; Valentino, Ruddy; Mehdaoui, Hossein; Thomas, Laurent

    2010-01-01

    Approximately 20-30 declared snakebite cases occurin Martinique each year. Bothrops lanceolatus, a member of the Crotalidae family, is considered to be the only involved snake. B. lanceolatus, commonly named “Fer-de-Lance”, is endemic and only found on this Caribbean island. Envenomation local features include the presence of fang marks, swelling, pain, bleeding from punctures, and ecchymosis. Severe envenomation is associated with multiple systemic thromboses appearing within 48 h of the bit...

  6. Injury Mechanisms and Severity in Narrow Offset Frontal Impacts

    Pintar, Frank A.; Yoganandan, Narayan; Maiman, Dennis J.

    2008-01-01

    Current standard frontal crash tests include full frontal or 40% offset. Frontal impacts with offsets less than 40% and corner impacts have received little attention. Because of the limited engagement of vehicle structures that would permit less energy dissipation, these crashes have the potential for severe trauma to the near-side occupant. Narrow offset and corner-impact crashes under a frontal impact classification were analyzed using data obtained from the United States Department of Tran...

  7. Severe Refractory Coeliac Disease with Response Only to Parenteral Nutrition

    Ng, Ka Ying Bonnie; Mehta, Ravi; Mohamed, Salma; Mohamed, Zameer; Arnold, Jayantha

    2014-01-01

    Refractory coeliac disease (RCD) is characterised by recurrent or persistent malabsorptive symptoms and villous atrophy, despite strict adherence to a gluten-free diet for at least 6 months and where other causes of malabsorption including malignancy have been excluded. There is limited evidence and guidance on the effective management of these patients. We describe a case of severe RCD in our hospital, with symptoms controlled effectively only by total parenteral nutrition (TPN). This 68-yea...

  8. Severe Acute Respiratory Syndrome: Clinical and Laboratory Manifestations

    Lam, Christopher W.K.; Chan, Michael H M; Wong, Chun K.

    2004-01-01

    Severe acute respiratory syndrome (SARS) is a recently emerged infectious disease with significant morbidity and mortality. An epidemic in 2003 affected 8,098 patients in 29 countries with 774 deaths. The aetiological agent is a new coronavirus spread by droplet transmission. Clinical and general laboratory manifestations included fever, chills, rigor, myalgia, malaise, diarrhoea, cough, dyspnoea, pneumonia, lymphopenia, neutrophilia, thrombocytopenia, and elevated serum lactate dehydrogenase...

  9. Articles which include chevron film cooling holes, and related processes

    Bunker, Ronald Scott; Lacy, Benjamin Paul

    2014-12-09

    An article is described, including an inner surface which can be exposed to a first fluid; an inlet; and an outer surface spaced from the inner surface, which can be exposed to a hotter second fluid. The article further includes at least one row or other pattern of passage holes. Each passage hole includes an inlet bore extending through the substrate from the inlet at the inner surface to a passage hole-exit proximate to the outer surface, with the inlet bore terminating in a chevron outlet adjacent the hole-exit. The chevron outlet includes a pair of wing troughs having a common surface region between them. The common surface region includes a valley which is adjacent the hole-exit; and a plateau adjacent the valley. The article can be an airfoil. Related methods for preparing the passage holes are also described.

  10. Relation between measurements of cough severity

    Chang, A; Phelan, P.; Robertson, C.; Roberts, R; Sawyer, S

    2003-01-01

    Background: In asthma, measurements of airway inflammation correlate poorly with clinical markers and airway hyperresponsiveness. While the relation between determinants of asthma severity is known, that for cough is unknown. We hypothesised that cough sensitivity changes relate to changes in cough scores and objectively measured cough frequency.

  11. Rare, severe hypersensitivity reaction to potassium iodide

    Nielsen, Anne Sofie Korsholm; Ebbehøj, Eva; Richelsen, Bjørn

    2014-01-01

    The literature reports a large variety of adverse reactions to potassium iodide. A severe hypersensitivity reaction to potassium iodide in a 51-year-old woman with Graves' thyrotoxicosis is described. Following administration the patient developed sialadenitis, conjunctivitis, stomatitis and acne...

  12. Caffeinated drinks, alcohol consumption and hangover severity

    Penning, R.; de Haan, L.; Verster, J.C.

    2011-01-01

    This study examined the relationship between consumption of caffeinated beverages and alcohol, and effects on next day hangover severity. In 2010, a survey funded by Utrecht University was conducted among N=549 Dutch students. Beverages consumed on their latest drinking session that produced a hango

  13. Oral Fluid Therapy in Severe Diarrheal Dehydration

    Z Nowroozi

    1986-07-01

    Full Text Available 1330 children, birth to 24 months old, suffering from diarrhea and moderate to severe dehydration were hospitalized in Tehran university hospital over a period of 11 months. 15% of them had signs of shock, and 305 had marasmus. On admission, plasma sodium ranged from 106 to 144 mmol/l, potassium 1.4 to 7.7 mmol/l, bicarbonate 2 to 24 mmol/l, chloride 83 to 161 mmol/l and PH ranged from 6.48 to 7.56. All patients were treated orally in two phases: A Rehydration therapy, and B Maintenance therapy. For rehydration, electrolyte solution A (EA: Sodium 80, potassium 20 mmol/l was administrated at a rate of 40 ml/kg/h until all signs of dehydration disappeared. Following complete dehydration, the patients were discharged and maintenance therapy was performed at home, by mothers, administrating electrolyte solution B (EB: Sodium 40, potassium 30 mmol/l ad libitum. Antibiotics, anti-diarrhea and anti-emetic drugs were not used. Intravenous fluids were not used either, even in sever dehydration. The efficacy and safety of this regimen were confirmed by rapid and successful rehydration and correction of the electrolyte abnormalities present on admission. The study indicates that this protocol could be successfully employed in all types and severities of dehydration electrolyte abnormalities. It could be used in both well-nourished and in those with severe marasmus. It could also replace intravenous fluid in the majority of such patients.

  14. Several Forms of Fuzzy Analogical Reasoning

    Bouchon-Meunier, B; Delechamp, J.; Marsala, C.; Rifqi, M.

    1997-01-01

    We present a general framework representing analogy, on the basis of a link between variables and measures of comparison between values of variables. This analogical scheme is proven to represent a common description of several forms of reasoning used in fuzzy control or in the management of knowledge-based systems, such as deductive reasoning, inductive reasoning or prototypical reasoning, gradual reasoning.

  15. Severe chorea after acute carbon monoxide poisoning.

    Davous, P; Rondot, P; Marion, M H; Gueguen, B

    1986-01-01

    Ten days after an acute exposure to carbon monoxide, a 33-year-old woman exhibited severe chorea. CT scan revealed bilateral lucencies of the pallidum and anterior arm of the internal capsule. Chorea was successfully treated by chlorpromazine and did not relapse after treatment withdrawal. The mechanism of chorea in acute carbon monoxide poisoning is discussed.

  16. Speech Intelligibility in Severe Adductor Spasmodic Dysphonia

    Bender, Brenda K.; Cannito, Michael P.; Murry, Thomas; Woodson, Gayle E.

    2004-01-01

    This study compared speech intelligibility in nondisabled speakers and speakers with adductor spasmodic dysphonia (ADSD) before and after botulinum toxin (Botox) injection. Standard speech samples were obtained from 10 speakers diagnosed with severe ADSD prior to and 1 month following Botox injection, as well as from 10 age- and gender-matched…

  17. Coexisting Problem Behaviour in Severe Dyslexia

    Dahle, Anne Elisabeth; Knivsberg, Ann-Mari; Andreassen, Anne Brit

    2011-01-01

    A small group of children and young adolescent with dyslexia has severely impaired reading skills despite prolonged special education. These are the students in focus. In dyslexia, problem behaviour, internalised as well as externalised, has previously been reported, so also for the participants with dyslexia in this study. The aim of the present…

  18. CLINICAL ASPECTS OF UNCOMPLICATED AND SEVERE MALARIA

    Alessandro Bartoloni

    2012-05-01

    Full Text Available The first symptoms of malaria, common to all the different malaria species, are nonspecific and mimic a flu-like syndrome. Although fever represents the cardinal feature, clinical findings in malaria are extremely diverse and may range in severity from mild headache to serious complications leading to death, particularly in falciparum malaria. As the progression to these complications can be rapid, any malaria patient must be assessed and treated rapidly, and frequent observations are needed to look for early signs of systemic complications. In fact, severe malaria is a life threatening but treatable disease.  The protean and nonspecific clinical findings occurring in malaria (fever, malaise, headache, myalgias, jaundice and sometimes gastrointestinal symptoms of nausea, vomiting and diarrhoea may lead physicians who see malaria infrequently to a wrong diagnosis, such as influenza (particularly during the seasonal epidemic flu, dengue, gastroenteritis, typhoid fever, viral hepatitis, encephalitis. Physicians should be aware that malaria is not a clinical diagnosis but must be diagnosed, or excluded, by performing microscopic examination of blood films. Prompt diagnosis and appropriate treatment are then crucial to prevent morbidity and fatal outcomes. Although Plasmodium falciparum malaria is the major cause of severe malaria and death, increasing evidence has recently emerged that Plasmodium vivax and Plasmodium knowlesi can also be severe and even fatal.

  19. Service Needs of Severely Disturbed Children.

    Trupin, Eric W.; And Others

    1991-01-01

    Investigates the service needs of severely emotionally disturbed children. Primary case workers of 3,398 children and adolescents under state care were surveyed regarding the children's treatment history and social and clinical conditions. Nontraditional home- and school-based services were the needs most frequently reported. (CJS)

  20. Why Does Asthma Attack Severely at Night?

    2008-01-01

    @@ The rhythmic changes of human physiological activities by day and at night may cause regular change of the patient's condition within one day. The following is the explanation with the theory of Chinese medicine for the reason why asthma attacks severely at night.

  1. Managing the Student with Severe Food Allergies

    Robinson, Joanne M.; Ficca, Michelle

    2012-01-01

    School nurses play a key role in managing students with food allergies. It is becoming more common to encounter students with severe allergies to multiple foods, putting them at risk for anaphylaxis. It is essential that the school nurse have a clear understanding of food allergies and how to effectively manage students in the school setting.…

  2. Convex trace functions of several variables

    Hansen, Frank

    We prove that the function (x1,...,xk)¿Tr(f(x1,...,xk)), defined on k-tuples of symmetric matrices of order (n1,...,nk) in the domain of f, is convex for any convex function f of k variables. The matrix f(x1,...,xk) is defined by the functional calculus for functions of several variables, and it is...

  3. Semi-synthesis of Several Stigmasterol Saponins

    LI, Chun-Xia; GUO, Tian-Tian; WANG, Peng; GUAN, Hua-Shi; LI, Ying-Xia

    2006-01-01

    Several stigamasterol saponins were concisely synthesized. Namely, four monosaccharide (glucopyranose, galactopyranose, xylopyranose, 2-acetamido-2-deoxy-a-D-glucopyranose), lactopyranose and chacotriose were coupled with 3-OH of stigmasterol. All the compounds were identified by NMR, IR and high resolusion MS.

  4. Global Strain in Severe Aortic Valve Stenosis

    Dahl, Jordi S; Videbæk, Lars; Poulsen, Mikael K;

    2012-01-01

    Score, history with ischemic heart disease and ejection fraction. CONCLUSIONS: -In patients with symptomatic severe aortic stenosis undergoing AVR reduced GLS provides important prognostic information beyond standard risk factors. Clinical Trial Registration-URL: http://www.clinicaltrial.gov. Unique identifier...

  5. Bilateral microperc in a severe kyphoscoliosis

    Dağgülli, Mansur; Penbegül, Necmettin; Dede, Onur; Utanğaç, Mehmet Mazhar

    2016-01-01

    Percutaneous nephrolithotomy is the standard modality for large renal calculi in normal and abnormal renal anatomic situations. This case report describes a 57-year-old male patient who presented with bilateral kidney stones and severe kyphoscoliosis. He had successfully been treated with a bilateral microperc technique. PMID:27011881

  6. Severe Accident Test Station Activity Report

    Pint, Bruce A [ORNL; Terrani, Kurt A [ORNL

    2015-06-01

    Enhancing safety margins in light water reactor (LWR) severe accidents is currently the focus of a number of international R&D programs. The current UO2/Zr-based alloy fuel system is particularly susceptible since the Zr-based cladding experiences rapid oxidation kinetics in steam at elevated temperatures. Therefore, alternative cladding materials that offer slower oxidation kinetics and a smaller enthalpy of oxidation can significantly reduce the rate of heat and hydrogen generation in the core during a coolant-limited severe accident. In the U.S. program, the high temperature steam oxidation performance of accident tolerant fuel (ATF) cladding solutions has been evaluated in the Severe Accident Test Station (SATS) at Oak Ridge National Laboratory (ORNL) since 2012. This report summarizes the capabilities of the SATS and provides an overview of the oxidation kinetics of several candidate cladding materials. A suggested baseline for evaluating ATF candidates is a two order of magnitude reduction in the steam oxidation resistance above 1000ºC compared to Zr-based alloys. The ATF candidates are categorized based on the protective external oxide or scale that forms during exposure to steam at high temperature: chromia, alumina, and silica. Comparisons are made to literature and SATS data for Zr-based alloys and other less-protective materials.

  7. SEVERE PERIPHERAL NEUROPATHY SECONDARY TO VINCRISTIN THERAPY

    Ayşe Oytun Bayrak

    2007-01-01

    Full Text Available Patients with hereditary neuropathy being at high risk of severe vincristin neurotoxicity are well known. Here, along with the review of the literature, we described two patients with unrecognized hereditary neuropathy who developed foot drop following low dose vincristin therapy. With this report we wanted to emphasize the importance of detailed neurologic examination and history taking before initiating therapy.

  8. Needs of people with severe mental illness

    Wiersma, D

    2006-01-01

    Objective: This study reviews conceptual and methodological issues of needs for care among people with severe mental illness (SMI) and presents data on their prevalence, correlates and consequences for mental health care. Method: Focus is on the definition of the concept of need as what people can b

  9. Postpartum Depression After Mild and Severe Preeclampsia

    Hoedjes, Meeke; Berks, Durk; Vogel, Ineke; Franx, Arie; Bangma, Meike; Darlington, Anne-Sophie E.; Visser, Willy; Duvekot, Johannes J.; Habbema, J. Dik F.; Steegers, Eric A. P.; Raat, Hein

    2011-01-01

    Objective: To describe the prevalence of postpartum depressive symptoms after preeclampsia, to assess the extent to which the prevalence of postpartum depressive symptoms differs after mild and severe preeclampsia, and to investigate which factors contribute to such differences. Methods: Women diagn

  10. Application of FFTBM to severe accidents

    In Europe an initiative for the reduction of uncertainties in severe accident safety issues was initiated. Generally, the error made in predicting plant behaviour is called uncertainty, while the discrepancies between measured and calculated trends related to experimental facilities are called the accuracy of the prediction. The purpose of the work is to assess the accuracy of the calculations of the severe accident International Standard Problem ISP-46 (Phebus FPT1), performed with two versions of MELCOR 1.8.5 for validation purposes. For the quantitative assessment of calculations the improved fast Fourier transform based method (FFTBM) was used with the capability to calculate time dependent code accuracy. In addition, a new measure for the indication of the time shift between the experimental and the calculated signal was proposed. The quantitative results obtained with FFTBM confirm the qualitative conclusions made during the Jozef Stefan Institute participation in ISP-46. In general good agreement of thermal-hydraulic variables and satisfactory agreement of total releases for most radionuclide classes was obtained. The quantitative FFTBM results showed that for the Phebus FPT1 severe accident experiment the accuracy of thermal-hydraulic variables calculated with the MELCOR severe accident code is close to the accuracy of thermal-hydraulic variables for design basis accident experiments calculated with best-estimate system codes. (author)

  11. Measuring Severity and Change in Anorexia Nervosa.

    Piazza, Eugene; And Others

    1983-01-01

    Describes the State of Mind (SOM) Questionnaire, which measures severity and change of clinical state in anorexia nervosa. A study of 42 anorexia patients and 4 control groups showed a strong correlation between depression as measured by the Beck Depression Inventory and the Anorexia Scale, which comprise the SOM. (JAC)

  12. Severe apnoeas following immunisation in premature infants

    Slack, M; Schapira, D

    1999-01-01

    Four premature infants developed apnoeas severe enough to warrant resuscitation after immunisation with diphtheria, pertussis, and tetanus (DPT), and Haemophilus influenzae B (Hib). One required re-intubation and ventilation.
 Although apnoeas after immunisation are recognised, they are not well documented. It is time for further research to elucidate the best time to immunise such infants.



  13. Severe shock and vibration environments for electronic components

    Martinez, D.R.

    1990-01-01

    Electronic components used in system applications must be qualified to mechanical shock and vibration environments. Often these environments are severe, requiring the development and use of special test techniques and procedures. Environmental specifications are based upon analytical model predictions and measured test data. Test specifications are determined after careful consideration of simulation techniques, input levels, dynamic behavior of the test fixturing, as well as an assessment of the degree of conservatism imposed by the specification and testing procedures. The process of determining component shock and vibration specifications is discussed, beginning with the initial description of system and subsystem level environments, and concluding with component level test specifications. Included is a discussion of the difference between environmental specifications and test specifications, and the instrumentation/measurement problems associated with obtaining valid field measurements for severe shock data. The role of finite element analysis in predicting the dynamic structural response of components is also explained. Shock data analysis techniques are described including both time-domain and frequency-domain characterizations of the data. The resonant plate shock testing technique for simulating severe shock environments is presented, including difficulties that arise in practical applications. 18 refs., 10 figs.

  14. Comparison of radiation dosimetry for several potential myocardial imaging agents

    Although myocardial imaging is currently dominated by Tl-201, several alternative agents with improved physiologic or radionuclidic properties have been proposed. Based on human and animal studies in the literature, the metabolism of several of these compounds was studied for the purpose of generating radiation dose estimates. Dose estimates are listed for several I-123-labeled free fatty acids, an I-123-labeled phosphonium compound, Rb-82, Cu-64, F-18 FDG (all compounds which are taken up by the normal myocardium), and for Tc-99m pyrophosphate (PYP) (which localizes in myocardial infarcts). Dose estimates could not be generated for C-11 palmitate, but his compound was included in a comparison of myocardial retention times. For the I-123-labeled compounds, I-124 was included as a contaminant in generating the dose estimates. Radiation doses were lowest for Rb-82 (gonads 0.3-0.4 Gy/MBq, kidneys 8.6 Gy/MBq). Doses for the I-123-labeled fatty acids were similar to one another, with IPPA being the lowest (gonads 15 Gy/MBq, heart wall 18 Gy/MBq). Doses for Tc-99m PYP were also low (gonads 4-7 Gy/MBq, heart wall 4 Gy/MBq, skeleton 15 Gy/MBq). The desirability of these compounds is discussed briefly, considering half-life, imaging mode and energy, and dosimetry, including a comparison of the effective whole body dose equivalents. 37 references, 11 tables

  15. Westinghouse severe accident management guidance overview and current status

    The Westinghouse Owners Group has completed a major development program in Severe Accident Management. This program draws on all presently available sources of information in the field, including in the field, including NRC, NUMARC and EPRI programs, plant specific Individual Plant Examinations and Probabilistic Safety Assessments, and other international activities. The program has developed a full set of Severe Accident Management Guidance (SAMG) applicable to Westinghouse and Westinghouse licensee PWR plant. The SAMG enhances the capabilities of the plant emergency response team for accident sequences that progress to fuel damage, and therefore beyond the range of applicability of present guidance in the form of Emergency Operating Procedures. Since the first draft of SAMG was transmitted officially to the WOG members and the NRC in July 1993, many activities have been carried out by the different organizations involved, and although no significant changes to the SAMG structure have resulted from these activities, several enhancement have been included, mainly from the comments recorded during the generic SAMG validation exercise at the Point Beach plant. With the issue in June 1994 of the revision 0 SAMG, some plants in the U.S. and abroad are already implementing plant specific guidelines. This paper provides an overview of the SAMG package, and also describe the most important comments and feedback from the validation and review efforts. (author)

  16. Severe Jaccoud's arthropathy in systemic lupus erythematosus.

    Santiago, Mittermayer B; Galvão, Verena; Ribeiro, Daniel Sá; Santos, Willer D; da Hora, Priscila R; Mota, Anna Paula; Pimenta, Emanuela; Oliveira, Isabela; Atta, Ajax M; Reis, Mitermayer G; Reis, Eliana A G; Lins, Carolina

    2015-10-01

    Jaccoud's arthropathy (JA) is a clinical situation nowadays present mostly in systemic lupus erythematosus (SLE). It is characterized by the presence of joint deformities such as "swan neck," ulnar deviation and "Z-thumb" resembling rheumatoid arthritis (RA) but that are passively correctable and without bone erosion on plain radiographs. From our cohort of SLE patients with JA, we selected a subgroup with a more severe form of this arthropathy and looked at their clinical and laboratory profile as well as studied the magnetic resonance imaging (MRI) findings or ultrasound (US) obtained from the hand with most evident deformities. Seven SLE patients with a severe form of JA were identified. All seven patients have "swan neck," ulnar deviation and "Z-thumb" deformities. Two out of seven had "mutilans-type JA" and four had fixed deformities in the metacarpophalangeal (MCP) joints. The MRI of the hand with more evident deformity clinically performed in six cases and US performed in one case showed mild synovitis in five and moderate synovitis in two patients, mild flexor tenosynovitis in six and severe tenosynovitis in one. Only two small bone erosions were observed in the second and third MCP joints of one patient with moderate synovitis. Severe JA compromises the functional capacity of the joints and imposes the risk of misdiagnosis of RA. With the improvement of the survival rate of SLE and the lack of specific prophylactic or therapeutical measures for JA, it is reasonable to assume that more and more cases of severe JA are going to be identified. PMID:26310503

  17. Long-term reductions in tinnitus severity

    Folmer Robert L

    2002-09-01

    Full Text Available Abstract Background This study was undertaken to assess long-term changes in tinnitus severity exhibited by patients who completed a comprehensive tinnitus management program; to identify factors that contributed to changes in tinnitus severity within this population; to contribute to the development and refinement of effective assessment and management procedures for tinnitus. Methods Detailed questionnaires were mailed to 300 consecutive patients prior to their initial appointment at the Oregon Health & Science University Tinnitus Clinic. All patients were then evaluated and treated within a comprehensive tinnitus management program. Follow-up questionnaires were mailed to the same 300 patients 6 to 36 months after their initial tinnitus clinic appointment. Results One hundred ninety patients (133 males, 57 females; mean age 57 years returned follow-up questionnaires 6 to 36 months (mean = 22 months after their initial tinnitus clinic appointment. This group of patients exhibited significant long-term reductions in self-rated tinnitus loudness, Tinnitus Severity Index scores, tinnitus-related anxiety and prevalence of current depression. Patients who improved their sleep patterns or Beck Depression Inventory scores exhibited greater reductions of tinnitus severity scores than patients who continued to experience insomnia and depression at follow-up. Conclusions Individualized tinnitus management programs that were designed for each patient contributed to overall reductions in tinnitus severity exhibited on follow-up questionnaires. Identification and treatment of patients experiencing anxiety, insomnia or depression are vital components of an effective tinnitus management program. Utilization of acoustic therapy also contributed to improvements exhibited by these patients.

  18. Designing a Pediatric Severe Sepsis Screening Tool

    Robert eSepanski

    2014-06-01

    Full Text Available We sought to create a screening tool with improved predictive value for pediatric severe sepsis and septic shock that can be incorporated into the electronic medical record and actively screen all patients arriving at a pediatric Emergency Department (ED. Gold standard severe sepsis cases were identified using a combination of coded discharge diagnosis and physician chart review from 7,402 children who visited a pediatric ED over two months. The tool’s identification of severe sepsis was initially based on International Consensus Conference on Pediatric Sepsis (ICCPS parameters that were refined by an iterative, virtual process that allowed us to propose successive changes in sepsis detection parameters in order to optimize the tool’s predictive value based on receiver operating curve (ROC characteristics. Age-specific normal and abnormal values for heart rate (HR and respiratory rate (RR were empirically derived from 143,603 children seen in a second pediatric ED over three years. Univariate analyses were performed for each measure in the tool to assess its association with severe sepsis and to characterize it as an early or late indicator of severe sepsis. A split-sample was used to validate the final, optimized tool. The final tool incorporated age-specific thresholds for abnormal HR and RR and employed a linear temperature correction for each category. The final tool’s positive predictive value was 48.7%, a significant, nearly three-fold improvement over the original ICCPS tool. False positive Systemic Inflammatory Response Syndrome (SIRS identifications were nearly six-fold lower.

  19. Procalcitonin levels associate with severity of Clostridium difficile infection.

    Krishna Rao

    Full Text Available OBJECTIVE: Clostridium difficile infection (CDI is a major cause of morbidity and biomarkers that predict severity of illness are needed. Procalcitonin (PCT, a serum biomarker with specificity for bacterial infections, has been little studied in CDI. We hypothesized that PCT associated with CDI severity. DESIGN: Serum PCT levels were measured for 69 cases of CDI. Chart review was performed to evaluate the presence of severity markers and concurrent acute bacterial infection (CABI. We defined the binary variables clinical score as having fever (T >38°C, acute organ dysfunction (AOD, and/or WBC >15,000 cells/mm(3 and expanded score, which included the clinical score plus the following: ICU admission, no response to therapy, colectomy, and/or death. RESULTS: In univariate analysis log10 PCT associated with clinical score (OR 3.13, 95% CI 1.69-5.81, P0.2 ng/mL was 81% sensitive/73% specific for a positive clinical score and had a negative predictive value of 90%. CONCLUSION: An elevated PCT level associated with the presence of CDI severity markers and CDI was unlikely to be severe with a serum PCT level below 0.2 ng/mL. The extent to which PCT changes during CDI therapy or predicts recurrent CDI remains to be quantified.

  20. Severe cytomegalovirus infection in apparently immunocompetent patients: a systematic review

    Varbobitis Ioannis C

    2008-03-01

    Full Text Available Abstract Background The morbidity and mortality associated with cytomegalovirus (CMV infection in immunocompromised patients (especially in HIV-infected patients and transplant recipients, as well as with congenital CMV infection are well known. In contrast, relatively little attention has been paid to the morbidity and mortality that CMV infection may cause in immunocompetent patients. Methods We reviewed the evidence associated with severe manifestations of CMV infection in apparently immunocompetent patients and the potential role of antiviral treatment for these infections. We searched in PubMed, Scopus, and the Cochrane Library for the period of 1950–2007 to identify relevant articles. Results We retrieved 89 articles reporting on severe CMV infection in 290 immunocompetent adults. Among these reports, the gastrointestinal tract (colitis and the central nervous system (meningitis, encephalitis, transverse myelitis were the most frequent sites of severe CMV infection. Manifestations from other organ-systems included haematological disorders (haemolytic anaemia, thrombocytopenia, thrombosis of the venous or arterial vascular system, ocular involvement (uveitis, and lung disease (pneumonitis. The clinical practice reported in the literature has been to prescribe antiviral treatment for the most severe manifestations of monophasic meningoencephalitis (seizures and coma, ocular involvement, and lung involvement due to CMV. Conclusion Severe life-threatening complications of CMV infection in immunocompetent patients may not be as rare as previously thought.

  1. New classification scheme for atrial fibrillation symptom severity and burden.

    Koci, Florian; Forbes, Peter; Mansour, Moussa C; Heist, E Kevin; Singh, Jagmeet P; Ellinor, Patrick T; Ruskin, Jeremy N

    2014-07-15

    Although atrial fibrillation (AF) symptom severity is used to guide clinical care, a simple, standardized assessment tool is not available for routine clinical use. We sought to develop and validate a patient-generated score and classification scheme for AF-related symptom severity and burden. Atrial Fibrillation Symptom and Burden, a simple 2-part questionnaire, was designed to assess (1) AF symptom severity using 8 questions to determine how symptoms affect daily life and (2) AF burden using 6 questions to measure AF frequency, duration, and health-care utilization. The resulting score was used to classify patients into 4 classes of symptom and burden severity. Patients were asked to complete the questionnaire, a survey evaluating the questionnaire, and an Short Form-12v2 generic health-related quality-of-life form. Validation of the questionnaire included assessments of its reliability and construct and known groups validity. The strength of interrater agreement between patient-generated and blinded provider-generated classifications of AF symptom severity was also assessed. The survey had good internal consistency (Cronbach α>0.82) and reproducibility (intraclass correlation coefficient=0.93). There was a good linear correlation with health-related quality-of-life aggregates measured by Pearson correlation coefficient (r=0.62 and 0.42 vs physical component summary and mental component summary, respectively). Compared with physical and mental component summary scores, the patient-generated symptom severity classification scheme showed robust discrimination between mild and moderate severity (pcorrelated with standardized quality-of-life measures. PMID:24878121

  2. Postprandial biochemistry changes in penguins (Spheniscus demersus) including hyperuricemia.

    Cray, Carolyn; Stremme, Donald W; Arheart, Kristopher L

    2010-06-01

    In a clinical setting, it is important to differentiate abnormal values that may be a normal change resulting from feeding and those that may be disease related. Such postprandial changes have been identified in mammalian and avian species. In the current study, pre- and postvalues for several routine biochemical analytes from penguins (Spheniscus demersus) were examined. Significant increases were found in uric acid, triglycerides, and bile acids (P abnormal biochemistry values in penguins. PMID:20597226

  3. ORNL ALICE: a statistical model computer code including fission competition

    A listing of the computer code ORNL ALICE is given. This code is a modified version of computer codes ALICE and OVERLAID ALICE. It allows for higher excitation energies and for a greater number of evaporated particles than the earlier versions. The angular momentum removal option was made more general and more internally consistent. Certain roundoff errors are avoided by keeping a strict accounting of partial probabilities. Several output options were added

  4. Aeroelastic modal dynamics of wind turbines including anisotropic effects

    Skjoldan, Peter Fisker; Hansen, Morten Hartvig; Rubak, Rune; Thomsen, Kenneth

    2011-01-01

    Several methods for aeroelastic modal analysis of a rotating wind turbine are developed and used to analyse the modal dynamics of two simplified models and a complex model in isotropic and anisotropic conditions. The Coleman transformation is used to enable extraction of the modal frequencies, damping, and periodic mode shapes of a rotating wind turbine by describing the rotor degrees of freedom in the inertial frame. This approach is valid only for an isotropic system. Anisotropic systems, e...

  5. Stages of Plasma Cell Neoplasms (Including Multiple Myeloma)

    ... Treatment Health Professional Plasma Cell Neoplasms Treatment Research Plasma Cell Neoplasms (Including Multiple Myeloma) Treatment (PDQ®)–Patient Version General Information About Plasma Cell Neoplasms Go to Health Professional Version Key ...

  6. Treatment Options for Plasma Cell Neoplasms (Including Multiple Myeloma)

    ... Treatment Health Professional Plasma Cell Neoplasms Treatment Research Plasma Cell Neoplasms (Including Multiple Myeloma) Treatment (PDQ®)–Patient Version General Information About Plasma Cell Neoplasms Go to Health Professional Version Key ...

  7. Chronic Obstructive Pulmonary Disease (COPD) Includes: Chronic Bronchitis and Emphysema

    ... Obstructive Pulmonary Disease (COPD) Includes: Chronic Bronchitis and Emphysema Recommend on Facebook Tweet Share Compartir Data are ... of adults who have ever been diagnosed with emphysema: 3.4 million Percent of adults who have ...

  8. Pets: Your Plan Should Include All Family Members

    ... Emergencies › Pets Pets Your Plan Should Include All Family Members The best way to protect your household ... About Us Latest News Search for Jobs Military Families Disaster Relief International Services National Celebrity Cabinet Mission & ...

  9. Prototype solar heating and cooling systems, including potable hot water

    Bloomquist, D.; Oonk, R. L.

    1977-01-01

    Progress made in the development, delivery, and support of two prototype solar heating and cooling systems including potable hot water is reported. The system consists of the following subsystems: collector, auxiliary heating, potable hot water, storage, control, transport, and government-furnished site data acquisition. A comparison of the proposed Solaron Heat Pump and Solar Desiccant Heating and Cooling Systems, installation drawings, data on the Akron House at Akron, Ohio, and other program activities are included.

  10. Joining and fabrication techniques for high temperature structures including the first wall in fusion reactor

    Lee, Ho Jin; Lee, B. S.; Kim, K. B

    2003-09-01

    The materials for PFC's (Plasma Facing Components) in a fusion reactor are severely irradiated with fusion products in facing the high temperature plasma during the operation. The refractory materials can be maintained their excellent properties in severe operating condition by lowering surface temperature by bonding them to the high thermal conducting materials of heat sink. Hence, the joining and bonding techniques between dissimilar materials is considered to be important in case of the fusion reactor or nuclear reactor which is operated at high temperature. The first wall in the fusion reactor is heated to approximately 1000 .deg. C and irradiated severely by the plasma. In ITER, beryllium is expected as the primary armour candidate for the PFC's; other candidates including W, Mo, SiC, B4C, C/C and Si{sub 3}N{sub 4}. Since the heat affected zones in the PFC's processed by conventional welding are reported to have embrittlement and degradation in the sever operation condition, both brazing and diffusion bonding are being considered as prime candidates for the joining technique. In this report, both the materials including ceramics and the fabrication techniques including joining technique between dissimilar materials for PFC's are described. The described joining technique between the refractory materials and the dissimilar materials may be applicable for the fusion reactor and Generation-4 future nuclear reactor which are operated at high temperature and high irradiation.

  11. Joining and fabrication techniques for high temperature structures including the first wall in fusion reactor

    The materials for PFC's (Plasma Facing Components) in a fusion reactor are severely irradiated with fusion products in facing the high temperature plasma during the operation. The refractory materials can be maintained their excellent properties in severe operating condition by lowering surface temperature by bonding them to the high thermal conducting materials of heat sink. Hence, the joining and bonding techniques between dissimilar materials is considered to be important in case of the fusion reactor or nuclear reactor which is operated at high temperature. The first wall in the fusion reactor is heated to approximately 1000 .deg. C and irradiated severely by the plasma. In ITER, beryllium is expected as the primary armour candidate for the PFC's; other candidates including W, Mo, SiC, B4C, C/C and Si3N4. Since the heat affected zones in the PFC's processed by conventional welding are reported to have embrittlement and degradation in the sever operation condition, both brazing and diffusion bonding are being considered as prime candidates for the joining technique. In this report, both the materials including ceramics and the fabrication techniques including joining technique between dissimilar materials for PFC's are described. The described joining technique between the refractory materials and the dissimilar materials may be applicable for the fusion reactor and Generation-4 future nuclear reactor which are operated at high temperature and high irradiation

  12. Maternal and fetal recovery after severe respiratory failure due to influenza

    Madsen, Kristine; Strange, Ditte Gry; Hedegaard, Morten; Mathiesen, Elisabeth R; Damm, Peter

    2013-01-01

    During pregnancy women are at increased risk of severe complications to influenza infection, including death of mother or fetus, especially if chronic comorbid medical conditions such as diabetes mellitus are present.......During pregnancy women are at increased risk of severe complications to influenza infection, including death of mother or fetus, especially if chronic comorbid medical conditions such as diabetes mellitus are present....

  13. Relatives of patients with severe brain injury

    Norup, Anne; Petersen, Janne; Lykke Mortensen, Erik

    2015-01-01

    PRIMARY OBJECTIVE: To investigate trajectories and predictors of trajectories of anxiety and depression in relatives of patients with a severe brain injury during the first year after injury. RESEARCH DESIGN: A prospective longitudinal study with four repeated measurements. SUBJECTS: Ninety...... relatives of patients with severe brain injury. METHODS: The relatives were assessed on the anxiety and depression scales from the Symptom Checklist-90-Revised and latent variable growth curve models were used to model the trajectories. The effects of patient's age, patient's Glasgow Coma Score, level of...... function and consciousness, gender and relationship of the relatives were modelled. RESULTS: Improvement was found in both symptoms of anxiety and depression during the 12-month study period. The analysis revealed different trajectories for symptoms of anxiety and depression, as anxiety had a more rapid...

  14. Processing magnesium alloys by severe plastic deformation

    Figueiredo, Roberto B.; Aguilar, Maria Teresa P.; Cetlin, Paulo Roberto; Langdon, Terence G.

    2014-08-01

    The use of severe plastic deformation techniques for processing magnesium alloys has moved from the early difficulties of processing to a stage of tailoring the best properties of these materials. The present paper reviews processing, structure and mechanical properties characterization. It is shown that ultrafine-grained structures are obtained in magnesium alloys processed by multiple passes of Equal-Channel Angular Pressing at moderate temperatures. Ultrafine-grained structures are also obtained by room temperature processing by High- Pressure Torsion. The ultrafine-grained structures increase strength and introduce excellent superplastic capabilities in many magnesium alloys. Moreover, processing magnesium alloys by severe plastic deformation leads to the development of anisotropy in mechanical behavior.

  15. Very severe aplastic anemia appearing after thymectomy.

    Park, Chi Young; Kim, Hee Je; Kim, Yoo Jin; Park, Yoon Hee; Lee, Jong Wook; Min, Woo Sung; Kim, Chun Choo

    2003-03-01

    Aplastic anemia is a rare complication of thymoma and is extremely infrequent after thymectomy. We present a case of a 60-year-old woman with very severe aplastic anemia appearing sixteen months after thymectomy for a thymoma. She underwent thymectomy for a thymoma in April 2000. Preoperative examination revealed no hematologic abnormality. About sixteen months after the operation, she was readmitted because of pancytopenia with cough and fever. Bone marrow aspiration revealed a very severe hypoplasia in all the three cell lines with over 80% fatty tissue, and chest CT revealed no recurrence of thymoma. Her aplastic anemia had responded to cyclosporine A and granulocyte-colony stimulating factor (G-CSF). PMID:12760272

  16. CORPORATE DEBT AND CRISIS SEVERITY IN EUROPE

    Kinga Niemczak

    2013-05-01

    Full Text Available The aim of this paper is to analyse the financial structure of non-financial corporations in the European Union prior to the 2008 crisis and to determine whether the ex-ante differences in corporate financial structure had an impact on the severity of the 2008 financial crisis in European countries. The analysis confirms a negative relationship between the corporate debt ratio prior to the crisis and crisis-induced contractions in corporate investment and GDP. The results indicate a greater importance of the growth in corporate indebtedness in the years prior to the crisis for crisis vulnerability than solely the level of debt immediately before the crisis. The paper has several important implications for crisis prevention and mitigation policy.

  17. A cumulative scale of severe sexual sadism.

    Nitschke, Joachim; Osterheider, Michael; Mokros, Andreas

    2009-09-01

    The article assesses the scale properties of the criterion set for severe sexual sadism in a sample of male forensic patients (N = 100). Half of the sample consists of sexual sadists; the remainder is sampled at random from the general group of nonsadistic sex offenders. Eleven of 17 criteria (plus the additional item of inserting objects into the victim's bodily orifices) of Marshall, Kennedy, Yates, and Serran's list form a cumulative scale. More specifically, this scale comprises all the 5 core criteria that Marshall and his colleagues considered particularly relevant. The resulting 11-item scale of severe sexual sadism is highly reliable (r(tt) = .93) and represents a strong scale (H = .83) of the Guttman type (coefficient of reproducibility = .97). The 11-item scale distinguishes perfectly between sexual sadists and nonsadistic sex offenders in the sample. PMID:19605691

  18. Four billion people facing severe water scarcity.

    Mekonnen, Mesfin M; Hoekstra, Arjen Y

    2016-02-01

    Freshwater scarcity is increasingly perceived as a global systemic risk. Previous global water scarcity assessments, measuring water scarcity annually, have underestimated experienced water scarcity by failing to capture the seasonal fluctuations in water consumption and availability. We assess blue water scarcity globally at a high spatial resolution on a monthly basis. We find that two-thirds of the global population (4.0 billion people) live under conditions of severe water scarcity at least 1 month of the year. Nearly half of those people live in India and China. Half a billion people in the world face severe water scarcity all year round. Putting caps to water consumption by river basin, increasing water-use efficiencies, and better sharing of the limited freshwater resources will be key in reducing the threat posed by water scarcity on biodiversity and human welfare. PMID:26933676

  19. Can thyroid dysfunction explicate severe menopausal symptoms?

    Badawy, A; State, O; Sherief, S

    2007-07-01

    Many of the menopausal manifestations look like those accredited to thyroid hyperfunction or hypofunction. Can thyroid dysfunction explicate severe menopausal symptoms? The study comprised 350 women with different menopausal symptoms. All women had serum TSH, T3 and free T4 estimated. Women with thyroid dysfunction were appropriately treated and other women were treated with ERT. The study showed that 21 women (6%) had hypothyroidism and 18 (5.1%) had hyperthyroidism. Marked improvement in the menopausal-like symptoms occurred after treatment of the thyroid dysfunction. Elderly women with severe or resistant menopausal symptoms can be offered TSH, T3 and T4 assays to rule out the thyroid disturbances before attempting hormone replacement therapy. PMID:17701801

  20. Heart failure due to severe myocardial calcification

    A 28-year-old female who had had irradiation on the chest wall at the age of 5 as a remedy for keloid granulation after burn, recently developed congestive heart failure. Severe tricuspid regurgitation was demonstrated by echocardiography with a certain calcification in the cardiac shadow on chest radiogram. Calcified right ventricle and ventricular septum were noticed operatively, which disturbed ventricular motion and also caused tricuspid valve deformity. These calcified myocardium apparently corresponded with the irradiation field. After tricuspid valve replacement, she regained physical activity satisfactorily without congestive heart failure. Because she had no other known causes of cardiac calcification such as hypercalcemia, myocarditis, myocardial infarction or renal diseases, irradiation on the chest wall could be responsible for the severe myocardial calcification. (author)