WorldWideScience

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.

  2. Drugs (including oxygen) in severe COPD.

    Albert, P; Calverley, P M A

    2008-05-01

    Access to comprehensive guidelines on the management of chronic obstructive pulmonary disease (COPD) is now available, and several treatment goals of therapy have been identified from these guidelines, which have since been studied in clinical trials. Drug therapy is a key component of an individual patient's management plan, particularly in more severe disease. During the past few years, a number of new drug treatments have become available, although these are not always appropriately prescribed; this is particularly the case for oxygen. For patients with a history of exacerbations, there is good evidence for the use of inhaled long-acting anticholinergic agents or combined inhaled steroids and long-acting beta-agonists. Evidence for prophylactic antibiotics and antioxidant agents is lacking. Nutritional and calorie supplementation have not been shown to improve exercise capacity. Statins may improve outcomes in COPD, but prospective trials are needed to confirm this. The evidence for the use of long-term oxygen therapy in hypoxaemic patients is robust. Ambulatory oxygen improves exercise capacity, but whether it is used appropriately is in doubt. Overall, short burst oxygen therapy does not offer a benefit and therefore cannot be recommended.

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

    Somech, Raz; Etzioni, Amos

    2014-01-01

    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. TAKE-HOME MESSAGES Severe combined immunodeficiency, a life-threatening condition, can be detected by neonatal screening. The earlier the detection and the quicker the implementation of appropriate treatment, the greater the likelihood for improved outcome, even cure, for the affected children. TRECs and KRECs quantification are useful screening tests for severe T and B cell immunodeficiency and can be used also to evaluate every medical condition involving T and B cell immunity. PMID:24498508

  4. Models that include supercoiling of topological domains reproduce several known features of interphase chromosomes.

    Benedetti, Fabrizio; Dorier, Julien; Burnier, Yannis; Stasiak, Andrzej

    2014-03-01

    Understanding the structure of interphase chromosomes is essential to elucidate regulatory mechanisms of gene expression. During recent years, high-throughput DNA sequencing expanded the power of chromosome conformation capture (3C) methods that provide information about reciprocal spatial proximity of chromosomal loci. Since 2012, it is known that entire chromatin in interphase chromosomes is organized into regions with strongly increased frequency of internal contacts. These regions, with the average size of ∼1 Mb, were named topological domains. More recent studies demonstrated presence of unconstrained supercoiling in interphase chromosomes. Using Brownian dynamics simulations, we show here that by including supercoiling into models of topological domains one can reproduce and thus provide possible explanations of several experimentally observed characteristics of interphase chromosomes, such as their complex contact maps.

  5. 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.

  6. 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

  7. 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.

  8. A Multiplex Immunoassay Using the Guthrie Specimen to Detect T-Cell Deficiencies Including Severe Combined Immunodeficiency Disease

    Janik, David K.; Lindau-Shepard, Barbara; Comeau, Anne Marie; Pass, Kenneth A.

    2011-01-01

    BACKGROUND Severe combined immunodeficiency (SCID) fulfills many of the requirements for addition to a newborn screening panel. Two newborn screening SCID pilot studies are now underway using the T-cell receptor excision circle (TREC) assay, a molecular technique. Here we describe an immunoassay with CD3 as a marker for T cells and CD45 as a marker for total leukocytes that can be used with the Guthrie specimen. METHODS The multiplexing capabilities of the Luminex platform were used. Antibody pairs were used to capture and detect CD3 and CD45 from a single 3-mm punch of the Guthrie specimen. The assay for each bio-marker was developed separately in identical buffers and then combined to create a multiplex assay. RESULTS Using calibrators made from known amounts of leukocytes, a detection limit of 0.25 × 106 cells/mL for CD3 and 0.125 × 106 cells/mL for CD45 was obtained. Affinity tests showed no cross-reactivity between the antibodies to CD3 and CD45. The multiplex assay was validated against 8 coded specimens of known clinical status and linked to results from the TREC assay that had identified them. All were correctly identified by the CD345 assay. CONCLUSIONS The performance parameters of the CD345 assay met the performance characteristics generally accepted for immunoassays. Our assay classifications of positive specimens concur with previous TREC results. This CD345 assay warrants evaluation as a viable alternative or complement to the TREC assay as a primary screening tool for detecting T-cell immunodeficiencies, including SCID, in Guthrie specimens. PMID:20660143

  9. Postnatal visual deprivation in rats regulates several retinal genes and proteins, including differentiation-associated fibroblast growth factor-2.

    Prokosch-Willing, Verena; Meyer zu Hoerste, Melissa; Mertsch, Sonja; Stupp, Tobias; Thanos, Solon

    2015-01-01

    Little is known about the retinal cellular basis of amblyopia, which is a developmental disease characterized by impaired visual acuity. This study examined the retinal transcripts associated with experimentally induced unilateral amblyopia in rats. Surgical tarsorrhaphy of the eyelids on one side was performed in pups prior to eye opening at postnatal day 14, thereby preventing any visual experience. This condition was maintained for over 2 months, after which electroretinograms (ERGs) were recorded, the retinal ganglion cell (RGC) arrangement and number were determined using neuroanatomical tracing, the retinal transcripts were studied using microarray analysis, regulated mRNAs were confirmed with quantitative reverse-transcriptase PCR, and proteins were stained using Western blotting and immunohistochemistry. An attenuated ERG was found in eyes that were deprived of visual experience. Retrograde neuroanatomical staining disclosed a larger number of RGCs within the retina on the visually deprived side compared to the non-deprived, control side, and a multilayered distribution of RGCs. At the retinomic level, several transcripts associated with retinal differentiation, such as fibroblast growth factor 2 (FGF-2), were either up- or downregulated. Most of the transcripts could be verified at the mRNA level. To unravel the role of a differentiation-associated protein, we tested FGF-2 in dissociated postnatal retinal cell cultures and found that FGF-2 is a potent factor triggering ganglion cell differentiation. The data suggest that visual experience shapes the postnatal retinal differentiation, whereas visual deprivation induces changes at the functional, cellular and molecular levels within the retina.

  10. Development of seismic sloshing analysis method of liquid coolant sodium in the KALIMER reactor vessel including several cylindrical components

    Lee, Jae Han; Yoo, Bong

    2000-11-01

    It is important to establish a highly accurate technique of evaluating the sloshing behavior of liquid sodium coolant during earthquake for structural integrity of KALIMER reactor vessel and internals. The analysis procedure of sloshing behaviors is established using finite element computer program ANSYS, and the effectiveness of the procedure is confirmed by comparison with theoretical and experimental results in the literature. The analysis results agree well with experimental ones. Based on the procedure, the sloshing characteristics of liquid sodium coolant in the KALIMER reactor vessel including reactor internal components are evaluated. The maximum response height of sodium free surface at the reactor vessel is about 55cm when subjected to horizontal safe shutdown earthquake (SSE) of 0.3g for seismically isolated reactor building.

  11. 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.

  12. Gene-alcohol interactions identify several novel blood pressure loci including a promising locus near SLC16A9

    Jeannette eSimino

    2013-12-01

    Full Text Available Alcohol consumption is a known risk factor for hypertension, with recent candidate studies implicating gene-alcohol interactions in blood pressure (BP regulation. We used 6,882 (predominantly Caucasian participants aged 20 to 80 years from the Framingham SHARe (SNP Health Association Resource to perform a genome-wide analysis of SNP-alcohol interactions on BP traits. We used a two-step approach in the ABEL suite to examine genetic interactions with three alcohol measures [ounces of alcohol consumed per week, drinks consumed per week, and the number of days drinking alcohol per week] on four BP traits [systolic (SBP, diastolic (DBP, mean arterial (MAP, and pulse (PP pressure]. In the first step, we fit a linear mixed model of each BP trait onto age, sex, BMI, and antihypertensive medication while accounting for the phenotypic correlation among relatives. In the second step, we conducted 1 degree-of-freedom (df score tests of the SNP main effect, alcohol main effect, and SNP-alcohol interaction using the maximum likelihood estimates of the parameters from the first step. We then calculated the joint 2 df score test of the SNP main effect and SNP-alcohol interaction using MixABEL. The effect of SNP rs10826334 (near SLC16A9 on SBP was significantly modulated by both the number of alcoholic drinks and the ounces of alcohol consumed per week (p-values of 1.27E-08 and 3.92E-08, respectively. Each copy of the G-allele decreased SBP by 3.79 mmHg in those consuming 14 drinks per week versus a 0.461 mmHg decrease in non-drinkers. Index SNPs in 20 other loci exhibited suggestive (p-value≤1E-06 associations with BP traits by the 1 df interaction test or joint 2df test, including 3 rare variants, one low-frequency variant, and SNPs near/in genes ESRRG, FAM179A, CRIPT-SOCS5, KAT2B,ADCY2, GLI3, ZNF716, SLIT1, PDE3A, KERA-LUM, RNF219-AS1, CLEC3A , FBX015, and IGSF5. SNP -alcohol interactions may enhance discovery of novel variants with large effects that can

  13. Method for 3D Object Reconstruction Using Several Portion of 2D Images from the Different Aspects Acquired with Image Scopes Included in the Fiber Retractor

    Kohei Arai

    2012-12-01

    Full Text Available Method for 3D object reconstruction using several portions of 2D images from the different aspects which are acquired with image scopes included in the fiber retractor is proposed. Experimental results show a great possibilityfor reconstruction of acceptable quality of 3D object on the computer with several imageswhich are viewed from the different aspects of 2D images.

  14. A prospective study of the prevalence of tuberculosis and bacteraemia in Bangladeshi children with severe malnutrition and pneumonia including an evaluation of Xpert MTB/RIF assay.

    Mohammod Jobayer Chisti

    Full Text Available BACKGROUND: Severe malnutrition is a risk factor for pneumonia due to a wide range of pathogens but aetiological data are limited and the role of Mycobacterium tuberculosis is uncertain. METHODS: We prospectively investigated severely malnourished young children (<5 years with radiological pneumonia admitted over a 15-month period. Investigations included blood culture, sputa for microscopy and mycobacterial culture. Xpert MTB/RIF assay was introduced during the study. Study children were followed for 12 weeks following their discharge from the hospital. RESULTS: 405 eligible children were enrolled, with a median age of 10 months. Bacterial pathogens were isolated from blood culture in 18 (4.4% children, of which 72% were Gram negatives. Tuberculosis was confirmed microbiologically in 7% (27/396 of children that provided sputum - 10 by culture, 21 by Xpert MTB/RIF assay, and 4 by both tests. The diagnostic yield from induced sputum was 6% compared to 3.5% from gastric aspirate. Sixty (16% additional children had tuberculosis diagnosed clinically that was not microbiologically confirmed. Most confirmed tuberculosis cases did not have a positive contact history or positive tuberculin test. The sensitivity and specificity of Xpert MTB/RIF assay compared to culture was 67% (95% CI: 24-94 and 92% (95% CI: 87-95 respectively. Overall case-fatality rate was 17% and half of the deaths occurred in home following discharge from the hospital. CONCLUSION AND SIGNIFICANCE: TB was common in severely malnourished Bangladeshi children with pneumonia. X-pert MTB/RIF assay provided higher case detection rate compared to sputum microscopy and culture. The high mortality among the study children underscores the need for further research aimed at improved case detection and management for better outcomes.

  15. 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.

  16. Therapeutic monitoring of opioids: a sensitive LC-MS/MS method for quantitation of several opioids including hydrocodone and its metabolites.

    Langman, Loralie J; Korman, Eric; Stauble, M Elaine; Boswell, Mark V; Baumgartner, Richard N; Jortani, Saeed A

    2013-06-01

    For pain management, opioid therapy is a mainstay for treating acute pain and relieving moderate to severe chronic pain. Quantitative measurement of opioids and their metabolites in urine is used mainly for confirmation of screened results obtained for clinical and forensic purposes. Due to limitations in interpretation of urine results for pain management testing purposes, the use of blood or serum to assess opioids and their metabolites may be of benefit. This report describes a sensitive liquid chromatography-tandem mass spectrometry method for the detection of hydrocodone and its metabolites hydromorphone, norhydrocodone, and dihydrocodeine, and other common opiates that patients may be taking, including morphine, codeine, oxycodone, and oxymorphone in a single extraction. The method uses solid-phase extraction of 500 µL of sample with quantitation by liquid chromatography-tandem mass spectrometry. The assay is linear from 1.0 to 100 ng/mL and has a between-day coefficient of variation of <10%. The major advantage of this method is that a single extraction can detect hydrocodone and its metabolites and other opiates or opioids that patients frequently use simultaneously with hydrocodone.

  17. Dextrocardia, atrial septal defect, severe developmental delay, facial anomalies, and supernumerary ribs in a child with a complex unbalanced 8;22 translocation including partial 8p duplication.

    Pope, Kathleen; Samanich, Joy; Ramesh, K H; Cannizzaro, Linda; Pan, Qiulu; Babcock, Melanie

    2012-03-01

    We report on a child with dextrocardia, atrial septal defect (ASD), severe developmental delay, hypotonia, 13 pairs of ribs, left preauricular choristoma, hirsutism, and craniofacial abnormalities. Prenatal cytogenetic evaluation showed karyotype 46,XY,?dup(8p)ish del(8)pter. Postnatal array CGH demonstrated a 6.8 Mb terminal deletion at 8p23.3-p23, an interstitial 31.1 Mb duplication within 8p23.1-p11, and a terminal duplication of 0.24 Mb at 22q13.33, refining the karyotype to 46,XY,der(8)dup(8)(p23.1p11.1)t(8;22)(p23.1;q13.1).ish der(8)dup(8)(p23.1p11.1)t(8;22)(p23.1;q13.1) (D8S504-,MS607 + ,ARSA + ,D8Z1 + , RP115713 + +). Previous reports of distal 8p deletion, 8p duplication, and distal 22q duplication have shown similar manifestations, including congenital heart disease, intellectual impairment, and multiple minor anomalies. We correlate the patient's clinical findings with these particular areas of copy number. This case study supports the use of aCGH to identify subtle chromosomal rearrangement in infants with cardiac malformation as their most significant or only apparent birth defect. Additionally, it illustrates why aCGH is essential in the description of chromosome rearrangements, even those seemingly visible via routine karyotype. This method shows that there is often greater complexity submicroscopically, essential to an adequate understanding of a patient's genotype and phenotype.

  18. 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.

  19. Infliximab, adalimumab and golimumab for treating moderately to severely active ulcerative colitis after the failure of conventional therapy (including a review of TA140 and TA262): clinical effectiveness systematic review and economic model.

    Archer, Rachel; Tappenden, Paul; Ren, Shijie; Martyn-St James, Marrissa; Harvey, Rebecca; Basarir, Hasan; Stevens, John; Carroll, Christopher; Cantrell, Anna; Lobo, Alan; Hoque, Sami

    2016-01-01

    Vie) or golimumab (GOL) (Simponi(®), MSD) were more likely to achieve clinical response and remission than those receiving placebo (PBO). Hospitalisation data were limited, but suggested more favourable outcomes for ADA- and IFX-treated patients. Data on the use of surgical intervention were sparse, with a potential benefit for intervention-treated patients. Data were available from one trial to support the use of IFX in paediatric patients. Safety issues identified included serious infections, malignancies and administration site reactions. Based on the NMA, in the induction phase, all biological treatments were associated with statistically significant beneficial effects relative to PBO, with the greatest effect associated with IFX. For patients in response following induction, all treatments except ADA and GOL 100 mg at 32-52 weeks were associated with beneficial effects when compared with PBO, although these were not significant. The greatest effects at 8-32 and 32-52 weeks were associated with 100 mg of GOL and 5 mg/kg of IFX, respectively. For patients in remission following induction, all treatments except ADA at 8-32 weeks and GOL 50 mg at 32-52 weeks were associated with beneficial effects when compared with PBO, although only the effect of ADA at 32-52 weeks was significant. The greatest effects were associated with GOL (at 8-32 weeks) and ADA (at 32-52 weeks). The economic analysis suggests that colectomy is expected to dominate drug therapies, but for some patients, colectomy may not be considered acceptable. In circumstances in which only drug options are considered, IFX and GOL are expected to be ruled out because of dominance, while the incremental cost-effectiveness ratio for ADA versus conventional treatment is approximately £50,300 per QALY gained. LIMITATIONS The health economic model is subject to several limitations: uncertainty associated with extrapolating trial data over a lifetime horizon, the model does not consider explicit sequential

  20. Inhibitory Interneurons That Express GFP in the PrP-GFP Mouse Spinal Cord Are Morphologically Heterogeneous, Innervated by Several Classes of Primary Afferent and Include Lamina I Projection Neurons among Their Postsynaptic Targets.

    Ganley, Robert P; Iwagaki, Noboru; del Rio, Patricia; Baseer, Najma; Dickie, Allen C; Boyle, Kieran A; Polgár, Erika; Watanabe, Masahiko; Abraira, Victoria E; Zimmerman, Amanda; Riddell, John S; Todd, Andrew J

    2015-05-13

    The superficial dorsal horn of the spinal cord contains numerous inhibitory interneurons, which regulate the transmission of information perceived as touch, pain, or itch. Despite the importance of these cells, our understanding of their roles in the neuronal circuitry is limited by the difficulty in identifying functional populations. One group that has been identified and characterized consists of cells in the mouse that express green fluorescent protein (GFP) under control of the prion protein (PrP) promoter. Previous reports suggested that PrP-GFP cells belonged to a single morphological class (central cells), received inputs exclusively from unmyelinated primary afferents, and had axons that remained in lamina II. However, we recently reported that the PrP-GFP cells expressed neuronal nitric oxide synthase (nNOS) and/or galanin, and it has been shown that nNOS-expressing cells are more diverse in their morphology and synaptic connections. We therefore used a combined electrophysiological, pharmacological, and anatomical approach to reexamine the PrP-GFP cells. We provide evidence that they are morphologically diverse (corresponding to "unclassified" cells) and receive synaptic input from a variety of primary afferents, with convergence onto individual cells. We also show that their axons project into adjacent laminae and that they target putative projection neurons in lamina I. This indicates that the neuronal circuitry involving PrP-GFP cells is more complex than previously recognized, and suggests that they are likely to have several distinct roles in regulating the flow of somatosensory information through the dorsal horn.

  1. Rapid DNA typing for HLA-C using sequence-specific primers (PCR-SSP): identification of serological and non-serologically defined HLA-C alleles including several new alleles.

    Bunce, M; Welsh, K I

    1994-01-01

    Detection of HLA-C antigens by complement mediated cytotoxicity using human alloantisera is often difficult. Between 20 to 40% of individuals in every race have undetectable HLA-C locus antigens and 9 out of the 29 sequenced HLA-C alleles so far published encode serologically undetected antigens. In addition, HLA-C molecules are expressed at the cell surface at about 10% of the levels of HLA-A and HLA-B. Recently, amplification of DNA using sequence-specific primers (PCR-SSP) has proved a reliable and rapid method for typing HLA-DR, HLA-DQA and HLA-DQB genes. PCR-SSP takes two hours to perform and is therefore suitable for the genotyping of cadaveric donors. We have designed a set of primers which will positively identify the HLA-C alleles corresponding to the serologically defined series HLA-Cw1, Cw2, Cw3, Cw4, Cw5, Cw6, Cw7 and Cw8. The serologically undetectable alleles have also been detected in groups according to sequence homology. In addition, three new unsequenced variants have been identified. DNA samples from 56 International Histocompatibility Workshop reference cell lines and 103 control individuals have been typed by the HLA-C PCR-SSP technique. 4/56 cell line types and 11/103 normal control individuals types were discrepant with the reported serological types. All combinations of serologically detectable and most of the serologically blank HLA-C antigens can be readily identified. DNA typing for HLA-Cw by PCR-SSP can take as little as 130 minutes from start to finish, including DNA preparation.

  2. 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.

  3. Visual Impairment, Including Blindness

    ... Who Knows What? Survey Item Bank Search for: Visual Impairment, Including Blindness Links updated, April 2017 En ... doesn’t wear his glasses. Back to top Visual Impairments in Children Vision is one of our ...

  4. [Severe asthma].

    González, Claudio D

    2016-01-01

    The objectives of this work were to investigate the frequency of severe asthma (SA) according to WHO definition and to compare SA patients' characteristics with those of non-severe asthma (NSA); secondly, to investigate the level of control reached throughout a period of regular treatment. Between 1-1-2005 and 12-31-2014, 471 medical records from patients with bronchial asthma assisted in Buenos Aires City were analyzed. SA frequency was 40.1% (189/471), being significantly higher among patients from the public health system (47.7%, 108/226 vs. 33%, 81/245, p = 0.001). SA patients were older than NSA ones (51.3 ± 17.4 vs. 42.6 ± 17.1 years, p = 0.000), presented longer time since onset of the disease (median 30 vs. 20 years, p = 0.000), lower educational levels (secondary level or higher 41.7% vs. 58.1%, p = 0.000), lower frequency of rhinitis (47% vs. 60.6%, p = 0.004), more severe levels of airway obstruction (FEV% 50.2 ± 13.7 vs. 77.7 ± 12.4, p = 0.000), more frequent antecedents of Near Fatal Asthma (11.1% vs. 2.8%, p = 0.000), higher levels of serum IgE (median of 410 vs. 279 UI/l, p = 0.01) and higher demand of systemic steroids requirements and hospitalizations (68.7% vs. 50.7%, p = 0.000 and 37.5% vs. 15.9%, p = 0.000, respectively). A 30.6% of SA patients (58/189) reached a follow-up period of 12 months, 13 (22.5%) of whom reached the controlled asthma level. The frequency of SA found seems to be considerable. Multicenter studies to investigate the levels of control reached by SA patients with access to proper treatment are recommended.

  5. 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.

  6. Being Included and Excluded

    Korzenevica, Marina

    2016-01-01

    Following the civil war of 1996–2006, there was a dramatic increase in the labor mobility of young men and the inclusion of young women in formal education, which led to the transformation of the political landscape of rural Nepal. Mobility and schooling represent a level of prestige that rural...... people regard as a prerequisite for participating in local community politics. Based on a fieldwork in two villages of Panchthar district in eastern Nepal, this article explores how these changes strengthen or weaken women’s political agency and how this is reflected in their participation in community...... politics. It analyzes how formal education and mobility either challenge or reinforce traditional gendered norms which dictate a lowly position for young married women in the household and their absence from community politics. The article concludes that women are simultaneously excluded and included from...

  7. Management of severe preeclampsia.

    Brichant, G; Dewandre, P Y; Foidart, J M; Brichant, J F

    2010-01-01

    Features of severe preeclampsia include severe proteinuric hypertension and symptoms of central nervous system dysfunction, hepatocellular injury, thrombocytopenia, oliguria, pulmonary oedema, cerebrovascular accident and severe intrauterine growth restriction. Women with severe preeclampsia must be hospitalized to confirm the diagnosis, to assess the severity of the disease, to monitor the progression of the disease and to try to stabilize the disease. Severe preeclampsia may be managed expectantly, in selected cases. The objective of expectant management in these patients is to improve neonatal outcome. Expectant management is based on antihypertensive treatment and prevention of end organ dysfunction. Antihypertensive treatment improves maternal outcome but has the potential to be deleterious for the foetus. Plasma volume expansion has been suggested for severe preeclampsia but trials failed to show any benefit. Magnesium sulfate is the anticonvulsivant of choice to treat or prevent eclampsia when indicated. Antenatal corticosteroids are recommended in severely preeclamptic women with 26-34 weeks gestation. Timing of delivery is based upon gestational age, severity of preeclampsia, maternal and foetal risks.

  8. 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.

  9. Severe asthma in children.

    Guilbert, Theresa W; Bacharier, Leonard B; Fitzpatrick, Anne M

    2014-01-01

    Severe asthma in children is characterized by sustained symptoms despite treatment with high doses of inhaled corticosteroids or oral corticosteroids. Children with severe asthma may fall into 2 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, or poor adherence due to adverse psychological or environmental factors. In contrast, treatment resistant is defined as difficult asthma despite management of these factors. It is increasingly recognized that severe asthma is a highly heterogeneous disorder associated with a number of clinical and inflammatory phenotypes that have been described in children with severe asthma. Guideline-based drug therapy of severe childhood asthma is based primarily on extrapolated data from adult studies. The recommendation is that children with severe asthma be treated with higher-dose inhaled or oral corticosteroids combined with long-acting β-agonists and other add-on therapies, such as antileukotrienes and methylxanthines. It is important to identify and address the influences that make asthma difficult to control, including reviewing the diagnosis and removing causal or aggravating factors. Better definition of the phenotypes and better targeting of therapy based upon individual patient phenotypes is likely to improve asthma treatment in the future.

  10. ADIPONECTIN IN SEVERE PREECLAMPSIA

    Nien, Jyh Kae; Mazaki-Tovi, Shali; Romero, Roberto; Erez, Offer; Kusanovic, Juan Pedro; Gotsch, Francesca; Pineles, Beth L.; Gomez, Ricardo; Edwin, Samuel; Mazor, Moshe; Espinoza, Jimmy; Yoon, Bo Hyun; Hassan, Sonia S.

    2008-01-01

    Aims Adiponectin is an adipokine with insulin-sensitizing, anti-atherogenic, anti-inflammatory and angiogenic properties. The aims of this study were to determine whether maternal plasma adiponectin concentrations differ between patients with severe preeclampsia and those with normal pregnancies, and to explore the relationship between plasma adiponectin and the results of Doppler velocimetry of the uterine arteries. Methods This case-control study included two groups: (1) patients with severe preeclampsia (n=50) and (2) patients with normal pregnancies (n=150). Pulsed-wave and color Doppler ultrasound examination of the uterine arteries were performed. Plasma adiponectin concentrations were determined by ELISA. Non-parametric statistics were used for analysis. Results (1) Patients with severe preeclampsia had a higher median plasma concentration of adiponectin than that of normal pregnant women. (2) The median plasma adiponectin concentration did not differ between women with severe preeclampsia who had a high impedance to blood flow in the uterine arteries and those with normal impedance to blood flow. (3) Among patients with normal pregnancies, plasma adiponectin concentrations were negatively correlated with BMI in the first trimester and at sampling. Conclusions Women with severe preeclampsia have a higher median plasma concentration of adiponectin than that of normal pregnant women. This may reflect a compensatory feedback mechanism to the metabolically-altered, anti-angiogenic and pro-atherogenic state of severe preeclampsia. PMID:17919115

  11. [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.

  12. 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.

  13. 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...

  14. Severe Weather Forecast Decision Aid

    Bauman, William H., III; Wheeler, Mark M.; Short, David A.

    2005-01-01

    This report presents a 15-year climatological study of severe weather events and related severe weather atmospheric parameters. Data sources included local forecast rules, archived sounding data, Cloud-to-Ground Lightning Surveillance System (CGLSS) data, surface and upper air maps, and two severe weather event databases covering east-central Florida. The local forecast rules were used to set threat assessment thresholds for stability parameters that were derived from the sounding data. The severe weather events databases were used to identify days with reported severe weather and the CGLSS data was used to differentiate between lightning and non-lightning days. These data sets provided the foundation for analyzing the stability parameters and synoptic patterns that were used to develop an objective tool to aid in forecasting severe weather events. The period of record for the analysis was May - September, 1989 - 2003. The results indicate that there are certain synoptic patterns more prevalent on days with severe weather and some of the stability parameters are better predictors of severe weather days based on locally tuned threat values. The results also revealed the stability parameters that did not display any skill related to severe weather days. An interactive web-based Severe Weather Decision Aid was developed to assist the duty forecaster by providing a level of objective guidance based on the analysis of the stability parameters, CGLSS data, and synoptic-scale dynamics. The tool will be tested and evaluated during the 2005 warm season.

  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.

  16. Biodiversity conservation including uncharismatic species

    Muñoz, Joaquin

    2007-01-01

    Recent papers mention ideas on the topics of biodiversity conservation strategies and priorities (Redford et al. 2003; Lamoreux et al. 2006; Rodrı´guez et al. 2006), the current status of biodiversity (Loreau et al. 2006), the obligations of conservation biologists regarding management policies...... (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...

  17. Percutaneous absorption of several chemicals, some pesticides included, in the red-winged blackbird

    Rogers, J.G.; Cagan, R.H.; Kare, M.R.

    1974-01-01

    Percutaneous absorption in vivo through the skin of the feet of the red-winged blackbird (Agelaius phoeniceus) has been investigated. Absorption after 18-24 hours exposure to 0.01 M solutions of salicylic acid, caffeine, urea, 2,4-D, dieldrin, diethylstilbesterol, and DDT was measured. Of these, only DDT and diethylstilbesterol were not absorbed to a measurable degree. The solvents ethanol, dimethylsulfoxide (DMSO), and vegetable oil were compared with water in their effects on the absorption ofcaffeine, urea, and salicylic acid. Ethanol, DMSO,and oil each decreased percutaneous absorption of salicylic acid. DMSO increased absorption of caffeine, and ethanol had no effect on it. Neither DMSO nor ethanol affected penetration of urea. Partition coefficients (K) (epidermis/water) were determined for all seven penetrants. Compounds with higher values of K showed lower percutaneous absorption. These findings suggest that K may be useful to predict percutaneous absorption in vivo. It appears unlikely that percutaneous absorption contributes greatly to the body burden of 2,4-D and dieldrin in A. phoeniceus.

  18. Including Magnetostriction in Micromagnetic Models

    Conbhuí, Pádraig Ó.; Williams, Wyn; Fabian, Karl; Nagy, Lesleis

    2016-04-01

    The magnetic anomalies that identify crustal spreading are predominantly recorded by basalts formed at the mid-ocean ridges, whose magnetic signals are dominated by iron-titanium-oxides (Fe3-xTixO4), so called "titanomagnetites", of which the Fe2.4Ti0.6O4 (TM60) phase is the most common. With sufficient quantities of titanium present, these minerals exhibit strong magnetostriction. To date, models of these grains in the pseudo-single domain (PSD) range have failed to accurately account for this effect. In particular, a popular analytic treatment provided by Kittel (1949) for describing the magnetostrictive energy as an effective increase of the anisotropy constant can produce unphysical strains for non-uniform magnetizations. I will present a rigorous approach based on work by Brown (1966) and by Kroner (1958) for including magnetostriction in micromagnetic codes which is suitable for modelling hysteresis loops and finding remanent states in the PSD regime. Preliminary results suggest the more rigorously defined micromagnetic models exhibit higher coercivities and extended single domain ranges when compared to more simplistic approaches.

  19. Severe Combined Immunodeficiency (SCID)

    ... with facebook share with twitter share with linkedin Severe Combined Immunodeficiency (SCID) SCID is a group of rare disorders ... life-saving treatments. Why Is the Study of Severe Combined Immunodeficiency (SCID) a Priority for NIAID? SCID is a ...

  20. 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...

  1. 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.

  2. 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

  3. Severe Combined Immunodeficiency Disorders.

    Chinn, Ivan K; Shearer, William T

    2015-11-01

    Severe combined immunodeficiency disorders represent pediatric emergencies due to absence of adaptive immune responses to infections. The conditions result from either intrinsic defects in T-cell development (ie, severe combined immunodeficiency disease [SCID]) or congenital athymia (eg, complete DiGeorge anomaly). Hematopoietic stem cell transplant provides the only clinically approved cure for SCID, although gene therapy research trials are showing significant promise. For greatest survival, patients should undergo transplant before 3.5 months of age and before the onset of infections. Newborn screening programs have yielded successful early identification and treatment of infants with SCID and congenital athymia in the United States.

  4. Inlet Guide Vane Wakes Including Rotor Effects

    Johnston, R. T.; Fleeter, S.

    2001-02-01

    Fundamental experiments are described directed at the investigation of forcing functions generated by an inlet guide vane (IGV) row, including interactions with the downstream rotor, for application to turbomachine forced response design systems. The experiments are performed in a high-speed research fan facility comprised of an IGV row upstream of a rotor. IGV-rotor axial spacing is variable, with the IGV row able to be indexed circumferentially, thereby allowing measurements to be made across several IGV wakes. With an IGV relative Mach number of 0.29, measurements include the IGV wake pressure and velocity fields for three IGV-rotor axial spacings. The decay characteristics of the IGV wakes are compared to the Majjigi and Gliebe empirical correlations. After Fourier decomposition, a vortical-potential gust splitting analysis is implemented to determine the vortical and potential harmonic wake gust forcing functions both upstream and downstream of the rotor. Higher harmonics of the vortical gust component of the IGV wakes are found to decay at a uniform rate due to viscous diffusion.

  5. [Severe asthma--where are we today?].

    von Bülow, Anna; Backer, Vibeke; Porsbjerg, Celeste

    2014-01-13

    Severe asthma is defined by persistent symptoms and frequent exacerbations despite intensive asthma therapy. The prevalence is estimated to be 5-10% of all asthmatics. Severe asthma is responsible for a major burden of illness including low quality of life and a disproportionate use of health-care resources. The clinical assessment of severe asthma must include verification of the correct diagnosis, adherence to medication, excluding differential diagnosis and identification and treatment of aggravating co-morbidities and trigger factors.

  6. Epidemiology of severe trauma.

    Alberdi, F; García, I; Atutxa, L; Zabarte, M

    2014-12-01

    Major injury is the sixth leading cause of death worldwide. Among those under 35 years of age, it is the leading cause of death and disability. Traffic accidents alone are the main cause, fundamentally in low- and middle-income countries. Patients over 65 years of age are an increasingly affected group. For similar levels of injury, these patients have twice the mortality rate of young individuals, due to the existence of important comorbidities and associated treatments, and are more likely to die of medical complications late during hospital admission. No worldwide, standardized definitions exist for documenting, reporting and comparing data on severely injured trauma patients. The most common trauma scores are the Abbreviated Injury Scale (AIS), the Injury Severity Score (ISS) and the Trauma and Injury severity Score (TRISS). Documenting the burden of injury also requires evaluation of the impact of post-trauma impairments, disabilities and handicaps. Trauma epidemiology helps define health service and research priorities, contributes to identify disadvantaged groups, and also facilitates the elaboration of comparable measures for outcome predictions.

  7. 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.

  8. Physiopathology of severe asthma

    Todo-Bom, Ana; Mota-Pinto, Anabela

    2006-01-01

    A história natural da asma e as condições determinantes de evolução para formas moderadas ou graves não estão completamente estabelecidas. Contudo, quer os fatores genéticos quer os fatores ambientais serão determinantes na fisiopatologia e no prognóstico da doença. Nesta revisão são apresentados os mecanismos envolvidos na fisiopatologia da asma grave The natural history of asthma and the determinant factors involved in its evolution from moderate to severe forms are not completely establ...

  9. 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...

  10. 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.

  11. SEVERAL MEASURES OF BUDGETARY POLICY

    Ioan Dan Morar

    2012-12-01

    Full Text Available Budget policy for the funding and sometimes care about the public sector, certain actions and utilities on the private sector within limits set by the strategies, tactics and operational deciyiile promoted executive. Phenomenon budget includes both revenues and expenditure side edge contained in the public budget. Often, perhaps excessive zeal in translating domain-specific phrases are even officially speak about "fiscal policy measures", with reference to all areas of the budget, containing and thus the budget expenditure. Budgetary policy has several specific policy budget subdomains like Cookie fiscal policy, budget expenditure allocation Polti, policy and public loans.

  12. 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.

  13. Operative management of severe constipation.

    Lahr, S J; Lahr, C J; Srinivasan, A; Clerico, E T; Limehouse, V M; Serbezov, I K

    1999-12-01

    This report investigates the concept that severe constipation requiring major abdominal surgery may result from one of three common causes: 1) colonic inertia, 2) pelvic hiatal hernia, or 3) both colonic inertia and pelvic hernia. This study evaluates the symptoms, anatomy and outcome in 201 patients with severe surgical constipation treated by a single surgeon. In 2042 patients with constipation referred to one colon and rectal surgeon, 211 major abdominal surgical procedures were performed on 201 patients for severe constipation between 1989 and 1999. There were 187 women and 14 men. Mean age was 49 years (range, 9-84). Five high-risk patients had ileostomy; 196 had major colonic surgery for anatomic or physiologic causes of constipation, excluding malignancy, diverticular disease, and inflammatory bowel disease. Pelvic hiatal hernia was defined as the herniation of bowel through the hiatus of the pelvic diaphragm seen on pelvic videofluoroscopy or physical examination. Of these 196 patients, 44 per cent had pelvic hiatal hernia repair (PHHR), 27 per cent had total abdominal colectomy and ileorectal anastomosis for colonic inertia, and 29 per cent had surgery for both colonic inertia and pelvic hiatal hernia. Of the 144 patients undergoing PHHR, 95 had Gore-Tex patch (W. L. Gore and Associates, Inc., Phoenix, AZ) sacral colpopexy. PHHR for pelvic hiatal hernia without colonic inertia included sigmoid resection, rectopexy, and Gore-Tex patch sacral colpopexy. Mean duration of follow-up was 20 months. Symptoms noted preoperatively included abdominal pain (84%), straining at stool (90%), incomplete rectal emptying (85%), painful bowel movements (74%), pelvic pain (69%), vaginal bulge (55%), digital assistance with evacuation (35%), and incontinence of stool (38%). Outcome assessed by symptom relief was successful in 89.1 per cent of patients. 8.6 per cent of patient conditions were unchanged, and 2.3 per cent were unsatisfied with the outcome. There were no

  14. 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...

  15. Haemophilus influenzae Disease (Including Hib) Symptoms

    ... Search The CDC Cancel Submit Search The CDC Haemophilus influenzae Disease (Including Hib) Note: Javascript is disabled or ... and Symptoms Recommend on Facebook Tweet Share Compartir Haemophilus influenzae , including Hib, disease causes different symptoms depending on ...

  16. 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.

  17. 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.

  18. 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

  19. Approach to Severe Hypertension in Children

    Muhammet Şükrü Paksu

    2011-12-01

    Full Text Available Severe symptomatic hypertension which is also called hypertensive crisis is an acute elevation in blood pressure to a level that has the potential to cause end-organ damage. Although not common in childhood, it is a life-threatening medical emergency. Hypertensive crises are classically distinguished into hypertensive urgency and hypertensive emergency depending on end-organ involvement including central nervous system (CNS, heart, eye, and kidney. A severe elevation in blood pressure without evidence of acute target organ damage describes hypertensive urgency. Hypertensive emergency is defined as severe hypertension complicated with severe symptoms or acute target organ dysfunction. (Journal of Current Pediatrics 2011; 9: 133-6

  20. [Difficult to control severe asthma].

    Magnan, Antoine; Pipet, Anaïs

    2011-03-01

    Difficult to control severe asthma is characterized by the persistence of inacceptable symptoms of asthma despite a continuous treatment with at least high doses of inhaled steroids and long acting bronchodilators. The diagnosis is done after a period of observation and some investigations that will allow confirm the diagnosis of asthma, eliminate alternative diagnosis and etiological forms that would be difficult to treat intrinsically (allergic broncho-pulmonary aspergillosis, Churg and Strauss disease, chronic eosinophilic pneumonia, occupational asthma). At the end of this period devoted to diagnosis a systematic approach is set up to take care of these patients. Therapeutic education includes action plans and measures for triggering factors avoidance in order to prevent exacerbations. Comorbidities such as rhinitis, nasal polyposis, gastro-oesophageal reflux and obesity are taken into account. Lastly, the treatment must be adapted according to the patient's preferences and aims, and to the asthma severity. Ultimately in steroid-dependent asthma, the lowest efficient dose is tracked continuously. For these patients, new molecules are needed.

  1. 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…

  2. 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…

  3. 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...... 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....

  4. 28 CFR 20.32 - Includable offenses.

    2010-07-01

    ...., drunkenness, vagrancy, disturbing the peace, curfew violation, loitering, false fire alarm, non-specific charges of suspicion or investigation, and traffic violations (except data will be included on arrests...

  5. 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,...

  6. Lung Disease Including Asthma and Adult Vaccination

    ... Healthcare Professionals Lung Disease including Asthma and Adult Vaccination Language: English Español (Spanish) Recommend on Facebook Tweet ... more about health insurance options. Learn about adult vaccination and other health conditions Asplenia Diabetes Heart Disease, ...

  7. 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...

  8. 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 ...

  9. Severe Obesity and Heart Failure

    ... https://medlineplus.gov/news/fullstory_161011.html Severe Obesity and Heart Failure Study sees link even without ... 2016 FRIDAY, Sept. 16, 2016 (HealthDay News) -- Severe obesity appears to be an independent risk factor for ...

  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. 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

  12. Radiosensitive Severe Combined Immunodeficiency Disease

    Dvorak, Christopher C.; Cowan, Morton J.

    2009-01-01

    Synopsis Inherited defects in components of the non-homologous 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 traditionally utilized for conditioning prior to allogeneic hematopoietic cell transplantation (HCT). Known etiologies of radiosensitive SCID include deficiencies of Artemis, DNA Ligase IV, DNA-dependent protein kinase catalytic subunit (DNA-PKcs), and Cernunnos-XLF, all of which have been treated with HCT. Because of their sensitivity to certain forms of chemotherapy, the approach to donor selection and type of conditioning regimen utilized for a radiosensitive SCID patient requires careful consideration. Significantly more research needs to be done in order to determine the long-term outcomes of radiosensitive SCID patients following HCT, as well as to discover novel non-toxic approaches to HCT that might benefit those with intrinsic radio- and chemo-sensitivity, as well as potentially all patients undergoing an HCT. PMID:20113890

  13. Cargo transport by several motors

    Zhang, Yunxin

    2010-01-01

    In cells, organelles and vesicles are usually transported by cooperation of several motor proteins, including plus-end directed motor kinesin and minus-end directed motor dynein. Many biophysical models have been constructed to understand the mechanism of this motion. However, so far, the basic principle about it remains unclosed. In this paper, based on the recent experimental results and existing theoretical models, a spider-like model is provided. In this model, each motor is regarded as a bead-spring system. The bead can bind to or unbind from the track stochastically, and step forward or backward with fixed step size L and force dependent transition rates. The spring connects the bead to cargo tightly. At any time, the position of cargo is determined by force balance condition. The obvious characteristics of our model are that, the motors interact with each other and they do not share the external load equally. Our results indicate, the stall force of cargo, under which the mean velocity of cargo vanishe...

  14. 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.

  15. 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

    -to-roll methods is taken as a premise, and thus the progression from a highly successful laboratory technique (i.e., spin coating) to large-scale roll-to-roll equipment is described in terms of all of the intermediate steps that must be available to make the transfer possible. Spin coating is compatible...

  16. Including the Excluded: One School for All.

    EFA 2000 Bulletin, 1998

    1998-01-01

    This issue of "EFA 2000" focuses on the theme of inclusive education, i.e., including children with disabilities in general education classrooms. The cover story discusses a 1995 UNESCO survey of 63 countries that showed that integration of children with disabilities in regular schools is a declared policy in almost every country.…

  17. 47 CFR 65.820 - Included items.

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Included items. 65.820 Section 65.820 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) INTERSTATE RATE...) Cash working capital. The average amount of investor-supplied capital needed to provide funds for...

  18. Nuclear Chemistry: Include It in Your Curriculum.

    Atwood, Charles H.; Sheline, R. K.

    1989-01-01

    Some of the topics that might be included in a nuclear chemistry section are explored. Offers radioactivity, closed shells in nuclei, energy of nuclear processes, nuclear reactions, and fission and fusion as topics of interest. Provided are ideas and examples for each. (MVL)

  19. Musculoskeletal ultrasound including definitions for ultrasonographic pathology

    Wakefield, RJ; Balint, PV; Szkudlarek, Marcin

    2005-01-01

    Ultrasound (US) has great potential as an outcome in rheumatoid arthritis trials for detecting bone erosions, synovitis, tendon disease, and enthesopathy. It has a number of distinct advantages over magnetic resonance imaging, including good patient tolerability and ability to scan multiple joint...

  20. An acoustic finite element including viscothermal effects

    Nijhof, M.J.J.; Wijnant, Y.H.; Boer, de A.

    2007-01-01

    In acoustics it is generally assumed that viscous- en thermal boundary layer effects play a minor role in the propagation of sound waves. Hence, these effects are neglected in the basic set of equations describing the sound field. However, for geometries that include small confinements of air or thi

  1. Numerical simulation of spark ignition including ionization

    Thiele, M; Selle, S; Riedel, U; Warnatz, J; Maas, U

    2000-01-01

    A detailed understanding of the processes associated Midi spark ignition, as a first step during combustion, is of great importance fur clean operation of spark ignition engines. In the past 10 years. a growing concern for environmental protection, including low emission of pollutants, has increased

  2. Common paths to ASD severity and PTSD severity

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

    , 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 only a significant risk factor of ASD severity. Together with two control factors these factors explained 73 % of the variance in ASD severity and 52 % of the variance in PTSD severity. Future research should focus on replicating these results across different trauma populations as they point...

  3. 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

  4. [Biophysical Characterization of Biopharmaceuticals, Including Antibody Drugs].

    Uchiyama, Susumu

    2016-01-01

    Biopharmaceuticals, including antibody drugs, are now popular because of their high specificity with low adverse effects, especially in the treatment of cancer and autoimmune diseases. However, because the active pharmaceutical ingredients of biopharmaceuticals are proteins, biophysical characterization of these therapeutic proteins should be required. In this manuscript, methods of chemical and physical characterization of therapeutic proteins are described. In terms of chemical characterization, analysis of chemical modifications of the constituent amino acids is explained. Physical characterization includes higher order structural analysis and assessment of protein aggregates. Quantification methods of aggregates with different sizes, recently encouraged by the U.S. Food and Drug Administration (FDA), are introduced. As for the stability of therapeutic proteins, the importance of chemical and physical stability is explained. Finally, the contribution of colloidal and structural stability to the production of an antibody drug less prone to aggregation is introduced.

  5. SKIRT: Stellar Kinematics Including Radiative Transfer

    Baes, Maarten; Dejonghe, Herwig; Davies, Jonathan

    2011-09-01

    SKIRT is a radiative transfer code based on the Monte Carlo technique. The name SKIRT, acronym for Stellar Kinematics Including Radiative Transfer, reflects the original motivation for its creation: it has been developed to study the effects of dust absorption and scattering on the observed kinematics of dusty galaxies. In a second stage, the SKIRT code was extended with a module to self-consistently calculate the dust emission spectrum under the assumption of local thermal equilibrium. This LTE version of SKIRT has been used to model the dust extinction and emission of various types of galaxies, as well as circumstellar discs and clumpy tori around active galactic nuclei. A new, extended version of SKIRT code can perform efficient 3D radiative transfer calculations including a self-consistent calculation of the dust temperature distribution and the associated FIR/submm emission with a full incorporation of the emission of transiently heated grains and PAH molecules.

  6. Rotor assembly including superconducting magnetic coil

    Snitchler, Gregory L. (Shrewsbury, MA); Gamble, Bruce B. (Wellesley, MA); Voccio, John P. (Somerville, MA)

    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.

  7. 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)

  8. Rehabilitation of a triple amputee including a hip disarticulation.

    Shin, J C; Park, C I; Kim, Y C; Jang, S H; Bang, I K; Shin, J S

    1998-12-01

    A multiple amputee more severe than a triple amputee is uncommon. There have been no reports on the rehabilitation outcome of a triple amputee, including hip disarticulation and transtibial amputation. The authors report the rehabilitation of a patient with left hip disarticulation, right trans-tibial amputation, and left trans-humeral amputation due to a train accident. He has successfully completed the rehabilitation programme and has become independent in prosthetic ambulation, activities of daily living, and driving.

  9. Therapeutic Strategies for Severe Acute Lung Injury

    Diaz, Janet. V.; Brower, Roy; Calfee, Carolyn S.; Matthay, Michael A.

    2015-01-01

    Objective In the management of patients with severe Acute Lung Injury and the Acute Respiratory Distress Syndrome (ALI/ARDS), clinicians are sometimes challenged to maintain acceptable gas exchange while avoiding harmful mechanical ventilation practices. In some of these patients, physicians may consider the use of “rescue therapies” to sustain life. Our goal is to provide a practical, evidence-based review to assist critical care physicians’ care for patients with severe ALI/ARDS. Data Sources and Study Selection We searched the Pub Med database for clinical trials examining the use of the following therapies in ALI/ARDS: recruitment maneuvers, high positive end expiratory pressure, prone position, high frequency oscillatory ventilation, glucocorticoids, inhaled nitric oxide, buffer therapy and extracorporeal life support. Study selection All clinical trials that included patients with severe ALI/ARDS were included in the review. Data Synthesis The primary author reviewed the aforementioned trials in depth and then disputed findings and conclusions with other authors until consensus was achieved. Conclusions This article is designed to: a) provide clinicians with a simple, bedside definition for the diagnosis of severe ARDS; b) describe several therapies that can be used in severe ARDS with an emphasis on the potential risks as well as the indications and benefits; and c) to offer practical guidelines for implementation of these therapies. PMID:20562704

  10. Eating disorder severity and functional impairment

    Davidsen, Annika Helgadóttir; Hoyt, William T.; Poulsen, Stig Bernt

    2016-01-01

    PURPOSE: The aim was to examine duration of illness and body mass index as possible moderators of the relationship between eating disorder severity and functional impairment, as well as psychological distress as a possible mediator of this relationship. METHODS: The study included 159 patients...

  11. Drug delivery device including electrolytic pump

    Foulds, Ian G.

    2016-03-31

    Systems and methods are provided for a drug delivery device and use of the device for drug delivery. In various aspects, the drug delivery device combines a “solid drug in reservoir” (SDR) system with an electrolytic pump. In various aspects an improved electrolytic pump is provided including, in particular, an improved electrolytic pump for use with a drug delivery device, for example an implantable drug delivery device. A catalytic reformer can be incorporated in a periodically pulsed electrolytic pump to provide stable pumping performance and reduced actuation cycle.

  12. Including supplementary elements in a compositional biplot

    Daunis-i-Estadella, J.; Thió-Henestrosa, S.; Mateu-Figueras, G.

    2011-05-01

    The biplot is a widely and powerful methodology used with multidimensional data sets to describe and display the relationships between observations and variables in an easy way. Compositional data are vectors with positive components, whose sum is constant because they represent a relative contribution of different parts to a whole; due to this property standard biplots cannot be performed with compositional data, instead of a previous transformation of the data is performed. In this paper, we extend the compositional biplot defined by Aitchison and Greenacre (2002), in order to include in the display supplementary elements which are not used in the definition of the compositional biplot. Different types of supplementary elements are considered: supplementary parts of the composition, supplementary continuous variables external to the composition, supplementary categorical variables and supplementary observations. The projection of supplementary parts of the composition is done by means of the equivalence of clr and lr biplots. The other supplementary projections are done by classical methodology. An application example with a real geological data is included.

  13. 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

  14. 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,

  15. 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.

  16. 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...

  17. 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...

  18. 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...

  19. DEVELOPMENT OF WATER CIRCULATION MODEL INCLUDING IRRIGATION

    Kotsuki, Shunji; Tanaka, Kenji; Kojiri, Toshiharu; Hamaguchi, Toshio

    It is well known that since agricultural water withdrawal has much affect on water circulation system, accurate analysis of river discharge or water balance are difficult with less regard for it. In this study, water circulation model composed of land surface model and distributed runoff model is proposed at 10km 10km resolution. In this model, irrigation water, which is estimated with land surface model, is introduced to river discharge analysis. The model is applied to the Chao Phraya River in Thailand, and reproduced seasonal water balance. Additionally, the discharge on dry season simulated with the model is improved as a result of including irrigation. Since the model, which is basically developed from global data sets, simulated seasonal change of river discharge, it can be suggested that our model has university to other river basins.

  20. 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...... surgical techniques and better outcome after peripheral nerve injury. Decision making in peripheral nerve surgery continues to be a complex challenge, where the mechanism of injury, repeated clinical evaluation, neuroradiological and neurophysiological examination, and detailed knowledge of the peripheral...... 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...

  1. 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.

  2. Reconnection experiments including 3D magnetic nulls

    Le, A.; Egedal, J.; Vrublevskis, A.

    2010-11-01

    A rich collection of magnetic reconnection scenarios is possible in three dimensions depending on the topological and geometric structure of the magnetic field [1]. In recent experiments at the Versatile Toroidal Facility (VTF) three-dimensional effects were essential even in nearly axisymmetric plasmas with a non-vanishing toroidal field [2]. To explore reconnection in 3D geometries including magnetic null points, a new adjustable set of coils will be installed in the vacuum chamber of VTF. The range of vacuum magnetic field topologies attainable in VTF will be explored numerically. Plasma reconnection experiments will be run in these configurations, and measurements will be presented if available. [4pt] [1] CE Parnell, et al., (2009) ``Three-Dimensional Magnetic Reconnection, in Magnetic Coupling between the Interior and the Atmosphere of the Sun,'' eds. S.S. Hasan and R.J. Rutten, Springer-Verlag, Heidelberg, Berlin. [0ex] [2] Katz, N. et al., (2010) Phys. Rev. Lett. 104, 255004.

  3. 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.

  4. 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...

  5. Thermovoltaic semiconductor device including a plasma filter

    Baldasaro, Paul F.

    1999-01-01

    A thermovoltaic energy conversion device and related method for converting thermal energy into an electrical potential. An interference filter is provided on a semiconductor thermovoltaic cell to pre-filter black body radiation. The semiconductor thermovoltaic cell includes a P/N junction supported on a substrate which converts incident thermal energy below the semiconductor junction band gap into electrical potential. The semiconductor substrate is doped to provide a plasma filter which reflects back energy having a wavelength which is above the band gap and which is ineffectively filtered by the interference filter, through the P/N junction to the source of radiation thereby avoiding parasitic absorption of the unusable portion of the thermal radiation energy.

  6. Obscure Severe Infrarenal Aortoiliac Stenosis With Severe Transient Lactic Acidosis

    Teerapat Nantsupawat MD

    2013-01-01

    Full Text Available A 57-year-old man presented with sudden onset of leg pain, right-sided weakness, aphasia, confusion, drooling, and severe lactic acidosis (15 mmol/L. He had normal peripheral pulses and demonstrated no pain, pallor, poikilothermia, paresthesia, or paralysis. Empiric antibiotics, aspirin, full-dose enoxaparin, and intravenous fluid were initiated. Lactic acid level decreased to 2.5 mmol/L. The patient was subsequently extubated and was alert and oriented with no complaints of leg or abdominal pain. Unexpectedly, the patient developed cardiac arrest, rebound severe lactic acidosis (8.13 mmol/L, and signs of acute limb ischemia. Emergent computed tomography of the aorta confirmed infrarenal aortoiliac thrombosis. Transient leg pain and transient severe lactic acidosis can be unusual presentations of severe infrarenal aortoiliac stenosis. When in doubt, vascular studies should be implemented without delay to identify this catastrophic diagnosis.

  7. Parthenium dermatitis severity score to assess clinical severity of disease

    Kaushal K Verma; Arika Bansal; Neetu Bhari; Gomathy Sethuraman

    2017-01-01

    Background: Parthenium dermatitis is the most common type of airborne contact dermatitis in India. It is a chronic disease of a remitting and relapsing course with significant morbidity and distress, but there is no scoring system to assess its severity. Aim: To design a scoring system for the assessment of clinical severity of disease in Parthenium dermatitis and to use this scoring system in various studies to determine its sensitivity, specificity, and reproducibility. Methods and Results:...

  8. Parthenium dermatitis severity score to assess clinical severity of disease

    Kaushal K Verma

    2017-01-01

    Full Text Available Background: Parthenium dermatitis is the most common type of airborne contact dermatitis in India. It is a chronic disease of a remitting and relapsing course with significant morbidity and distress, but there is no scoring system to assess its severity. Aim: To design a scoring system for the assessment of clinical severity of disease in Parthenium dermatitis and to use this scoring system in various studies to determine its sensitivity, specificity, and reproducibility. Methods and Results: In our first few studies on Parthenium dermatitis, we designed and used a basic clinical severity scoring system based on itching, morphology of the lesions, and areas involved. However, in subsequent studies, we modified it to the present scoring system as Parthenium dermatitis severity score (PDSS. Our studies showed the high sensitivity of PDSS in characterization of the disease severity at the given point of time, as well as to determine the efficacy of a prescribed treatment modality which was reliable and reproducible. Conclusion: Thus, PDSS may be used by clinicians for appropriate scoring of the clinical severity of Parthenium dermatitis and in monitoring the disease response to therapy.

  9. Imaging of axial spondyloarthritis including ankylosing spondylitis.

    Braun, J; Baraliakos, X

    2011-03-01

    New bone formation of the vertebral column is pathognomonic for ankylosing spondylitis (AS), while acute and/or chronic changes in the sacroiliac joints are relevant for diagnosis. The 'gold standard' for assessment of structural changes in AS are conventional radiographs, while MRI is useful to assess inflammation. Recent MRI studies have shown that the lower half of the thoracic spine is most commonly affected in AS. Scoring tools for spinal inflammation such as the ASspiMRI-a have been proposed, successfully used in large clinical trials and compared in a multireader experiment; none was finally preferred by OMERACT. Quantification of structural spinal AS changes is performed by the modified Stokes AS Spine Score (mSASSS), which evaluates lateral cervical and lumbar radiographs. Two years was identified as the shortest possible follow-up time based on the reliability and sensitivity to change of the mSASSS. A potential disadvantage of the mSASSS is that the thoracic spine is not included. Recent data based on the mSASSS have suggested that tumour necrosis factor blockers do not inhibit radiographic progression in AS. Since the mean radiographic change is reported to be less than 1 syndesmophyte over 2 years, the sensitivity to change of the mSASSS has been questioned. However, in one study where continuous non-steroidal anti-inflammatory drugs use was compared with on-demand use, a difference between these two methods of drug intake was reported. The face and construct validity of the mSASSS has been criticised because a score of ´1´ contains a mixture of osteodestructive (erosions) and osteoproliferative changes (squaring and sclerosis). A new scoring system, the RASSS, which concentrates only on bone formation and which includes the lower part of the thoracic spine is currently being evaluated. The relationship between inflammation and new bone formation in AS has recently been investigated. Low sclerostin and DKK-1 serum levels, both inhibitors of bone

  10. 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.

  11. Engine lubrication circuit including two pumps

    Lane, William H.

    2006-10-03

    A lubrication pump coupled to the engine is sized such that the it can supply the engine with a predetermined flow volume as soon as the engine reaches a peak torque engine speed. In engines that operate predominately at speeds above the peak torque engine speed, the lubrication pump is often producing lubrication fluid in excess of the predetermined flow volume that is bypassed back to a lubrication fluid source. This arguably results in wasted power. In order to more efficiently lubricate an engine, a lubrication circuit includes a lubrication pump and a variable delivery pump. The lubrication pump is operably coupled to the engine, and the variable delivery pump is in communication with a pump output controller that is operable to vary a lubrication fluid output from the variable delivery pump as a function of at least one of engine speed and lubrication flow volume or system pressure. Thus, the lubrication pump can be sized to produce the predetermined flow volume at a speed range at which the engine predominately operates while the variable delivery pump can supplement lubrication fluid delivery from the lubrication pump at engine speeds below the predominant engine speed range.

  12. Odontogenic fibroma, including amyloid and ossifying variants.

    Eversole, Lewis R

    2011-12-01

    Sixty-five cases of odontogenic fibroma (OdonF) are herein presented having been segregated into peripheral, extra bony tumors (n = 40) and tumors arising in bone or centrally (n = 25). All cases were characterized microscopically by a fibrous proliferation that varied within and between cases in cellularity and collagen fibril diameter, with intermixed odontogenic epithelial islands and cords. All central lesions presented as well demarcated radiolucencies and resorption of contiguous tooth roots was a common finding. These intraosseous lesions were of the WHO type; the so-called nonWHO type was excluded as all lesions with this diagnosis were devoid of an epithelial component and could be reclassified as other soft tissue fibrogenic tumors. Neither the central tumors nor the peripheral lesions recurred following enucleation/curettage, with a mean follow-up of 4 and 3.4 years respectively. Three distinct microscopic variations were encountered in this series: (1) two cases of OdonF with giant cell reaction, (2) two instances of OdonF with ossifying fibroma; and (3) four instances of OdonF with odontogenic ameloblast-associated protein (ODAM), an amyloid-like protein found deposited adjacent to epithelial cords plus CD1a+/S-100+ Langerhans dendritic cells entwined around the epithelial element. A single instance of the odontogenic fibroma-like hamartoma/enamel hypoplasia syndrome has been included in this series.

  13. Full Boltzmann equations for leptogenesis including scattering

    Hahn-Woernle, F; Wong, Y Y Y

    2009-01-01

    We study the evolution of a cosmological baryon asymmetry produced via leptogenesis by means of the full classical Boltzmann equations, without the assumption of kinetic equilibrium and including all quantum statistical factors. Beginning with the full mode equations we derive the usual equations of motion for the right-handed neutrino number density and integrated lepton asymmetry, and show explicitly the impact of each assumption on these quantities. For the first time, we investigate also the effects of scattering of the right-handed neutrino with the top quark to leading order in the Yukawa couplings by means of the full Boltzmann equations. We find that in our full Boltzmann treatment the final lepton asymmetry can be suppressed by as much as a factor of 1.5 in the weak wash-out regime (K1), the full Boltzmann treatment and the integrated approach give nearly identical final lepton asymmetries (within 10 % of each other at K>3). Finally, we show that the opposing effects of quantum statistics on decays/i...

  14. 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.

  15. 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...

  16. 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.

  17. Severe dengue outbreak in Yunnan, China, 2013

    Fu-Chun Zhang

    2014-10-01

    Full Text Available In recent decades, the impact of dengue has increased both geographically and in intensity, and this disease is now a threat to approximately half of the world's population. An unexpected large outbreak of dengue fever was reported in Xishuangbanna Dai Autonomous Prefecture, Yunnan Province, China, in 2013. This was the first autochthonous outbreak with a significant proportion of severe dengue cases in mainland China in a decade. According to the 2009 World Health Organization guidelines, half of the 136 laboratory confirmed cases during the epidemic were severe dengue. The clinical presentation included severe haemorrhage (such as massive vaginal and gastrointestinal bleeding, severe plasma leakage (such as pleural effusion, ascites, or hypoproteinaemia, and organ involvement (such as myocarditis and lung impairment; 21 cases eventually deteriorated to shock. During this outbreak, all severe cases occurred in adults, among whom about 43% had co-morbid conditions. Nucleic acid detection and virus isolation confirmed dengue virus serotype 3 (DENV-3 to be the pathogenic agent of this outbreak. Phylogenetic analyses of envelope gene sequences showed that these DENV-3 isolates belonged to genotype II. This finding is of great importance to understand the circulation of DENV and predict the risk of severe disease in mainland China. Here, we provide a brief report of the epidemiology, clinical manifestations, and aetiology of this dengue fever outbreak, and characterize DENV strains isolated from clinical specimens.

  18. Immunocompromised Children with Severe Adenoviral Respiratory Infection.

    Tylka, Joanna C; McCrory, Michael C; Gertz, Shira J; Custer, Jason W; Spaeder, Michael C

    2016-01-01

    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.

  19. [Severe hyponatremia revealing Sheehan's syndrome].

    Jousten, E; Legros, J J

    2009-01-01

    We describe the case of a young woman admitted for severe hyponatremia due to hypopituitarism caused by a Sheehan's syndrome. Sheehan's syndrome is a rare disorder. It develops after obstetrical hemorrhage that causes ischemic necrosis of the pituitary gland. In most cases, illness appears progressively and diagnosis is made after variable delay. Acute syndrome may develop immediately after delivery in some rare cases. Hyponatremia is a frequent manifestation and may be severe. It is principally caused by secondary adrenal failure.

  20. 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 test...... 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....

  1. [Treatment of severe Rhesus erythroblastosis].

    Bichler, A; Frisch, H

    1977-01-01

    Report about the management of cases of severe Rhesus erythroblastosis. One case is specially discussed because of it's actuality. This was a patient with severe Rh-sensitization (OOD at 450 mm from the beginning of the 30th week of gestation in zone III according to Liley). Because of the haemolytic disease and the chronic fetal distress the Caesarean section was already performed in the 32nd week of gestation after Betamethason treatment of the mother. The Lecithin-Sphingomyelin (L/S) ratio in the amniotic fluid as a criterium of fetal lung maturity raised almost twicefold (from 0.9 to 1.6) after Cortison treatment. The intensive care (assisted ventilation with PEEP, correction of the acidosis and transfusion of packed red cells) of the severely anaemic (Hb 3.5 g%, Hk 15 vol.%) and hydropic newborn was already started in the delivery room. The newborn developed no RDS and was discharged healthy. With reference to this and other cases the management of severe Rh-sensitization before the 34th week of gestation is discussed. Premature infants are mainly susceptable to the development of a Respiratory Distress syndrome (RDS). After antepartum Cortison treatment for prevention of an RDS the date of confinement should be arranged earlier. The value of an early Caesarian section after antepartum Glucocorticoid treatment as compared to the application of intrauterine transfusions in cases of severe erythroblastosis is discussed. It is also reported about recent methods of treatment of severe conditions of hydrops fetalis.

  2. 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".

  3. 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 

  4. CT findings in severe thoracic sarcoidosis

    Hennebicque, Anne-Sophie; Brillet, Pierre-Yves; Moulahi, Hassen; Brauner, Michel W. [UFR Bobigny, Department of Radiology, Federation MARTHA and EA 2363, Bobigny Cedex (France); Nunes, Hilario; Valeyre, Dominique [UFR Bobigny, Department of Pneumology, Federation MARTHA and EA 2363, Bobigny Cedex (France)

    2005-01-01

    Severe thoracic sarcoidosis includes manifestations with significant clinical and functional impairment and a risk of mortality. Severe thoracic sarcoidosis can take on various clinical presentations and is associated with increased morbidity. The purpose of this article was to describe the CT findings in severe thoracic sarcoidosis and to explain some of their mechanisms. Subacute respiratory insufficiency is a rare and early complication due to a high profusion of pulmonary lesions. Chronic respiratory insufficiency due to pulmonary fibrosis is a frequent and late complication. Three main CT patterns are identified: bronchial distortion, honeycombing and linear opacities. CT can be helpful in diagnosing some mechanisms of central airway obstruction such as bronchial distortion due to pulmonary fibrosis or an extrinsic bronchial compression by enlarged lymph nodes. An intrinsic narrowing of the bronchial wall by endobronchial granulomatous lesions may be suggested by CT when it shows evidence of bronchial mural thickening. Pulmonary hypertension usually occurs in patients with end-stage pulmonary disease and is related to fibrotic destruction of the distal capillary bed and to the resultant chronic hypoxemia. Several other mechanisms may contribute to the development of pulmonary hypertension including extrinsic compression of major pulmonary arteries by enlarged lymph nodes and secondary pulmonary veno-occlusive disease. Aspergilloma colonization of a cavity is the main cause of hemoptysis in sarcoidosis. Other rare causes are bronchiesctasis, necrotizing bronchial aspergillosis, semi-invasive pulmonary aspergillosis, erosion of a pulmonary artery due to a necrotic sarcoidosis lesion, necrosis of parenchymal sarcoidosis lesions and specific endobronchial macroscopic lesions. (orig.)

  5. Clinical Practice Guidelines for Severe Asthma Treatment.

    Eddy Pereira Valdes

    2009-03-01

    Full Text Available 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 elements related with ventilation. It includes assessment guidelines focused on the most important aspects to be accomplished.

  6. 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.

  7. Cinacalcet effect on severe hyperparathyroidism

    Al Saran Khalid; Sabry Alaa; Yehia Ahmed; Molhem Azeb

    2010-01-01

    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 ...

  8. Treatment of severe orthopedic infections.

    Dernell, W S

    1999-09-01

    Severe infections are uncommon following orthopedic surgery, yet they can be frustrating for the veterinarian and owner to treat and can result in devastating consequences for the patient. This article reviews the common causes for postoperative infection, reviews established treatment, and introduces newer methods for treatment and control. A thorough understanding of the pathogenesis, application of appropriate diagnostic procedures, the institution of aggressive treatment regimens, with adherence to established principles, will often result in satisfactory outcomes even with severe orthopedic infections. For those more refractory to treatment, the use of newer treatment methods, specifically locally implantable materials for sustained release of antimicrobials can improve success in the treatment of these more difficult cases.

  9. 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.

  10. 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

  11. 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.

  12. Worldwide epidemiology of liver hydatidosis including the Mediterranean area

    Giuseppe Grosso; Salvatore Gruttadauria; Antonio Biondi; Stefano Marventano; Antonio Mistretta

    2012-01-01

    The worldwide incidence and prevalence of cystic echinococcosis have fallen dramatically over the past several decades.Nonetheless,infection with Echinococcus granulosus (E.granulosus) remains a major public health issue in several countries and regions,even in places where it was previously at low levels,as a result of a reduction of control programmes due to economic problems and lack of resources.Geographic distribution differs by country and region depending on the presence in that country of large numbers of nomadic or semi-nomadic sheep and goat flocks that represent the intermediate host of the parasite,and their close contact with the final host,the dog,which mostly provides the transmission of infection to humans.The greatest prevalence of cystic echinococcosis in human and animal hosts is found in countries of the temperate zones,including several parts of Eurasia (the Mediterranean regions,southern and central parts of Russia,central Asia,China),Australia,some parts of America (especially South America) and north and east Africa.Echinococcosis is currently considered an endemic zoonotic disease in the Mediterranean region.The most frequent strain associated with human cystic echinococcosis appears to be the common sheep strain (G1).This strain appears to be widely distributed in all continents.The purpose of this review is to examine the distribution of E.granulosus and the epidemiology of a re-emerging disease such as cystic echinococcosis.

  13. 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.

  14. Stuttering Severity and Educational Attainment

    O'Brian, Sue; Jones, Mark; Packman, Ann; Menzies, Ross; Onslow, Mark

    2011-01-01

    Purpose: This study investigated the relationship between self-reported stuttering severity ratings and educational attainment. Method: Participants were 147 adults seeking treatment for stuttering. At pretreatment assessment, each participant reported the highest educational level they had attained and rated their typical and worst stuttering…

  15. Predicting severity of paranoid schizophrenia

    Kolesnichenko Elena Vladimirovna

    2015-01-01

    Clinical symptoms, course and outcomes of paranoid schizophrenia are polymorphic. 206 cases of paranoid schizophrenia were investigated. Clinical predictors were collected from hospital records and interviews. Quantitative assessment of the severity of schizophrenia as special indexes was used. Schizoid, epileptoid, psychasthenic and conformal accentuation of personality in the premorbid, early onset of psychosis, paranoid and hallucinatory-paranoid variants of onset predicted more expressed ...

  16. Diagnosis of severe combined immunodeficiency

    Gennery, A; Cant, A

    2001-01-01

    Early diagnosis of severe combined immunodeficiency (SCID) is important to enable prompt referral to a supraregional centre for bone marrow transplantation before the occurrence of end organ damage secondary to infective complications. This review outlines clinical, microbiological, and immunopathological clues that aid the diagnosis of SCID and emphasises the multidisciplinary approach needed to diagnose and treat these infants.

  17. Several topics in complex variables

    Smit, I.M.

    2015-01-01

    This thesis is based on three articles in the field of Several Complex Variables. The first article, which is joint work with M. El Kadiri, defines and studies the concept of maximality for plurifinely plurisubharmonic functions. Its main result is that a finite plurifinely plurisubharmonic function

  18. Probiotics for severe trauma patients

    Rijkers, Ger T

    2011-01-01

    Probiotics are live micro-organisms with a health promoting effect. Because of their immunomodulating capacity as well as improvement of gut barrier function, probiotics have the capacity to prevent infectious complications in a variety of clinical settings. Now selected probiotics show potential for improving the clinical outcome of severe trauma patients.

  19. Nigel: A Severe Auditory Dyslexic

    Cotterell, Gill

    1976-01-01

    Reported is the case study of a boy with severe auditory dyslexia who received remedial treatment from the age of four and progressed through courses at a technical college and a 3-year apprenticeship course in mechanics by the age of eighteen. (IM)

  20. Water Recreation and Illness Severity

    Abstract Background: The health endpoint of prior studies of water recreation has been the occurrence gastrointestinal (GI) of illness. The use of this dichotomous health outcome fails to take into account the range of symptom severity among those with GI illness, as well as thos...

  1. Positive lightning and severe weather

    Price, C.; Murphy, B.

    2003-04-01

    In recent years researchers have noticed that severe weather (tornados, hail and damaging winds) are closely related to the amount of positive lightning occurring in thunderstorms. On 4 July 1999, a severe derecho (wind storm) caused extensive damage to forested regions along the United States/Canada border, west of Lake Superior. There were 665,000 acres of forest destroyed in the Boundary Waters Canoe Area Wilderness (BWCAW) in Minnesota and Quetico Provincial Park in Canada, with approximately 12.5 million trees blown down. This storm resulted in additional severe weather before and after the occurrence of the derecho, with continuous cloud-to-ground (CG) lightning occurring for more than 34 hours during its path across North America. At the time of the derecho the percentage of positive cloud-to-ground (+CG) lightning measured by the Canadian Lightning Detection Network (CLDN) was greater than 70% for more than three hours, with peak values reaching 97% positive CG lightning. Such high ratios of +CG are rare, and may be useful indicators for short-term forecasts of severe weather.

  2. Concrete under severe conditions. Environment and loading

    NONE

    2007-07-01

    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

  3. Therapy of moderate and severe psoriasis

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

    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 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 effective in placebo

  4. 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.

  5. 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...

  6. Radiosensitive Severe Combined Immunodeficiency Disease

    Dvorak, Christopher C.; Cowan, Morton J.

    2010-01-01

    Inherited defects in components of the non-homologous 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 traditionally utilized for conditioning prior to allogeneic hematopoietic cell transplantation (HCT). Known etiologies of radiosensit...

  7. Severe Preeclampsia: Characteristics and Consequences

    Arturo Pérez de Villa Amil Álvarez

    2015-07-01

    Full Text Available Background: preeclampsia is a hypertensive disorder of pregnancy and a major cause of perinatal and maternal morbidity and mortality. Objective: to identify maternal and therapeutic factors as well as damage associated with severe preeclampsia in pregnant women. Method: a case series study was conducted in 69 patients diagnosed with severe preeclampsia treated at the Dr. Gustavo Aldereguía Lima University General Hospital from January 1, 2012 through December 31, 2013. They were divided into two groups according to presence of severe preeclampsia with and without aggravating factors. The variables analyzed were related to maternal characteristics, characteristics of medical care and fetal and neonatal characteristics. A questionnaire based on the data obtained from medical records was applied in line with the International Classification of Diseases, Tenth Revision. Comparisons between groups were performed using a chi-square statistic, considering a P<0.05 statically significant. Results: frequency of severe preeclampsia was 0.8 per 100 deliveries. The highest frequency occurred in the age range of 31-35 years. Eclampsia was observed in 0.91 per 1000 deliveries. Maternal damage amounted to 30.4%. Magnesium sulfate prophylaxis was used in 89% of cases. Eclampsia frequency when not used was 50%, while it was only 6.4% when this therapy was applied. Caesarean section was performed in 85.5% of patients. Neonatal damage was 52.3%. The late fetal death rate was 4.6 per 100 live births. Among the intergroup differences, significant dissimilarities were observed in neonatal damage. Conclusion: high association of intrauterine growth restriction with induced prematurity is evident as well as the high rate of first-time Caesarean sections and significant maternal, fetal and neonatal damage. The use of magnesium sulfate shows good results in the prophylaxis of eclampsia.

  8. Severe acute respiratory syndrome (SARS)

    ... include: Arterial blood tests Blood clotting tests Blood chemistry tests Chest x-ray or chest CT scan ... The death rate from SARS was 9 to 12% of those diagnosed. In people over age 65, the death ...

  9. Gender differences in addiction severity.

    Díaz-Mesa, Eva M; García-Portilla, Paz; Fernández-Artamendi, Sergio; Sáiz, Pilar A; Bobes Bascarán, Teresa; Casares, María José; Fonseca, Eduardo; Al-Halabí, Susana; Bobes, Julio

    2016-06-14

    Gender has been associated with substance use disorders (SUD). However, there are few studies that have evaluated gender differences in a global and a standardized way, and with a large sample of patients with SUD. Our goal is to analyze the role of gender in addiction severity throughout multiple life domains, using the Addiction Severity Index-6 (ASI-6). A naturalistic, multicenter and prospective study was conducted. A total of 221 patients with SUD (80.1% men) were interviewed with the ASI-6. Our results indicate that the Recent Summary Scores (RSSs) of men and women are similar, with the exception of Psychiatric and Partner- Problems, where women showed higher severity (p = .017 and p = .013, respectively). Statistically significant gender differences were found in certain aspects of the ASI-6 domains: men have more problems of physical health, legal issues, and alcohol and other substance use; and woman score higher in problems of mental health, social network, subjective evaluations of SUD consequences, and treatment needs. These results should be taken into account to improve the identification, prevention, and treatment of SUD.

  10. Severe sepsis in older adults.

    Umberger, Reba; Callen, Bonnie; Brown, Mary Lynn

    2015-01-01

    Severe sepsis may be underrecognized in older adults. Therefore, the purpose of this article is to review special considerations related to early detection of severe sepsis in older adults. Normal organ changes attributed to aging may delay early detection of sepsis at the time when interventions have the greatest potential to improve patient outcomes. Systems are reviewed for changes. For example, the cardiovascular system may have a limited or absent compensatory response to inflammation after an infectious insult, and the febrile response and recruitment of white blood cells may be blunted because of immunosenescence in aging. Three of the 4 hallmark responses (temperature, heart rate, and white blood cell count) to systemic inflammation may be diminished in older adults as compared with younger adults. It is important to consider that older adults may not always manifest the typical systemic inflammatory response syndrome. Atypical signs such as confusion, decreased appetite, and unsteady gait may occur before sepsis related organ failure. Systemic inflammatory response syndrome criteria and a comparison of organ failure criteria were reviewed. Mortality rates in sepsis and severe sepsis remain high and are often complicated by multiple organ failures. As the numbers of older adults increase, early identification and prompt treatment is crucial in improving patient outcomes.

  11. CME front and severe space weather

    Balan, N.; Skoug, R.; Tulasi Ram, S.; Rajesh, P. K.; Shiokawa, K.; Otsuka, Y.; Batista, I. S.; Ebihara, Y.; Nakamura, T.

    2014-12-01

    Thanks to the work of a number of scientists who made it known that severe space weather can cause extensive social and economic disruptions in the modern high-technology society. It is therefore important to understand what determines the severity of space weather and whether it can be predicted. We present results obtained from the analysis of coronal mass ejections (CMEs), solar energetic particle (SEP) events, interplanetary magnetic field (IMF), CME-magnetosphere coupling, and geomagnetic storms associated with the major space weather events since 1998 by combining data from the ACE and GOES satellites with geomagnetic parameters and the Carrington event of 1859, the Quebec event of 1989, and an event in 1958. The results seem to indicate that (1) it is the impulsive energy mainly due to the impulsive velocity and orientation of IMF Bz at the leading edge of the CMEs (or CME front) that determine the severity of space weather. (2) CMEs having high impulsive velocity (sudden nonfluctuating increase by over 275 km s-1 over the background) caused severe space weather (SvSW) in the heliosphere (failure of the solar wind ion mode of Solar Wind Electron Proton Alpha Monitor in ACE) probably by suddenly accelerating the high-energy particles in the SEPs ahead directly or through the shocks. (3) The impact of such CMEs which also show the IMF Bz southward from the leading edge caused SvSW at the Earth including extreme geomagnetic storms of mean DstMP power outages happened during some of these SvSW events. (4) The higher the impulsive velocity, the more severe the space weather, like faster weather fronts and tsunami fronts causing more severe damage through impulsive action. (5) The CMEs having IMF Bz northward at the leading edge do not seem to cause SvSW on Earth, although, later when the IMF Bz turns southward, they can lead to super geomagnetic storms of intensity (Dstmin) less than even -400 nT.

  12. Severity Prediction in Acute Pancreatitis Using the CT Severity Index. A Self-Fulfilling Prophecy

    Jan J De Waele

    2006-07-01

    Full Text Available Dear Sir: We read with interest the paper by Gürleyik et al. [1] and the subsequent letter by Brestas and Dafni regarding the use of ROC curve analysis [2]. We fully agree with Dr. Brestas that ROC curve analysis should be used to report the true discriminative power of a test, and are impressed by the performance of the CT severity index in predicting severe disease which was reported in reply to this letter. There is however another very important bias when using the CT severity index, as introduced by Balthazar et al. [3], to predict disease severity. When a test or score is used to predict a disease state, two crucial elements must be taken into account. Firstly, the disease state to be predicted is not (yet present (otherwise it should not be a prognostic indicator, and secondly, the disease state to be predicted is not included in the score under study.

  13. 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.

  14. 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.

  15. Treatment of severe chloroquine poisoning.

    Riou, B; Barriot, P; Rimailho, A; Baud, F J

    1988-01-07

    No therapy has been proved to be effective for patients with severe chloroquine poisoning, which is usually fatal. In a retrospective study of 51 cases, we found that ingestion of more than 5 g of chloroquine was an accurate predictor of a fatal outcome, and therefore chose this dose as the criterion for severe chloroquine poisoning. We selected as a control group 11 consecutive patients who had ingested more than 5 g of chloroquine between July 1983 and December 1985. We then undertook a prospective study to determine whether a better outcome could be obtained with immediate mechanical ventilation and the administration of diazepam and epinephrine. Eleven consecutive patients who ingested more than 5 g of chloroquine in 1986 received this combination therapy. Ten of these patients survived, whereas only one control had survived (P = 0.0003). There was no significant difference between the combination-therapy and control groups in age (29 +/- 3 vs. 27 +/- 2 years), amount of chloroquine ingested (7.5 +/- 0.5 vs. 8.5 +/- 0.8 g), systolic arterial pressure (74 +/- 2 vs. 74 +/- 3 mm Hg), or QRS duration (0.14 +/- 0.01 vs. 0.14 +/- 0.01 second). In our combination-therapy group, blood chloroquine levels ranged from 40 to 80 mumol per liter, whereas a literature search showed that no patient in whom blood levels were more than 25 mumol per liter had survived. These preliminary data suggest that combining early mechanical ventilation with the administration of diazepam and epinephrine may be effective in the treatment of severe chloroquine poisoning.

  16. 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....

  17. HTGR severe accident sequence analysis

    Harrington, R.M.; Ball, S.J.; Kornegay, F.C.

    1982-01-01

    Thermal-hydraulic, fission product transport, and atmospheric dispersion calculations are presented for hypothetical severe accident release paths at the Fort St. Vrain (FSV) high temperature gas cooled reactor (HTGR). Off-site radiation exposures are calculated for assumed release of 100% of the 24 hour post-shutdown core xenon and krypton inventory and 5.5% of the iodine inventory. The results show conditions under which dose avoidance measures would be desirable and demonstrate the importance of specific release characteristics such as effective release height. 7 tables.

  18. Newborn with severe epidermolysis bullosa

    Boesen, Martin Lehmann; Bygum, Anette; Hertz, Jens Michael

    2016-01-01

    Epidermolysis bullosa (EB) is an inherited skin disease with four main subtypes that cannot be distinguished clinically at birth. All subtypes may present with widespread life-threatening blisters and fragile skin, making treatment and handling of the newborn with EB challenging. The prognosis...... of EB depends on the subtype, and therefore maximum treatment is necessary until the final diagnosis is known. In this case, it took 2 weeks before a final diagnosis was reached. In the meantime, we had several ethical discussions on the treatment level. The most important issues were management of pain...

  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. 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.

  1. Dyschromia related to severe combined immunodeficiency.

    Maldonado-Cid, Paola; Noguera-Morel, Lucero; Moreno-Alonso-de-Celada, Ricardo; De-Lucas-Laguna, Raúl; Feito-Rodríguez, Marta; Beato-Merino, Maria José; Casado-Jiménez, Mariano

    2013-12-01

    Severe combined immunodeficiency includes a group of diseases characterized by different inherited immunological defects. A 4-month-old girl diagnosed with Omenn syndrome, a subtype of severe combined immunodeficiency presenting with generalized erythroderma, was referred to our hospital for an allogeneic stem cell transplantation. Days before transplantation, she developed hyperpigmented macules that increased in number in the following months. As the erythroderma resolved after transplantation, diffuse hypopigmentation was simultaneously noted together with the expansion of hyperpigmented lesions. Cutaneous biopsy samples were taken at different moments, showing features of Omenn syndrome at first, and 2 months later changes consistent with hypopigmentation and repigmentation were observed. Although pigmentary disorders are rarely described in this context, these must be taken into account as a possible alternative diagnosis to graft-versus-host disease and toxicoderma in immunosuppressed patients.

  2. Severe Local Storms Cultural Heritage

    Gladich, I.; Gallai, I.; Giaiotti, D. B.; Morgan, G. M.; Stel, F.

    2009-09-01

    Local storms always had a deep impact on people communities, mainly because of the severe damage caused, because of their unpredictability and, up to a few years ago, even because of the lack of knowledge and awareness on their physical origin. Because of this large impact on real life and on imagination, people needed and wanted to describe and report the occurrence of these events, giving them suited names. Often, these nouns are related to the myth developed to explain the cause of the events. In this work, a short presentation and description of the popular nouns used to describe severe local storm events in different areas of the World is given. Countries taken into account span from Italy, moving toward Africa and reaching a few communities of Native Americans. The etymology of the names gives interesting information, useful even under the anthropological point of view, on the Culture and Believes of the peoples who adopted them. This research work is the result of an underground activity carried out in the last ten years by the authors, during their contacts with students and researchers coming from different Countries and mainly met at the International Center for Theoretical Physics in Trieste.

  3. Numerical Modeling of Electroacoustic Logging Including Joule Heating

    Plyushchenkov, Boris D.; Nikitin, Anatoly A.; Turchaninov, Victor I.

    It is well known that electromagnetic field excites acoustic wave in a porous elastic medium saturated with fluid electrolyte due to electrokinetic conversion effect. Pride's equations describing this process are written in isothermal approximation. Update of these equations, which allows to take influence of Joule heating on acoustic waves propagation into account, is proposed here. This update includes terms describing the initiation of additional acoustic waves excited by thermoelastic stresses and the heat conduction equation with right side defined by Joule heating. Results of numerical modeling of several problems of propagation of acoustic waves excited by an electric field source with and without consideration of Joule heating effect in their statements are presented. From these results, it follows that influence of Joule heating should be taken into account at the numerical simulation of electroacoustic logging and at the interpretation of its log data.

  4. 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 ...

  5. ACR-1000 design provisions for severe accidents

    Popov, N.K.; Santamaura, P.; Shapiro, H.; Snell, V.G. [Atomic Energy of Canada Limited, Mississauga, Ontario (Canada)]. E-mail: popovn@aecl.ca

    2006-07-01

    Atomic Energy of Canada Limited (AECL) developed the Advanced CANDU Reactor-700 (ACR-700) as an evolutionary advancement of the current CANDU 6 reactor. As a further advancement of the ACR design, AECL is currently developing the ACR-1000 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 enhanced safety features, shorter construction schedule, high plant capacity factor, improved operations and maintenance, and increased operating life. 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. The ACR-1000 design meets Canadian regulatory requirements and follows established international practice with respect to severe accident prevention and mitigation. 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. While maintaining existing structures of CANDU reactors that provide inherent prevention and retention of core debris, the ACR-1000 design includes additional features for prevention and mitigation of severe accidents. Core retention within vessel in CANDU-type reactors includes both retention within fuel channels, and retention within the calandria vessel. The ACR-1000 calandria vessel design permits for passive rejection of decay heat from the moderator to the shield water. Also, the calandria vessel is designed for debris retention by minimizing penetrations at the bottom periphery and by accommodating thermal and weight loads of the core debris. The ACR-1000 containment is required to withstand external events such as earthquakes, tornados, floods and aircraft crashes

  6. Severe rhabdomyolysis after excessive bodybuilding.

    Finsterer, J; Zuntner, G; Fuchs, M; Weinberger, A

    2007-12-01

    A 46-year-old male subject performed excessive physical exertion during 4-6 h in a studio for body builders during 5 days. He was not practicing sport prior to this training and denied the use of any aiding substances. Despite muscle aching already after 1 day, he continued the exercises. After the last day, he recognized tiredness and cessation of urine production. Two days after discontinuation of the training, a Herpes simplex infection occurred. Because of acute renal failure, he required hemodialysis. There were absent tendon reflexes and creatine kinase (CK) values up to 208 274 U/L (normal: <170 U/L). After 2 weeks, CK had almost normalized and, after 4 weeks, hemodialysis was discontinued. Excessive muscle training may result in severe, hemodialysis-dependent rhabdomyolysis. Triggering factors may be prior low fitness level, viral infection, or subclinical metabolic myopathy.

  7. [ICSI treatment in severe asthenozoospermia].

    Mitchell, V; Sigala, J; Jumeau, F; Ballot, C; Peers, M C; Decanter, C; Rives, N; Perdrix, A; Rigot, J-M; Escalier, D

    2012-12-01

    In the management of asthenozoospermia, the spermogram-spermocytogram plays an important role during diagnosis. It is of major importance to distinguish between necrozoospermia and sperm vitality. An ultrastructural study of spermatozoa is processed in the case of primary infertility without female implication, severe, unexplained and irreversible asthenozoospermia, sperm vitality at least 50 % and normal concentration of spermatozoa. Ultrastructural flagellar abnormalities are numerous and involve most spermatozoa. ICSI provides a suitable solution for patients with sperm flagellar defects to conceive children with their own gametes but the rate of ICSI success may be influenced by the type of flagellar abnormality. Some fertilization and birth rate failures which are related to some flagellar abnormalities might occur.

  8. Management of severe perioperative bleeding

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

    2013-01-01

    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 subcommittees......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 stabilisation of the macro- and microcirculations in order to optimise the patient's tolerance to bleeding. Third, targeted procoagulant interventions to reduce the amount of bleeding, morbidity, mortality and costs. The purpose of these guidelines is to provide an overview of current knowledge on the subject...

  9. [Severe hyperkalemia in cardiac patients].

    Barrillon, A; Bousser, J P; Labrousse, J; Cousteau, J P; Lhoste, F; Gerbaux, A

    1976-10-02

    Hyperkalaemia with severe myocardial consequence may complicate the treatment of heart failure. In five patients who developed kalaemia ranging from 6.5. to 8.6. mEq/l, the ECG showed altered auriculogram and/or widened QRS, the latter change being associated with ST segment elevation and very large T wave in one case. Such hyperkalaemia cannot be termed iatrogenic, although it is promoted by diuretic-induced hyponatraemia and dehydration. The essential part is played by an aggravation of the haemodynamic status, responsible for acute renal insufficiency with oligoanuria, and by the attendant metabolic acidosis. The correction of this metabolic acidosis promotes diuresis, causing potassium depletion and the rapid regression of electrocardiographic abnormalities. Parenteral alkalinization with sodium bicarbonate, associated with furosemid to prevent sodium overload, instituted in emergency, is the only way to prevent asystole or ventricular fibrillation when kalaemia exceeds 8 mEq/l.

  10. 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.

  11. 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.

  12. 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.

  13. Remote observations of reentering spacecraft including the space shuttle orbiter

    Horvath, Thomas J.; Cagle, Melinda F.; Grinstead, Jay H.; Gibson, David M.

    Flight measurement is a critical phase in development, validation and certification processes of technologies destined for future civilian and military operational capabilities. This paper focuses on several recent NASA-sponsored remote observations that have provided unique engineering and scientific insights of reentry vehicle flight phenomenology and performance that could not necessarily be obtained with more traditional instrumentation methods such as onboard discrete surface sensors. The missions highlighted include multiple spatially-resolved infrared observations of the NASA Space Shuttle Orbiter during hypersonic reentry from 2009 to 2011, and emission spectroscopy of comparatively small-sized sample return capsules returning from exploration missions. Emphasis has been placed upon identifying the challenges associated with these remote sensing missions with focus on end-to-end aspects that include the initial science objective, selection of the appropriate imaging platform and instrumentation suite, target flight path analysis and acquisition strategy, pre-mission simulations to optimize sensor configuration, logistics and communications during the actual observation. Explored are collaborative opportunities and technology investments required to develop a next-generation quantitative imaging system (i.e., an intelligent sensor and platform) with greater capability, which could more affordably support cross cutting civilian and military flight test needs.

  14. 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

  15. 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.

  16. Occult hemorrhage in children with severe ITP.

    Flores, Adolfo; Buchanan, George R

    2016-03-01

    Little is known about the frequency and significance of clinically unapparent or occult hemorrhage in ITP. Therefore, we prospectively explored the sites and frequency of occult bleeding in children with severe ITP at diagnosis or upon symptomatic relapse in a prospective, single-institution cohort study of patients ≤ 18 years of age and a platelet count ≤ 10,000/mm(3) . Data collected included bleeding severity assessment, urinalysis, fecal occult blood testing, and non-contrast brain MRI. Stool and urine samples were tested within 7 days of diagnosis or symptomatic relapse. Three months after diagnosis or relapse a noncontrast brain MRI evaluated hemosiderin deposits resulting from prior localized hemorrhage. Fifty-two ITP patients were enrolled with a mean platelet count of 4,000/mm(3) . A significant occurrence of occult hemorrhage was identified in the urine (27%) compared with clinically overt hematuria (0.91%, P occult bleeding in the urinary tract. There was no relationship between occult hemorrhage and bleeding manifestations on physical examination. Occult hemorrhage was not a harbinger of subsequent bleeding. Our findings suggest that occult hemorrhage occurs with greater frequency than overt bleeding in children with severe ITP. CNS microbleeding is a potential risk in this patient population. Assessment of brain microbleeds and microscopic hematuria in this patient population require additional study.

  17. Mechanisms of severe transfusion reactions.

    Kopko, P M; Holland, P V

    2001-06-01

    Serious adverse effects of transfusion may be immunologically or non-immunologically mediated. Currently, bacterial contamination of blood products, particularly platelets, is one of the most significant causes of transfusion-related morbidity and mortality. Septic transfusion reactions can present with clinical symptoms similar to immune-mediated hemolytic transfusion reactions and transfusion-related acute lung injury. Extremely high fever and/or gastrointestinal symptoms, in a transfusion recipient, may be indicative of sepsis. The diagnosis is based upon culturing the same organism from both the patient and the transfused blood component. Numerous organisms have been implicated as the cause of septic transfusion reactions. Due to different storage conditions, gram negative organisms are more often isolated from red blood cell components; gram positive organisms are more often isolated from platelets. Prevention of septic transfusion reactions is primarily dependent on an adequate donor history and meticulous preparation of the donor phlebotomy site. Visual inspection of blood components prior to transfusion is also vital to preventing these reactions. Several methods of detection of bacterial contamination and inactivation of pathogens are currently under active investigation.

  18. Morbimortality Indicators in Severe Acute Pancreatitis

    Tercio De Campos

    2008-11-01

    Full Text Available Objective The aim of this study was to determine the factors related to the development of systemic complications, mortality and pancreatic necrosis in patients with severe acute pancreatitis. Patients Thirty-nine patients (22.3% out of 175 patients with acute pancreatitis who were admitted to our center, had an APACHE II score greater than 8; they were classified as having severe acute pancreatitis and were evaluated in the study. Main outcome measures Sepsis-related Organ Failure Assessment (SOFA and Marshall scores were obtained. The variables analyzed were age, sex, etiology, hematocrit, leukocyte count, CRP level, CT findings and length of hospital stay. These variables were related to the development of systemic complications, mortality and necrotizing pancreatitis. Results The mean APACHE II value of the patients included was 11.6±3.1, the mean SOFA score was 3.2±2.0 and the Marshall score was 1.5±1.9. Eleven patients developed necrotizing pancreatitis. The mortality rate among severe acute pancreatitis patients was 3 out of 39 (7.7%. Variables found to be related to systemic complications were the APACHE II score as well as SOFA and Marshall scores greater than 3. The variables related to mortality were SOFA score greater than 3 and leukocytosis greater than 19,000 mm-3. CRP greater than 19.5 mg/dL and length of hospital stay were related to necrotizing pancreatitis. Conclusions The scoring systems, especially the SOFA score, were related to the development of systemic complications and mortality. CRP showed a relationship to necrotizing pancreatitis. There was no relationship between the evaluated scoring systems and necrotizing pancreatitis in patients with severe acute pancreatitis.

  19. 76 FR 23812 - Reliability and Continuity of Communications Networks, Including Broadband Technologies; Effects...

    2011-04-28

    ... COMMISSION Reliability and Continuity of Communications Networks, Including Broadband Technologies; Effects on Broadband Communications Networks of Damage or Failure of Network Equipment or Severe Overload; Independent Panel Reviewing the Impact of Hurricane Katrina on Communications Networks AGENCY:...

  20. Teaching Associated Work Skills to Adolescents with Severe Handicaps.

    Egan, Isabelle; And Others

    1985-01-01

    Five adolescents with moderate to severe mental retardation, including one with hearing impairments and blindness, were taught 12 associated work skills through an approach featuring reinforcement for desirable behavior and negative consequences and cueing for undesirable behavior. (CL)

  1. Reliability and Validity of the Yale Global Tic Severity Scale

    Storch, Eric A.; Murphy, Tanya K.; Geffken, Gary R.; Sajid, Muhammad; Allen, Pam; Roberti, Jonathan W.; Goodman, Wayne K.

    2005-01-01

    To investigate the reliability and validity of the Yale Global Tic Severity Scale (YGTSS), 28 youth aged 6 to 17 years with Tourette's syndrome (TS) participated in the study. Data included clinician reports of tics and obsessive-compulsive disorder (OCD) severity, parent reports of tics, internalizing and externalizing problems, and child reports…

  2. 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.

  3. 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.

  4. Ranking of severe accident research priorities

    Schwinges, B. [Gesell Anlagen and Reaktorsicherheit GRS mbH, D-50667 Cologne (Germany); Journeau, C. [CEA Cadarache, DEN STRI LMA, F-13115 St Paul Les Durance (France); Haste, T. [Paul Scherrer Inst, NES LTH, OVGA 312, CH-5232 Villigen (Switzerland); Meyer, L.; Tromm, W. [Forschungszentrum Karlsruhe, D-76021 Karlsruhe (Germany); Trambauer, K. [GRS mbH, Forschungsgelande, D-85748 Garching (Germany)

    2010-07-01

    The objectives of the SARNET network are to define common research programmes in the field of severe accidents and to develop common computer tools and methodologies for safety assessment in this field. To reach these objectives, one of the work packages, named 'Severe Accident Research Priorities' (SARP), aimed at reviewing and reassessing the priorities of research issues as a basis to harmonize and to re-orient research programmes, to define new ones, and to close - if possible - resolved issues on a common basis. The work was performed in close collaboration with 8 participating institutions, led by GRS, representing technical safety organisations, industry and utilities (IRSN, CEA, EDF, FZK, GRS, KTH, TUS, VTT). This action made use notably of (1) the outcomes of the EURSAFE project in the 5. Framework Programme, i. e. the Phenomena Identification and Ranking Tables (PIRT) on severe accidents, (2) the results of the validation and benchmarking activities on ASTEC, (3) the results of reactor calculations carried out in the other SARNET tasks, and (4) the outcome of the research performed in the three thematic sub-domains of SARNET (corium, containment and source term). The main outcome of EURSAFE was a list of 21 topics which included recommendations for experimental programmes and code developments. This list formed the basis of the work in SARP. Also the methodology applied in EURSAFE to consider both the risk potential and the severe accident issues where large uncertainties still subsist was adopted. The analyses of the progress of research and development activities considered whether (1) any research issue was resolved due to reduction of uncertainties or gain of scientific insights, (2) any new issue had to be added to the list of needed research, (3) any new process or phenomenon had to be included in the general PIRT list taking into account the safety relevance and the lack of knowledge, and (4) any new accident management program has to be

  5. Suggestions for revised definitions of noise quantities, including quantum effects

    Kerr, A. R.

    1999-03-01

    Recent advances in millimeter- and submillimeter-wavelength receivers and the development of low-noise optical amplifiers focus attention on inconsistencies and ambiguities in the standard definitions of noise quantities and the procedures for measuring them. The difficulty is caused by the zero-point (quantum) noise hf/2 W/Hz, which is present even at absolute zero temperature, and also by the nonlinear dependence at low temperature of the thermal noise power of a resistor on its physical temperature, as given by the Planck law. Until recently, these effects were insignificant in all but the most exotic experiments, and the familiar Rayleigh-Jeans noise formula P=kT W/Hz could safely be used in most situations, Now, particularly in low-noise millimeter-wave and photonic devices, the quantum noise is prominent and the nonlinearity of the Planck law can no longer be neglected. The IEEE Standard Dictionary of Electrical and Electronics Terms gives several definitions of the noise temperature of a resistor or a port, which include: 1) the physical temperature of the resistor and 2) its available noise power density divided by Boltzmann's constant-definitions which are incompatible because of the nature of the Planck radiation law. In addition, there is no indication of whether the zero-point noise should be included as part of the noise temperature. Revised definitions of the common noise quantities are suggested, which resolve the shortcomings of the present definitions. The revised definitions have only a small effect on most RF and microwave measurements, but they provide a common consistent noise terminology from dc to light frequencies.

  6. Internet interventions for chronic pain including headache: A systematic review

    Monica Buhrman

    2016-05-01

    Full Text Available Chronic pain is a major health problem and behavioral based treatments have been shown to be effective. However, the availability of these kinds of treatments is scarce and internet-based treatments have been shown to be promising in this area. The objective of the present systematic review is to evaluate internet-based interventions for persons with chronic pain. The specific aims are to do an updated review with a broad inclusion of different chronic pain diagnoses and to assess disability and pain and also measures of catastrophizing, depression and anxiety. A systematic search identified 891 studies and 22 trials were selected as eligible for review. Two of the selected trials included children/youth and five included individuals with chronic headache and/or migraine. The most frequently measured domain reflected in the primary outcomes was interference/disability, followed by catastrophizing. Result across the studies showed a number of beneficial effects. Twelve trials reported significant effects on disability/interference outcomes and pain intensity. Positive effects were also found on psychological variable such as catastrophizing, depression and anxiety. Several studies (n = 12 were assessed to have an unclear level of risk bias. The attrition levels ranged from 4% to 54% where the headache trials had the highest drop-out levels. However, findings suggest that internet-based treatments based on cognitive behavioural therapy (CBT are efficacious measured with different outcome variables. Results are in line with trials in clinical settings. Meta-analytic statistics were calculated for interference/disability, pain intensity, catastrophizing and mood ratings. Results showed that the effect size for interference/disability was Hedge's g = −0.39, for pain intensity Hedge's g = −0.33, for catastrophizing Hedge's g = −0.49 and for mood variables (depression Hedge's g = −0.26.

  7. [Guidelines for the management of severe traumatic brain injury. Part 3. Surgical management of severe traumatic brain injury (Options)].

    Potapov, A A; Krylov, V V; Gavrilov, A G; Kravchuk, A D; Likhterman, L B; Petrikov, S S; Talypov, A E; Zakharova, N E; Solodov, A A

    2016-01-01

    Traumatic brain injury (TBI) is one of the main causes of mortality and severe disability in young and middle age patients. Patients with severe TBI, who are in coma, are of particular concern. Adequate diagnosis of primary brain injuries and timely prevention and treatment of secondary injury mechanisms markedly affect the possibility of reducing mortality and severe disability. The present guidelines are based on the authors' experience in developing international and national recommendations for the diagnosis and treatment of mild TBI, penetrating gunshot wounds of the skull and brain, severe TBI, and severe consequences of brain injury, including a vegetative state. In addition, we used the materials of international and national guidelines for the diagnosis, intensive care, and surgical treatment of severe TBI, which were published in recent years. The proposed recommendations for surgical treatment of severe TBI in adults are addressed primarily to neurosurgeons, neurologists, neuroradiologists, anesthesiologists, and intensivists who are routinely involved in treating these patients.

  8. 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.

  9. 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.

  10. Rescue and treatment of severely injured lower extremities

    GUO Qi-feng; XU Zhong-he

    2005-01-01

    Objective: To explore a treatment approach for severely injured lower extremities. Methods: The data of 42 patients with severely traumatic lower extremities from 1989 to 1999 were retrospectively reviewed. According to MESS(mangled extremity severity score) the mean score of all the limbs was 6.24±1.45, 34 cases had MESS score<7 and 8 cases had MESS score≥7. Treatment approaches included microvascular anastomosis technique, compound tissue flap transplantation technique and compound bone tissue flap transplantation. Conclusions: Successful emergency treatment of severely injured lower extremities could be achieved by using microsurgery techniques and strict controlling of lower extremity salvagel indications.

  11. 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.

  12. Modified koyanagi repair for severe hypospadias

    Vepakomma, Deepti; Alladi, Anand; Ramareddy, Raghu S.; Akhtar, Tanveer

    2013-01-01

    Aim: To report the results of an early series of patients who underwent modified Koyanagi repair for severe hypospadias. Materials and Methods: A total of 24 boys (age: 9 months to 11 years) with proximal hypospadias, chordee, and poor urethral plate underwent modified Koyanagi repair between September 2008 and January 2012. Nine boys had associated penoscrotal transposition that was corrected simultaneously. Vascularized parameatal based foreskin flap was used to correct the hypospadias in a single stage. The follow-up ranged from 6 months to 3.5 years. Results: A total of 13 of the 24 children had a good outcome and were voiding normally, while 11 boys developed complications, 3 of which were major and 8 minor. The major complications were complete breakdown (n = 1), meatal and distal neourethral stenosis requiring laying open of distal urethra (n = 1), and glans breakdown (n = 1). The minor complications included fistulae (n = 5), meatal stenosis amenable to dilatation (n = 1), and lateral chordee (n = 1). Majority of the complications were in the initial patients, with successful outcomes in the last 1 year. Most of these complications were successfully managed by minor second procedures. Conclusion: Modified Koyanagi repair not only corrects severe hypospadias with chordee but also corrects the associated penoscrotal transposition in a single stage. The results are good once the learning curve is crossed. PMID:24019639

  13. Fungal infections in severe acute pancreatitis.

    Kochhar, Rakesh; Noor, Mohd Talha; Wig, Jaidev

    2011-06-01

    Severe acute pancreatitis (SAP) is associated with significant morbidity and mortality. The majority of deaths related to SAP are the result of infectious complications. Although bacterial infections are most commonly encountered, fungal infections are increasingly being recognized. Candida is the most common fungal infection. The occurrence of fungal infection in patients with acute pancreatitis adversely affects the clinical course, leading to a higher incidence of systemic complications, and possibly mortality as well. Important risk factors for fungal infection in patients with acute pancreatitis include broad-spectrum antibiotics, prolonged hospitalization and surgical/endoscopic interventions, use of total parenteral nutrition, and mechanical ventilation. Patients with higher severity of pancreatitis are at a greater risk. The pathogenesis of fungal infection in patients with acute pancreatitis is multifactorial. Translocation of microorganisms across the gut epithelium, lymphocyte dysfunction, and the virulence of the invading microorganisms play important roles. Histological demonstration of fungi remains the gold standard of diagnosis, but a positive biopsy is rarely obtained. The role of biomarkers in the diagnosis is being investigated. As early diagnosis and treatment can lead to improved outcome, a high index of suspicion is required for prompt diagnosis. Limiting the use of broad-spectrum antibiotics, early introduction of enteral nutrition, and timely change of vascular catheters are important preventive strategies. The role of antifungal prophylaxis remains controversial. Surgical necrosectomy with antifungal therapy is the most widely used treatment approach. Clinical trials on antifungal prophylaxis are needed, and indications for surgical intervention need to be clearly defined.

  14. How I treat severe combined immunodeficiency.

    Gaspar, H Bobby; Qasim, Waseem; Davies, E Graham; Rao, Kanchan; Amrolia, Persis J; Veys, Paul

    2013-11-28

    Severe combined immunodeficiency (SCID) arises from different genetic defects associated with lymphocyte development and function and presents with severe infections. Allogeneic hematopoietic stem cell transplantation is an extremely effective way of restoring immunity in these individuals. Numerous multicenter studies have identified the factors determining successful outcome, and survival for SCID has shown great improvement. Advances in understanding the genetic basis of disease also mean that we increasingly tailor transplant protocols to the specific SCID form. Wherever possible, we attempt to transplant SCID patients without the use of cytoreductive conditioning, but it is clear that this is only successful for specific SCID forms and, although survival is good, in specific patients there are ongoing humoral defects. We aim to use matched related and unrelated donors (including cord blood) whenever possible and have limited the use of mismatched haploidentical donors. The development of autologous hematopoietic stem cell gene therapy provides another treatment of the X-linked and adenosine deaminase-deficient forms of SCID, and we discuss how we have integrated gene therapy into our treatment strategy. These developments together with the advent of universal newborn screening for SCID should allow for a highly favorable outcome for this otherwise lethal condition.

  15. Performance of several low-cost accelerometers

    Evans, J.R.; Allen, R.M.; Chung, A. I.; Cochran, E.S.; Guy, R.; Hellweg, M.; Lawrence, J. F.

    2014-01-01

    Several groups are implementing low‐cost host‐operated systems of strong‐motion accelerographs to support the somewhat divergent needs of seismologists and earthquake engineers. The Advanced National Seismic System Technical Implementation Committee (ANSS TIC, 2002), managed by the U.S. Geological Survey (USGS) in cooperation with other network operators, is exploring the efficacy of such systems if used in ANSS networks. To this end, ANSS convened a working group to explore available Class C strong‐motion accelerometers (defined later), and to consider operational and quality control issues, and the means of annotating, storing, and using such data in ANSS networks. The working group members are largely coincident with our author list, and this report informs instrument‐performance matters in the working group’s report to ANSS. Present examples of operational networks of such devices are the Community Seismic Network (CSN; csn.caltech.edu), operated by the California Institute of Technology, and Quake‐Catcher Network (QCN; Cochran et al., 2009; qcn.stanford.edu; November 2013), jointly operated by Stanford University and the USGS. Several similar efforts are in development at other institutions. The overarching goals of such efforts are to add spatial density to existing Class‐A and Class‐B (see next paragraph) networks at low cost, and to include many additional people so they become invested in the issues of earthquakes, their measurement, and the damage they cause.

  16. Maternal mortality and severe maternal morbidity surveillance in Canada.

    Allen, Victoria M; Campbell, Melanie; Carson, George; Fraser, William; Liston, Robert M; Walker, Mark; Barrett, Jon

    2010-12-01

    The Canadian Perinatal Surveillance System has provided a comprehensive review of maternal mortality and severe maternal morbidity in Canada, and has identified several important limitations to existing national maternal data collection systems, including variability in the detail and quality of mortality data. The Canadian Perinatal Surveillance System report recommended the establishment of an ongoing national review and reporting system, as well as consistency in definitions and classifications of maternal mortality and severe maternal morbidity, in order to enhance surveillance of maternal mortality and severe maternal morbidity. Using review articles and studies that examined maternal mortality in general as opposed to maternal mortality associated with particular management strategies or conditions, maternal mortality and severe morbidity classifications, terminology, and comparative statistics were reviewed and employed to evaluate deficiencies in past and current methods of data collection and to seek solutions to address the need for enhanced and consistent national surveillance of maternal mortality and severe maternal morbidity in Canada.

  17. Severe Asthma in Children: Lessons Learned and Future Directions.

    Fitzpatrick, Anne M

    2016-01-01

    Severe asthma in children is a complicated and heterogeneous disorder that is extremely challenging to treat. Although most children with asthma derive clinical benefit from daily administration of low-to-medium-dose inhaled corticosteroid (ICS) therapy, a small subset of children with "severe" or "refractory" asthma require high doses of ICS and even systemic corticosteroids to maintain symptom control. These children with severe asthma are at increased risk for adverse outcomes including medication-related side effects and recurrent and life-threatening exacerbations that significantly impair quality of life. This review highlights findings on severe asthma in school-age children (age 6-17 years) from the National Heart, Lung and Blood Institute's Severe Asthma Research Program (SARP) over a 10-year period, between 2001 and 2011. Although SARP has advanced knowledge of the unique clinical, biological, and molecular attributes of severe asthma in children, considerable gaps remain for which additional studies are needed.

  18. Anchoring the Panic Disorder Severity Scale

    Keough, Meghan E.; Porter, Eliora; Kredlow, M. Alexandra; Worthington, John J.; Hoge, Elizabeth A.; Pollack, Mark H.; Shear, M. Katherine; Simon, Naomi M.

    2012-01-01

    The Panic Disorder Severity Scale (PDSS) is a clinician-administered measure of panic disorder symptom severity widely used in clinical research. This investigation sought to provide clinically meaningful anchor points for the PDSS both in terms of clinical severity as measured by the Clinical Global Impression-Severity Scale (CGI-S) and to extend…

  19. Management of acute severe ulcerative colitis

    Saurabh; Kedia; Vineet; Ahuja; Rakesh; Tandon

    2014-01-01

    The management strategy of acute severe ulcerative colitis has evolved over the past decade from being entirely restricted to twin choices of intravenous steroids or colectomy to include colon rescue therapies like cyclosporin as well as infliximab. However it still remains a medical emergency requiring hospitalization and requires care from a multidisciplinary team comprising of a gastroenterologist and a colorectal surgeon. The frame shift in management has been the emphasis on time bound decision making with an attempt to curtail the mortality rate to below 1%. Intravenous corticosteroids are the mainstay of therapy. Response to steroids should be assessed at day 3 of admission and partial/non-responders should be considered for alternative medical therapy/surgery. Medical rescue therapies include intravenous cyclosporin and infliximab. Cyclosporin is administered in a dose of 2 mg/kg per day and infliximab is administered as a single dose intravenous infusion of 5 mg/kg. Approximately 75% patients have short term and 50% patients have long term response to cyclosporin. Long term response to cyclosporin is improved in patients who are thiopurine na?ve and are started on thiopurines on day 7. Infliximab also has a response rate of approximately 70% in short term and 50% in long term. Both cyclosporin and infliximab are equally efficacious medical rescue therapies as demonstrated in a recent randomized control trial. Patientsnot responding to infliximab or cyclosporin should be considered for colectomy.

  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. Evaluation of the DSM-5 severity indicator for bulimia nervosa.

    Grilo, Carlos M; Ivezaj, Valentina; White, Marney A

    2015-04-01

    This study examined the DSM-5 severity criterion for bulimia nervosa (BN) based on the frequency of inappropriate weight compensatory behaviors. 199 community volunteers classified with BN were categorized using DSM-5 severity levels and compared on demographic and clinical variables. 77 (39%) participants were categorized as mild, 68 (34%) as moderate, 32 (16%) as severe, and 22 (11%) as extreme. The severity groups did not differ significantly in demographic variables or body mass index. Shape and Weight concerns did not differ significantly across severity groups. Binge eating differed with the extreme group having significantly higher frequency than the severe, moderate, and mild groups, which did not differ from each other. Restraint differed with the extreme group having significantly higher levels than the mild group. Eating concerns differed with the extreme group having significantly higher levels than moderate and mild groups. Depression differed with the extreme group having significantly higher levels than severe, moderate, and mild groups, which did not differ from each other. Findings from this non-clinical group provide new, albeit modest, support for DSM-5 severity rating for BN based on frequency of inappropriate weight compensatory behaviors. Statistical findings indicate that differences in collateral clinical variables associated with the DSM-5 severity ratings reflect small effect sizes. Further research is needed with treatment-seeking patient groups with BN to establish the validity of the DSM-5 severity specifier and should include broader clinical and functional validators.

  2. 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

  3. 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.

  4. 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.

  5. 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.

  6. SARNET: Severe accident research network of excellence

    Albiol, T.; Van Dorsselaere, J. P. [IRSN, DPAM, F-13115 St Paul Les Durance (France); Chaumont, B. [IRSN, DSR, SAGR, F-92262 Fontenay Aux Roses (France); Haste, T. [Paul Scherrer Inst, NES, LTH, OVGA 312, CH-5232 Villigen (Switzerland); Journeau, Ch. [CEA Cadarache, DEN, STRI, LMA, F-13115 St Paul Les Durance (France); Meyer, L. [Forschungszentrum Karlsruhe, D-76021 Karlsruhe (Germany); Sehgal, Bal Raj [KTH, AlbaNova Univ Ctr, S-10691 Stockholm (Sweden); Schwinges, Bernd [Gesell Anlagen and Reaktorsicherheit GRS mbH, D-50667 Cologne (Germany); Beraha, D. [GRS mbH, Forschungsgelande, D-85748 Garching (Germany); Annunziato, A. [Commiss European Communities, JRC, IPSC, I-21020 Ispra, VA (Italy); Zeyen, R. [Commiss European Communities, JRC IE, IRSN DPAM DIR, F-13115 St Paul Les Durance (France)

    2010-07-01

    Fifty-one organisations network in SARNET (Severe Accident Research Network of Excellence) their research capacities in order to resolve the most important pending issues for enhancing, with regard to Severe Accidents (SA), the safety of existing and future Nuclear Power Plants (NPPs). This project. co-funded by the European Commission (EC) under the 6. Framework Programme, has been defined in order to optimise the use of the available means and to constitute sustainable research groups in the European Union. SARNET tackles the fragmentation that may exist between the different national R and D programmes, in defining common research programmes and developing common computer tools and methodologies for safety assessment. SARNET comprises most of the organisations involved in SA research in Europe, plus Canada. To reach these objectives, all the organisations networked in SARNET contributed to a joint Programme of Activities, which consisted of: Implementation of an advanced communication tool for accessing all project information, fostering exchange of information, and managing documents; Harmonization and re-orientation of the research programmes, and definition of new ones; Analysis of the experimental results provided by research programmes in order to elaborate a common understanding of relevant phenomena; Development of the ASTEC code (integral computer code used to predict the NPP behaviour during a postulated SA), which capitalizes in terms of physical models the knowledge produced within SARNET; Development of Scientific Databases in which all the results of research programmes are stored in a common format (DATANET); Development of a common methodology for Probabilistic Safety Assessment of NPPs; Development of short courses and writing a textbook on Severe Accidents for students and researchers; Promotion of personnel mobility amongst various European organisations. This paper presents the major achievements after four and a half years of operation of the

  7. Pancytopenia, including macrocytic anemia, associated with leflunomide in a rheumatoid arthritis patient.

    Toyokawa, Yasuhiko; Kingetsu, Isamu; Yasuda, Chiho; Yasuda, Jun; Yoshida, Ken; Kurosaka, Daitaro; Yamada, Akio

    2007-01-01

    A female rheumatoid arthritis patient was admitted for productive cough and general fatigue that had gradually developed after leflunomide therapy. Side effects including severe hypoxia, thrombocytopenia, lymphocytopenia, and macrocytic anemia with schistocytes (probably drug-induced megaloblastic anemia) were noted. Leflunomide-eliminating cholestyramine therapy successfully treated all conditions excluding severe hypoxia, which occurred owing to deteriorating interstitial pneumonia and complicated bacterial pneumonia following antibiotic treatment. This is a rare case of leflunomide-associated multiple hematopoietic impairments.

  8. MELCOR DB Construction for the Severe Accident Analysis DB

    Song, Y. M.; Ahn, K. I. [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2011-10-15

    The Korea Atomic Energy Research Institute (KAERI) has been constructing a severe accident analysis database (DB) under a National Nuclear R and D Program. In particular, an MAAP (commercial code being widely used in industries for integrated severe accident analysis) DB for many scenarios including a station blackout (SBO) has been completed. This paper shows the MELCOR DB construction process with examples of SBO scenarios, and the results will be used for a comparison with the MAAP DB

  9. 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...

  10. 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

    2015-10-07

    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 pregnancy nutrition and lifestyle. These high-risk women represent a group to target for education about health behaviours prior to and during pregnancy.

  11. Measurement of disease severity in cutaneous autoimmune diseases

    2013-01-01

    The development of disease-specific outcome instruments for several autoimmune skin diseases including cutaneous lupus erythematosus (CLE), dermatomyositis, vitiligo, pemphigus and alopecia areata has facilitated the objective assessment of disease in clinical trials. Validation of these instruments provides reliable tools to measure disease severity and therapeutic effect in clinical studies. However, the existence of multiple outcome measures for each disease and the lack of uniformity betw...

  12. 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.

  13. llogeneic peripheral blood stem cell transplantation in the treatment of severe aplastic anemia and severe infection

    万理萍; 颜式可; 王椿; 杨新潮; 周柱; 高彦荣; 蔡琦; 张冰

    2003-01-01

    Objective To investigate the efficacy of allogeneic peripheral blood stem cell transplantation (PBSCT) in the treatment of severe aplastic anemia (SAA) and severe infection. Methods A patient with SAA and pseudomonas aeruginosa septicemia was treated with PBSCT from an HLA-identical sibling with cyclophosphamide (CY) and total body irradiation (TBI) for conditioning. The patient was infused with 20.3×108/kg mononuclear cells including 61.0×106/kg CD34+cells following the conditioning regimen. Results Twenty days after PBSCT, the absolute neutrophil count (ANC) of 1.0×109/L was achieved, with platelet count >50×109/L. The donor origin of engraftment was confirmed by polymerase chain reaction (PCR) analysis of short tandem repeats at the end of the first, sixth and twelfth month. The patient's body temperature dropped to normal level when her ANC reached 0.5×109/L on day 10, and the bacterial culture of blood sample became negative subsequently. Symptoms and signs of acute or chronic graft versus host disease (GVHD) were not observed in 30 months after PBSCT. Conclusions Hematopoiesis was reconstituted shortly after PBSCT. The combination of CY and TBI and the infusion of sufficient peripheral blood stem cells may contribute to the successful engraftment. PBSCT may be considered as the first choice when hematopoietic stem cell transplantation is needed for SAA patients complicated with severe infection.

  14. [Children severe OSAHS with pectus excavatum: a case report].

    Ma, Wei; Wang, Jinfeng; Xie, Yuping

    2016-03-01

    The primary etiopathology of pediatric OSAHS includes tonsil or adenoid hypertrophy. Severe OSAHS contributes to or aggravates thoracic deformity, which is rarely reported. In the current report, This children sleep snoring more than 4 years, increasing with thoracic severe depression during sleep 2 days. Clinical examination indicated tonsil and adenoid hypertrophy, and polysomnography revealed OSAHS . The symptoms of OSAHS and severe inhalation-related sternum depression disappeared rapidly after tonsillectomy. Our findings indicated that OSAHS were the major causes underlying funnel chest in children. The rarity of the incidence may result in missed diagnosis or misdiagnosis. Polysomnography was recommended for the child diagnosed with funnel chest accompanied by upper airway stenosis.

  15. The diagnosis and treatment of severe cerebral fat embolism

    周东生; 王甫; 王伯珉; 王鲁博; 李连欣; 许世宏; 穆卫东

    2003-01-01

    Objective: To improve the diagnosis and treatment of severe cerebral fat embolism (SCFE).Methods: The data of nine patients with SCFE were retrospectively analyzed. The manifestations of the central nerve system, respiratory system and hemorrhage were recorded, at the same time, accessory examination including arterial oxygen, fat macroglobules in venous blood and image examination was adapted. The patients were treated with exopexy, pharmocotherapy and oxygentherapy.Results: Two of the nine patients died of severe complications, the other seven recovered without severe sequela.Conclusions: Gurd standard should be improved for early diagnosis of SCFE. If svere complications can be prevented, patients who receive early treatment will have favourable prognosis.

  16. Etiology of severe pneumonia in Ecuadorian children

    Jonnalagadda, Sivani; Rodríguez, Oswaldo; Estrella, Bertha; Sabin, Lora L.; Sempértegui, Fernando

    2017-01-01

    Background In Latin America, community-acquired pneumonia remains a major cause of morbidity and mortality among children. Few studies have examined the etiology of pneumonia in Ecuador. Methods This observational study was part of a randomized, double blind, placebo-controlled clinical trial conducted among children aged 2–59 months with severe pneumonia in Quito, Ecuador. Nasopharyngeal and blood samples were tested for bacterial and viral etiology by polymerase chain reaction. Risk factors for specific respiratory pathogens were also evaluated. Results Among 406 children tested, 159 (39.2%) had respiratory syncytial virus (RSV), 71 (17.5%) had human metapneumovirus (hMPV), and 62 (15.3%) had adenovirus. Streptococcus pneumoniae was identified in 37 (9.2%) samples and Mycoplasma pneumoniae in three (0.74%) samples. The yearly circulation pattern of RSV (P = 0.0003) overlapped with S. pneumoniae, (P = 0.03) with most cases occurring in the rainy season. In multivariable analysis, risk factors for RSV included younger age (adjusted odds ratio [aOR] = 1.9, P = 0.01) and being underweight (aOR = 1.8, P = 0.04). Maternal education (aOR = 0.82, P = 0.003), pulse oximetry (aOR = 0.93, P = 0.005), and rales (aOR = 0.25, P = 0.007) were associated with influenza A. Younger age (aOR = 3.5, P = 0.007) and elevated baseline respiratory rate were associated with HPIV-3 infection (aOR = 0.94, P = 0.03). Conclusion These results indicate the importance of RSV and influenza, and potentially modifiable risk factors including undernutrition and future use of a RSV vaccine, when an effective vaccine becomes available. Trial registration ClinicalTrials.gov NCT 00513929 PMID:28182741

  17. SEVERITY OF INJURIES IN TRAUMA PATIENTS

    KINGMA, J

    1995-01-01

    The present purpose was to illustrate the range of severity scores among trauma patients. A computerised conversion of ICD-9CM injury diagnoses into scores for severity of injury was processed on data of 36,178 trauma patients. More than 94% of the patients had injuries of minor severity. The probab

  18. 16 CFR 312.12 - Severability.

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Severability. 312.12 Section 312.12 Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS CHILDREN'S ONLINE PRIVACY PROTECTION RULE § 312.12 Severability. The provisions of this part are separate and severable...

  19. The prevalence of severe refractory asthma

    Hekking, Pieter-Paul W; Wener, Reinier R; Amelink, Marijke; Zwinderman, Aelko H; Bouvy, Marcel L; Bel, Elisabeth H

    2014-01-01

    BACKGROUND: Severe asthma is characterized by difficulty to achieve disease control despite high-intensity treatment. However, prevalence figures of severe asthma are lacking, whereas longstanding estimates vary between 5% and 10% of all asthmatic patients. Knowing the exact prevalence of severe ref

  20. Ocular complications of severe vernal keratoconjunctivitis (VKC) in Yemen☆

    Al-Akily, Saleh A.; Bamashmus, Mahfouth A.

    2011-01-01

    Objectives The objective of this study was to assess the ocular complications and visual loss among patients with severe vernal keratoconjunctivitis (VKC). Methods Four hundred and thirty-one patients with VKC seen at Ibn Al-Haitham Eye Center were the study group. This is a retrospective non-comparative observational study between 01 January 2002 and 31 December 2002. Visual acuity was measured with the standard Snellen visual acuity chart and for children under 5 years of age Kay pictures were used. Visual impairment was assessed by means of the World Health Organization criteria for visual disabilities. Cases with severe VKC that developed ocular complications leading to blindness and severe visual impairment were analyzed. Results The majority of VKC patients were males (75.9%) with a male:female ratio of 3.1:1. A total of 68 (15.7%) patients (54 boys and 14 girls) had severe VKC. The ocular findings among 20 patients with severe VKC that led to blindness and severe visual impairment included keratoconus (7); steroid-induced cataract (5), central corneal scars (5) and steroid-induced glaucoma (3). Two of the keratoconus cases developed acute hydrops. Conclusion Severe VKC in developing countries including Yemen is a potentially blinding disease. Visual loss may be due to keratoconus and corneal scars, as well as complications of the unsupervised use of topically administered corticosteroids. PMID:23960939

  1. 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.

  2. Haemophilus influenzae Disease (Including Hib) Diagnosis and Treatment

    ... Search The CDC Cancel Submit Search The CDC Haemophilus influenzae Disease (Including Hib) Note: Javascript is disabled or ... Compartir On this Page Diagnosis Treatment Complications Diagnosis Haemophilus influenzae , including Hib, disease is usually diagnosed with one ...

  3. 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...

  4. 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.

  5. 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.

  6. Associations between lifestyle factors and hand eczema severity

    Sørensen, Jennifer A; Fisker, Maja H; Agner, Tove;

    2016-01-01

    BACKGROUND: It has been suggested that lifestyle factors such as smoking, being overweight and stress may influence the prevalence and severity of hand eczema. OBJECTIVES: To investigate the association between lifestyle factors and hand eczema severity in a cohort of patients with work......-related hand eczema. METHODS: Individuals with work-related hand eczema notified in the period between June 2012 and November 2013 were included in this questionnaire-based cross-sectional study. Participants responded to a questionnaire including questions on lifestyle factors, as well as a photographic guide...

  7. Severe upper airway obstruction during sleep.

    Bonekat, H William; Hardin, Kimberly A

    2003-10-01

    Few disorders may manifest with predominantly sleep-related obstructive breathing. Obstructive sleep apnea (OSA) is a common disorder, varies in severity and is associated with significant cardiovascular and neurocognitive morbidity. It is estimated that between 8 and 18 million people in the United States have at least mild OSA. Although the exact mechanism of OSA is not well-delineated, multiple factors contribute to the development of upper airway obstruction and include anatomic, mechanical, neurologic, and inflammatory changes in the pharynx. OSA may occur concomitantly with asthma. Approximately 74% of asthmatics experience nocturnal symptoms of airflow obstruction secondary to reactive airways disease. Similar cytokine, chemokine, and histologic changes are seen in both disorders. Sleep deprivation, chronic upper airway edema, and inflammation associated with OSA may further exacerbate nocturnal asthma symptoms. Allergic rhinitis may contribute to both OSA and asthma. Continuous positive airway pressure (CPAP) is the gold standard treatment for OSA. Treatment with CPAP therapy has also been shown to improve both daytime and nighttime peak expiratory flow rates in patients with concomitant OSA and asthma. It is important for allergists to be aware of how OSA may complicate diagnosis and treatment of asthma and allergic rhinitis. A thorough sleep history and high clinical suspicion for OSA is indicated, particularly in asthma patients who are refractory to standard medication treatments.

  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

    Drent, Marjolein [Department of Respiratory Medicine, University Hospital of Maastricht, P.O. Box 5800, 6202, AZ Maastricht (Netherlands); Nutrition and Toxicology Research Institute Maastricht (NUTRIM), P.O. Box 5800, 6202, AZ Maastricht (Netherlands); Sarcoidosis Management Center, University Hospital of Maastricht, P.O. Box 5800, 6202, AZ Maastricht (Netherlands); Vries, Jolanda De [Department of Clinical Health Psychology, Tilburg University, P.O. Box 90153, 5000, LE Tilburg (Netherlands); Lenters, Merinke; Wouters, Emiel F.M. [Department of Respiratory Medicine, University Hospital of Maastricht, P.O. Box 5800, 6202, AZ Maastricht (Netherlands); Nutrition and Toxicology Research Institute Maastricht (NUTRIM), P.O. Box 5800, 6202, AZ Maastricht (Netherlands); Lamers, Rob J.S. [Department of Radiology, University Hospital of Maastricht, P.O. Box 5800, 6202, AZ Maastricht (Netherlands); Rothkranz-Kos, Snjezana; Dieijen-Visser, Marja P. van [Nutrition and Toxicology Research Institute Maastricht (NUTRIM), P.O. Box 5800, 6202, AZ Maastricht (Netherlands); Department of Clinical Chemistry, University Hospital of Maastricht, P.O. Box 5800, 6202, AZ Maastricht (Netherlands); Verschakelen, Johny A. [Department of Radiology, Catholic University, 3000, Leuven (Belgium)

    2003-11-01

    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 FEV{sub 1}, FVC, DLco, Pao{sub 2}max (all p<0.05) and A-aPo{sub 2}max (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. 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...... 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...

  11. [Refeeding syndrome in severely malnourished patient].

    Bovin, Ann; Vinter-Jensen, Lars

    2008-11-01

    Refeeding syndrome is a potentially lethal condition observed in severely malnourished patients due to severe shifts in electrolytes during refeeding. We report the refeeding of a severely malnourished 53-year old male with a body mass index (BMI) of 10. Initially refeeding was enteral 25 kCal/kg which had to be replaced by combined enteral and parenteral nutrition. The patient suffered several complications, e.g. severe electrolyte disturbances, oedema of the lung, and infections. The patient was successfully discharged to a recreational facility after three months.

  12. High dose corticosteroids in severe leptospirosis: a systematic review.

    Rodrigo, Chaturaka; Lakshitha de Silva, Nipun; Goonaratne, Ravindi; Samarasekara, Keshinie; Wijesinghe, Indika; Parththipan, B; Rajapakse, Senaka

    2014-12-01

    The role of corticosteroids in the treatment of severe leptospirosis is unclear. The rationale for their use is that, in severe leptospirosis, there is a severe immunological response that is harmful to the host resulting in multi-organ dysfunction, which is potentially offset by the nonspecific immunosuppression of high dose steroids. We conducted a systematic review of studies that have assessed the use of high dose corticosteroids in patients with severe leptospirosis by searching MEDLINE and Scopus SciVerse without any language or time restrictions. We identified five studies, including one open randomized clinical trial, which had assessed the use of high dose steroids in severe leptospirosis. Four studies demonstrated a benefit of corticosteroids in treating severe disease with pulmonary involvement when administered early in the course of the disease, but these studies had several methodological constraints as highlighted in the text. Only the randomized controlled trial study showed that corticosteroids are ineffective and may increase the risk of nosocomial infections. There is no robust evidence to suggest that high dose corticosteroids are effective in severe leptospirosis, and a well-designed randomized clinical trial is needed to resolve this.

  13. 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.

  14. Insufficient treatment of severe depression in neuromyelitis optica spectrum disorder

    Chavarro, Velina S.; Mealy, Maureen A.; Simpson, Alexandra; Lacheta, Anna; Pache, Florence; Ruprecht, Klemens; Gold, Stefan M.; Brandt, Alexander Ulrich; Levy, Michael

    2016-01-01

    Objective: To investigate depression frequency, severity, current treatment, and interactions with somatic symptoms among patients with neuromyelitis optica spectrum disorder (NMOSD). Methods: In this dual-center observational study, we included 71 patients diagnosed with NMOSD according to the International Panel for NMO Diagnosis 2015 criteria. The Beck Depression Inventory (BDI) was classified into severe, moderate, or minimal/no depressive state category. We used the Fatigue Severity Scale to evaluate fatigue. Scores from the Brief Pain Inventory and the PainDETECT Questionnaire were normalized to estimate neuropathic pain. Psychotropic, pain, and immunosuppressant medications were tabulated by established classes. Results: Twenty-eight percent of patients with NMOSD (n = 20) had BDI scores indicative of moderate or severe depression; 48% of patients (n = 34) endorsed significant levels of neuropathic pain. Severity of depression was moderately associated with neuropathic pain (r = 0.341, p < 0.004) but this relationship was confounded by levels of fatigue. Furthermore, only 40% of patients with moderate or severe depressive symptoms received antidepressant medical treatment. Fifty percent of those treated reported persistent moderate to severe depressive symptoms under treatment. Conclusions: Moderate and severe depression in patients with NMOSD is associated with neuropathic pain and fatigue and is insufficiently treated. These results are consistent across 2 research centers and continents. Future research needs to address how depression can be effectively managed and treated in NMOSD. PMID:27800532

  15. Consequences of severe nuclear accidents in Europe

    Seibert, Petra; Arnold, Delia; Mraz, Gabriele; Arnold, Nikolaus; Gufler, Klaus; Kromp-Kolb, Helga; Kromp, Wolfgang; Sutter, Philipp

    2013-04-01

    A first part of the presentation is devoted to the consequences of the severe accident in the 1986 Chernobyl NPP. It lead to a substantial radioactive contaminated of large parts of Europe and thus raised the awareness for off-site nuclear accident consequences. Spatial patterns of the (transient) contamination of the air and (persistent) contamination of the ground were studied by both measurements and model simulations. For a variety of reasons, ground contamination measurements have variability at a range of spatial scales. Results will be reviewed and discussed. Model simulations, including inverse modelling, have shown that the standard source term as defined in the ATMES study (1990) needs to be updated. Sensitive measurements of airborne activities still reveal the presence of low levels of airborne radiocaesium over the northern hemisphere which stems from resuspension. Over time scales of months and years, the distribution of radionuclides in the Earth system is constantly changing, for example relocated within plants, between plants and soil, in the soil, and into water bodies. Motivated by the permanent risk of transboundary impacts from potential major nuclear accidents, the multidisciplinary project flexRISK (see http://flexRISK.boku.ac.at) has been carried out from 2009 to 2012 in Austria to quantify such risks and hazards. An overview of methods and results of flexRISK is given as a second part of the presentation. For each of the 228 NPPs, severe accidents were identified together with relevant inventories, release fractions, and release frequencies. Then, Europe-wide dispersion and dose calculations were performed for 2788 cases, using the Lagrangian particle model FLEXPART. Maps of single-case results as well as various aggregated risk parameters were produced. It was found that substantial consequences (intervention measures) are possible for distances up to 500-1000 km, and occur more frequently for a distance range up to 100-300 km, which is in

  16. Aeroelastic Tailoring of Transport Wings Including Transonic Flutter Constraints

    Stanford, Bret K.; Wieseman, Carol D.; Jutte, Christine V.

    2015-01-01

    Several minimum-mass optimization problems are solved to evaluate the effectiveness of a variety of novel tailoring schemes for subsonic transport wings. Aeroelastic stress and panel buckling constraints are imposed across several trimmed static maneuver loads, in addition to a transonic flutter margin constraint, captured with aerodynamic influence coefficient-based tools. Tailoring with metallic thickness variations, functionally graded materials, balanced or unbalanced composite laminates, curvilinear tow steering, and distributed trailing edge control effectors are all found to provide reductions in structural wing mass with varying degrees of success. The question as to whether this wing mass reduction will offset the increased manufacturing cost is left unresolved for each case.

  17. Factors associated with crash severity on rural roadways in Wyoming

    Debbie S. Shinstine

    2016-08-01

    Full Text Available The ability to identify risk factors associated with crashes is critical to determine appropriate countermeasures for improving roadway safety. Many studies have identified risk factors for urban systems and intersections, but few have addressed crashes on rural roadways, and none have analyzed crashes on Indian Reservations. This study analyzes crash severity for rural highway systems in Wyoming. These rural systems include interstates, state highways, rural county local roads, and the roadway system on the Wind River Indian Reservation (WRIR. In alignment with the Wyoming strategic highway safety goal of reducing critical crashes (fatal and serious injury, crash severity was treated as a binary response in which crashes were classified as severe or not severe. Multiple logistic regression models were developed for each of the highway systems. Five effects were prevalent on all systems including animals, driver impairment, motorcycles, mean speed, and safety equipment use. With the exception of animal crashes, all of these effects increased the probability that a crash would be severe. Based upon these results, DOTs can pursue effective policies and targeted design decisions to reduce the severity of crashes on rural highways.

  18. [Prophylaxis of venous thromboembolism after severe stroke].

    Riabinkina, Iu V; Gnedovskaia, E V; Piradov, M A; Kuntsevich, G I

    2010-01-01

    Venous thromboembolism (VTE), a deep and superficial thrombosis and pulmonary embolism, is a very important problem of severe stroke. Pulmonary embolism (PE) significantly influences the course and outcome of severe stroke. The cause of this effect lies not only in severe patient's condition, high risk of VTE and difficulties in diagnosis of VTE but in still common limits in prophylaxis and treatment of PE in severe stroke, first of all, in brain hemorrhages and large brain infarctions with secondary hemorrhage. The paper presents the main principles and methods of prophylaxis of VTE in severe stroke. The suggested approach allows to decrease the frequency of VTE and fatal outcomes in severe stroke in the modern neuro-intensive care units.

  19. Severe chronic allergic (and related) diseases

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

    2012-01-01

    and associated diseases (rhinitis, chronic rhinosinusitis, chronic urticaria and atopic dermatitis) in order to have a uniform definition of severity, control and risk, usable in most situations. It is based on the appropriate diagnosis, availability and accessibility of treatments, treatment responsiveness......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...

  20. Screening for severe combined immunodeficiency in neonates

    Kelly BT; Tam JS; Verbsky JW; Routes JM

    2013-01-01

    Brian T Kelly,1 Jonathan S Tam,1 James W Verbsky,1,2 John M Routes1,2 1Department of Pediatrics, 2Department of Microbiology and Molecular Genetics, Medical College of Wisconsin, Milwaukee, WI, USA Abstract: Severe combined immunodeficiency (SCID) is a rare disease that severely affects the cellular and humoral immune systems. Patients with SCID present with recurrent or severe infections and often with chronic diarrhea and failure to thrive. The disease is uniformly fatal, making early diag...

  1. Screening for severe combined immunodeficiency in neonates

    Kelly, Brian T; Tam, Jonathan S; Verbsky, James W; Routes, John M

    2013-01-01

    Severe combined immunodeficiency (SCID) is a rare disease that severely affects the cellular and humoral immune systems. Patients with SCID present with recurrent or severe infections and often with chronic diarrhea and failure to thrive. The disease is uniformly fatal, making early diagnosis essential. Definitive treatment is hematopoietic stem cell transplantation, with best outcomes prior to 3.5 months of age. Newborn screening for SCID using the T-cell receptor excision circle assay has revolutionized early identification of infants with SCID or severe T-cell lymphopenia. PMID:24068875

  2. 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,

  3. Four Stories, Four Children, One Special Need: To Be Warmly Included.

    Soriano-Nagurski, Lisa; Bakley, Sue; Kulak, Alisa; Blasi, Mary Jane; Priestley, Lori

    1998-01-01

    Contains four articles: (1) "And the Walls Came Tumbling Down: Including Children Who Are Differently Abled in Typical Early Childhood Educational Settings"; (2) "On Teasing, Taunting, and 'I Can Do It by Myself'"; (3) "A Teacher's Responsibility--To Be Enthusiastic about Teaching Fast and Slow Learners Alike"; (4) "A Child with Severe Hearing…

  4. Designing Research to Include Racial/Ethnic Diversity and Marginalized Voices

    James, Katherine

    2003-01-01

    Environmental education research designs will either exclude or include voices outside the dominant culture. Examining the questions we ask and the data collection techniques we use may enable us to design research that is more sensitive to marginalized voices. This article puts forward several methodological considerations that either draw out…

  5. 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.

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

    Patel, Pavankumar; Sallam, Hanaa S.; 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.

  7. Educational Technology for the Severely Handicapped: A Comprehensive Bibliography.

    Gaines, Debby, Comp.; And Others

    The bibliography presents approximately 650 references (1955-1975) on educational programs for the severely handicapped. Citations are listed alphabetically by author's name in the following areas: behavior management, curriculum guides, medico-prosthetic aids, motor development, parent training (including aspects of parent involvement in school…

  8. Voriconazole metabolism is influenced by severe inflammation : a prospective study

    Veringa, Anette; Ter Avest, Mendy; Span, Lambert F R; van den Heuvel, Edwin R; Touw, Daan J; Zijlstra, Jan G; Kosterink, Jos G W; van der Werf, Tjip S; Alffenaar, Jan-Willem C

    2016-01-01

    BACKGROUND: During an infection or inflammation, several drug-metabolizing enzymes in the liver are down-regulated, including cytochrome P450 iso-enzymes. Since voriconazole is extensively metabolized by cytochrome P450 iso-enzymes, the metabolism of voriconazole can be influenced during inflammatio

  9. Vector Communication Curriculum: Moderate and Severe, Multiple Disabilities.

    Baine, David

    This CD-ROM disk contains a curriculum on vector communication for students with moderate and severe multiple disabilities. Section 1 discusses pragmatic communication, functional analysis of behavior, augmentative and alternative communication, including gestures and signs, use of pictures and pictographs, and low, medium, and high tech…

  10. 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.

  11. Citrus diseases with global ramifications including citrus canker and huanglongbing

    Although there are a number of diseases that plague citrus production worldwide, two bacterial diseases are particularly problematic. Both are of Asian origin and currently cause severe economic damage: Asiatic citrus canker (ACC) and citrus huanglongbing (HLB). Although ACC has been found in the ...

  12. EVAR for aortoiliac aneurysms, including iliac branched grafts

    Paraskevas, K.; Moellendorf, C.; Fernandes, R. Fernandes E.; Tielliu, I.; Verhoeven, E.

    2012-01-01

    For aortoiliac aneurysms involving the common iliac arteries several treatment options have been developed. In the early stages of the endovascular era the internal iliac artery was usually overstented with or without embolization. Thereafter relocation or bypass techniques were used in an attempt t

  13. 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

  14. Risk of severe driver injury by driving with psychoactive substances

    Hels, Tove; Lyckegaard, Allan; Bernhoft, Inger Marie;

    2013-01-01

    /L) and benzoylecgonine. The least risky drug seemed to be cannabis and benzodiazepines and Z-drugs. For male drivers, the risk of being severely injured by driving with any of the psychoactive substances was about 65% of that of female drivers. For each of the substance groups there was a decrease in the risk of severe......Driving with alcohol and other psychoactive substances imposes an increased risk of severe injury accidents. In a population-based case-control design, the relative risks of severe driver injury (MAIS ≥ 2) by driving with ten substance groups were approximated by odds ratios (alcohol, amphetamines......, benzoylecgonine, cocaine, cannabis, illicit opiates, benzodiazepines and Z-drugs, i.e. zolpidem and zopiclone, medicinal opioids, alcohol-drug combinations and drug-drug combinations). Data from six countries were included in the study: Belgium, Denmark, Finland, Italy, Lithuania and the Netherlands. Case samples...

  15. [State of the art diagnostic criteria of severe periodontitis].

    Ouyang, X Y

    2017-02-09

    Periodontitis could be categorized as mild, moderate, and severe according to the severity of the disease. This categorizing system could also be used together with other classification systems. The present article introduced the status about the case definition of severe periodontitis, including the standard of case definitions for surveillance of periodontitis reported by the Centers for Disease Control and Prevention (CDC) in partnership with the American Academy of Periodontology (AAP) and the consensus report on the definition of periodontitis case for use in risk factor research by Europe workshop. A consensus on the state of the art definition of severe periodontitis for use in clinical work was gained base on the expertise of Chinese Society of Periodontology, Chinese Association of Stomatology. The background of this consensus and the significance of the criteria for the case definition were discussed.

  16. 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...

  17. 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…

  18. 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)

  19. 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) Aquaculture is a value loss crop and is compensable only in accord with restrictions set in this...

  20. 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...

  1. 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.

  2. Including All Children in Standards-Based Physical Education.

    Johnson, Lynn V.; Kasser, Susan L.; Nichols, Beverly A.

    2002-01-01

    Discusses the inclusion of students with and without disabilities in physical education as the movement toward standards-based education progresses, examining whether standards should be applied to all students, obstacles to including all students, ways to include all students, and the importance of standards for teachers. An example of inclusive…

  3. 21 CFR 870.5300 - DC-defribrillator (including paddles).

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false DC-defribrillator (including paddles). 870.5300...-defribrillator (including paddles). (a) Low-energy DC-defibrillator—(1) Identification. A low-energy DC... electrocardiogram or may operate asynchronously. The device delivers the electrical shock through paddles...

  4. Including Students with Disabilities. ERIC Mini-Bib EB14.

    Sorenson, Barbara R., Comp.

    This annotated bibliography lists 19 publications to help educators more effectively include students with disabilities in general education classrooms. The publications, including books, journal articles, videotapes, and reports, are dated from 1993 through 1999, and most are available through the ERIC (Educational Resources Information Center)…

  5. 14 CFR 23.1181 - Designated fire zones; regions included.

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Designated fire zones; regions included. 23... Powerplant Powerplant Fire Protection § 23.1181 Designated fire zones; regions included. Designated fire zones are— (a) For reciprocating engines— (1) The power section; (2) The accessory section; (3)...

  6. 14 CFR 29.1181 - Designated fire zones: regions included.

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Designated fire zones: regions included. 29... Protection § 29.1181 Designated fire zones: regions included. (a) Designated fire zones are— (1) The engine power section of reciprocating engines; (2) The engine accessory section of reciprocating engines;...

  7. 14 CFR 25.1181 - Designated fire zones; regions included.

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Designated fire zones; regions included. 25... Protection § 25.1181 Designated fire zones; regions included. (a) Designated fire zones are— (1) The engine power section; (2) The engine accessory section; (3) Except for reciprocating engines, any...

  8. 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...

  9. Interleukin-15 is associated with disease severity in viral bronchiolitis.

    Leahy, T Ronan; McManus, Ross; Doherty, Derek G; Grealy, Robert; Coulter, Tanya; Smyth, Paul; Blackshields, Gordon; Sheils, Orla; Carr, Michael J; Purandare, Nikhil; Geary, Michael; Hodemaekers, Hennie M; Janssen, Riny; Bont, Louis; Slattery, Dubhfeasa; Ryan, Thomas

    2016-01-01

    Disease severity in viral bronchiolitis in infancy is difficult to predict and has been linked to host innate immunity. The study aimed to investigate the innate cytokine interleukin-15 (IL-15) as a marker of disease severity.A prospective single-centre observational study was conducted in a university-affiliated paediatric teaching hospital, comparing children (0-18 months) hospitalised for viral bronchiolitis, those admitted to the paediatric intensive care unit with severe disease and healthy age-matched controls. IL-15-related parameters were compared between groups. PCR and microRNA (miRNA) sequencing was undertaken on natural killer (NK) cells collected from study participants.Samples from 88 children with viral bronchiolitis and 43 controls enrolled between 2009 and 2012 were analysed. Peripheral blood mononuclear cell (PBMC) IL-15 mRNA expression was significantly higher in those with moderate severity bronchiolitis compared with controls and those with severe disease. Serum IL-15 levels correlated with disease severity. The relative frequency of NK cells in peripheral blood was significantly reduced in participants with bronchiolitis. The NK cell miRNA transcriptome in bronchiolitis was distinct. Targets of de-regulated miRNA were differentially expressed in bronchiolitis, including JAK3, STAT5A and NFKB1 on the IL-15 signalling pathway.IL-15 is associated with disease severity in children hospitalised with viral bronchiolitis.

  10. Risk factors for severe perineal tear: can we do better?

    Riskin-Mashiah, Shlomit; O'Brian Smith, E; Wilkins, Isabelle A

    2002-07-01

    Our aim was to investigate the risk factors associated with severe perineal tears defined as either third- or forth-degree tears and, ultimately, find strategies for prevention. We carried a retrospective analysis of a computerized perinatal database, collected prospectively, from a single county hospital between January 1, 1993 and June 30, 1998. Singleton vaginal vertex deliveries were analyzed for potential risk factors using univariate and multiple logistic regression analysis including all two-way interactions. Severe perineal tear occurred in 1905 (8.2%) of 23,244 vaginal deliveries. In the multiple logistic regression analysis, the following factors carried a significantly higher risk for severe laceration: midline episiotomy, primary vaginal delivery, use of pudendal block, forceps deliveries, and birth weight more than 4000 g. The study of interactions demonstrated that mediolateral episiotomy was associated with an increased risk for severe tear only during the first vaginal delivery, but not during a repeat vaginal delivery. Our data suggest that primary vaginal delivery, fetal weight above 4000 g, and the use of pudendal analgesia can help identify in advance patients at highest risk for severe perineal tear. During the delivery of these patients usage of vacuum (instead of forceps) and restricting the use of midline episiotomy might reduce the incidence of severe perineal tear. In cases where episiotomy seems crucial, the use of a mediolateral episiotomy may reduce the likelihood of severe perineal tear.

  11. Allogeneic Transplant in ELANE and MEFV Mutation Positive Severe Cyclic Neutropenia: Review of Prognostic Factors for Secondary Severe Events

    2017-01-01

    Objective and Importance. Cyclic neutropenia (CyN) is a rare autosomal dominant inherited disorder due to the mutation ELANE primarily affecting bone marrow stem cells and is characterized by recurrent neutropenia every 2 to 4 weeks. Symptoms vary from benign to severe, including death. Postulations on the cause of wide spectrum in symptom presentation include the possibility of other genetic mutations, such as MEFV. Recommended treatment for CyN is G-CSF to keep ANC higher to minimize risk of infection. Case. A 25-year-old male diagnosed with CyN, on G-CSF but worsening quality of life. Pretransplant investigations revealed ELANE mutation positive severe CyN along with familial Mediterranean fever (MEFV) mutation. Intervention. Bone marrow transplantation as treatment for dual mutation (ELANE and MEFV mutation) positive severe CyN. Conclusion. BMT may be considered as an alternative treatment for severe CyN in patients who are refractory to G-CSF. It is postulated that in our patient the combined mutations (CyN and MEFV) may have contributed to the severity of this individual's symptoms. We suggest CyN patients who present with severe symptoms have evaluation with ELANE mutation testing, Periodic Fever Syndromes Panel, and routine marrow assessment with FISH, conventional cytogenetics, and morphological evaluation for MDS/AML.

  12. Determination of the Optical Properties of La2 xBaxCuO4 for Several Dopings, Including the Anomalous x = 1/8 Phase

    Homes C. C.; Hucker, M.; Li, Q.; Xu, Z.J.; Wen, J.S.; Gu, G.D.; Tranquada, J.M.

    2012-04-11

    The optical properties of single crystals of the high-temperature superconductor La{sub 2-x}Ba{sub x}CuO{sub 4} have been measured over a wide frequency and temperature range for light polarized in the a-b planes and along the c axis. Three different Ba concentrations have been examined, x = 0.095 with a critical temperature T{sub c} = 32 K, x = 0.125 where the superconductivity is dramatically weakened with T{sub c} {approx_equal} 2.4 K, and x = 0.145 with T{sub c} {approx_equal} 24 K. The in-plane behavior of the optical conductivity for these materials at high temperature is described by a Drude-like response with a scattering rate that decreases with temperature. Below T{sub c} in the x = 0.095 and 0.145 materials there is a clear signature of the formation of a superconducting state in the optical properties allowing the superfluid density ({rho}{sub s0}) and the penetration depth to be determined. In the anomalous 1/8 phase, some spectral weight shifts from lower to higher frequency ({ge} 300 cm{sup -1}) on cooling below the spin-ordering temperature T{sub so} {approx_equal} 42 K, associated with the onset of spin-stripe order; we discuss alternative interpretations in terms of a conventional density-wave gap versus the response to pair-density-wave superconductivity. The two dopings for which a superconducting response is observed both fall on the universal scaling line {rho}{sub s0}/8 {approx_equal} 4.4 {sigma}{sub dc}T{sub c}, which is consistent with the observation of strong dissipation within the a-b planes. The optical properties for light polarized along the c axis reveal an insulating character dominated by lattice vibrations, superimposed on a weak electronic background. No Josephson plasma edge is observed in the low-frequency reflectance along the c axis for x = 1/8; however, sharp plasma edges are observed for x = 0.095 and 0.145 below T{sub c}.

  13. Determination of the optical properties of La2-xBaxCuO4 for several dopings, including the anomalous x=(1)/(8) phase

    Homes, C. C.; Hücker, M.; Li, Q.; Xu, Z. J.; Wen, J. S.; Gu, G. D.; Tranquada, J. M.

    2012-04-01

    The optical properties of single crystals of the high-temperature superconductor La2-xBaxCuO4 have been measured over a wide frequency and temperature range for light polarized in the a-b planes and along the c axis. Three different Ba concentrations have been examined, x=0.095 with a critical temperature Tc=32 K, x=0.125 where the superconductivity is dramatically weakened with Tc≃2.4 K, and x=0.145 with Tc≃24 K. The in-plane behavior of the optical conductivity for these materials at high temperature is described by a Drude-like response with a scattering rate that decreases with temperature. Below Tc in the x=0.095 and 0.145 materials there is a clear signature of the formation of a superconducting state in the optical properties allowing the superfluid density (ρs0) and the penetration depth to be determined. In the anomalous 1/8 phase, some spectral weight shifts from lower to higher frequency (≳300 cm-1) on cooling below the spin-ordering temperature Tso≃42 K, associated with the onset of spin-stripe order; we discuss alternative interpretations in terms of a conventional density-wave gap versus the response to pair-density-wave superconductivity. The two dopings for which a superconducting response is observed both fall on the universal scaling line ρs0/8≃4.4σdcTc, which is consistent with the observation of strong dissipation within the a-b planes. The optical properties for light polarized along the c axis reveal an insulating character dominated by lattice vibrations, superimposed on a weak electronic background. No Josephson plasma edge is observed in the low-frequency reflectance along the c axis for x=1/8; however, sharp plasma edges are observed for x=0.095 and 0.145 below Tc.

  14. AN OVERVIEW OF WIND ENERGY, TAKING INTO CONSIDERATION SEVERAL IMPORTANT ISSUES INCLUDING AN ANALYSIS OF REGULATORY REQUIREMENTS FOR THE CONNECTION OF WIND GENERATION INTO THE POWER SYSTEM

    JUAN MANUEL GIMENEZ ALVAREZ

    2012-01-01

    Full Text Available Los problemas de contaminación tal como el efecto invernadero, así como el alto valor y la volatilidad de los precios del combustible, han obligado y acelerado el desarrollo y uso de fuentes de energía renovables. En este trabajo se presenta una revisión de la generación eólica. Primero, se detalla una breve historia de la evolución de la energía eólica. A continuación se discuten algunos aspectos relacionados con el estado actual y el futuro. Seguido a esto se realiza una revisión de las estructuras modernas de generación eólica. En cuarto lugar se lleva a cabo una comparación entre turbinas de pequeño y de gran tamaño. A continuación también se mencionan los diferentes tipos de almacenamiento de energía. Por último se discuten algunos aspectos normativos.

  15. Borrelidin Isolated from Streptomyces sp. Inhibited Adipocyte Differentiation in 3T3-L1 Cells via Several Factors Including GATA-Binding Protein 3.

    Matsuo, Hirotaka; Kondo, Yoshiyuki; Kawasaki, Takashi; Tokuyama, Shinji; Imamura, Nobutaka

    2015-01-01

    An inhibitor of 3T3-L1 adipocyte differentiation was isolated from Streptomyces sp. TK08330 and identified by spectroscopy as the 18-membered macrolide borrelidin. Treatment with 1.0 μM borrelidin suppressed intracellular lipid accumulation by 80% and inhibited the expression of adipocyte-specific genes. Borrelidin suppressed the mRNA expression of two master regulators of adipocyte differentiation, peroxisome proliferator-activated receptor gamma (PPARγ) and CCAAT/enhancer binding protein (C/EBPα). Studies on well-known upstream regulators of PPARγ revealed that borrelidin down-regulated C/EBPδ mRNA expression but did not affect expression of C/EBPβ. Borrelidin increased mRNA expression of negative regulators of differentiation such as GATA-binding protein (GATA) 3, Krüppel-like factor (KLF) 3 and KLF7, as well as positive regulators, KLF4, KLF6 and KLF15, at early stages of differentiation. To elucidate a primary mediator of borrelidin differentiation inhibitory activity, small interfering RNA (siRNA) transfection experiments were performed. The mRNA expression of PPARγ, which was down-regulated by borrelidin, was not changed by KLF3 and KLF7 siRNA treatment. In contrast, expression of PPARγ in GATA-3 siRNA-treated cells was not significantly different from that of control siRNA-treated cells. Borrelidin significantly inhibited lipid accumulation in control siRNA-treated cells, and treatment with GATA-3 siRNA slightly reduced the inhibitory effect of borrelidin. These results indicate that borrelidin inhibited adipocyte differentiation partially via GATA-3.

  16. [Quality of data on folic acid content in vegetables included in several Spanish Food Composition Tables and new data on their folate content].

    Olivares, A B; Bernal, M J; Ros, G; Martínez, C; Periago, M J

    2006-01-01

    The relationship between adequate folate intake, adequate serum levels, and lowering the risk of suffering from cardiovascular diseases, neural tube defects, neural illness and some kind of cancers have been widely studied. Because of the expected health benefits, the consumption of foods with high folate content or enriched foods is increasing. Therefore, an adequate folate intake is important in order to reach acceptable serum levels. Reliable food composition data are necessary in order to evaluate and estimate the populations folate intake, elaborate diets and formulate recommended dietary intakes. For this reason, we revised folic acid data in Spanish Food Composition Tables (FCT). The quality of the data was evaluated and compared with other well-known international Food Composition Tables as well as with a high-resolution liquid chromatographic method (HPLC) validated in our laboratory. We evaluated all data about folate content, as well as all the information given like data origin, analytical method, sampling or original database. For the HPLC method, the food samples were incubated with hog kidney conjugase. After that, the samples were purified and concentrated by strong anion exchange (SAX), then the folate content was quantified by HPLC with a combination of two ultraviolet and fluorescence detectors. The evaluation and comparison of data was established according to some parameters, which define the quality of data, giving punctuation depending on the compliance with these parameters. The study of different sources showed that nutrients were different in definition, analysis method, units and expression of data, and that this fact could have a potential influence on TCA data values. In addition, it has been possible to show a wide variation in food number, name of these foods as well as the analysis of raw or cooked products with different composition. When the quality conditions were tested, the Spanish FCT had the lowest punctuation in folate content data. That is because the Spanish FCT did not use a validated method to quantify folic acid in foods (Direct method of FCT elaboration), but they used folate content data from others FCT (Indirect method of FCT elaboration). These data manifest the importance of getting a consensus method to determine folate content in foods with the aim to obtain a FCT with reliable folate data.

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

    Navarrete, J. M.; Muller, G.; Cabrera, L.; Martinez, T.

    2006-01-01

    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(Ti) 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.

  18. 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

  19. 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...

  20. Severe acquired anaemia in Africa: new concepts

    M. Boele van Hensbroek; F. Jonker; I. Bates

    2011-01-01

    Severe anaemia is common in Africa. It has a high mortality and particularly affects young children and pregnant women. Recent research provides new insights into the mechanisms and causes of severe acquired anaemia and overturns accepted dogma. Deficiencies of vitamin B12 and vitamin A, but not of

  1. 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…

  2. Screening for severe combined immunodeficiency in neonates

    Kelly BT

    2013-09-01

    Full Text Available Brian T Kelly,1 Jonathan S Tam,1 James W Verbsky,1,2 John M Routes1,2 1Department of Pediatrics, 2Department of Microbiology and Molecular Genetics, Medical College of Wisconsin, Milwaukee, WI, USA Abstract: Severe combined immunodeficiency (SCID is a rare disease that severely affects the cellular and humoral immune systems. Patients with SCID present with recurrent or severe infections and often with chronic diarrhea and failure to thrive. The disease is uniformly fatal, making early diagnosis essential. Definitive treatment is hematopoietic stem cell transplantation, with best outcomes prior to 3.5 months of age. Newborn screening for SCID using the T-cell receptor excision circle assay has revolutionized early identification of infants with SCID or severe T-cell lymphopenia. Keywords: severe combined immunodeficiency, T-cell receptor excision circle, newborn screening, primary immunodeficiency

  3. 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.

  4. High performance, durable polymers including poly(phenylene)

    Fujimoto, Cy; Pratt, Harry; Anderson, Travis Mark

    2017-02-28

    The present invention relates to functionalized polymers including a poly(phenylene) structure. In some embodiments, the polymers and copolymers of the invention include a highly localized concentration of acidic moieties, which facilitate proton transport and conduction through networks formed from these polymers. In addition, the polymers can include functional moieties, such as electron-withdrawing moieties, to protect the polymeric backbone, thereby extending its durability. Such enhanced proton transport and durability can be beneficial for any high performance platform that employs proton exchange polymeric membranes, such as in fuel cells or flow batteries.

  5. Electric drive systems including smoothing capacitor cooling devices and systems

    Dede, Ercan Mehmet; Zhou, Feng

    2017-02-28

    An electric drive system includes a smoothing capacitor including at least one terminal, a bus bar electrically coupled to the at least one terminal, a thermoelectric device including a first side and a second side positioned opposite the first side, where the first side is thermally coupled to at least one of the at least one terminal and the bus bar, and a cooling element thermally coupled to the second side of the thermoelectric device, where the cooling element dissipates heat from the thermoelectric device.

  6. Thermal swing reactor including a multi-flight auger

    Ermanoski, Ivan

    2017-03-07

    A thermal swing reactor including a multi-flight auger and methods for solar thermochemical reactions are disclosed. The reactor includes a multi-flight auger having different helix portions having different pitch. Embodiments of reactors include at least two distinct reactor portions between which there is at least a pressure differential. In embodiments, reactive particles are exchanged between portions during a reaction cycle to thermally reduce the particles at first conditions and oxidize the particles at second conditions to produce chemical work from heat.

  7. An unusual case of generalized severe gingival enlargement during pregnancy.

    McIntosh, Crystal L; Kolhatkar, Shilpa; Winkler, James R; Ojha, Junu; Bhola, Monish

    2010-01-01

    Increased hormone levels that are present during puberty and pregnancy are associated with localized or generalized gingival enlargement. This article reviews the gingival alterations that can occur during pregnancy and describes a case of generalized severe gingival enlargement associated with pregnancy and its management. A 36-year-old woman had severe bilateral gingival enlargement of short duration. The patient denied taking any medications. The laboratory report revealed no systemic abnormalities; however, the report disclosed that she was pregnant. Surgical therapy for the gingival enlargement included gingivectomy and gingivoplasty of all quadrants, which reduced the size of the enlarged gingiva. Postoperative visits demonstrated uneventful healing, with no recurrence seen at the one-year follow-up appointment. It appears that the English literature includes only one other case report that discusses generalized gingival enlargement during pregnancy. Pregnancy-related gingival enlargement should be included as a differential diagnosis in women who have non-drug-induced generalized gingival enlargement.

  8. Practical uses for ecdysteroids in mammals including humans: An update

    R. Lafont

    2003-03-01

    Full Text Available Ecdysteroids are widely used as inducers for gene-switch systems based on insect ecdysteroid receptors and genes of interest placed under the control of ecdysteroid-response elements. We review here these systems, which are currently mainly used in vitro with cultured cells in order to analyse the role of a wide array of genes, but which are expected to represent the basis for future gene therapy strategies. Such developments raise several questions, which are addressed in detail.

  9. 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 ...

  10. When Should Zero Be Included on a Scale Showing Magnitude?

    Kozak, Marcin

    2011-01-01

    This article addresses an important problem of graphing quantitative data: should one include zero on the scale showing magnitude? Based on a real time series example, the problem is discussed and some recommendations are proposed.

  11. Post-Polio Health International including International Ventilator Users Network

    ... Place Explore the past, the present and help build a promising future for the world’s polio survivors. ... Polio Health International (PHI) Including International Ventilator Users Network 4207 Lindell Blvd., #110, Saint Louis, MO 63108- ...

  12. Clinical care for severe influenza and other severe illness in resource-limited settings: the need for evidence and guidelines.

    Ortiz, Justin R; Jacob, Shevin T; West, T Eoin

    2013-09-01

    The 2009 influenza A (H1N1) pandemic highlighted the importance of quality hospital care of the severely ill, yet there is evidence that the impact of the 2009 pandemic was highest in low- and middle-income countries with fewer resources. Recent data indicate that death and suffering from seasonal influenza and severe illness in general are increased in resource-limited settings. However, there are limited clinical data and guidelines for the management of influenza and other severe illness in these settings. Life-saving supportive care through syndromic case management is used successfully in high-resource intensive care units and in global programs such as the Integrated Management of Childhood Illness (IMCI). While there are a variety of challenges to the management of the severely ill in resource-limited settings, several new international initiatives have begun to develop syndromic management strategies for these environments, including the World Health Organization's Integrated Management of Adult and Adolescent Illness Program. These standardized clinical guidelines emphasize syndromic case management and do not require high-resource intensive care units. These efforts must be enhanced by quality clinical research to provide missing evidence and to refine recommendations, which must be carefully integrated into existing healthcare systems. Realizing a sustainable, global impact on death and suffering due to severe influenza and other severe illness necessitates an ongoing and concerted international effort to iteratively generate, implement, and evaluate best-practice management guidelines for use in resource-limited settings.

  13. Good Security Practices for Electronic Commerce, Including Electronic Data Interchange

    1993-12-01

    FROM - TO) xx-xx-2002 to xx-xx-2002 4. TITLE AND SUBTITLE Good Security Practices for Electronic Commerce , Including Electronic Data Interchange...Report 12/1/1993 4. TITLE AND SUBTITLE Good Security Practices for Electronic Commerce , Including Electronic Data Interchange 5. FUNDING NUMBERS 6...Maximum 200 Words) Electronic commerce (EC) is the use of documents in electronic form, rather than paper, for carrying out functions of business or

  14. 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

  15. Which aeroallergens are associated with eczema severity?

    Hon, K L E; Leung, T F; Lam, M C A; Wong, K Y; Chow, C M; Fok, T F; Ng, P C

    2007-07-01

    We investigated if a correlation exists between aeroallergen sensitization and the severity of eczema. Data on aeroallergen response to skin-prick testing (SPT) and disease severity of children with eczema (n = 119) were evaluated. Atopy, as defined by at least one positive response to aeroallergen skin prick testing, was found in > 90% of eczema patients. House dust mite was the most commonly sensitized aeroallergen, followed by cat fur. Dermatophagoides pteronyssinus and Dermatophagoides farinae sensitization were associated with eczema severity (present in 67% of the mild and 97% of the severe group; P = 0.001). However, there was no association between eczema severity and higher strengths of SPT response (defined as SPT > 1+ to dust mites or dust). Atopy to moulds, Bermuda grass, cockroach, cat and dog was less prevalent and was not associated with eczema severity. It is sensible to advise parents on specific avoidance strategies only in severely affected children who have a definitive history of eczema exacerbation by specific aeroallergens and who are not responsive to conventional treatment.

  16. 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.

  17. Low severity coal liquefaction promoted by cyclic olefins

    Curtis, C.W.

    1992-01-01

    Low severity coal liquefaction promoted by cyclic olefins offers a means of liquefying coal at low severity conditions. Lower temperature, 350[degrees]C, and lower hydrogen pressure, 500 psi, have been used to perform liquefaction reactions. The presence of the cyclic olefin, hexahydroanthracene, made a substantial difference in the conversion of Illinois No. 6 coal at these low severity conditions. The Researchperformed this quarter was a parametric evaluation of the effect of different parameters on the coal conversion and product distribution from coal. The effect of the parameters on product distribution from hexahydroanthracene was also determined. The work planned for next quarter includes combining the most effective parametric conditions for the low severity reactions and determining their effect. The second part ofthe research performed this quarter involved performing Fourier transform infrared (FTIR) spectroscopy using cyclic olefins. The objective of this study was to determine the feasibility of using FTIR and a heated cell to determine the reaction pathway that occurs in the hydrogen donation reactions from cyclic olefins. The progress made to date includes evaluating the FTIR spectra of cyclic olefins and their expected reaction products. This work is included in this progress report.

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

    Collomb, D.; Paramelle, P.J.; Calaque, O. [Department of Radiology, CHU Grenoble, BP 218, 38043, Grenoble Cedex (France); Bosson, J.L. [Department of Statistics and Vascular diseases, CHU Grenoble, BP 218, 38043, Grenoble Cedex (France); Vanzetto, G. [Department of Cardiology, CHU Grenoble, BP 218, 38043, Grenoble Cedex (France); Barnoud, D. [Department of Medical Intensive Care, CHU Grenoble, BP 218, BP 218, 38043, Grenoble Cedex (France); Pison, C. [Department of Pulmonary Medicine, CHU Grenoble, BP 218, 38043, Grenoble Cedex (France); Coulomb, M.; Ferretti, G.

    2003-07-01

    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.)

  19. Regressive language in severe head injury.

    Thomsen, I V; Skinhoj, E

    1976-09-01

    In a follow-up study of 50 patients with severe head injuries three patients had echolalia. One patient with initially global aphasia had echolalia for some weeks when he started talking. Another patient with severe diffuse brain damage, dementia, and emotional regression had echolalia. The dysfunction was considered a detour performance. In the third patient echolalia and palilalia were details in a total pattern of regression lasting for months. The patient, who had extensive frontal atrophy secondary to a very severe head trauma, presented an extreme state of regression returning to a foetal-body pattern and behaving like a baby.

  20. 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...

  1. A difficult diagnosis: severe Graves' ophthalmolopathy.

    Yip, Ivan Yeu Ming; Mushtaq, Fizza; Reuser, Tristan

    2015-03-09

    An 81-year-old woman with atrial fibrillation, on warfarin, with known hyperthyroidism, was admitted to hospital following a fall with proptosis and severely restricted movements in her left eye. Medics initially thought the presentation was related to an intracranial pathology but through subsequent tests and examination, ophthalmologists diagnosed a severe case of thyroid eye disease with intense inflammation. The patient responded well to systemic steroid treatment. This case report highlights a severe rapidly progressing case of thyroid eye disease with diagnostic difficulties arising from multiple comorbidities in an elderly patient.

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

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

    2015-01-01

    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 <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 fola...

  3. [Optimization of complex treatment of patients with severe oral leukoplakia].

    Rabinovich, O F; Rabinovich, I M; Abramova, E S

    2015-01-01

    The aim of the study was to prove the rationale for antiviral therapy combined with surgical procedures for treatment of severe oral leukoplakia. Complex clinical and laboratory evaluation and treatment was performed in 56 patients divided in 2 groups. Control group was presented by 13 patients receiving dental treatment, local and systemic keratoplastic formulations. Main group involved 43 patients in which conventional treatment protocol was completed by antiviral therapy and surgical procedures. Leukoplakia diagnosis was based on clinical findings, histological and immunohistochemical studies as well as optic coherent tomography data. The obtained results evidently prove the necessity for including antiviral therapy and surgical procedures in treatment scheme of severe oral leukoplakia.

  4. Survival trends and predictors of mortality in severe pelvic trauma

    Pohlemann, Tim; Stengel, Dirk; Tosounidis, Georgios;

    2011-01-01

    STUDY OBJECTIVE: To determine longitudinal trends in mortality, and the contribution of specific injury characteristics and treatment modalities to the risk of a fatal outcome after severe and complex pelvic trauma. METHODS: We studied 5048 patients with pelvic ring fractures enrolled in the German...... Pelvic Trauma Registry Initiative between 1991 and 1993, 1998 and 2000, and 2004 and 2006. Complete datasets were available for 5014 cases, including 508 complex injuries, defined as unstable fractures with severe peri-pelvic soft tissue and organ laceration. Multivariable mixed-effects logistic...

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

    Kastenberg, W.E. [ed.; Apostolakis, G.; Jae, M.; Milici, T.; Park, H.; Xing, L.; Dhir, V.K.; Lim, H.; Okrent, D.; Swider, J.; Yu, D. [California Univ., Los Angeles, CA (United States). Dept. of Mechanical, Aerospace and Nuclear Engineering

    1991-11-01

    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.

  6. A sonic boom propagation model including mean flow atmospheric effects

    Salamone, Joe; Sparrow, Victor W.

    2012-09-01

    This paper presents a time domain formulation of nonlinear lossy propagation in onedimension that also includes the effects of non-collinear mean flow in the acoustic medium. The model equation utilized is an augmented Burgers equation that includes the effects of nonlinearity, geometric spreading, atmospheric stratification, and also absorption and dispersion due to thermoviscous and molecular relaxation effects. All elements of the propagation are implemented in the time domain and the effects of non-collinear mean flow are accounted for in each term of the model equation. Previous authors have presented methods limited to showing the effects of wind on ray tracing and/or using an effective speed of sound in their model equation. The present work includes the effects of mean flow for all terms included in the augmented Burgers equation with all of the calculations performed in the time-domain. The capability to include the effects of mean flow in the acoustic medium allows one to make predictions more representative of real-world atmospheric conditions. Examples are presented for nonlinear propagation of N-waves and shaped sonic booms. [Work supported by Gulfstream Aerospace Corporation.

  7. Managing severe peripartum hyponatraemia: A case report

    Lim, Jerry; Laing, Christopher M; MacCallum, Niall S; Brealey, David A

    2014-01-01

    We present a case of severe peripartum hyponatraemia that occurred following a major obstetric haemorrhage causing both an ischaemic stroke and Sheehan's syndrome and outline the investigations and management strategy required. PMID:27512448

  8. Clinical severity and prognosis of hand eczema

    Hald, M; Agner, T; Blands, J

    2009-01-01

    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...... 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 by patients using a self-administered photographic guide. Additional information was obtained from a baseline questionnaire. RESULTS: At baseline, 60.3% assessed their HE as moderate to very severe using the self-administered photographic guide compared with 36.1% at follow-up. The mean HECSI value decreased...

  9. Correlates of Illness Severity in Infectious Mononucleosis

    John Odame

    2014-01-01

    Full Text Available INTRODUCTION: Understanding the spectrum and frequencies of Epstein-Barr virus (EBV complications and markers of illness severity in immunocompetent patients with primary EBV infection will inform management of patients with EBV-related illnesses.

  10. Learning about Severe Combined Immunodeficiency (SCID)

    ... bone marrow. Some lymphocyte precursors move to the thymus gland, where they become T cells. Others remain ... linked SCID mutation database (IL2RGbase) On Other Sites: Development of population-based newborn screening for severe combined ...

  11. 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...

  12. Plasmapheresis in the management of severe hypertriglyceridemia.

    Seda, Gilbert; Meyer, Jill M; Amundson, Dennis E; Daheshia, Massoud

    2013-08-01

    Plasmapheresis can benefit a variety of critically ill patients. A woman with diabetic ketoacidosis and severe hypertriglyceridemia was treated with plasmapheresis when conventional treatments did not markedly reduce her triglyceridemia. The patient was admitted to a medical intensive care unit because of diabetic ketoacidosis with severe lipemia. The lipemia-associated interference in laboratory studies made treatment of electrolyte abnormalities extremely difficult. The hypertriglyceridemia was initially treated with insulin, antilipidemic medications, and heparin, but the levels of triglycerides remained elevated, delaying results of needed laboratory studies for hours. After plasmapheresis, the serum level of triglycerides decreased by 77% in less than 24 hours. Severe lipemia interferes with photometric laboratory studies, yielding an underestimation of serum levels of electrolytes. Plasmapheresis is safe, rapid, and effective for emergent management of severe hypertriglyceridemia in critically ill patients. The impact of the procedure on critical care nursing is growing as nurses become involved in the treatment and follow-up care of patients who have plasmapheresis.

  13. 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.

  14. Exploring Driver Injury Severity at Intersection: An Ordered Probit Analysis

    Yaping Zhang

    2015-02-01

    Full Text Available It is well known that intersections are the most hazardous locations; however, only little is known about driver injury severity in intersection crashes. Hence, the main goal of this study was to further examine the different factors contributing to driver injury severity involved in fatal crashes at intersections. Data used for the present analysis was from the US DOT-Fatality Analysis Reporting System (FARS crash database from the year 2011. An ordered probit model was employed to fit the fatal crash data and analyze the factors impacting each injury severity level. The analysis results displayed that driver injury severity is significantly affected by many factors. They include driver age and gender, driver ethnicity, vehicle type and age (years of use, crash type, driving drunk, speeding, violating stop sign, cognitively distracted driving, and seat belt usage. These findings from the current study are beneficial to form a solid basis for adopting corresponding measures to effectively drop injury severity suffering from intersection crash. More insights into the effects of risk factors on driver injury severity could be acquired using more advanced statistical models.

  15. FOXN1 deficient nude severe combined immunodeficiency

    Rota, Ioanna A.; Dhalla, Fatima

    2017-01-01

    Nude severe combined immunodeficiency is a rare inherited disease caused by autosomal recessive loss-of-function mutations in FOXN1. This gene encodes a transcription factor essential for the development of the thymus, the primary lymphoid organ that supports T-cell development and selection. To date nine cases have been reported presenting with the clinical triad of absent thymus resulting in severe T-cell immunodeficiency, congenital alopecia universalis and nail dystrophy. Diagnosis relies...

  16. Very severe spinal muscular atrophy (Type 0).

    Al Dakhoul, Suleiman

    2017-01-01

    This case report describes a rare phenotype of very severe spinal muscular atrophy (SMA) in a newborn who presented with reduced fetal movements in utero and significant respiratory distress at birth. The patient was homozygously deleted for exon 7 and exon 8 of the survival motor neuron gene 1. Very severe SMA should be considered in the differential diagnosis of respiratory distress at birth, and more research should be dedicated to investigate the genetic determinants of its widely variable phenotypes.

  17. [Severe laryngitis associated to gastroesophageal reflux].

    Botto, Hugo; Antonioli, Cintia; Nieto, Mary; Cocciaglia, Alejandro; Cuestas, Giselle; Roques Revol, Magdalena; López Marti, Jessica; Rodríguez, Hugo

    2014-02-01

    There is a strong association between gastroesophageal reflux and pharyngolaryngeal reflux as factors leading to respiratory disease, manifested as dysphonia, wheezing, coughing, recurrent laryngitis, bronchial obstruction, laryngospasm and apparent life-threatening events (ALTEs). These manifestations can be mild or severe and may sometimes put the patient's life at risk. We present two cases of patients with severe laryngitis who required endotracheal intubation, one of which underwent tracheostomy. The diagnostic methods and their limitations and the patients outcomes are described.

  18. 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.

  19. Classical mechanics including an introduction to the theory of elasticity

    Hentschke, Reinhard

    2017-01-01

    This textbook teaches classical mechanics as one of the foundations of physics. It describes the mechanical stability and motion in physical systems ranging from the molecular to the galactic scale. Aside from the standard topics of mechanics in the physics curriculum, this book includes an introduction to the theory of elasticity and its use in selected modern engineering applications, e.g. dynamic mechanical analysis of viscoelastic materials. The text also covers many aspects of numerical mechanics, ranging from the solution of ordinary differential equations, including molecular dynamics simulation of many particle systems, to the finite element method. Attendant Mathematica programs or parts thereof are provided in conjunction with selected examples. Numerous links allow the reader to connect to related subjects and research topics. Among others this includes statistical mechanics (separate chapter), quantum mechanics, space flight, galactic dynamics, friction, and vibration spectroscopy. An introductory...

  20. A Framework for Including Family Health Spillovers in Economic Evaluation.

    Al-Janabi, Hareth; van Exel, Job; Brouwer, Werner; Coast, Joanna

    2016-02-01

    Health care interventions may affect the health of patients' family networks. It has been suggested that these "health spillovers" should be included in economic evaluation, but there is not a systematic method for doing this. In this article, we develop a framework for including health spillovers in economic evaluation. We focus on extra-welfarist economic evaluations where the objective is to maximize health benefits from a health care budget (the "health care perspective"). Our framework involves adapting the conventional cost-effectiveness decision rule to include 2 multiplier effects to internalize the spillover effects. These multiplier effects express the ratio of total health effects (for patients and their family networks) to patient health effects. One multiplier effect is specified for health benefit generated from providing a new intervention, one for health benefit displaced by funding this intervention. We show that using multiplier effects to internalize health spillovers could change the optimal funding decisions and generate additional health benefits to society.

  1. Internet addiction neuroscientific approaches and therapeutical implications including smartphone addiction

    Reuter, Martin

    2017-01-01

    The second edition of this successful book provides further and in-depth insight into theoretical models dealing with Internet addiction, as well as includes new therapeutical approaches. The editors also broach the emerging topic of smartphone addiction. This book combines a scholarly introduction with state-of-the-art research in the characterization of Internet addiction. It is intended for a broad audience including scientists, students and practitioners. The first part of the book contains an introduction to Internet addiction and their pathogenesis. The second part of the book is dedicated to an in-depth review of neuroscientific findings which cover studies using a variety of biological techniques including brain imaging and molecular genetics. The third part of the book focuses on therapeutic interventions for Internet addiction. The fourth part of the present book is an extension to the first edition and deals with a new emerging potential disorder related to Internet addiction – smartphone addicti...

  2. Pediatric deformity treatment update, including 3D correction concepts%Pediatric deformity treatment update,including 3D correction concepts

    Randal R. Betz; Patrick J. Cahill; Joshua M. Pahys; Amer F. Samdani

    2011-01-01

    The purpose of this article is to highlight some of the new developments in the treatment of adolescent idiopathic scoliosis,including 3D correction of deformity,posterior and minimally invasive surgery,and fusionless strategies.

  3. Linear scleroderma en coup de sabre including abnormal dental development

    Hørberg, M; Lauesen, S R; Daugaard-Jensen, J;

    2015-01-01

    . A paediatric dentist may be the first medical person to identify SCS by its involvement in dentition. It is assumed that the malformation of a dentition could be associated with the severity of the skin deviation. CASE REPORT: A 6-year and 10-month-old Turkish girl with a history of SCS was referred for dental...... diagnostics and treatment. The SCS skin lesion affected the left side of her hairline over the forehead and nose, involving the left orbit proceeding towards the left oral region. Dental clinical/radiographic examination revealed malformed left maxillary incisors with short roots and lack of eruption. FOLLOW...

  4. Effective equations for isotropic quantum cosmology including matter

    Bojowald, Martin; Skirzewski, Aureliano

    2007-01-01

    Effective equations often provide powerful tools to develop a systematic understanding of detailed properties of a quantum system. This is especially helpful in quantum cosmology where several conceptual and technical difficulties associated with the full quantum equations can be avoided in this way. Here, effective equations for Wheeler-DeWitt and loop quantizations of spatially flat, isotropic cosmological models sourced by a massive or interacting scalar are derived and studied. The resulting systems are remarkably different from that given for a free, massless scalar. This has implications for the coherence of evolving states and the realization of a bounce in loop quantum cosmology.

  5. Submental Intubation Including Extubation: Airway Complications of Maxillomandibular Fixation

    Santosh Kumar Yadav

    2012-01-01

    Full Text Available Hernandez first described the submental route for endotracheal intubation in 1986 as an alternative airway maneuver for maxillofacial procedures. Since that time, several case studies have been performed demonstrating the efficacy of the submental approach. This method was recently implemented in the case of a patient with altered nasal anatomy who sustained a mandibular fracture necessitating maxillomandibular fixation. Unlike most of the cases described in the literature, this patient’s operative course was confounded by the need to extubate through the submental tunnel. The patient tolerated the procedure well and was able to avoid other forms of surgical airway.

  6. Experimentation with a water tank including a PCM module

    Cabeza, Luisa F.; Sole, Cristian; Roca, Joan; Nogues, Miquel [Department d' Informatica i Eng. Industrial, Universitat de Lleida, Jaume II 69, 25001 Lleida (Spain); Ibanez, Manuel [Department de Medi Ambient i Ciencies del Sol, Universitat de Lleida (Spain)

    2006-05-23

    Storage of heat is seen as a major issue for the development of solar energy for house heating and cooling under all climates. Most of the storage systems available on the market use water as the storage medium. The idea studied here was to add a phase change material (PCM) module at the top of a hot-water storage tank with stratification. An experimental solar pilot plant was constructed to test the PCM behaviour in real conditions. The PCM module geometry adopted was to use several cylinders. A granular PCM-graphite compound was chosen as the PCM for the experiments presented here. (author)

  7. 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.

  8. Methods of producing adsorption media including a metal oxide

    Mann, Nicholas R; Tranter, Troy J

    2014-03-04

    Methods of producing a metal oxide are disclosed. The method comprises dissolving a metal salt in a reaction solvent to form a metal salt/reaction solvent solution. The metal salt is converted to a metal oxide and a caustic solution is added to the metal oxide/reaction solvent solution to adjust the pH of the metal oxide/reaction solvent solution to less than approximately 7.0. The metal oxide is precipitated and recovered. A method of producing adsorption media including the metal oxide is also disclosed, as is a precursor of an active component including particles of a metal oxide.

  9. Seismic Response of Wind Turbines: Time Domain Simulations Including SSI

    Amdal, Åse Marit Wist

    2014-01-01

    In this study, a numerical model of a 5MW offshore wind turbine on a monopile foundation was created in order to calculate the dynamic response of the structure including soil-structure interaction. The main focus was to develop a reliable numerical model of the coupled system - including the tower, monopile foundation and the surrounding soil. The wind turbine was subjected to earthquake load in the time-domain. The global response of the wind turbine was compared for the two prevalent meth...

  10. Tunable cavity resonator including a plurality of MEMS beams

    Peroulis, Dimitrios; Fruehling, Adam; Small, Joshua Azariah; Liu, Xiaoguang; Irshad, Wasim; Arif, Muhammad Shoaib

    2015-10-20

    A tunable cavity resonator includes a substrate, a cap structure, and a tuning assembly. The cap structure extends from the substrate, and at least one of the substrate and the cap structure defines a resonator cavity. The tuning assembly is positioned at least partially within the resonator cavity. The tuning assembly includes a plurality of fixed-fixed MEMS beams configured for controllable movement relative to the substrate between an activated position and a deactivated position in order to tune a resonant frequency of the tunable cavity resonator.

  11. Solar Energy Education. Renewable energy: a background text. [Includes glossary

    1985-01-01

    Some of the most common forms of renewable energy are presented in this textbook for students. The topics include solar energy, wind power hydroelectric power, biomass ocean thermal energy, and tidal and geothermal energy. The main emphasis of the text is on the sun and the solar energy that it yields. Discussions on the sun's composition and the relationship between the earth, sun and atmosphere are provided. Insolation, active and passive solar systems, and solar collectors are the subtopics included under solar energy. (BCS)

  12. The Future of Constitutionally Required Lesser Included Offenses

    Michael H. Hoffheimer

    2006-04-01

    Full Text Available For over a generation courts have recognized that failing to instruct juries on lesser included offenses results in wrongful convictions. In Beck v. Alabama, the Supreme Court held that in capital cases juries must be instructed on the option of returning convictions of non-capital lesser included offenses. The Court explained that this right prevents juries from being forced to make all-or-nothing choices between guilt and innocence in cases where serious crimes have been committed and pressures to convict of some crime are great.

  13. 10 CFR 905.11 - What must an IRP include?

    2010-01-01

    ... data (such as service area, geographical characteristics, customer mix, historical loads, projected... consumer. (iii) Considerations that may be used to develop potential options include cost, market potential... customer must make the load forecasting data available to Western upon request. (6) Measurement...

  14. Including patients’ perspectives in patient information leaflets: A polyocular approach

    Fage-Butler, Antoinette Mary

    2013-01-01

    Existing research reveals that patients’ perspectives are missing from mandatory patient information leaflets (PILs). At the same time, there is overwhelming consensus that they should be included in this genre, and a corresponding need for potential approaches to tackle this problem. This paper...

  15. Modeling Electric Double-Layers Including Chemical Reaction Effects

    Paz-Garcia, Juan Manuel; Johannesson, Björn; Ottosen, Lisbeth M.

    2014-01-01

    A physicochemical and numerical model for the transient formation of an electric double-layer between an electrolyte and a chemically-active flat surface is presented, based on a finite elements integration of the nonlinear Nernst-Planck-Poisson model including chemical reactions. The model works...

  16. 30 CFR 250.211 - What must the EP include?

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What must the EP include? 250.211 Section 250.211 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR OFFSHORE OIL AND GAS AND... exploration drilling, well test flaring, installing a well protection structure, and temporary...

  17. The Instructional Improvement Questionnaire [Including Supporting and Technical Data].

    Pohlmann, John T.; Elmore, Patricia B.

    The Instructional Improvement Questionnaire (IIQ) is a student rating form designed to provide evaluative feedback to instructors about their teaching. The IIQ was first developed at Southern Illinois University at Carbondale in 1969 and revised in 1972. The documents included here describe the development of the IIQ and research associated with…

  18. 34 CFR 429.20 - What must an application include?

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false What must an application include? 429.20 Section 429.20 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF VOCATIONAL AND ADULT EDUCATION, DEPARTMENT OF EDUCATION BILINGUAL VOCATIONAL MATERIALS, METHODS, AND TECHNIQUES...

  19. Including History in the Study of Psychological and Political Power

    Reich, Stephanie M.; Pinkard, Tracy; Davidson, Heather

    2008-01-01

    Isaac Prilleltensky's (2003) concept of psychopolitical validity stresses the need to consider both the political and the psychological nature of power in the study of wellness, oppression, and liberation. The authors advocate that psychopolitical validity would be strengthened if it included an explicit appreciation of historical context. The…

  20. Interviewing Objects: Including Educational Technologies as Qualitative Research Participants

    Adams, Catherine A.; Thompson, Terrie Lynn

    2011-01-01

    This article argues the importance of including significant technologies-in-use as key qualitative research participants when studying today's digitally enhanced learning environments. We gather a set of eight heuristics to assist qualitative researchers in "interviewing" technologies-in-use (or other relevant objects), drawing on concrete…

  1. Smart Antenna Skins, including Conformal Array, MMICs and Applications

    Bogaart, F.L.M. van den

    2000-01-01

    Low-cost technologies are presented for future space-borne and airborne SAR systems. These technologies include state-of-the art highly integrated circuits to miniaturise front-end, solutions to lower-cost interconnection technologies, new beamforming aspects and new architectures. The MMICs address

  2. Mixture including hydrogen and hydrocarbon having pressure-temperature stability

    Mao, Wendy L. (Inventor); Mao, Ho-Kwang (Inventor)

    2009-01-01

    The invention relates to a method of storing hydrogen that employs a mixture of hydrogen and a hydrocarbon that can both be used as fuel. In one embodiment, the method involves maintaining a mixture including hydrogen and a hydrocarbon in the solid state at ambient pressure and a temperature in excess of about 10 K.

  3. Should Listening and Speaking be included in a Language Test?

    李宗文

    2013-01-01

      Language test is widely used in our daily life for various purposes, while a lot of language tests fail to include listening or speaking for one reason or another. The question that whether this type of test is still valid enough to serve test purposes and have a positive washback for English learning has come up.

  4. Methodological challenges when doing research that includes ethnic minorities

    Morville, Anne-Le; Erlandsson, Lena-Karin

    2016-01-01

    minorities are included. Method: A thorough literature search yielded 21 articles obtained from the scientific databases PubMed, Cinahl, Web of Science and PsychInfo. Analysis followed Arksey and O’Malley’s framework for scoping reviews, applying content analysis. Results: The results showed methodological...

  5. Thick Plate Homogenization of Sandwich Panels Including Folded Cellular Cores

    LEBEE, Arthur; Sab, Karam

    2011-01-01

    In the present work, we provide the Bending-Gradient homogenization scheme and apply it to a sandwich panel including the chevron pattern. It turns out that the shear forces stiffness of the sandwich panel is strongly influenced by a skin distortion phenomenon which cannot be neglected in conventional design.

  6. The International Project 1992 Update Including "Microfilming Projects Abroad."

    Rutimann, Hans

    1993-01-01

    Describes microfilming projects in 30 countries collected from questionnaire responses. Additional topics discussed include cooperative programs for preservation and access; an overview of national programs; mass deacidification; new technologies, such as digital preservation; microfilming projects abroad; and future priorities. (Contains 10…

  7. Visual Impairments, "Including Blindness." NICHCY Disability Fact Sheet #13

    National Dissemination Center for Children with Disabilities, 2012

    2012-01-01

    Vision is one of the five senses. Being able to see gives tremendous access to learning about the world around--people's faces and the subtleties of expression, what different things look like and how big they are, and the physical environments, including approaching hazards. When a child has a visual impairment, it is cause for immediate…

  8. Assessing the Doctoral Thesis When It Includes Published Work

    Sharmini, Sharon; Spronken-Smith, Rachel; Golding, Clinton; Harland, Tony

    2015-01-01

    In this article we explore how examiners assess a thesis that includes published work. An online survey was used to gather data on approaches to assessing publication-based theses (PBTs). The respondents were 62 supervisors who had experience examining PBTs across a range of disciplines at a research-intensive university in New Zealand. Nearly…

  9. 20 CFR 220.114 - Evaluation of symptoms, including pain.

    2010-04-01

    ... a determination as to the intensity, persistence, or functionally limiting effects of the claimant's... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Evaluation of symptoms, including pain. 220.114 Section 220.114 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE...

  10. Understanding heat transfer in 2D channel flows including recirculation

    Dirkse, M.H.; Loon, van W.K.P.; Stigter, J.D.; Bot, G.P.A.

    2007-01-01

    Inviscid, irrotational two-dimensional flows can be modelled using the Schwarz¿Christoffel integral. Although bounded flows including boundary layer separation and recirculation are not irrotational, a model is presented that uses the Schwarz¿Christoffel integral to model these flows. The model sepa

  11. A Reactive Behavior Agent: Including Emotions into a Video Game

    A. L. Laureano-Cruces

    2012-10-01

    Full Text Available Why we have emotions and how they influence human behavior are two questions we constantly ask ourselves.According to researchers in the field, there are two kinds of information that the person receives to make a decision.This information is integrated to generate a whole. One comes from ourselves it is proprioceptive and refers toemotions; the other one is external, it comes from the environment. Thus, emotions are immersed in different areas ofa person’s life, including social, functional, and cognitive aspects. It has an important role in the decision-makingprocess. It is on this last point that this paper focuses its approach, which consists of including a cognitive structure ofemotions in a reactive behavior in order to enrich behavior, including the information generated through internalevaluation of the external physical stimuli. Our work is based on the OCC theory (named after the name of its authors:Ortony, Collins and Clore. This theory proposes that a decision-making process is affected through differentperspectives: a goals and events, b agents and their actions, and c objects and their capacity for attraction. Thecase study is situated within a scenario that represents an approach that seeks to include a module of emotions withinthe design of the architecture of a videogame.

  12. Synaptic channel model including effects of spike width variation

    2015-01-01

    Synaptic Channel Model Including Effects of Spike Width Variation Hamideh Ramezani Next-generation and Wireless Communications Laboratory (NWCL) Department of Electrical and Electronics Engineering Koc University, Istanbul, Turkey Ozgur B. Akan Next-generation and Wireless Communications Laboratory (NWCL) Department of Electrical and Electronics Engineering Koc University, Istanbul, Turkey ABSTRACT An accu...

  13. 31 CFR 306.87 - Partnerships (including nominee partnerships).

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Partnerships (including nominee partnerships). 306.87 Section 306.87 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY BUREAU OF THE PUBLIC DEBT GENERAL...

  14. /facet: A Generic Facet Browser Including Temporal and Spatial Visualization

    Hildebrand, M.

    2007-01-01

    A generic facet browser including temporal and spatial visualization. The existing MultimediaN Eculture demo is updated in two ways: improved visualization of the semantic timeline and added a natural language sentence generator for cluster headers. Relation search interface is also implemente

  15. Computer aided design of reentrant coaxial filters including coaxial excitation

    Boria, V.; Gerini, G.; Guglielmi, M.

    1999-01-01

    An advanced EM based CAD tool is used for the detailed characterisation of a family of reentrant coaxial waveguide filters. The EM analysis includes the effects of tuning screws and of the input/output coaxial excitation. The software is essentially used as an efficient replacement for the tradition

  16. Rating scales measuring the severity of psychotic depression

    Østergaard, S D; Rothschild, A J; Flint, A J

    2015-01-01

    OBJECTIVE: Unipolar psychotic depression (PD) is a severe and debilitating syndrome, which requires intensive monitoring. The objective of this study was to provide an overview of the rating scales used to assess illness severity in PD. METHOD: Selective review of publications reporting results...... on non-self-rated, symptom-based rating scales utilized to measure symptom severity in PD. The clinical and psychometric validity of the identified rating scales was reviewed. RESULTS: A total of 14 rating scales meeting the predefined criteria were included in the review. These scales grouped...... into the following categories: (i) rating scales predominantly covering depressive symptoms, (ii) rating scales predominantly covering psychotic symptoms, (iii) rating scales covering delusions, and (iv) rating scales covering PD. For the vast majority of the scales, the clinical and psychometric validity had...

  17. Meiotic abnormalities and spermatogenic parameters in severe oligoasthenozoospermia.

    Vendrell, J M; García, F; Veiga, A; Calderón, G; Egozcue, S; Egozcue, J; Barri, P N

    1999-02-01

    The incidence of meiotic abnormalities and their relationship with different spermatogenic parameters was assessed in 103 male patients with presumably idiopathic severe oligoasthenozoospermia (motile sperm concentration Meiotic patterns included normal meiosis and two meiotic abnormalities, i.e. severe arrest and synaptic anomalies. A normal pattern was found in 64 (62.1%), severe arrest in 21 (20.4%) and synaptic anomalies in 18 (17.5%). The overall rate of meiotic abnormalities was 37.9%. Most (66.7%) meiotic abnormalities occurred in patients with a sperm concentration meiotic abnormalities were found in 57.8% of the patients; of these, 26.7% had synaptic anomalies. When the sperm concentration was meiotic abnormalities occurred in 54.8% (synaptic anomalies in 22.6%). There were statistically significant differences among the three meiotic patterns in relation to sperm concentration (P 10 IU/l were the only predictors of meiotic abnormalities.

  18. 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.

  19. Severe acute renal failure in malaria.

    Mehta K

    2001-01-01

    Full Text Available BACKGROUND: We have noticed a recent rise in the incidence and severity of acute renal failure (ARF in malaria. AIM: To study the incidence, severity and outcome of ARF in malaria. SETTING and DESIGN: It is a retrospective analysis of data of one year from a tertiary medical centre in a metropolitan city. MATERIALS AND METHODS: Patients with ARF and smear positive malaria were evaluated. STATISTICAL ANALYSIS: Results were expressed as mean, range and standard deviation. RESULTS: Out of 402 detected smear positive malaria, 24 had ARF. Eighteen were of the age group 21-40 years. Plasmodium falciparum (PF was detected in 16, Plasmodium vivax in three, and mixed infection in five. Non-oliguric ARF was seen in 14. Eighteen showed severe ARF (Serum creatinine >5 mg%. Twenty-two patients needed dialysis. Prolonged ARF lasting for 2-6 weeks was seen in eight. Seventeen patients recovered completely, while seven showed fatal combination of disseminated intravascular coagulation (DIC, acute respiratory distress syndrome (ARDS, severe ARF and PF malaria. No response was seen to chloroquine and artesunate given alone and twenty patients required quinine. CONCLUSION: ARF necessitating dialysis was seen in 92% of patients with ARF in malaria. PF infection, severe ARF, DIC and ARDS were poor prognostic factors. Resistance was noted to both chloroquine and artesunate.

  20. 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 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.

  1. Regression of severe tricuspid regurgitation after mitral balloon valvotomy for severe mitral stenosis

    Mohamed Eid Fawzy

    2014-03-01

    Conclusions: Regression of significant TR after successful MBV in patients with severe mitral stenosis was observed in patients who had severe pulmonary hypertension. This improvement in TR occurred even in the presence of organic tricuspid valve disease.

  2. 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.

  3. 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

  4. A computational procedure for multibody systems including flexible beam dynamics

    Downer, J. D.; Park, K. C.; Chiou, J. C.

    1990-01-01

    A computational procedure suitable for the solution of equations of motions for flexible multibody systems has been developed. The flexible beams are modeled using a fully nonlinear theory which accounts for both finite rotations and large deformations. The present formulation incorporates physical measures of conjugate Cauchy stress and covariant strain increments. As a consequence, the beam model can easily be interfaced with real-time strain measurements and feedback control systems. A distinct feature of the present work is the computational preservation of total energy for undamped systems; this is obtained via an objective strain increment/stress update procedure combined with an energy-conserving time integration algorithm which contains an accurate update of angular orientations. The procedure is demonstrated via several example problems.

  5. Inferring time derivatives including cell growth rates using Gaussian processes

    Swain, Peter S.; Stevenson, Keiran; Leary, Allen; Montano-Gutierrez, Luis F.; Clark, Ivan B. N.; Vogel, Jackie; Pilizota, Teuta

    2016-12-01

    Often the time derivative of a measured variable is of as much interest as the variable itself. For a growing population of biological cells, for example, the population's growth rate is typically more important than its size. Here we introduce a non-parametric method to infer first and second time derivatives as a function of time from time-series data. Our approach is based on Gaussian processes and applies to a wide range of data. In tests, the method is at least as accurate as others, but has several advantages: it estimates errors both in the inference and in any summary statistics, such as lag times, and allows interpolation with the corresponding error estimation. As illustrations, we infer growth rates of microbial cells, the rate of assembly of an amyloid fibril and both the speed and acceleration of two separating spindle pole bodies. Our algorithm should thus be broadly applicable.

  6. Diagnostic Relevance of microRNAs in Other Body Fluids Including Urine, Feces, and Saliva.

    Igaz, Ivan; Igaz, Peter

    2015-01-01

    Beside blood-borne circulating miRNAs, miRNAs have been identified in other body fluid and excrements including stool, bile, saliva, and urine. Given the direct link of these body fluids to certain organs, their analysis for potential diagnostic miRNA markers is plausible. Several independent findings underline the potential utility of stool-derived miRNAs in the diagnosis of colorectal and pancreatic cancer. Given the difficulties in the diagnosis of cholangiocellular cancer, biliary miRNAs might be envisaged as useful markers. Several miRNAs have been identified in the saliva that could be associated with diseases, including tumors of the oral cavity. The urinary pool of miRNAs could be exploited for the diagnosis of urinary tract diseases and some appear to enable early diagnosis. In this chapter, we present findings supporting the potential diagnostic utility of fecal, biliary, salivary, and urinary miRNAs focusing mostly on tumors.

  7. CT features of lymphobronchial tuberculosis in children, including complications and associated abnormalities

    Lucas, Susan; Andronikou, Savvas [Faculty of Health Sciences, University of the Witwatersrand, Department of Radiology, Johannesburg (South Africa); Goussard, Pierre; Gie, Robert [Stellenbosch University, Department Paediatrics, Stellenbosch (South Africa)

    2012-08-15

    Lymphobronchial tuberculosis (TB) is tuberculous lymphadenopathy involving the airways, which is particularly common in children. To describe CT findings of lymphobronchial TB in children, the parenchymal complications and associated abnormalities. CT scans of children with lymphobronchial TB were reviewed retrospectively. Lymphadenopathy, bronchial narrowing, parenchymal complications and associations were documented. Infants comprised 51% of patients. The commonest site of lymphadenopathy was the subcarinal mediastinum (97% of patients). Bronchial compression was seen in all children (259 bronchi, of these 28% the bronchus intermedius) with severe or complete stenosis in 23% of affected bronchi. Parenchymal complications were present in 94% of patients, including consolidation (88%), breakdown (42%), air trapping (38%), expansile pneumonia (28%), collapse (17%) and bronchiectasis (9%), all predominantly on the right side (63%). Associated abnormalities included ovoid lesions, miliary nodules, pleural disease and intracavitary bodies. Airway compression was more severe in infants and most commonly involved the bronchus intermedius. Numerous parenchymal complications were documented, all showing right-side predominance. (orig.)

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

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

    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).......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)....

  9. The Physics of Semiconductors An Introduction Including Devices and Nanophysics

    Grundmann, Marius

    2006-01-01

    The Physics of Semiconductors provides material for a comprehensive upper-level-undergrauate and graduate course on the subject, guiding readers to the point where they can choose a special topic and begin supervised research. The textbook provides a balance between essential aspects of solid-state and semiconductor physics, on the one hand, and the principles of various semiconductor devices and their applications in electronic and photonic devices, on the other. It highlights many practical aspects of semiconductors such as alloys, strain, heterostructures, nanostructures, that are necessary in modern semiconductor research but typically omitted in textbooks. For the interested reader some additional advanced topics are included, such as Bragg mirrors, resonators, polarized and magnetic semiconductors are included. Also supplied are explicit formulas for many results, to support better understanding. The Physics of Semiconductors requires little or no prior knowledge of solid-state physics and evolved from ...

  10. XFEL OSCILLATOR SIMULATION INCLUDING ANGLE-DEPENDENT CRYSTAL REFLECTIVITY

    Fawley, William; Lindberg, Ryan; Kim, K-J; Shvyd' ko, Yuri

    2010-08-23

    The oscillator package within the GINGER FEL simulation code has now been extended to include angle-dependent reflectivity properties of Bragg crystals. Previously, the package was modified to include frequencydependent reflectivity in order to model x-ray FEL oscillators from start-up from shot noise through to saturation. We present a summary of the algorithms used for modeling the crystal reflectivity and radiation propagation outside the undulator, discussing various numerical issues relevant to the domain of high Fresnel number and efficient Hankel transforms. We give some sample XFEL-O simulation results obtained with the angle-dependent reflectivity model, with particular attention directed to the longitudinal and transverse coherence of the radiation output.

  11. Improving the strength of amalgams by including steel fibers

    Cochran, Calvin T. [Hendrix College, Conway, AR 72032 (United States); Van Hoose, James R. [Siemens, Orlando, FL 32826 (United States); McGill, Preston B. [Marshall Space Flight Center, EM20, Huntsville, AL 35812 (United States); Grugel, Richard N., E-mail: richard.n.grugel@nasa.gov [Marshall Space Flight Center, EM30, Huntsville, AL 35812 (United States)

    2012-05-30

    Highlights: Black-Right-Pointing-Pointer A room temperature liquid Ga-In alloy was successfully substituted for mercury. Black-Right-Pointing-Pointer Physically sound amalgams with included steel fibers can be made. Black-Right-Pointing-Pointer A small volume fraction inclusion of fibers increased strength by {approx}20%. - Abstract: Mercury amalgams, due to their material properties, are widely and successfully used in dental practice. They are, however, also well recognized as having poor tensile strength. With the possibility of expanding amalgam applications it is demonstrated that tensile strength can be increased some 20% by including a small amount of steel fibers. Furthermore, it is shown that mercury can be replaced with a room temperature liquid gallium-indium alloy. Processing, microstructures, and mechanical test results of these novel amalgams are presented and discussed in view of means to further improve their properties.

  12. Including investment risk in large-scale power market models

    Lemming, Jørgen Kjærgaard; Meibom, P.

    2003-01-01

    the analyses quantitatively, a framework based on an iterative interaction between the equilibrium model and a separate risk-adjustment module was constructed. To illustrate the features of the proposed modelling approach we examined how uncertainty in demand and variable costs affects the optimal choice......Long-term energy market models can be used to examine investments in production technologies, however, with market liberalisation it is crucial that such models include investment risks and investor behaviour. This paper analyses how the effect of investment risk on production technology selection...... can be included in large-scale partial equilibrium models of the power market. The analyses are divided into a part about risk measures appropriate for power market investors and a more technical part about the combination of a risk-adjustment model and a partial-equilibrium model. To illustrate...

  13. Maximum-entropy closure of hydrodynamic moment hierarchies including correlations.

    Hughes, Keith H; Burghardt, Irene

    2012-06-07

    Generalized hydrodynamic moment hierarchies are derived which explicitly include nonequilibrium two-particle and higher-order correlations. The approach is adapted to strongly correlated media and nonequilibrium processes on short time scales which necessitate an explicit treatment of time-evolving correlations. Closure conditions for the extended moment hierarchies are formulated by a maximum-entropy approach, generalizing related closure procedures for kinetic equations. A self-consistent set of nonperturbative dynamical equations are thus obtained for a chosen set of single-particle and two-particle (and possibly higher-order) moments. Analytical results are derived for generalized Gaussian closures including the dynamic pair distribution function and a two-particle correction to the current density. The maximum-entropy closure conditions are found to involve the Kirkwood superposition approximation.

  14. Tissue-Specific Effects of Bariatric Surgery Including Mitochondrial Function

    Simon N. Dankel

    2011-01-01

    Full Text Available A better understanding of the molecular links between obesity and disease is potentially of great benefit for society. In this paper we discuss proposed mechanisms whereby bariatric surgery improves metabolic health, including acute effects on glucose metabolism and long-term effects on metabolic tissues (adipose tissue, skeletal muscle, and liver and mitochondrial function. More short-term randomized controlled trials should be performed that include simultaneous measurement of metabolic parameters in different tissues, such as tissue gene expression, protein profile, and lipid content. By directly comparing different surgical procedures using a wider array of metabolic parameters, one may further unravel the mechanisms of aberrant metabolic regulation in obesity and related disorders.

  15. Progressive IRP Models for Power Resources Including EPP

    Yiping Zhu

    2017-01-01

    Full Text Available In the view of optimizing regional power supply and demand, the paper makes effective planning scheduling of supply and demand side resources including energy efficiency power plant (EPP, to achieve the target of benefit, cost, and environmental constraints. In order to highlight the characteristics of different supply and demand resources in economic, environmental, and carbon constraints, three planning models with progressive constraints are constructed. Results of three models by the same example show that the best solutions to different models are different. The planning model including EPP has obvious advantages considering pollutant and carbon emission constraints, which confirms the advantages of low cost and emissions of EPP. The construction of progressive IRP models for power resources considering EPP has a certain reference value for guiding the planning and layout of EPP within other power resources and achieving cost and environmental objectives.

  16. Evolution of Collagenous Colitis into Severe and Extensive Ulcerative Colitis

    Hugh J Freeman

    2007-01-01

    Full Text Available Collagenous colitis is an inflammatory mucosal disorder of the colon with distinctive histopathological features, including a thickened subepithelial collagen layer. The clinical course is usually benign, but serious complications, including death, may occur. In the present report, a 69-year-old woman with watery diarrhea and collagenous colitis developed bloody diarrhea that was refractory to treatment medications, including corticosteroids and azathioprine. Endoscopic and histopathological studies showed a focal neutrophilic inflammatory process that progressed to a diffuse and extensive form of colitis, eventually requiring total proctocolectomy. Careful histological review of the resected colon showed no evidence of persistent collagenous colitis. These findings suggest an important need for continued long-term follow-up of patients with collagenous colitis because superimposed and serious colonic complications may occur, including a severe and extensive pancolitis refractory to medications and necessitating total proctocolectomy.

  17. Tuneable photonic device including an array of metamaterial resonators

    Brener, Igal; Wanke, Michael; Benz, Alexander

    2017-03-14

    A photonic apparatus includes a metamaterial resonator array overlying and electromagnetically coupled to a vertically stacked plurality of quantum wells defined in a semiconductor body. An arrangement of electrical contact layers is provided for facilitating the application of a bias voltage across the quantum well stack. Those portions of the semiconductor body that lie between the electrical contact layers are conformed to provide an electrically conductive path between the contact layers and through the quantum well stack.

  18. An Axisymmetrical Acoustic BEM Formulation Including Visco-Thermal Losses

    Cutanda Henriquez, Vicente; Juhl, Peter Møller

    2011-01-01

    dimensions. However, this is not usually true for small devices such as microphones, hearing aids, couplers, MEMS devices, mobile phones, etc., and then the losses need to be modeled. In this paper a numerical implementation of the Boundary Element Method (BEM) which includes visco-thermal losses...... of the boundary into elements is adequate and the problem has a manageable size. The method can be extended to full three-dimensional BEM....

  19. Chiral-scale effective theory including a dilatonic meson

    Li, Yan-Ling; Rho, Mannque

    2016-01-01

    A scale-invariant chiral effective Lagrangian is constructed for octet pions and a dilaton figuring as Nambu-Goldstone bosons with vector mesons incorporated as hidden gauge fields. The Lagrangian is built to the next-to-leading order in chiral-scale counting without baryon fields and then to leading order including baryons. The resulting theory is hidden scale-symmetric and local symmetric. We also discuss some possible applications of the present Lagrangian.

  20. Prenatal susceptibility to carcinogenesis by xenobiotic substances including vinyl chloride.

    Rice, J M

    1981-01-01

    The carcinogenicity of vinyl chloride for experimental animals when administered transplacentally is reviewed in comparison with known transplacental carcinogens, including those that, like vinyl chloride, are dependent on enzyme-mediated metabolic conversion to a reactive intermediate in maternal or fetal tissues. Vinyl chloride is converted by mixed-function oxidases to the reactive metabolite chlorooxirane, the carcinogenicity of which is also reviewed. Vinyl chloride is unequivocally a tr...

  1. Outcomes Among Pregnant Women Included in the Operation TOMODACHI Registry

    2013-02-12

    Table 1 shows the status of potentially-exposed pregnancies. Pregnancy outcomes include live delivery, spontaneous loss, and induced abortion ...birth defects, which are defined according to the Case Definition of the National Birth Defects Prevention Network.3 Additional uses for these data...pregnancy outcome in the electronic medical data/records. Overall, the live delivery rates are quite high and the spontaneous loss rates are quite

  2. Evaporative cooler including one or more rotating cooler louvers

    Gerlach, David W

    2015-02-03

    An evaporative cooler may include an evaporative cooler housing with a duct extending therethrough, a plurality of cooler louvers with respective porous evaporative cooler pads, and a working fluid source conduit. The cooler louvers are arranged within the duct and rotatably connected to the cooler housing along respective louver axes. The source conduit provides an evaporative cooler working fluid to the cooler pads during at least one mode of operation.

  3. Circuit Modeling of a MEMS Varactor Including Dielectric Charging Dynamics

    Giounanlis, P.; Andrade-Miceli, D.; Gorreta, S.; Pons-Nin, J.; Dominguez-Pumar, M.; Blokhina, E.

    2016-10-01

    Electrical models for MEMS varactors including the effect of dielectric charging dynamics are not available in commercial circuit simulators. In this paper a circuit model using lumped ideal elements available in the Cadence libraries and a basic Verilog-A model, has been implemented. The model has been used to simulate the dielectric charging in function of time and its effects over the MEMS capacitance value.

  4. Transport Phenomena in Thin Rotating Liquid Films Including: Nucleate Boiling

    Faghri, Amir

    2005-01-01

    In this grant, experimental, numerical and analytical studies of heat transfer in a thin liquid film flowing over a rotating disk have been conducted. Heat transfer coefficients were measured experimentally in a rotating disk heat transfer apparatus where the disk was heated from below with electrical resistance heaters. The heat transfer measurements were supplemented by experimental characterization of the liquid film thickness using a novel laser based technique. The heat transfer measurements show that the disk rotation plays an important role on enhancement of heat transfer primarily through the thinning of the liquid film. Experiments covered both momentum and rotation dominated regimes of the flow and heat transfer in this apparatus. Heat transfer measurements have been extended to include evaporation and nucleate boiling and these experiments are continuing in our laboratory. Empirical correlations have also been developed to provide useful information for design of compact high efficiency heat transfer devices. The experimental work has been supplemented by numerical and analytical analyses of the same problem. Both numerical and analytical results have been found to agree reasonably well with the experimental results on liquid film thickness and heat transfer Coefficients/Nusselt numbers. The numerical simulations include the free surface liquid film flow and heat transfer under disk rotation including the conjugate effects. The analytical analysis utilizes an integral boundary layer approach from which

  5. New chemical evolution analytical solutions including environment effects

    Spitoni, E

    2015-01-01

    In the last years, more and more interest has been devoted to analytical solutions, including inflow and outflow, to study the metallicity enrichment in galaxies. In this framework, we assume a star formation rate which follows a linear Schmidt law, and we present new analytical solutions for the evolution of the metallicity (Z) in galaxies. In particular, we take into account environmental effects including primordial and enriched gas infall, outflow, different star formation efficiencies, and galactic fountains. The enriched infall is included to take into account galaxy-galaxy interactions. Our main results can be summarized as: i) when a linear Schmidt law of star formation is assumed, the resulting time evolution of the metallicity Z is the same either for a closed-box model or for an outflow model. ii) The mass-metallicity relation for galaxies which suffer a chemically enriched infall, originating from another evolved galaxy with no pre-enriched gas, is shifted down in parallel at lower Z values, if co...

  6. Modeling heart rate variability including the effect of sleep stages

    Soliński, Mateusz; Gierałtowski, Jan; Żebrowski, Jan

    2016-02-01

    We propose a model for heart rate variability (HRV) of a healthy individual during sleep with the assumption that the heart rate variability is predominantly a random process. Autonomic nervous system activity has different properties during different sleep stages, and this affects many physiological systems including the cardiovascular system. Different properties of HRV can be observed during each particular sleep stage. We believe that taking into account the sleep architecture is crucial for modeling the human nighttime HRV. The stochastic model of HRV introduced by Kantelhardt et al. was used as the initial starting point. We studied the statistical properties of sleep in healthy adults, analyzing 30 polysomnographic recordings, which provided realistic information about sleep architecture. Next, we generated synthetic hypnograms and included them in the modeling of nighttime RR interval series. The results of standard HRV linear analysis and of nonlinear analysis (Shannon entropy, Poincaré plots, and multiscale multifractal analysis) show that—in comparison with real data—the HRV signals obtained from our model have very similar properties, in particular including the multifractal characteristics at different time scales. The model described in this paper is discussed in the context of normal sleep. However, its construction is such that it should allow to model heart rate variability in sleep disorders. This possibility is briefly discussed.

  7. 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 hands...

  8. Severe cerebral vasospasm after traumatic brain injury.

    Fehnel, Corey R; Wendell, Linda C; Potter, N Stevenson; Klinge, Petra; Thompson, Bradford B

    2014-07-01

    Severe traumatic brain injury is associated with both acute and delayed neuro- logical injury. Cerebral vasospasm is commonly associated with delayed neurological decline in aneurysmal subarachnoid hemorrhage patients. However, the role played by vasospasm in traumatic brain injury is less clear. Vasospasm occurs earlier, for a shorter duration, and often without significant neurological consequence among traumatic brain injury patients. Detection and management strategies for vasospasm in aneurysmal subarachnoid hemorrhage are not easily transferrable to traumatic brain injury patients. We present a patient with a severe traumatic brain injury who had dramatic improvement following emergent decompressive hemicraniectomy. Two weeks after initial presentation he suffered a precipitous decline despite intensive surveillance. This case illustrates the distinct challenges of diagnosing cerebral vasospasm in the setting of severe traumatic brain injury.

  9. Profound hypokalemia associated with severe diabetic ketoacidosis.

    Davis, Shanlee M; Maddux, Aline B; Alonso, Guy T; Okada, Carol R; Mourani, Peter M; Maahs, David M

    2016-02-01

    Hypokalemia is common during the treatment of diabetic ketoacidosis (DKA); however, severe hypokalemia at presentation prior to insulin treatment is exceedingly uncommon. A previously healthy 8-yr-old female presented with new onset type 1 diabetes mellitus, severe DKA (pH = 6.98), and profound hypokalemia (serum K = 1.3 mmol/L) accompanied by cardiac dysrhythmia. Insulin therapy was delayed for 9 h to allow replenishment of potassium to safe serum levels. Meticulous intensive care management resulted in complete recovery. This case highlights the importance of measuring serum potassium levels prior to initiating insulin therapy in DKA, judicious fluid and electrolyte management, as well as delaying and/or reducing insulin infusion rates in the setting of severe hypokalemia.

  10. 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...... in 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...

  11. Severe metabolic acidosis following assault chemical burn.

    Roock, Sophie D; Deleuze, Jean-Paul; Rose, Thomas; Jennes, Serge; Hantson, Philippe

    2012-04-01

    Assault chemical burns are uncommon in northern Europe. Besides local toxicity, systemic manifestations are possible after strong acid exposure. A 40-year-old woman was admitted 1 h after a criminal assault with sulfuric acid. The total burned surface area was 35%, third degree. Injury was due to sulfuric acid (measured pH 0.9) obtained from a car battery. Immediate complications were obstructive dyspnea and metabolic acidosis. The admission arterial pH was 6.92, with total bicarbonate 8.6 mEq/l and base deficit 23.4 mEq/l. The correction of metabolic acidosis was achieved after several hours by the administration of bicarbonate and lactate buffers. The patient developed several burns-related complications (sepsis and acute renal failure). Cutaneous projections of strong acids may cause severe metabolic acidosis, particularly when copious irrigation and clothes removal cannot be immediately performed at the scene.

  12. LEAF DISEASE SEVERITY MEASUREMENT USING IMAGE PROCESSING

    Sanjay B. Patil

    2011-10-01

    Full Text Available Fungi-caused diseases in sugarcane are the most predominant diseases which appear as spots on the leaves. If not treated on time, causes the severe loss. Excessive use of pesticide for plant diseases treatment increases the cost and environmental pollution so their use must be minimized. This can be achieved by targeting the diseases places, with the appropriate quantity and concentration of pesticide by estimating disease severity using image processing technique. Simple threshold and Triangle thresholding methods are used to segment the leaf area and lesion region area respectively. Finally diseases are catcogrise by calculating the quotient of lesion area and leaf area. The accuracy of the experiment is found to be 98.60 %. Research indicates that this method to calculate leaf disease severity is fast and accurate.

  13. Severe metabolic acidosis following assault chemical burn

    Sophie De Roock

    2012-01-01

    Full Text Available Assault chemical burns are uncommon in northern Europe. Besides local toxicity, systemic manifestations are possible after strong acid exposure. A 40-year-old woman was admitted 1 h after a criminal assault with sulfuric acid. The total burned surface area was 35%, third degree. Injury was due to sulfuric acid (measured pH 0.9 obtained from a car battery. Immediate complications were obstructive dyspnea and metabolic acidosis. The admission arterial pH was 6.92, with total bicarbonate 8.6 mEq/l and base deficit 23.4 mEq/l. The correction of metabolic acidosis was achieved after several hours by the administration of bicarbonate and lactate buffers. The patient developed several burns-related complications (sepsis and acute renal failure. Cutaneous projections of strong acids may cause severe metabolic acidosis, particularly when copious irrigation and clothes removal cannot be immediately performed at the scene.

  14. Infliximab to treat severe ulcerative colitis

    Dídia Bisamra Cury; Marcelo de Souza Cury; Geraldo Vinicius Hemerly Elias; Sender Jankiel Mizsputen

    2009-01-01

    A 48-year-old female with severe ulcerative colitis refractory to conventional therapy was referred to our facility for management. The patient showed extensive ulcerative colitis since the age of 20 years and had failed therapy with 5-aminosalicylic acid agents and azathioprine. The disease remained active despite treatment with steroids and cyclosporine. The clinical and endoscopic parameters were consistent with severe disease. Infectious precipitants were ruled out. Given the severity of the disease and in order to avoid a colectomy, we started the patient on infliximab therapy. A dramatic clinical and endoscopic response was observed and she remained in remission at the end of a 1-year follow-up period. We discuss findings in the literature regarding the use of infliximab therapy in patients with ulcerative colitis who have failed steroids and cyclosporine.

  15. Severe odontogenic infection: An emergency. Case report

    Crisosto-Jara, Claudia; Diaz-Ricouz, Camilo; Peñarrocha-Diago, Miguel; Peñarrocha-Oltra, David

    2017-01-01

    Odontogenic infections (OI) are a major reason for consultation in dental practice. They affect people of all ages, and most of them respond well to current medical and surgical treatments. However, some OI can spread to vital and deep structures, overcome the host immune system - especially in diabetic, immunocompromised or weakened patients - and even prove fatal. Ludwig’s angina is a severe form of diffuse cellulitis that can have an acute onset and spread very rapidly, bilaterally affecting areas of the head and neck, and may prove life threatening. A case of severe dental infection is presented in which emphasis is placed on the importance of airway maintenance, followed by surgical decompression under adequate antibiotic coverage. Key words:Ludwig’s angina, severe odontogenic infection, surgical decompression, dental infection. PMID:28210456

  16. Satellite Cell Functional Alterations Following Cutaneous Burn in rats Include an Increase in Their Osteogenic Potential

    2013-10-07

    skeletal muscle hypertrophy and atrophy. Nat Cell Biol 2003;5:87. [6] Brack AS, Rando TA. Intrinsic changes and extrinsic influences of myogenic stem...Skeletal muscle Muscle precursor cell Thermal injury Atrophy Heterotopic ossification a b s t r a c t Background: Significant consequences of severe burn...include skeletal muscle atrophy and heterotopic ossification (HO). The cellular mechanisms underlying either of these condi- tions are not known

  17. Model for safety reports including descriptive examples; Mall foer saekerhetsrapporter med beskrivande exempel

    NONE

    1995-12-01

    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.

  18. Long-term outcomes after severe shock.

    Pratt, Cristina M; Hirshberg, Eliotte L; Jones, Jason P; Kuttler, Kathryn G; Lanspa, Michael J; Wilson, Emily L; Hopkins, Ramona O; Brown, Samuel M

    2015-02-01

    Severe shock is a life-threatening condition with very high short-term mortality. Whether the long-term outcomes among survivors of severe shock are similar to long-term outcomes of other critical illness survivors is unknown. We therefore sought to assess long-term survival and functional outcomes among 90-day survivors of severe shock and determine whether clinical predictors were associated with outcomes. Seventy-six patients who were alive 90 days after severe shock (received ≥1 μg/kg per minute of norepinephrine equivalent) were eligible for the study. We measured 3-year survival and long-term functional outcomes using the Medical Outcomes Study 36-Item Short-Form Health Survey, the EuroQOL 5-D-3L, the Hospital Anxiety and Depression Scale, the Impact of Event Scale-Revised, and an employment instrument. We also assessed the relationship between in-hospital predictors and long-term outcomes. The mean long-term survival was 5.1 years; 82% (62 of 76) of patients survived, of whom 49 were eligible for follow-up. Patients who died were older than patients who survived. Thirty-six patients completed a telephone interview a mean of 5 years after hospital admission. The patients' Physical Functioning scores were below U.S. population norms (P shock had a high 3-year survival rate. Patients' long-term physical and psychological outcomes were similar to those reported for cohorts of less severely ill intensive care unit survivors. Anxiety and depression were relatively common, but only a few patients had symptoms of posttraumatic stress disorder. This study supports the observation that acute illness severity does not determine long-term outcomes. Even extremely critically ill patients have similar outcomes to general intensive care unit survivor populations.

  19. Severe iritis and choroidal effusion following selective laser trabeculoplasty.

    Kim, Danny Y; Singh, Anna

    2008-01-01

    A patient with uncontrolled primary open-angle glaucoma underwent selective laser trabeculoplasty and developed a significant anterior chamber reaction, shallow anterior chamber, and choroidal effusion. Common complications associated with selective laser trabeculoplasty include conjunctival injection, mild anterior chamber reaction, and post-treatment intraocular pressure elevation. The authors believe this is the first reported case of severe iritis and choroidal effusion following selective laser trabeculoplasty.

  20. Biomarkers of Endocannabinoid System Activation in Severe Obesity

    Sipe, Jack C.; T Michael Scott; Sarah Murray; Olivier Harismendy; Simon, Gabriel M.; Cravatt, Benjamin F; Jill Waalen

    2010-01-01

    BACKGROUND: Obesity is a worldwide epidemic, and severe obesity is a risk factor for many diseases, including diabetes, heart disease, stroke, and some cancers. Endocannabinoid system (ECS) signaling in the brain and peripheral tissues is activated in obesity and plays a role in the regulation of body weight. The main research question here was whether quantitative measurement of plasma endocannabinoids, anandamide, and related N-acylethanolamines (NAEs), combined with genotyping for mutation...

  1. Concomitant autoimmune and genetic pancreatitis leads to severe inflammatory conditions

    Jean Louis Frossard; Jean Marc Dumonceau; Catherine Pastor; Laurent Spahr; Antoine Hadengue

    2008-01-01

    Chronic pancreatitis characterized by an early onset should be extensively investigated including the search for a mutation of the PRSS1, SPINK-1 or CFTR genes and potential features of autoimmune pancreatitis.We here describe a case of chronic pancreatitis with an onset at a very young age in which a mutation of the PRSS1 and several features of autoimmune pancreatitis were identified.

  2. Worsening Bradycardia Following Antithymocyte Globulin Treatment of Severe Aplastic Anemia

    2011-01-01

    Immunosuppressive regimens, which include antithymocyte globulin (ATG), are widely used for the treatment of severe aplastic anemia (SAA). However, bradycardia has been reported only as a rare side effect of ATG therapy in the manufacturer's product information and, in rare cases, in the adult literature. We present an adolescent with SAA and preexisting bradycardia who underwent immunosuppression therapy with ATG, methylprednisolone, and tacrolimus and developed profound sinus bradycardia wi...

  3. Oral rehabilitation of severe dentoalveolar trauma: a clinical report.

    Robinson, Fonda G; Cunningham, Larry L

    2012-12-01

    This clinical report describes the oral rehabilitation of an adult male who suffered severe dentoalveolar trauma as a result of a motor vehicle accident. The specific objectives of this treatment were to restore esthetics and masticatory function. Treatment included removal of fractured roots, placement of multiple endosseous implants, and placement of anterior and posterior metal-ceramic crowns and fixed partial dentures. Three year clinical examination revealed no pathology associated with the rehabilitation. The patient's esthetic and functional expectations were successfully achieved.

  4. Functional neurologic recovery in two dogs diagnosed with severe

    Mônica Vicky Bahr Arias; Daniela Scapini Mendes; Nazilton de Paula Reis Filho

    2015-01-01

    Traumatic injuries to the vertebral column, spinal cord, and cauda equina nerve roots occur frequently in human and veterinary medicine and lead to devastating consequences. Complications include partial or complete loss of motor, sensory, and visceral functions, which are among the main causes of euthanasia in dogs. The present case report describes neurological functional recovery in two dogs that were treated surgically for severe spinal fracture and vertebral luxation. In the first case, ...

  5. Risk of Severe Upper Gastrointestinal Complications among Oral Bisphosphonate Users

    Arianna Ghirardi; Lorenza Scotti; Antonella Zambon; Gianluca Della Vedova; Luca Cavalieri D'oro; Francesco Lapi; Francesco Cipriani; Caputi, Achille P; Alberto Vaccheri; Dario Gregori; Rosaria Gesuita; Annarita Vestri; Tommaso Staniscia; Giampiero Mazzaglia; Giovanni Corrao

    2013-01-01

    BACKGROUND: Oral bisphosphonates (BPs) are the primary agents for the treatment of osteoporosis. Although BPs are generally well tolerated, serious gastrointestinal adverse events have been observed. AIM: To assess the risk of severe upper gastrointestinal complications (UGIC) among BP users by means of a large study based on a network of Italian healthcare utilization databases. METHODS: A nested case-control study was carried out by including 110,220 patients aged 45 years or older who, fro...

  6. Severe Ketoacidosis Associated with Canagliflozin (Invokana): A Safety Concern

    Alehegn Gelaye; Abdallah Haidar; Christina Kassab; Syed Kazmi; Prabhat Sinha

    2016-01-01

    Canagliflozin (Invokana) is a selective sodium glucose cotransporter-2 (SGLT-2) inhibitor that was first introduced in 2013 for the treatment of type 2 diabetes mellitus (DM). Though not FDA approved yet, its use in type 1 DM has been justified by the fact that its mechanism of action is independent of insulin secretion or action. However, some serious side effects, including severe anion gap metabolic acidosis and euglycemic diabetic ketoacidosis (DKA), have been reported. Prompt identificat...

  7. More severe violence exposure associated with poly-pharmaceutical use.

    Kubiak, Sheryl Pimlott; Arfken, Cynthia L; Boyd, Carol; Cortina, Lilia M

    2006-01-01

    Exposure to emotional, physical, and sexual abuse carries varying psychological and somatic sequelae, including the increased use of alcohol and illicit drugs. Less studied is the association between violence exposure and prescription drug use. Using previously determined lifetime exposure profiles of 16,000 men and women, the current use of three specific drug categories was assessed and a strong relationship between victimization severity and prescription drugs used within the last month was found. Victimization screening has important implications in health care settings.

  8. The COG database: an updated version includes eukaryotes

    Sverdlov Alexander V

    2003-09-01

    Full Text Available Abstract Background The availability of multiple, essentially complete genome sequences of prokaryotes and eukaryotes spurred both the demand and the opportunity for the construction of an evolutionary classification of genes from these genomes. Such a classification system based on orthologous relationships between genes appears to be a natural framework for comparative genomics and should facilitate both functional annotation of genomes and large-scale evolutionary studies. Results We describe here a major update of the previously developed system for delineation of Clusters of Orthologous Groups of proteins (COGs from the sequenced genomes of prokaryotes and unicellular eukaryotes and the construction of clusters of predicted orthologs for 7 eukaryotic genomes, which we named KOGs after eukaryotic orthologous groups. The COG collection currently consists of 138,458 proteins, which form 4873 COGs and comprise 75% of the 185,505 (predicted proteins encoded in 66 genomes of unicellular organisms. The eukaryotic orthologous groups (KOGs include proteins from 7 eukaryotic genomes: three animals (the nematode Caenorhabditis elegans, the fruit fly Drosophila melanogaster and Homo sapiens, one plant, Arabidopsis thaliana, two fungi (Saccharomyces cerevisiae and Schizosaccharomyces pombe, and the intracellular microsporidian parasite Encephalitozoon cuniculi. The current KOG set consists of 4852 clusters of orthologs, which include 59,838 proteins, or ~54% of the analyzed eukaryotic 110,655 gene products. Compared to the coverage of the prokaryotic genomes with COGs, a considerably smaller fraction of eukaryotic genes could be included into the KOGs; addition of new eukaryotic genomes is expected to result in substantial increase in the coverage of eukaryotic genomes with KOGs. Examination of the phyletic patterns of KOGs reveals a conserved core represented in all analyzed species and consisting of ~20% of the KOG set. This conserved portion of the

  9. Nonlocal Crowd Dynamics Models for several Populations

    Colombo, Rinaldo M

    2011-01-01

    This paper develops the basic analytical theory related to some recently introduced crowd dynamics models. Where well posedness was known only locally in time, it is here extended to all of $\\reali^+$. The results on the stability with respect to the equations are improved. Moreover, here the case of several populations is considered, obtaining the well posedness of systems of multi-D non-local conservation laws. The basic analytical tools are provided by the classical Kruzkov theory of scalar conservation laws in several space dimensions.

  10. Neuropsychiatric aspects of severe brain injuries

    O. S. Zaitsev

    2012-01-01

    Full Text Available The state-of-the-art of Russian neuropsychiatry and priority developments in different psychopathological syndromes in severe brain injuries are assessed. Many cognitive and emotional impairments are explained in terms of the idea on the organization of psychic activity over time. It is emphasized that to achieve the premorbid levels of an interhemispheric interaction and functional asymmetry of the cerebral hemispheres affords psychic activity recovery. The experience in investigating, classifying, and treating various mental disorders occurring after severe brain injuries is generalized. The basic principles of psychopharmacotherapy and rehabilitation of victims are stated.

  11. [Severe Raynaud's syndrome treated by lumbar sympathectomy].

    Thomsen, Thomas Laden; Roeder, Ole

    2016-03-28

    Avoiding exposure of extremities to cold combined with pharmacologic treatment usually suffice in the attempt to suppress the related symptoms of Raynaud's syndrome. This case report describes a severe case of Raynaud's syndrome affecting the lower extremities of a 16-year-old female. She was referred to a centre of vascular surgery with severe vasospasms of the feet. After failed attempts of pharmacologic treatment, a laparoscopic lumbar sympathectomy was performed with no complications and a slight reduction of symptoms three years post-surgically.

  12. Management of severe hypertension in pregnancy.

    Moroz, Leslie A; Simpson, Lynn L; Rochelson, Burton

    2016-03-01

    While hemorrhage is the leading cause of maternal death in most of the world, hypertensive disorders of pregnancy are the leading cause of maternal mortality in the United States. The opportunity to improve outcomes lies in timely and appropriate response to severe hypertension. The purpose of this article is to review the diagnostic criteria for severe hypertension, choice of antihypertensive agents, and recommended algorithms for evaluation and management of acute changes in clinical status. Adhering to standard practices ensures that care teams can timely and appropriate care to these high risk patients. With heightened surveillance and prompt evaluation of signs and symptoms of worsening hypertension, maternal morbidity and mortality can be decreased.

  13. Pancreaticoatmospheric fistula following severe acute necrotising pancreatitis.

    Simoneau, Eve; Chughtai, Talat; Razek, Tarek; Deckelbaum, Dan L

    2014-12-17

    Severe acute necrotising pancreatitis is associated with numerous local and systemic complications. Abdominal compartment syndrome requiring urgent decompressive laparotomy is a potential complication of this disease process and is associated with increased morbidity and mortality. We describe the case of a pancreaticoatmospheric fistula following decompressive laparotomy in a patient with severe acute necrotising pancreatitis. While this fistula was managed successfully using the current standard of care for pancreatic fistulas, the wound care for in this patient with drainage of the fistula through an open abdomen, is a significant challenge.

  14. NONLOCAL CROWD DYNAMICS MODELS FOR SEVERAL POPULATIONS

    Rinaldo M. Colombo; Magali Lécureux-Mercier

    2012-01-01

    This paper develops the basic analytical theory related to some recently introduced crowd dynamics models.Where well posedness was known only locally in time,it is here extended to all of R+.The results on the stability with respect to the equations are improved.Moreover,here the case of several populations is considered,obtaining the well posedness of systems of multi-D non-local conservation laws.The basic analytical tools are provided by the classical Kru(z)kov theory of scalar conservation laws in several space dimensions.

  15. Pneumonia severity scores in resource poor settings

    Jamie Rylance

    2014-06-01

    Full Text Available Clinical prognostic scores are increasingly used to streamline care in well-resourced settings. The potential benefits of identifying patients at risk of clinical deterioration and poor outcome, delivering appropriate higher level clinical care, and increasing efficiency are clear. In this focused review, we examine the use and applicability of severity scores applied to patients with community acquired pneumonia in resource poor settings. We challenge clinical researchers working in such systems to consider the generalisability of existing severity scores in their populations, and where performance of scores is suboptimal, to promote efforts to develop and validate new tools for the benefit of patients and healthcare systems.

  16. Relative performance of several inexpensive accelerometers

    Evans, John R.; Rogers, John A.

    1995-01-01

    We examined the performance of several low-cost accelerometers for highly cost-driven applications in recording earthquake strong motion. We anticipate applications for such sensors in providing the lifeline and emergency-response communities with an immediate, comprehensive picture of the extent and characteristics of likely damage. We also foresee their use as 'filler' instruments sited between research-grade instruments to provide spatially detailed and near-field records of large earthquakes (on the order of 1000 stations at 600-m intervals in San Fernando Valley, population 1.2 million, for example). The latter applications would provide greatly improved attenuation relationships for building codes and design, the first examples of mainshock information (that is, potentially nonlinear regime) for microzonation, and a suite of records for structural engineers. We also foresee possible applications in monitoring structural inter-story drift during earthquakes, possibly leading to local and remote alarm functions as well as design criteria. This effort appears to be the first of its type at the USGS. It is spurred by rapid advances in sensor technology and the recognition of potential non-classical applications. In this report, we estimate sensor noise spectra, relative transfer functions and cross-axis sensitivity of six inexpensive sensors. We tested three micromachined ('silicon-chip') sensors in addition to classical force-balance and piezoelectric examples. This sample of devices is meant to be representative, not comprehensive. Sensor noise spectra were estimated by recording system output with the sensor mounted on a pneumatically supported 545-kg optical-bench isolation table. This isolation table appears to limit ground motion to below our system noise level. These noise estimates include noise introduced by signal-conditioning circuitry, the analog-to-digital converter (ADC), and noise induced in connecting wiring by ambient electromagnetic fields in

  17. Severe acute pancreatitis:Pathogenetic aspects and prognostic factors

    Ibrahim A Al Mofleh

    2008-01-01

    Approximately 20% of patients with acute pancreatitis develop a severe disease associated with complications and high risk of mortality.The purpose of this study is to review pathogenesis and prognostic factors of severe acute pancreatitis (SAP).An extensive medline search was undertaken with focusing on pathogenesis,complications and prognostic evaluation of SAP.Cytokines and other inflammatory markers play a major role in the pathogenesis and course of SAP and can be used as prognostic markers in its early phase.Other markers such as simple prognostic scores have been found to be as effective as multifactorial scoring systems (MFSS) at 48 h with the advantage of simplicity,efficacy,low cost,accuracy and early prediction of SAP.Recently,several laboratory markers including hematocrit,blood urea nitrogen (BUN),creatinine,matrix metalloproteinase-9 (MMP-9) and serum amyloid A (SAA)have been used as early predictors of severity within the first 24 h.The last few years have witnessed a tremendous progress in understanding the pathogenesis and predicting the outcome of SAP.In this review we classified the prognostic markers into predictors of severity,pancreatic necrosis (PN),infected PN (IPN) and mortality.

  18. 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.

  19. Clinical manifestations and outcomes in severe ulcerative colitis

    YANG Xuesong; YAO Wei; LIU Wenbin; LI Jun; LU Yumin

    2007-01-01

    In order to evaluate the clinical manifestations and outcomes of severe ulcerative colitis (UC),we retrospectively reviewed 41 patients with severe UC from 144 consecutively hospitalized UC cases from 1988 to 2004.Data recorded included onset,symptoms,signs,laboratory results,endoscopic,radiologic and pathologic findings,the clinical treatment process and follow-up.Of these severe cases,92.7%(38/41)had pancolitis.Clinically,36.9%(15/41)were categorized as first onset type,36.9%(15/41)were chronic persistent and 26.8%(11/41)were chronic recurrent.Steroids played a main role in the remission of severe UC(61.0%).Thirty-one cases(75.6%) were relieved by drug therapy.Seven cases(17.1%) progressed to the need for operation.An early age of onset,pancolitis,low hemoglobin and serum albumin levels,and the need for intravenous steroids tended to be associated with the need for surgery.In conclusion,most of the severe UC patients respond well to drug therapy,but for individuals who are unresponsive to drug therapy,or for those depending on steroids,after a reasonable duration of treatment,the necessity for surgery should be considered.

  20. Measuring Disease Severity in Duchenne and Becker Muscular Dystrophy

    Melinda F. Davis

    2010-10-01

    Full Text Available Medical investigations use a wide variety of outcome indicators that are often not comparable. It can be challenging to integrate results across multiple studies that do not share a common metric. Some conditions such as Duchenne and Becker muscular dystrophy have a predictable course of disease progression. Severity can be inferred from a patient's medical history. This paper describes the development of a disease severity measure using common markers of disease progression. Rasch modeling was used to estimate severity using dichotomous events that indicate disease progression. Caregivers of 34 young men with Duchenne or Becker muscular dystrophy completed structured interviews about their care and medical history. Interview questions included surgeries (tendon release, scoliosis, tracheostomy, respiratory equipment (assisted ventilation, cough assist devices, and the use of other medical equipment (e.g., braces, walkers, wheelchairs, transfer boards, hospital beds. The resulting measure had a reliability of .83. The correlation between the severity measure and the Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS was .68. Preliminary results and item calibrations are provided for the severity measure that can be estimated from caregiver reports or administrative data. DOI: 10.2458/azu_jmmss.v1i1.76

  1. Two extraordinarily severe cases of Treacher Collins syndrome.

    Bauer, Mislen; Saldarriaga, Wilmar; Wolfe, S Anthony; Beckwith, J Bruce; Frias, Jaime L; Cohen, M Michael

    2013-03-01

    Here, we report two extraordinarily severe cases of Teacher Collins syndrome. Initially, amniotic bands and plical fold disruption were considered, but downslanting eyes made us consider severe Treacher Collins syndrome. A TCOF1 mutation in exon 24 was identified in Patient 1 (c.4355_4356ins14, resulting in p.1456Thrfs*18). Patient 2, who expired on day 4, is so similar to Patient 1 that severe Treacher Collins syndrome may be inferred in this instance. Neither the TCOF1 mutation nor the well-known variability in the expression in affected families with Treacher Collins syndrome (∼40% of reported cases) can explain the severity of these cases; otherwise, we would be aware of such cases within families from time to time. We are unaware of any recent sporadic cases (∼60% of reported cases) exactly like ours either with a single exception in the case reported by Writzl et al. [2008] with a TCOF1 mutation. The case described by Otto in 1841 is spectacular. We propose several hypotheses to be considered in explaining this developmental amplification, including some promoter effect on the gene, some position effect on the gene, a polymorphism elsewhere in the gene, a point mutation elsewhere in the gene, a polymorphism in another gene, or a point mutation in another gene, such as POLR1C (which maps to 6p21.1) or POLR1D (which maps to13q12.2). We also review the etiology and pathogenesis of Treacher Collins syndrome, and discuss several other severe cases from the past.

  2. Generalized fluid theory including non-Maxwellian kinetic effects

    Izacard, Olivier

    2016-01-01

    The results obtained by the plasma physics community for the validation and the prediction of turbulence and transport in magnetized plasma come mainly from the use of very CPU-consuming particle-in-cell or (gyro)kinetic codes which naturally include non-Maxwellian kinetic effects. To date, fluid codes are not considered to be relevant for the description of these kinetic effects. Here, after revisiting the limitations of the current fluid theory developed in the 19th century, we generalize t...

  3. Ground state of a confined Yukawa plasma including correlation effects

    Henning, C; Filinov, A; Piel, A; Bonitz, M

    2007-01-01

    The ground state of an externally confined one-component Yukawa plasma is derived analytically using the local density approximation (LDA). In particular, the radial density profile is computed. The results are compared with the recently obtained mean-field (MF) density profile \\cite{henning.pre06}. While the MF results are more accurate for weak screening, LDA with correlations included yields the proper description for large screening. By comparison with first-principle simulations for three-dimensional spherical Yukawa crystals we demonstrate that both approximations complement each other. Together they accurately describe the density profile in the full range of screening parameters.

  4. Endometrial cancer risk prediction including serum-based biomarkers

    Fortner, Renée T; Hüsing, Anika; Kühn, Tilman;

    2017-01-01

    Endometrial cancer risk prediction models including lifestyle, anthropometric, and reproductive factors have limited discrimination. Adding biomarker data to these models may improve predictive capacity; to our knowledge, this has not been investigated for endometrial cancer. Using a nested case......-control study within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, we investigated the improvement in discrimination gained by adding serum biomarker concentrations to risk estimates derived from an existing risk prediction model based on epidemiologic factors. Serum...... concentrations of sex steroid hormones, metabolic markers, growth factors, adipokines, and cytokines were evaluated in a step-wise backward selection process; biomarkers were retained at pdiscrimination was assessed using...

  5. The action principle for generalized fluid motion including gyroviscosity

    Lingam, M

    2014-01-01

    A general set of fluid equations that allow for energy-conserving momentum transport by gyroscopic motion of fluid elements is obtained. The equations are produced by a class of action principles that yield a large subset of the known fluid and magnetofluid models, including gyroviscosity. Analysis of the action principle yields broad, model-independent results regarding the conservation laws of energy and linear and angular momenta. The formalism is illustrated by studying fluid models with intrinsic angular momentum that may appear in the contexts of condensed matter, biological, and other areas of physics.

  6. Harmonic measure for percolation and ising clusters including rare events.

    Adams, David A; Sander, Leonard M; Ziff, Robert M

    2008-10-03

    We obtain the harmonic measure of the hulls of critical percolation clusters and Ising-model Fortuin-Kastelyn clusters using a biased random-walk sampling technique which allows us to measure probabilities as small as 10{-300}. We find the multifractal D(q) spectrum including regions of small and negative q. Our results for external hulls agree with Duplantier's theoretical predictions for D(q) and his exponent -23/24 for the harmonic measure probability distribution for percolation. For the complete hull, we find the probability decays with an exponent of -1 for both systems.

  7. Estimating the severity of safety related behaviour.

    Svensson, Ase; Hydén, Christer

    2006-03-01

    The aim of this work is to be a starting point for a more thorough description and analysis of safety related road user behaviour in order to better understand the different parts forming the traffic safety processes. The background is that it is problematic to use analysis of crash data and conflict data in the everyday traffic safety work due to low occurrence rates and the focus on rather exceptional and unsuccessful events. A new framework must consider the following aspects: (1) The importance of feedback to the road users. (2) Inclusion of more frequent events, "normal" road user behaviours and the possibility to link them to a severity dimension. (3) Prediction of safety/unsafety based on the more frequent events. By constructing severity hierarchies based on a uniform severity dimension (Time to Accident/Conflicting Speed value) it is possible to both describe the closeness to a crash and to get a comprehensive understanding of the connection between behaviour and safety by both considering unsuccessful and successful interactive situations. These severity hierarchies would make it possible to consider road users' expectations due to feedback and estimate its safety relevance.

  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. 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…

  10. 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

  11. 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.

  12. 24 CFR 3500.22 - Severability.

    2010-04-01

    ... 24 Housing and Urban Development 5 2010-04-01 2010-04-01 false Severability. 3500.22 Section 3500.22 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR HOUSING-FEDERAL HOUSING COMMISSIONER, DEPARTMENT OF HOUSING AND...

  13. Movement of chromosomes with severed kinetochore microtubules.

    Forer, Arthur; Johansen, Kristen M; Johansen, Jørgen

    2015-05-01

    Experiments dating from 1966 and thereafter showed that anaphase chromosomes continued to move poleward after their kinetochore microtubules were severed by ultraviolet microbeam irradiation. These observations were initially met with scepticism as they contradicted the prevailing view that kinetochore fibre microtubules pulled chromosomes to the pole. However, recent experiments using visible light laser microbeam irradiations have corroborated these earlier experiments as anaphase chromosomes again were shown to move poleward after their kinetochore microtubules were severed. Thus, multiple independent studies using different techniques have shown that chromosomes can indeed move poleward without direct microtubule connections to the pole, with only a kinetochore 'stub' of microtubules. An issue not yet settled is: what propels the disconnected chromosome? There are two not necessarily mutually exclusive proposals in the literature: (1) chromosome movement is propelled by the kinetochore stub interacting with non-kinetochore microtubules and (2) chromosome movement is propelled by a spindle matrix acting on the stub. In this review, we summarise the data indicating that chromosomes can move with severed kinetochore microtubules and we discuss proposed mechanisms for chromosome movement with severed kinetochore microtubules.

  14. 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…

  15. Hamiltonian constants for several new entire solutions

    2008-01-01

    Using the Hamiltonian identities and the corresponding Hamilto- nian constants for entire solutions of elliptic partial differential equations, we investigate several new entire solutions whose existence were shown recently, and show interesting properties of the solutions such as formulas for contact angles at infinity of concentration curves.

  16. Severe combined immunodeficiency--an update.

    Cirillo, Emilia; Giardino, Giuliana; Gallo, Vera; D'Assante, Roberta; Grasso, Fiorentino; Romano, Roberta; Di Lillo, Cristina; Galasso, Giovanni; Pignata, Claudio

    2015-11-01

    Severe combined immunodeficiencies (SCIDs) are a group of inherited disorders responsible for severe dysfunctions of the immune system. These diseases are life-threatening when the diagnosis is made too late; they are the most severe forms of primary immunodeficiency. SCID patients often die during the first two years of life if appropriate treatments to reconstitute their immune system are not undertaken. Conventionally, SCIDs are classified according either to the main pathway affected by the molecular defect or on the basis of the specific immunologic phenotype that reflects the stage where the blockage occurs during the differentiation process. However, during the last few years many new causative gene alterations have been associated with unusual clinical and immunological phenotypes. Many of these novel forms of SCID also show extra-hematopoietic alterations, leading to complex phenotypes characterized by a functional impairment of several organs, which may lead to a considerable delay in the diagnosis. Here we review the biological and clinical features of SCIDs paying particular attention to the most recently identified forms and to their unusual or extra-immunological clinical features.

  17. Severe aortic stenosis: diagnosis, treatment and prognosis

    M.W.A. van Geldorp (Martijn)

    2013-01-01

    textabstractDegenerative aortic stenosis is the most common valvular heart disease in developed countries. The prevalence of severe aortic stenosis increases with age from 1% in people below 65 years of age to nearly 6% in people over the age of 85. Since the population life expectancy continues to

  18. 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.

  19. Several explicit formulae for Bernoulli polynomials

    Komatsu, Takao; Pita Ruiz V., Claudio de J.

    2016-01-01

    We prove several explicit formulae for the $n$-th Bernoulli polynomial $B_{n}(x)$, in which $B_{n}(x)$ is equal to an affine combination of the polynomials $(x-1)^{n}$, $(x-2)^{n}$, $ldots$, $(x-k-1)^{n}$, where $k$ is any fixed positive integer greater or equal than $n$.

  20. Protein metabolism in severe childhood malnutrition

    The major clinical syndromes of severe childhood malnutrition (SCM) are marasmus (non-oedematous SCM), kwashiorkor and marasmic-kwashiorkor (oedematous SCM). Whereas treatment of marasmus is straightforward and the associated mortality is low, kwashiorkor and marasmic-kwashiorkor are difficult to tr...

  1. 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.

  2. Convex trace functions of several variables

    Hansen, Frank

    2002-01-01

    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 ...

  3. 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.…

  4. Severe aortic valve stenosis and nosebleed

    Schoedel, Johannes; Obergfell, Achim; Maass, Alexander H.; Schodel, Johannes

    2007-01-01

    Aortic valve stenosis is known to be associated with loss of high molecular von Willebrand multimers. This can lead to gastrointestinal bleeding in patients with gastrointestinal angiodysplasia, the Heyde syndrome. Here we present a case of anaemia and severe epistaxis associated with acquired von W

  5. 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.

  6. Severe leucopenia associated with Sitagliptin use.

    Pitocco, Dario; Zaccardi, Francesco; Martini, Francesca; Scavone, Giuseppe; Musella, Tittania; Caputo, Salvatore; Ghirlanda, Giovanni

    2011-02-01

    We report the case of a type 2 diabetes subject who developed severe leucopenia associated with treatment with the dipeptidil-peptidase 4 enzyme inhibitor Sitagliptin and highlights DPP4 inhibitors as a possible cause of unexplained hematolgical abnormalities in patients receiving DPP4-inhibitor treatment.

  7. Severe Hyperkalemia and Bilateral Adrenal Metastasis

    Michael Nagler

    2009-01-01

    Full Text Available Adrenal metastases are a common finding in metastatic lung and breast cancer. Often there are no clinical symptoms suggesting them. In this paper, we present a case of a 66-year-old man with metastatic lung cancer suffering from severe hyperkaliemia due to hypoaldosteronism as a result of bilateral adrenal metastasis.

  8. Cytokine Concentrations in Plasma from Children with Severe and Non-Severe Community Acquired Pneumonia.

    Johanne Haugen

    Full Text Available Children in low and middle-income countries have a high burden of pneumonia. Measuring the cytokine responses may be useful to identify novel markers for diagnosing, monitoring, and treating pneumonia.To describe and compare a wide range of inflammatory mediators in plasma from children with WHO-defined severe and non-severe community acquired pneumonia (CAP, and explore to what extent certain mediators are associated with severity and viral detection.We collected blood samples from 430 children with severe (n = 43 and non-severe (n = 387 CAP. Plasma from these children were analysed for 27 different cytokines, and we measured the association with age, disease severity and viral detection.There were generally higher plasma concentrations of several cytokines with both pro-inflammatory and anti-inflammatory effects among children with severe CAP than in children with non-severe CAP. We found significantly higher concentrations of interleukin (IL-1, IL-4, IL-6, IL-8, IL-9, IL-15, eotaxin, basic fibroblast growth factor (b-FGF, granulocyte colony-stimulating factor (G-CSF, granulocyte-macrophage colony-stimulating factor (GM-CSF, and tumor necrosis factor-alpha (TNF-α in the group of severe CAP. Most of these associations persisted when adjusting for age in linear regression analyses. The cytokine response was strongly associated with age but to a lesser extent with viral etiology.The plasma concentrations of several cytokines, both with pro-inflammatory and anti-inflammatory effects, were higher among children with severe illness. In particular G-CSF and IL-6 reflected severity and might provide complementary information on the severity of the infection.ClinicalTrials.gov NCT00148733.

  9. Thymoma associated with severe diarrhoea and anaemia

    2006-01-01

    @@ About 40% of patients with thymoma have one or more paraneoplastic syndromes, including myasthenia gravis, pure red cell aplasia (PRCA) or hypogammaglobulinaemia, but Good syndrome occurs in only 5% of these conditions. To our knowledge, only 11 patients (including our cases) of thymoma accompanied with PRCA and Good syndrome have been reported,1 however, no such case was reported in China before 2000.

  10. Including the public in pandemic planning: a deliberative approach

    Braunack-Mayer Annette J

    2010-08-01

    Full Text Available Abstract Background Against a background of pandemic threat posed by SARS and avian H5N1 influenza, this study used deliberative forums to elucidate informed community perspectives on aspects of pandemic planning. Methods Two deliberative forums were carried out with members of the South Australian community. The forums were supported by a qualitative study with adults and youths, systematic reviews of the literature and the involvement of an extended group of academic experts and policy makers. The forum discussions were recorded with simultaneous transcription and analysed thematically. Results Participants allocated scarce resources of antiviral drugs and pandemic vaccine based on a desire to preserve society function in a time of crisis. Participants were divided on the acceptability of social distancing and quarantine measures. However, should such measures be adopted, they thought that reasonable financial, household and psychological support was essential. In addition, provided such support was present, the participants, in general, were willing to impose strict sanctions on those who violated quarantine and social distancing measures. Conclusions The recommendations from the forums suggest that the implementation of pandemic plans in a severe pandemic will be challenging, but not impossible. Implementation may be more successful if the public is engaged in pandemic planning before a pandemic, effective communication of key points is practiced before and during a pandemic and if judicious use is made of supportive measures to assist those in quarantine or affected by social isolation measures.

  11. The role of chemical engineering in medicinal research including Alzheimer's.

    Kontogeorgis, Georgios M

    2015-01-01

    Various disciplines of chemical engineering, especially thermodynamics and kinetics, play an important role in medicinal research and this has been particularly recognized during the last 10-15 years (von Stockar and van der Wielen, J Biotechnol 59:25, 1997; Prausnitz, Fluid Phase Equilib 53:439, 1989; Prausnitz, Pure Appl Chem 79:1435, 2007; Dey and Prausnitz, Ind Eng Chem Res 50:3, 2011; Prausnitz, J Chem Thermodynamics 35:21, 2003; Tsivintzelis et al. AIChE J 55:756, 2009). It is expected that during the twenty-first century chemical engineering and especially thermodynamics can contribute as significantly to the life sciences development as it has been done with the oil and gas and chemical sectors in the twentieth century. Moreover, it has during the recent years recognized that thermodynamics can help in understanding diseases like human cataract, sickle-cell anemia, Creuzfeldt-Jacob ("mad cow" disease), and Alzheimer's which are connected to "protein aggregation." Several articles in the Perspectives section of prominent chemical engineering journals have addressed this issue (Hall, AIChE J 54:1956, 2008; Vekilov, AIChE J 54:2508, 2008). This work reviews recent applications of thermodynamics (and other areas of chemical engineering) first in drug development and then in the understanding of the mechanism of Alzheimer's and similar diseases.

  12. Radioprotection: mechanism and radioprotective agents including honeybee venom

    Varanda, E.A.; Tavares, D.C. [UNESP, Araraquara, SP (Brazil). Escola de Ciencias Farmaceuticas. Dept. de Ciencias Biologicas

    1998-07-01

    Since 1949, a great deal of research has been carried on the radioprotective action of chemical substances. These substances have shown to reduce mortality when administered to animals prior to exposure to a lethal dose of radiation. This fact is of considerable importance since it permits reduction of radiation-induced damage and provides prophylactic treatment for the damaging effects produced by radiotherapy. The following radioprotection mechanisms were proposed: free radical scavenger, repair by hydrogen donation to target molecules formation of mixed disulfides, delay of cellular division and induction of hypoxia in the tissues. Radioprotective agents have been divided into four major groups: the thiol compounds, other sulfur compounds, pharmacological agents (anesthetic drugs, analgesics, tranquilizers, etc.) and other radioprotective agents (WR-1065, WR-2721, vitamins C and E, glutathione, etc.). Several studies revealed the radioprotective action of Apis mellifera honeybee venom as well as that of its components mellitin and histamine. Radioprotective activity of bee venom involves mainly the stimulation of the hematopoietic system. In addition, release of histamine and reduction in oxygen tension also contribute to the radioprotective action of bee venom. (author)

  13. What determines the severity of space weather?

    Balan, Nanan; Skoug, Ruth; Hsu, Ray R.

    Thanks to the works of a number of scientists it is known that severe space weather (SSW) can cause extensive social and economic disruptions in the modern high-tech society. It is therefore important to understand what determines the severity of space weather, and whether it can be predicted. We present the results obtained from the analysis of solar-geophysical data during 30 space weather events that occurred since 1957 and produced geomagnetic storms of intensity less than -275 nT, and the Carrington event of 1859. The results seem to indicate that (1) space weather can become severe occasionally (7 since 1957) as experienced by satellite systems, Earth-based systems and Earth’s environment. (2) It is the impulsive energy (or power) at the leading edge of the CMEs (coronal mass ejections) mainly due to impulsive leading edge velocity and partly due to density that determines the severity of space weather in the heliosphere; the higher the impulsive velocity (sudden increase by over 275 km s-1 over the background), the more severe the space weather. (3) Such CMEs with IMF Bz also southward from the leading edge cause SSW on Earth though the magnitude of southward Bz does not seem important, and the minimum impulsive velocity for SSW on Earth seems higher than that for SSW in heliosphere. (4) CMEs having northward IMF Bz at the leading edge do not seem to cause SSW on Earth though they can lead to geomagnetic storms of long duration main phase with intensity less than even -420 nT.

  14. 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.

  15. 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.

  16. APORTACIONES DE LA INVESTIGACIÓN EUROPEA INCLUD-ED PARA LA REDUCCIÓN DEL ABANDONO ESCOLAR PREMATURO

    Maria Padrós Cuxart

    2011-05-01

    Full Text Available The challenge of reducing early school leaving in Europe, with special pressure in Spain, leads to the need of evidence based educational policies and measures. This paper presents measures to prevend and reduce early school leaving that have been identified within the research Project INCLUD-ED. Strategies for inclusion and social cohesion in Europe from education. This is the research Project with a higher level and resources developed  since now  in Europe regarding school education. The identified solutions are already being addressed in documents of the European Commission, such as the recent Communication to the European Parliament "Tackiling early school leaving: a key contribution to the Europe 2020 Agenda".

  17. A Mixed Mode Cochlear Amplifier Including Neural Feedback

    Flax, Matthew R.; Holmes, W. Harvey

    2011-11-01

    The mixed mode cochlear amplifier (MMCA) model is derived from the physiology of the cochlea. It is comprised of three main elements of the peripheral hearing system: the cochlear mechanics, hair cell motility, and neurophysiology. This model expresses both active compression wave and active traveling wave modes of operation. The inclusion of a neural loop with a time delay, and a new paradigm for the mechanical response of the outer hair cells, are believed to be unique features of the MMCA. These elements combine to form an active feedback loop to constitute the cochlear amplifier, whose input is a passive traveling wave vibration. The result is a cycle-by-cycle amplifier with nonlinear response. This system can assume an infinite number of different operating states. The stable state and the first few amplitude-limited unstable (Hopf-bifurcated) states are significant in describing the operation of the peripheral hearing system. A hierarchy of models can be constructed from this concept, depending on the amount of detail included. The simplest model of the MMCA is a nonlinear delay line resonator. It was found that even this simple MMCA version can explain a large number of hearing phenomena, at least qualitatively. This paper concentrates on explaining the fractional octave shift from the living to postmortem response in terms of the new model. Other mechanical, hair cell and neurological phenomena can also be accounted for by the MMCA, including two-tone suppression behavior, distortion product responses, otoacoustic emissions and neural spontaneous rates.

  18. Magnetic properties of nickel halide hydrates including deuteration effects

    DeFotis, G. C.; Van Dongen, M. J.; Hampton, A. S.; Komatsu, C. H.; Trowell, K. T.; Havas, K. C.; Davis, C. M.; DeSanto, C. L.; Hays, K.; Wagner, M. J.

    2017-01-01

    Magnetic measurements on variously hydrated nickel chlorides and bromides, including deuterated forms, are reported. Results include locations and sizes of susceptibility maxima, Tmax and χmax, ordering temperatures Tc, Curie constants and Weiss theta in the paramagnetic regime, and primary and secondary exchange interactions from analysis of low temperature data. For the latter a 2D Heisenberg model augmented by interlayer exchange in a mean-field approximation is applied. Magnetization data to 16 kG as a function of temperature show curvature and hysteresis characteristics quite system dependent. For four materials high field magnetization data to 70 kG at 2.00 K are also obtained. Comparison is made with theoretical relations for spin-1 models. Trends are apparent, primarily that Tmax of each bromide hydrate is less than for the corresponding chloride, and that for a given halide nD2O (n=1 or 2) deuterates exhibit lesser Tmax than do nH2O hydrates. A monoclinic unit cell determined from powder X-ray diffraction data on NiBr2·2D2O is different from and slightly larger than that of NiBr2·2H2O. This provides some rationale for the difference in magnetic properties between these.

  19. Proposal to Include Electrical Energy in the Industrial Return Statistics

    2003-01-01

    At its 108th session on the 20 June 1997, the Council approved the Report of the Finance Committee Working Group on the Review of CERN Purchasing Policy and Procedures. Among other topics, the report recommended the inclusion of utility supplies in the calculation of the return statistics as soon as the relevant markets were deregulated, without reaching a consensus on the exact method of calculation. At its 296th meeting on the 18 June 2003, the Finance Committee approved a proposal to award a contract for the supply of electrical energy (CERN/FC/4693). The purpose of the proposal in this document is to clarify the way electrical energy will be included in future calculations of the return statistics. The Finance Committee is invited: 1. to agree that the full cost to CERN of electrical energy (excluding the cost of transport) be included in the Industrial Service return statistics; 2. to recommend that the Council approves the corresponding amendment to the Financial Rules set out in section 2 of this docum...

  20. Including International Aviation in the EU Emissions Trading Scheme

    Kopsch, Fredrik

    2011-07-01

    Starting on January 1 st, 2012, the international aviation sector will be included into the already existing EU ETS. All air crafts departing and arriving within the European Union will be obliged to hold permits corresponding to their total emissions of CO{sub 2} for those routes. Since emissions from the international aviation sector are not included under the Kyoto Protocol, the European Commission has decided to introduce a trading barrier between the sectors in order not to jeopardize the Kyoto targets. The purpose of this paper is to analyse the potential loss in cost-effectiveness of introducing such a trading barrier between two sectors taking into account that damage from emissions is not necessarily uniform. A theoretical model is developed to address the question and it is found that, at least for the case with linking the international aviation sector to the stationary sources within the EU ETS, the trading barrier might be unwarranted as it might lead to higher damage from emissions as compared to alternative ways to link the trading sectors. However, it should be stressed that this finding is not general and caution should be taken in the future when linking emission trading schemes as, depending on the heterogeneity of emission damage, a trading barrier might very well be justified

  1. The Diversification Benefits of Including Carbon Assets in Financial Portfolios

    Yinpeng Zhang

    2017-03-01

    Full Text Available Carbon allowances traded in the EU-Emission Trading Scheme (EU-ETS were initially designed as an economic motivation for efficiently curbing greenhouse as emissions, but now it mimics quite a few characteristics of financial assets, and have now been used as a candidate product in building financial portfolios. In this study, we examine the time-varying correlations between carbon allowance prices with other financial indices, during the third phase of EU-ETS. The results show that, at the beginning of this period, carbon price was still strongly corrected with other financial indices. However, this connection was weakened over time. Given the relative independence of carbon assets from other financial assets, we argue for the diversification benefits of including carbon assets in financial portfolios, and building such portfolios, respectively, with the traditional global minimum variance (GMV strategy, the mean-variance-OGARCH (MV-OGARCH strategy, and the dynamic conditional correlation (DCC strategy. It is shown that the portfolio built with the MV-OGARCH strategy far out-performs the others and that including carbon assets in financial portfolios does help reduce investment risks.

  2. Generalized fluid theory including non-Maxwellian kinetic effects

    Izacard, Olivier

    2016-01-01

    The results obtained by the plasma physics community for the validation and the prediction of turbulence and transport in magnetized plasma come mainly from the use of very CPU-consuming particle-in-cell or (gyro)kinetic codes which naturally include non-Maxwellian kinetic effects. To date, fluid codes are not considered to be relevant for the description of these kinetic effects. Here, after revisiting the limitations of the current fluid theory developed in the 19th century, we generalize the fluid theory including kinetic effects such as non-Maxwellian super-thermal tails with as few fluid equations as possible. The collisionless and collisional fluid closures from the nonlinear Landau Fokker-Planck collision operator are shown for an arbitrary collisionality. Indeed, the first fluid models associated with two examples of collisionless fluid closures are obtained by assuming an analytic non-Maxwellian distribution function (e.g., the INMDF [O. Izacard, Phys. Plasmas 23, 082504 (2016)]). One of the main dif...

  3. Constant-Pressure Combustion Charts Including Effects of Diluent Addition

    Turner, L Richard; Bogart, Donald

    1949-01-01

    Charts are presented for the calculation of (a) the final temperatures and the temperature changes involved in constant-pressure combustion processes of air and in products of combustion of air and hydrocarbon fuels, and (b) the quantity of hydrocarbon fuels required in order to attain a specified combustion temperature when water, alcohol, water-alcohol mixtures, liquid ammonia, liquid carbon dioxide, liquid nitrogen, liquid oxygen, or their mixtures are added to air as diluents or refrigerants. The ideal combustion process and combustion with incomplete heat release from the primary fuel and from combustible diluents are considered. The effect of preheating the mixture of air and diluents and the effect of an initial water-vapor content in the combustion air on the required fuel quantity are also included. The charts are applicable only to processes in which the final mixture is leaner than stoichiometric and at temperatures where dissociation is unimportant. A chart is also included to permit the calculation of the stoichiometric ratio of hydrocarbon fuel to air with diluent addition. The use of the charts is illustrated by numerical examples.

  4. TOOLS TO INCLUDE BLIND STUDENTS IN SCHOOL BUILDING PERFORMANCE ASSESSMENTS

    Tania Pietzschke Abate

    2016-05-01

    Full Text Available This article discusses the design of data collection instruments that include the opinions of blind students, in accordance with the principles of Universal Design (UD. The aim of this study is to understand the importance of adapting data collection instruments for the inclusion of disabled persons in field research in Architecture and Design, among other fields. The data collection instruments developed were a play interview with a tactile map and a 3D survey with the use of tactile models. These instruments sought to assess the school environment experienced by blind students. The study involved students from the early years of a school for the blind who had not yet mastered the Braille system. The participation of these students was evaluated. A multidisciplinary team consisting of architects, designers, educators, and psychologists lent support to the study. The results showed that the data collection instruments adapted to blind students were successful in making the group of authors examine questions regarding UD. An analysis of the participatory phase showed that the limitations resulting from blindness determine the specificities in the adaptation and implementation process of the instruments in schools. Practical recommendations for future studies related to instruments in the UD thematic are presented. This approach is in line with the global trend of including disabled persons in society based on these users’ opinions concerning what was designed by architects and designers.

  5. Kabuki syndrome: expanding the phenotype to include microphthalmia and anophthalmia.

    McVeigh, Terri P; Banka, Siddharth; Reardon, William

    2015-10-01

    Kabuki syndrome is a rare genetic malformation syndrome that is characterized by distinct facies, structural defects and intellectual disability. Kabuki syndrome may be caused by mutations in one of two histone methyltransferase genes: KMT2D and KDM6A. We describe a male child of nonconsanguineous Irish parents presenting with multiple malformations, including bilateral extreme microphthalmia; cleft palate; congenital diaphragmatic hernia; duplex kidney; as well as facial features of Kabuki syndrome, including interrupted eyebrows and lower lid ectropion. A de-novo germline mutation in KMT2D was identified. Whole-exome sequencing failed to reveal mutations in any of the known microphthalmia/anopthalmia genes. We also identified four other patients with Kabuki syndrome and microphthalmia. We postulate that Kabuki syndrome may produce this type of ocular phenotype as a result of extensive interaction between KMT2D, WAR complex proteins and PAXIP1. Children presenting with microphthalmia/anophthalmia should be examined closely for other signs of Kabuki syndrome, especially at an age where the facial gestalt might be less readily appreciable.

  6. Evaluation of FEMA-440 for including soil-structure interaction

    Khoshnoudian F.; Behmanesh I.

    2010-01-01

    Replacing the entire soil-structure system with a fixed base oscillator to consider the effect of soil-structure interaction (SSI) is a common analysis method in seismic design. This technique has been included in design procedures such as NEHRP, ASCE, etc. By defining an equivalent fundamental period and damping ratio that can modify the response of the structure. However, recent studies indicate that the effects of SSI should be reconsidered when a structure undergoes a nonlinear displacement demand. In recent documents on Nonlinear Static Procedures (NSPs), FEMA-440 (2005), a modified damping ratio of the replacement oscillator was proposed by introducing the ductility of the soil-structure system obtained from pushover analysis. In this paper, the damping defined in FEMA-440 to include the soil-structure interaction effect is evaluated, and the accuracy of the Coefficiem Method given in FEMA-440 and the Equivalent Linearization Method is studied. Although the improvements for Nonlinear Static Procedures (NSPs) in FEMA-440 are achieved for a fixed base SDOF structure, the soil effects are not perfectly obtained. Furthermore, the damping definition of a soil-structure system is extended to structures to consider bilinear behavior.

  7. Molecular signature of clinical severity in recovering patients with severe acute respiratory syndrome coronavirus (SARS-CoV

    Wu Ting-Shu

    2005-09-01

    Full Text Available Abstract Background Severe acute respiratory syndrome (SARS, a recent epidemic human disease, is caused by a novel coronavirus (SARS-CoV. First reported in Asia, SARS quickly spread worldwide through international travelling. As of July 2003, the World Health Organization reported a total of 8,437 people afflicted with SARS with a 9.6% mortality rate. Although immunopathological damages may account for the severity of respiratory distress, little is known about how the genome-wide gene expression of the host changes under the attack of SARS-CoV. Results Based on changes in gene expression of peripheral blood, we identified 52 signature genes that accurately discriminated acute SARS patients from non-SARS controls. While a general suppression of gene expression predominated in SARS-infected blood, several genes including those involved in innate immunity, such as defensins and eosinophil-derived neurotoxin, were upregulated. Instead of employing clustering methods, we ranked the severity of recovering SARS patients by generalized associate plots (GAP according to the expression profiles of 52 signature genes. Through this method, we discovered a smooth transition pattern of severity from normal controls to acute SARS patients. The rank of SARS severity was significantly correlated with the recovery period (in days and with the clinical pulmonary infection score. Conclusion The use of the GAP approach has proved useful in analyzing the complexity and continuity of biological systems. The severity rank derived from the global expression profile of significantly regulated genes in patients may be useful for further elucidating the pathophysiology of their disease.

  8. Acute arterial infarcts in patients with severe head injuries

    Deepak Agrawal

    2012-01-01

    Full Text Available Aims and Objectives: To study the incidence, demographic profile, and outcome of patients with severe closed head injuries who develop acute arterial infarcts. Materials and Methods: Patients with severe head injury (Glasgow coma score (GCS ≤8 presenting within 8 h of injury in the Department of Neurosurgery over a period of 5 months were enrolled in the study. Patients with penetrating head injury, infarct due to herniation and iatrogenic arterial injuries were excluded from the study. Only arterial infarcts developing within 8 h of injury were included in the study. A computed tomography (CT head was done on all patients within 8 h of injury and repeated if necessary. Arterial infarct was defined as well-demarcated wedge-shaped hypodensity corresponding to an arterial territory on plain CT of the head. Outcome was assessed using Glasgow outcome score (GOS at 1 month post-injury or at death (whichever came earlier. Results: Forty-four patients of severe head injury were included in the study during the above period. Of these, four patients (9.1% had arterial infarcts on the initial CT scan. The male:female ratio was 1:3. The mean age was 54 years (range 3-85 years. Two patients had infarcts in the middle cerebral artery distribution and two in the superior cerebellar artery distribution. Poor outcome (GOS 1-3 was seen in 100% of the patients with arterial infarct compared to 52.5% (n=21 in patients with severe head injury without arterial infarct. Conclusions: A significant percentage of patients with severe head injury have arterial infarcts on admission, which may imply arterial injury. Our study shows that these patients have a poorer prognosis vis-a-vis patient without these findings.

  9. Sea Surface Temperature from EUMETSAT Including Sentinel-3 SLSTR

    O'Carroll, Anne; Bonekamp, Hans; Montagner, Francois; Santacesaria, Vincenzo; Tomazic, Igor

    2015-12-01

    The paper gives an overview of sea surface temperature (SST) activities at EUMETSAT including information on SST planned from the Sea and Land Surface Temperature Radiometer (SLSTR). Operational oceanography activities within the Marine Applications group at EUMETSAT continue with a focus on SST, sea surface winds, sea-ice products, radiative fluxes, significant wave height and sea surface topography. These are achieved through the mandatory, optional and third-party programmes, and for some products with the EUMETSAT Ocean and Sea-Ice Satellite Application Facility (OSI SAF). Progress towards products from sea-ice surface temperature, ocean colour products, turbidity and aerosol optical depth over water continue. Information on oceanography products from EUMETSAT can be found through the product navigator (http://navigator.eumetsat.int). EUMETSAT have been collaborating with ESA for a number of years on the development of SST for SLSTR.

  10. Neutrinos from Cosmic Accelerators including Magnetic Field and Flavor Effects

    Walter Winter

    2012-01-01

    Full Text Available We review the particle physics ingredients affecting the normalization, shape, and flavor composition of astrophysical neutrinos fluxes, such as different production modes, magnetic field effects on the secondaries (muons, pions, and kaons, and flavor mixing, where we focus on pγ interactions. We also discuss the interplay with neutrino propagation and detection, including the possibility to detect flavor and its application in particle physics, and the use of the Glashow resonance to discriminate pγ from pp interactions in the source. We illustrate the implications on fluxes and flavor composition with two different models: (1 the target photon spectrum is dominated by synchrotron emission of coaccelerated electrons and (2 the target photon spectrum follows the observed photon spectrum of gamma-ray bursts. In the latter case, the multimessenger extrapolation from the gamma-ray fluence to the expected neutrino flux is highlighted.

  11. Traversing Cosmological Singularities, Complete Journeys Through Spacetime Including Antigravity

    Bars, Itzhak

    2012-01-01

    A unique description of the Big Crunch-Big Bang transition is given at the classical gravity level, along with a complete set of homogeneous, isotropic, analytic solutions in scalar-tensor cosmology, with radiation and curvature. All solutions repeat cyclically; they have been obtained by using conformal gauge symmetry (Weyl symmetry) as a powerful tool in cosmology, and more generally in gravity. The significance of the Big Crunch-Big Bang transition is that it provides a model independent analytic resolution of the singularity, as an unambiguous and unavoidable solution of the equations at the classical gravitational physics level. It is controlled only by geometry (including anisotropy) and only very general features of matter coupled to gravity, such as kinetic energy of a scalar field, and radiation due to all forms of relativistic matter. This analytic resolution of the singularity is due to an attractor mechanism created by the leading terms in the cosmological equation. It is unique, and it is unavoid...

  12. A Case for Including Transactions in OpenMP

    Wong, M; Bihari, B L; de Supinski, B R; Wu, P; Michael, M; Liu, Y; Chen, W

    2010-01-25

    Transactional Memory (TM) has received significant attention recently as a mechanism to reduce the complexity of shared memory programming. We explore the potential of TM to improve OpenMP applications. We combine a software TM (STM) system to support transactions with an OpenMP implementation to start thread teams and provide task and loop-level parallelization. We apply this system to two application scenarios that reflect realistic TM use cases. Our results with this system demonstrate that even with the relatively high overheads of STM, transactions can outperform OpenMP critical sections by 10%. Overall, our study demonstrates that extending OpenMP to include transactions would ease programming effort while allowing improved performance.

  13. Preferential Biases for Texts That Include Neuroscientific Jargon.

    Tabacchi, Marco E; Cardaci, Maurizio

    2016-06-01

    The results of an experiment of preferential biases for texts that include neuroscientific jargon are presented. Such preferential bias has been reported even when the presented jargon is meaningless. In a variation of the well-known Weisberg et al. experiment, a group of undergraduate students (N = 150; females 48%, males 52%, other 0%; M age = 22.4 year, SD = 2.6) chose between two possible explanations for a psychological phenomenon: a correct explanation or a circular restatement of facts. Unrelated neuroscientific terms were added to one of the explanations. Participants were asked to choose the correct explanation. There was a statistically significant preference for the explanation without neuroscientific terms. These findings differ from Weisberg et al.'s experiment and a number of others. The implications of this discrepancy are discussed.

  14. Improving Planck calibration by including frequency-dependent relativistic corrections

    Quartin, Miguel

    2015-01-01

    The Planck satellite detectors are calibrated in the 2015 release using the "orbital dipole", which is the time-dependent dipole generated by the Doppler effect due to the motion of the satellite around the Sun. Such an effect has also relativistic time-dependent corrections of relative magnitude 10^(-3), due to coupling with the "solar dipole" (the motion of the Sun compared to the CMB rest frame), which are included in the data calibration by the Planck collaboration. We point out that such corrections are subject to a frequency-dependent multiplicative factor. This factor differs from unity especially at the highest frequencies, relevant for the HFI instrument. Since currently Planck calibration errors are dominated by systematics, to the point that polarization data is currently unreliable at large scales, such a correction can in principle be highly relevant for future data releases.

  15. Improving Planck calibration by including frequency-dependent relativistic corrections

    Quartin, Miguel; Notari, Alessio

    2015-09-01

    The Planck satellite detectors are calibrated in the 2015 release using the "orbital dipole", which is the time-dependent dipole generated by the Doppler effect due to the motion of the satellite around the Sun. Such an effect has also relativistic time-dependent corrections of relative magnitude 10-3, due to coupling with the "solar dipole" (the motion of the Sun compared to the CMB rest frame), which are included in the data calibration by the Planck collaboration. We point out that such corrections are subject to a frequency-dependent multiplicative factor. This factor differs from unity especially at the highest frequencies, relevant for the HFI instrument. Since currently Planck calibration errors are dominated by systematics, to the point that polarization data is currently unreliable at large scales, such a correction can in principle be highly relevant for future data releases.

  16. Oscillatory burning of solid propellants including gas phase time lag.

    T'Ien, J. S.

    1972-01-01

    An analysis has been performed for oscillatory burning of solid propellants including gas phase time lag. The gaseous flame is assumed to be premixed and laminar with a one-step overall chemical reaction. The propellant is assumed to decompose according to the Arrenhius Law, with no condensed phase reaction. With this model, strong gas phase resonance has been found in certain cases at the characteristic gas-phase frequencies, but the peaking of the acoustic admittance is in the direction favoring the damping of pressure waves. At still higher frequencies, moderate wave-amplifying ability was found. The limit of low frequency response obtained previously by Denison and Baum was recovered, and the limitations of the quasi-steady theory were investigated.

  17. CHIONANTHUS (OLEACEAE IN SULAWESI, INDONESIA, INCLUDING THREE NEW SPECIES

    RUTH KIEW

    2016-01-01

    Full Text Available KIEW, R. 2015. Chionanthus (Oleaceae in Sulawesi, Indonesia, including three new species. Reinwardtia 14(2: 287 ‒295. ― The genus Chionanthus (Oleaceae in Sulawesi is revised. Nine species are described of which C. kostermansiiKiew, C. sordidus Kiew and C. sulawesicus Kiew are new species. Four species are endemic, C. celebicus Koord., C.sordidus, C. stenurus (Merr. Kiew and C. sulawesicus. The geographic range of C. cordulatus Koord. extends to Borneoand Mollucas, while C. kostermansii also occurs in Sumbawa and Flores, and the range of C. rupicolus (Lingelsh.Kiew extends to Sumbawa, Mollucas, New Guinea and the Bismarck Archipelago. Chionanthus polygamus (Roxb.Kiew and C. ramiflorus Roxb. are both widespread species, the former from Sumatra to New Guinea and the latter fromcontinental Asia to the Solomon Islands. A key to identify the species is provided. Chionanthus gigantifolius Koord.remains incompletely known.

  18. The action principle for generalized fluid motion including gyroviscosity

    Lingam, M., E-mail: manasvi@physics.utexas.edu; Morrison, P.J., E-mail: morrison@physics.utexas.edu

    2014-11-07

    Highlights: • Method for constructing action principles for a diverse class of fluids with gyroscopic momentum transport is described. • General criteria for the conservation of momentum and angular momentum via Noether's theorem are obtained. • Fluids with intrinsic angular momentum are built as an illustration of the method. - Abstract: A general set of fluid equations that allow for energy-conserving momentum transport by gyroscopic motion of fluid elements is obtained. The equations are produced by a class of action principles that yield a large subset of the known fluid and magnetofluid models, including gyroviscosity. Analysis of the action principle yields broad, model-independent results regarding the conservation laws of energy and linear and angular momenta. The formalism is illustrated by studying fluid models with intrinsic angular momentum that may appear in the contexts of condensed matter, biological, and other areas of physics.

  19. OPAL Central Detector (Including vertex, jet and Z chambers)

    OPAL was one of the four experiments installed at the LEP particle accelerator from 1989 - 2000. OPAL's central tracking system consists of (in order of increasing radius) a silicon microvertex detector, a vertex detector, a jet chamber, and z-chambers. All the tracking detectors work by observing the ionization of atoms by charged particles passing by: when the atoms are ionized, electrons are knocked out of their atomic orbitals, and are then able to move freely in the detector. These ionization electrons are detected in the different parts of the tracking system. (This piece includes the vertex, jet and Z chambers) In the picture above, the central detector is the piece being removed to the right.

  20. Global model including multistep ionizations in helium plasmas

    Oh, Seung-Ju; Lee, Hyo-Chang; Chung, Chin-Wook

    2016-12-01

    Particle and power balance equations including stepwise ionizations are derived and solved in helium plasmas. In the balance equations, two metastable states (21S1 in singlet and 23S1 triplet) are considered and the followings are obtained. The plasma density linearly increases and the electron temperature is relatively in a constant value against the absorbed power. It is also found that the contribution to multi-step ionization with respect to the single-step ionization is in the range of 8%-23%, as the gas pressure increases from 10 mTorr to 100 mTorr. Compared to the results in the argon plasma, there is little variation in the collisional energy loss per electron-ion pair created (ɛc) with absorbed power and gas pressure due to the small collision cross section and higher inelastic collision threshold energy.

  1. Molecular phylogeny of coronaviruses including human SARS-CoV

    2003-01-01

    Phylogenetic tree of coronaviruses (CoVs) including the human SARS-associated virus is reconstructed from complete genomes by using our newly developed K- string composition approach. The relation of the human SARS-CoV to other coronaviruses, i.e. the rooting of the tree is suggested by choosing an appropriate outgroup. SARS-CoV makes a separate group closer but still distant from G2 (CoVs in mammalian host). The relation between different isolates of the human SARS virus is inferred by first constructing an ultrametric distance matrix from counting sequence variations in the genomes. The resulting tree is consistent with clinic relations between the SARS-CoV isolates. In addition to a larger variety of coronavirus genomes these results provide phylogenetic knowledge based on independent novel methodology as compared to recent phylogenetic studies on SARS-CoV.

  2. Ball Screw Actuator Including a Stop with an Integral Guide

    Wingett, Paul T. (Inventor); Perek, John (Inventor); Geck, Kellan (Inventor)

    2015-01-01

    An actuator includes a housing assembly, a ball nut, a ball screw, and a ball screw stop. The ball nut is rotationally mounted in the housing assembly, is adapted to receive an input torque, and is configured, upon receipt thereof, to rotate and supply a drive force. The ball screw is mounted within the housing assembly and extends through the ball nut. The ball screw has a first end and a second end, and is coupled to receive the drive force from the ball nut. The ball screw is configured, upon receipt of the drive force, to selectively translate between a stow position and a deploy position. The ball screw stop is mounted on the ball screw to translate therewith and is configured to at selectively engage the housing assembly while the ball screw is translating, and engage the ball nut when the ball screw is in the deploy position.

  3. Recent progress and advances in iterative software (including parallel aspects)

    Carey, G.; Young, D.M.; Kincaid, D. [and others

    1994-12-31

    The purpose of the workshop is to provide a forum for discussion of the current state of iterative software packages. Of particular interest is software for large scale engineering and scientific applications, especially for distributed parallel systems. However, the authors will also review the state of software development for conventional architectures. This workshop will complement the other proposed workshops on iterative BLAS kernels and applications. The format for the workshop is as follows: To provide some structure, there will be brief presentations, each of less than five minutes duration and dealing with specific facets of the subject. These will be designed to focus the discussion and to stimulate an exchange with the participants. Issues to be covered include: The evolution of iterative packages, current state of the art, the parallel computing challenge, applications viewpoint, standards, and future directions and open problems.

  4. Loan Products Included in the Offer of Commercial Banks

    Vasile Dedu

    2009-04-01

    Full Text Available A bank loan is the main form of economical credit. It is for corporate activities – for medium and big companies and for retail activities – for small companies and individuals. The conditions for credit mainly depend on the quality of customers, it means their ability to perform a profitable activity and to be able to pay back the credits. For reasons which are mainly connected to marketing, bank practice has developed a large range of credit names, trying to emphasize some of the parts of the products or to take profit of some competition advantages in relation with customers’ products. We are trying to include the offer of bank loans in a typology which takes into account the law, the bank field rules and the main technical features of the offered products.

  5. Dynamic Analysis of Wind Turbines Including Soil-Structure Interaction

    Harte, M.; Basu, B.; Nielsen, Søren R.K.

    2012-01-01

    This paper investigates the along-wind forced vibration response of an onshore wind turbine. The study includes the dynamic interaction effects between the foundation and the underlying soil, as softer soils can influence the dynamic response of wind turbines. A Multi-Degree-of-Freedom (MDOF...... rotational speed (3P effects). The effect of dynamic soil-structure interaction on the rotation of the foundation has also been investigated.......) horizontal axes onshore wind turbine model is developed for dynamic analysis using an Euler–Lagrangian approach. The model is comprised of a rotor blade system, a nacelle and a flexible tower connected to a foundation system using a substructuring approach. The rotor blade system consists of three rotating...

  6. Precision Obesity Treatments Including Pharmacogenetic and Nutrigenetic Approaches.

    Solas, Maite; Milagro, Fermin I; Martínez-Urbistondo, Diego; Ramirez, Maria J; Martínez, J Alfredo

    2016-07-01

    Five pharmaceutical strategies are currently approved by the US FDA for the treatment of obesity: orlistat, lorcaserin, liraglutide, phentermine/topiramate, and bupropion/naltrexone. The most effective treatment seems to be the combined administration of phentermine/topiramate followed by lorcaserin and bupropion/naltrexone. In relation to the management of excessive weight, other aspects also need to be considered, including comorbidities accompanying obesity, drug interactions, and the risk of negative collateral effects, as well as individualized treatments based on the genetic make-up. This review aims to provide an overview of the approved anti-obesity drugs and newer molecules that could affect different targets in the central nervous system or peripheral tissues, the molecular mechanisms, emerging dietary treatments and phytogenic compounds, and pharmacogenetic/nutrigenetic approaches for personalized obesity management.

  7. Relativistic bound state approach to fundamental forces including gravitation

    Morsch H.P.

    2012-06-01

    Full Text Available To describe the structure of particle bound states of nature, a relativistic bound state formalism is presented, which requires a Lagrangian including scalar coupling of two boson fields. The underlying mechanisms are quite complex and require an interplay of overlapping boson fields and fermion-antifermion production. This gives rise to two potentials, a boson-exchange potential and one identified with the long sought confinement potential in hadrons. With minimal requirements, two elementary massless fermions (quantons - with and without charge - and one gauge boson, hadrons and leptons but also atoms and gravitational systems are described by bound states with electric and magnetic coupling between the charges and spins of quantons. No need is found for colour, Higgs-coupling and supersymmetry.

  8. Fuel cell repeater unit including frame and separator plate

    Yamanis, Jean; Hawkes, Justin R; Chiapetta, Jr., Louis; Bird, Connie E; Sun, Ellen Y; Croteau, Paul F

    2013-11-05

    An example fuel cell repeater includes a separator plate and a frame establishing at least a portion of a flow path that is operative to communicate fuel to or from at least one fuel cell held by the frame relative to the separator plate. The flow path has a perimeter and any fuel within the perimeter flow across the at least one fuel cell in a first direction. The separator plate, the frame, or both establish at least one conduit positioned outside the flow path perimeter. The conduit is outside of the flow path perimeter and is configured to direct flow in a second, different direction. The conduit is fluidly coupled with the flow path.

  9. PROPERTIES AND MICROSTRUCTURE OF CEMENT PASTE INCLUDING RECYCLED CONCRETE POWDER

    Jaroslav Topič

    2017-02-01

    Full Text Available The disposal and further recycling of concrete is being investigated worldwide, because the issue of complete recycling has not yet been fully resolved. A fundamental difficulty faced by researchers is the reuse of the recycled concrete fines which are very small (< 1 mm. Currently, full recycling of such waste fine fractions is highly energy intensive and resulting in production of CO2. Because of this, the only recycling methods that can be considered as sustainable and environmentally friendly are those which involve recycled concrete powder (RCP in its raw form. This article investigates the performance of RCP with the grain size < 0.25 mm as a potential binder replacement, and also as a microfiller in cement-based composites. Here, the RCP properties are assessed, including how mechanical properties and the microstructure are influenced by increasing the amount of the RCP in a cement paste (≤ 25 wt%.

  10. Optimising the composition of natural moulding sands including thermal aspects

    Jerzy St. Kowalski

    2011-04-01

    Full Text Available The paper discusses the problem of the choice of the moulding sand mixture composition in terms of the sand behaviour in contact withmolten metal. Studies of high-temperature phenomena make assessment of the sand composition applicability under real operatingconditions possible, thus leading to the elimination of sand-originating casting defects. The research was conducted on selected moulding materials included in the composition of traditional moulding sand mixtures without the addition of carbon. The effect of moulding sand composition and moisture content on the linear dilatation and stress-induced allotropic changes of quartz was examined. The analysis of these phenomena was based on 3D charts and maps generated from data collected during the tests.

  11. Hydraulic engine valve actuation system including independent feedback control

    Marriott, Craig D

    2013-06-04

    A hydraulic valve actuation assembly may include a housing, a piston, a supply control valve, a closing control valve, and an opening control valve. The housing may define a first fluid chamber, a second fluid chamber, and a third fluid chamber. The piston may be axially secured to an engine valve and located within the first, second and third fluid chambers. The supply control valve may control a hydraulic fluid supply to the piston. The closing control valve may be located between the supply control valve and the second fluid chamber and may control fluid flow from the second fluid chamber to the supply control valve. The opening control valve may be located between the supply control valve and the second fluid chamber and may control fluid flow from the supply control valve to the second fluid chamber.

  12. The Physics of Semiconductors An Introduction Including Nanophysics and Applications

    Grundmann, Marius

    2010-01-01

    The Physics of Semiconductors contains ample material for a comprehensive upper-level undergraduate or beginning graduate course, guiding readers to the point where they can choose a special topic and begin supervised research. The textbook provides a balance between essential aspects of solid-state and semiconductor physics, on the one hand, and the principles of various semiconductor devices and their applications in electronic and photonic devices, on the other. It highlights many practical aspects of semiconductors such as alloys, strain, heterostructures, nanostructures, that are necessary in modern semiconductor research but typically omitted in textbooks. Coverage also includes additional advanced topics, such as Bragg mirrors, resonators, polarized and magnetic semiconductors. The text derives explicit formulas for many results to support better understanding of the topics. The Physics of Semiconductors requires little or no prior knowledge of solid-state physics and evolved from a highly regarded two...

  13. About meanings as a rule not included in dictionaries

    Violetta Koseska-Toszewa

    2015-11-01

    Full Text Available About meanings as a rule not included in dictionaries The article discusses the problem of ambiguity of the exponents of logical existential quantification occurring in the verbal group of Bulgarian, Polish and Russian sentences: Bulg. отвреме навреме, понякога, Pol. od czasu do czasu, czasem, czasami, Rus. время от времени, иногда. This ambiguity can be explained by strong and weak existential quantification. Lexical semantics did not distinguish between these two types of existentiality. Here we present a description of selected exponents of logical existential quantification in Bulgarian, Polish and Russian.

  14. Goldilocks Models of Higher-Dimensional Inflation (including modulus stabilization)

    Burgess, C P; Hayman, Peter; Patil, Subodh P

    2016-01-01

    We explore the mechanics of inflation in simplified extra-dimensional models involving an inflaton interacting with the Einstein-Maxwell system in two extra dimensions. The models are Goldilocks-like in that they are just complicated enough to include a mechanism to stabilize the extra-dimensional size, yet simple enough to solve the full 6D field equations using basic tools. The solutions are not limited to the effective 4D regime with H m_KK, but when they do standard 4D fluctuation calculations need not apply. When in a 4D regime the solutions predict eta ~ 0 hence n_s ~ 0.96 and r ~ 0.096 and so are ruled out if tensor modes remain unseen. Analysis of general parameters is difficult without a full 6D fluctuation calculation.

  15. Floating-point systolic array including serial processors

    Leeland, S.B.

    1989-10-03

    This patent describes, in a systolic array system utilizing a plurality of semiconductor chips, a semiconductor chip. It comprises: a plurality of processing elements each including a floating-point serial processor and a plurality of data storage registers; global bus means coupled to the serial processor of each of the plurality of processing elements for inputing and outputing data to and from each chip and for programming each serial processor; and a plurality of data buses coupled to each of the plurality of data storage registers of each of the plurality of processing elements. The global bus means being coupled to the plurality of data storage registers for programming the data storage registers.

  16. The physics of semiconductors an introduction including nanophysics and applications

    Grundmann, Marius

    2016-01-01

    The 3rd edition of this successful textbook contains ample material for a comprehensive upper-level undergraduate or beginning graduate course, guiding readers to the point where they can choose a special topic and begin supervised research. The textbook provides a balance between essential aspects of solid-state and semiconductor physics, on the one hand, and the principles of various semiconductor devices and their applications in electronic and photonic devices, on the other. It highlights many practical aspects of semiconductors such as alloys, strain, heterostructures, nanostructures, that are necessary in modern semiconductor research but typically omitted in textbooks. Coverage also includes additional advanced topics, such as Bragg mirrors, resonators, polarized and magnetic semiconductors, nanowires, quantum dots, multi-junction solar cells, thin film transistors, carbon-based nanostructures and transparent conductive oxides. The text derives explicit formulas for many results to support better under...

  17. Gravitational solutions, including radiation, for a perturbed light beam

    Nackoney, R.W.

    1986-09-01

    Linearized field equations and solutions are derived for a perturbed sheet beam of light. The work is based on an exact solution of a collimated beam in the geometrical limit. The linearized field changes of the initially curved background metric can be put, with the help of the harmonic conditions, into a normal coordinate form. These six normal coordinates satisfy six linearized, inhomogeneous, field equations in three variables. Stationary solutions include divergent beams. Gravitational waves propagating opposite to the beam's flux are found to be confined to a region about the propagation axis of the beam, much as is experienced in wave guides. Radiative cases can be produced by large angle scattering of light and are discussed in terms of their effect on an ideal optical antenna. The effect is one that grows linearly with time. The growth time is prohibitively long for the most energetic systems that can be realistically considered in the foreseeable future.

  18. A solid fuel which includes coal, coke and charcoal

    Takeuti, Y.; Iketani, Y.; Nisino, A.; Sonetaka, K.

    1983-04-15

    A composition of solid domestic fuel is proposed with a reduced liberation of toxic gases (CO and hydrocarbon (Uv)) upon combustion. The fuel is produced from (percent) 80 mineral coal, 10 charcoal, 10 CaC03 with an additive of 2 percent methylcellulose to the charge. Briquets are made from the mixture with perforated openings which have a transverse cross section (PS) of 10 to 200 square millimeters. The ratio of the total transverse cross section of all the openings and the transverse cross section of the fuel briquet, including the area of the openings is 25 to 70. Systems for disposition of the openings in the fuel are cited, along with the cross section of a furnace with the loaded fuel and the dependencies of the CO content in the furnace gas on the properties of the fuel.

  19. Visió general de la discussió sobre les àrees d’exclusió del projecte INCLUD-ED General overview of the discussion on exclusion areas in the INCLUD-ED project Visión general de la discusión sobre las áreas de exclusión del proyecto INCLUD-ED

    Carme García

    2010-01-01

    Full Text Available En aquest article es discuteixen les aportacions que es fan des del projecte INCLUD-ED: Strategies for inclusion and social cohesion from education in Europe sobre la relació que es pot establir entre l’exclusió/inclusió educativa i l’exclusió/inclusió en quatre àrees de la societat: ocupació, habitatge, salut i participació social i política. En particular, es reflexiona sobre els efectes que té tant l’exclusió, com formes de superar-la i promoure la inclusió, en les situacions que han d’afrontar les persones que pertanyen a algun dels cinc grups vulnerables que es defineixen en el projecte INCLUD-ED. Es presenta una visió general de l’estat de la qüestió sobre les investigacions i anàlisis de les àrees d’exclusió. Conclou amb unes breus reflexions sobre com superar les situacions d’exclusió i quines alternatives d’actuació s’obren des de l’àmbit educatiu. ____________________________________________ Dans cet article, nous discutons les contributions que fait le projet INCLUD-ED sur la relation que l’on peut établir entre l’exclusion/inclusion éducative et l’exclusion/inclusion dans quatre domaines de la société : emploi, logement, santé et participation sociale et politique. En particulier, nous réfléchissons sur les effets de l’exclusion ainsi que sur les manières de la dépasser et de promouvoir l’inclusion dans les situations que doivent affronter les individus appartenant à l’un des cinq groupes vulnérables qui sont définis dans le projet INCLUD-ED. Nous présentons une vision générale de l’état de la question sur les recherches et les analyses des domaines d’exclusion. L'article conclut avec de brèves réflexions sur la manière de dépasser les situations d’exclusion et sur les alternatives d’intervention qui s’ouvrent dans le domaine éducatif.In this paper, we discuss the contributions of the INCLUD-ED project to the relationship that can be established

  20. Extending Vulnerability Assessment to Include Life Stages Considerations.

    Emma E Hodgson

    Full Text Available Species are experiencing a suite of novel stressors from anthropogenic activities that have impacts at multiple scales. Vulnerability assessment is one tool to evaluate the likely impacts that these stressors pose to species so that high-vulnerability cases can be identified and prioritized for monitoring, protection, or mitigation. Commonly used semi-quantitative methods lack a framework to explicitly account for differences in exposure to stressors and organism responses across life stages. Here we propose a modification to commonly used spatial vulnerability assessment methods that includes such an approach, using ocean acidification in the California Current as an illustrative case study. Life stage considerations were included by assessing vulnerability of each life stage to ocean acidification and were used to estimate population vulnerability in two ways. We set population vulnerability equal to: (1 the maximum stage vulnerability and (2 a weighted mean across all stages, with weights calculated using Lefkovitch matrix models. Vulnerability was found to vary across life stages for the six species explored in this case study: two krill-Euphausia pacifica and Thysanoessa spinifera, pteropod-Limacina helicina, pink shrimp-Pandalus jordani, Dungeness crab-Metacarcinus magister and Pacific hake-Merluccius productus. The maximum vulnerability estimates ranged from larval to subadult and adult stages with no consistent stage having maximum vulnerability across species. Similarly, integrated vulnerability metrics varied greatly across species. A comparison showed that some species had vulnerabilities that were similar between the two metrics, while other species' vulnerabilities varied substantially between the two metrics. These differences primarily resulted from cases where the most vulnerable stage had a low relative weight. We compare these methods and explore circumstances where each method may be appropriate.